Journal of Transplantation / 2009 / Article / Tab 1

Review Article

A Comprehensive Review of Immunosuppression Used for Liver Transplantation

Table 1

Commonly used immunosuppressive agents in liver transplantation and their target pathways.

Immunosuppressive agentTarget pathway

Pharmacological

Corticosteroids(a) Inhibits cytokine transcription by antigen presenting cell
(b) Selective lysis of immature cortical thymocytes
Calcineurin inhibitors (cyclosporine/neoral and tacrolimus/Prograf/Fk506)Inhibits Signal 2 transduction via T cell receptor
Mammalian Target of rapamycin inhibitors (sirolimus/rapamycin, everolimus)Inhibits signal 3 transduction via IL-2 receptor
Azathioprine (Imuran)Inhibits purine and DNA synthesis
Mycophenolic acid (cell cept)Inhibits purine and DNA synthesis

Biological

Anti-CD3 monoclonal antibodies (OKT3)(a) Causes depletion and receptor modulation in T cell
(b) Interferes with signal 1
Antithymocyte globulin (ATG)(a) Causes depletion and receptor modulation in T cells
(b) Interferes with signal 1, 2 and 3
(c) Inhibits lymphocyte trafficking
Anti IL-2 alpha chain receptor antibodies (Basiliximab, Daclizumumab)Inhibits T cell proliferation to IL-2 (signal 3)
Anti-CD52 monoclonal antibodies (campath 1-H)Causes depletion of thymocytes, T cells,  B cells (not plasma cells) and monocytes

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