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New immunosuppressive agents

G L Bumgardner1, J P Roberts

  • 1Department of Surgery, University of California, San Francisco.

Gastroenterology Clinics of North America
|June 1, 1993
PubMed
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New immunosuppression strategies for transplantation are under investigation, targeting various cellular pathways and mediators. Evaluating these novel therapies requires assessing criteria beyond survival, such as rejection rates and patient tolerance.

Area of Science:

  • Immunology
  • Transplantation Medicine
  • Pharmacology

Background:

  • Current immunosuppressive protocols demonstrate excellent early graft and patient survival rates in liver transplantation.
  • Numerous novel immunosuppression modalities are being explored to improve transplant outcomes.
  • These new approaches target diverse aspects of the immune response, including specific cell subsets, activation pathways, effector functions, and cytokine mediators.

Purpose of the Study:

  • To review emerging immunosuppression strategies in transplantation.
  • To highlight the need for comprehensive evaluation criteria for new immunosuppressive therapies.
  • To emphasize the challenges in demonstrating statistically significant survival benefits in clinical trials due to high current success rates.

Main Methods:

Related Experiment Videos

  • Review of new immunosuppression drugs and monoclonal antibodies.
  • Analysis of targeted mechanisms including cell subsets, activation pathways, effector functions, and cytokine mediators.
  • Discussion of criteria for evaluating novel immunosuppressive therapies beyond survival rates.

Main Results:

  • New immunosuppressive therapies target various immune components like lymphocytes, cytokines, and cellular interactions.
  • Existing protocols yield high early survival rates, necessitating large patient cohorts for new trial significance.
  • Alternative endpoints such as rejection incidence, graft function, infectious complications, and patient tolerance are crucial.

Conclusions:

  • Evaluating novel immunosuppression therapies requires a multifaceted approach beyond graft and patient survival.
  • Clinical trials for new immunosuppressants must consider a broader range of efficacy and safety metrics.
  • Assessing long-term graft function, complication rates, and patient compliance is vital for understanding the true impact of new treatments.