SorensenJFImmunosuppressives in Transplant Rejection

Abstract

Suppression of immune reactivity can either be an undesirable effect or a situation which is specifically induced to the benefit of a patient. Examples of the first come from immunotoxicology, e.g., xenobiotics or environmental factors causing immunosuppression. Virus infections, as exemplified by human immunodeficiency virus (HIV), can cause severe immunodeficiency. Under clinical disease conditions, suppression of the immune system is specially indicated in two indications: autoimmunity and organ transplantation. In the conventional approach, autoimmune diseases like rheumatoid arthritis (RA) are mainly treated by inhibition of the effector phase with anti-inflammatory drugs like corticosteroids and antimetabolites like methotrexate (MTX). During the last decades, new treatments have been introduced including biologicals (monoclonal antibodies (mAbs) and fusion proteins) with anti-inflammatory and immunosuppressive activity. Also, immunosuppressants like cyclosporine A (CsA), which were at first developed for transplantation, are increasingly used in autoimmune diseases, and some like leflunomide have been developed for RA as the first indication