Systemic and Nonrenal Adverse Effects Occurring in Renal Transplant Patients Treated with mTOR Inhibitors
The mammalian target of rapamycin inhibitors (mTOR-I), sirolimus and everolimus, are immunosuppressive drugs largely used in renal transplantation. The main mechanism of action of these drugs is the inhibition of the mammalian target of rapamycin (mTOR), a regulatory protein kinase involved in lymph...
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| Format: | Article |
| Language: | English |
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Wiley
2013-01-01
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| Series: | Clinical and Developmental Immunology |
| Online Access: | http://dx.doi.org/10.1155/2013/403280 |
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| author | Gianluigi Zaza Paola Tomei Paolo Ria Simona Granata Luigino Boschiero Antonio Lupo |
| author_facet | Gianluigi Zaza Paola Tomei Paolo Ria Simona Granata Luigino Boschiero Antonio Lupo |
| author_sort | Gianluigi Zaza |
| collection | DOAJ |
| description | The mammalian target of rapamycin inhibitors (mTOR-I), sirolimus and everolimus, are immunosuppressive drugs largely used in renal transplantation. The main mechanism of action of these drugs is the inhibition of the mammalian target of rapamycin (mTOR), a regulatory protein kinase involved in lymphocyte proliferation. Additionally, the inhibition of the crosstalk among mTORC1, mTORC2, and PI3K confers the antineoplastic activities of these drugs. Because of their specific pharmacological characteristics and their relative lack of nephrotoxicity, these inhibitors are valid option to calcineurine inhibitors (CNIs) for maintenance immunosuppression in renal transplant recipients with chronic allograft nephropathy. However, as other immunosuppressive drugs, mTOR-I may induce the development of several adverse effects that need to be early recognized and treated to avoid severe illness in renal transplant patients. In particular, mTOR-I may induce systemic nonnephrological side effects including pulmonary toxicity, hematological disorders, dysmetabolism, lymphedema, stomatitis, cutaneous adverse effects, and fertility/gonadic toxicity. Although most of the adverse effects are dose related, it is extremely important for clinicians to early recognize them in order to reduce dosage or discontinue mTOR-I treatment avoiding the onset and development of severe clinical complications. |
| format | Article |
| id | doaj-art-860a1cb8b27c41478b17f06fc2fdc166 |
| institution | Kabale University |
| issn | 1740-2522 1740-2530 |
| language | English |
| publishDate | 2013-01-01 |
| publisher | Wiley |
| record_format | Article |
| series | Clinical and Developmental Immunology |
| spelling | doaj-art-860a1cb8b27c41478b17f06fc2fdc1662025-02-03T01:11:44ZengWileyClinical and Developmental Immunology1740-25221740-25302013-01-01201310.1155/2013/403280403280Systemic and Nonrenal Adverse Effects Occurring in Renal Transplant Patients Treated with mTOR InhibitorsGianluigi Zaza0Paola Tomei1Paolo Ria2Simona Granata3Luigino Boschiero4Antonio Lupo5Renal Unit, Department of Medicine, University Hospital of Verona, Piazzale Stefani 1, 37126 Verona, ItalyRenal Unit, Department of Medicine, University Hospital of Verona, Piazzale Stefani 1, 37126 Verona, ItalyRenal Unit, Department of Medicine, University Hospital of Verona, Piazzale Stefani 1, 37126 Verona, ItalyRenal Unit, Department of Medicine, University Hospital of Verona, Piazzale Stefani 1, 37126 Verona, ItalyFirst Surgical Clinic, Kidney Transplantation Center, University Hospital of Verona, Piazzale Stefani 1, 37126 Verona, ItalyRenal Unit, Department of Medicine, University Hospital of Verona, Piazzale Stefani 1, 37126 Verona, ItalyThe mammalian target of rapamycin inhibitors (mTOR-I), sirolimus and everolimus, are immunosuppressive drugs largely used in renal transplantation. The main mechanism of action of these drugs is the inhibition of the mammalian target of rapamycin (mTOR), a regulatory protein kinase involved in lymphocyte proliferation. Additionally, the inhibition of the crosstalk among mTORC1, mTORC2, and PI3K confers the antineoplastic activities of these drugs. Because of their specific pharmacological characteristics and their relative lack of nephrotoxicity, these inhibitors are valid option to calcineurine inhibitors (CNIs) for maintenance immunosuppression in renal transplant recipients with chronic allograft nephropathy. However, as other immunosuppressive drugs, mTOR-I may induce the development of several adverse effects that need to be early recognized and treated to avoid severe illness in renal transplant patients. In particular, mTOR-I may induce systemic nonnephrological side effects including pulmonary toxicity, hematological disorders, dysmetabolism, lymphedema, stomatitis, cutaneous adverse effects, and fertility/gonadic toxicity. Although most of the adverse effects are dose related, it is extremely important for clinicians to early recognize them in order to reduce dosage or discontinue mTOR-I treatment avoiding the onset and development of severe clinical complications.http://dx.doi.org/10.1155/2013/403280 |
| spellingShingle | Gianluigi Zaza Paola Tomei Paolo Ria Simona Granata Luigino Boschiero Antonio Lupo Systemic and Nonrenal Adverse Effects Occurring in Renal Transplant Patients Treated with mTOR Inhibitors Clinical and Developmental Immunology |
| title | Systemic and Nonrenal Adverse Effects Occurring in Renal Transplant Patients Treated with mTOR Inhibitors |
| title_full | Systemic and Nonrenal Adverse Effects Occurring in Renal Transplant Patients Treated with mTOR Inhibitors |
| title_fullStr | Systemic and Nonrenal Adverse Effects Occurring in Renal Transplant Patients Treated with mTOR Inhibitors |
| title_full_unstemmed | Systemic and Nonrenal Adverse Effects Occurring in Renal Transplant Patients Treated with mTOR Inhibitors |
| title_short | Systemic and Nonrenal Adverse Effects Occurring in Renal Transplant Patients Treated with mTOR Inhibitors |
| title_sort | systemic and nonrenal adverse effects occurring in renal transplant patients treated with mtor inhibitors |
| url | http://dx.doi.org/10.1155/2013/403280 |
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