Maria Wójcik-Jawień, Ewa Furdzik, Joanna Jaromin

Makrolidowe leki immunosupresyjne

The macrolide immunosuppressants. Tacrolimus, sirolimus and everolimus are macrolide lactone antibiotics, which form a new class of immunosuppressants. Tacrolimus is a calcineurin inhibitor and thus prevents a transcription of pro-inflammatory cytokines. Sirolimus (rapamycin) and its derivative everolimus belong to the inhibitors of the mammalian target of rapamycin (mTOR), a key signaling kinase that controls activation of numerous proteins, which direct progression of the cell cycle in response to pro-inflammatory cytokines. The introduction of these drugs to the immunosuppressive repertoire of transplant management has greatly improved the outcomes in organ transplantation. This review summarizes the differences in the pharmacology, pharmacokinetics, indications, clinical efficacy and adverse effects of these drugs.