Review Article
Immunosuppressant Management in Renal Transplant Patients with COVID-19
Table 1
Immunosuppressants, their mode of action and immunological outcomes in COVID-19.
| Immunosuppressant class | Examples | Mode of action | Immunological outcomes in COVID-19 | Reference |
| Corticosteroids | Dexamethasone, prednisone | Inhibition of lymphocyte gene expression | Suppressing cytokine storm prohibition of proinflammatory cytokine production, preserving the permeability and integrity of endothelium | [74] | Antimetabolites | Mycophenolic acid, azathioprine | Blocking DNA replication | Diminished immune response in vitro | [75] | Calcinurine inhibitors | Cyclosporine, tacrolimus | Inhibition of lymphocyte signalling | Selective inhibition of cytokine production and function | [57] | mTOR inhibitors | Sirolimus, everolimus | Inhibition of mammalian target of rapamycin (mTOR) | Inducing and cell cycle arrest in lymphocytes | [76] | Biologics | IL-2 inhibitors (daclizumab), IL-6 inhibitors(tocilizumab) | Act as anticytokine antibodies | Inhibiting the production of cytokines and thus alleviation of cytokine storm | [77] |
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