Summary
Kidney transplantation today has excellent short-term outcomes that have paralleled
the use of new immunosuppressive agents introduced in the 1990s. In addition to reducing
acute rejection, the goals for developing new agents is to improve long-term outcome,
minimize nephrotoxicity, and reduce infectious, cardiovascular, and malignancy-related
complications. Novel small molecules and biological agents currently in clinical development
may help to minimize the use of calcineurin inhibitors and steroids. These small molecules
include FTY720, a sphingosine phosphate–receptor modulator, FK778, an inhibitor of
pyrimidine synthesis, CP-690550, a JAK3 inhibitor, and AEB-071, a protein kinase C
inhibitor. The biological agents include drugs targeting interleukin-15, anti-CD40,
belatacept (LEA29Y), a second-generation CTLY4Ig that blocks the interaction between
CD80/86 and CD28 costimulatory pathways, and efalizumab, a humanized anti-LFA1 monoclonal
antibody. These new agents currently in preclinical and clinical trials appear promising
and may represent the emergence of novel immunosuppressive agents that can deliver
immunosuppression without long-term toxicity.
Keywords
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© 2007 Elsevier Inc. Published by Elsevier Inc. All rights reserved.
