A Comprehensive Review of Calcineurin Inhibitors Used for Immunosuppression in Cardiac Transplantation

Lydia R. Engwenyu, Allen S. Anderson

Research output: Chapter in Book/Report/Conference proceedingChapter

Abstract

Calcineurin inhibitors (CNIs) have been the foundation of immunosuppression in solid organ transplantation since the 1980s. Cyclosporine A (CSA), the first in class, was identified as the metabolite of the soil fungus Tolypocladium inflatum Gams as part of a larger program of screening for naturally occurring fungal metabolites with biologic activity in the 1970s. Significant immunosuppressive effects were discovered and consequently CSA was trialed as an immunosuppressant in renal transplantation. This initial success led to its widespread study and adoption in solid organ transplantation. This novel agent yielded significant improvements in both 1 year and longer-term allograft and patient survival. Subsequently, a similar and more potent CNI, tacrolimus was developed. Today, it is the principal CNI used for prevention of allograft rejection. Like all other immunosuppressives, the benefits of CNIs are counterbalanced by side effects and complications resulting from drug toxicity. This chapter comprehensively reviews the clinical use of CNIs in cardiac transplantation.

Original languageEnglish (US)
Title of host publicationHandbook of Experimental Pharmacology
PublisherSpringer Science and Business Media Deutschland GmbH
Pages27-38
Number of pages12
DOIs
StatePublished - 2022

Publication series

NameHandbook of Experimental Pharmacology
Volume272
ISSN (Print)0171-2004
ISSN (Electronic)1865-0325

Keywords

  • Calcineurin inhibitors
  • Complications of immunosuppression
  • Heart transplantation
  • Immunosuppression

ASJC Scopus subject areas

  • Biochemistry
  • Pharmacology, Toxicology and Pharmaceutics(all)

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