The evolving role of sirolimus in renal transplantation
Open Access
- 1 June 2003
- journal article
- review article
- Published by Oxford University Press (OUP) in QJM: An International Journal of Medicine
- Vol. 96 (6) , 401-409
- https://doi.org/10.1093/qjmed/hcg072
Abstract
Sirolimus (rapamycin) is a macrolide antibiotic isolated from the fungus Streptomyces hygroscopicus1 first identified in soil samples from Easter Island. Structurally similar to the calcineurin inhibitor (CNI) tacrolimus (Figure 1), it shares its potent immunosuppressive properties, but with a novel mechanism of action (Figure 2). Initial clinical trials have focussed on its use as adjunctive therapy, substituting for the anti-metabolite azathioprine. However, given that it lacks the nephrotoxicity of the CNIs (cyclosporin and tacrolimus), it has the potential to supplant these agents as baseline immunosuppressive therapy following renal transplantation, and offers the added potential benefit of promoting immunological tolerance.Keywords
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