[New immunosuppressive therapies in kidney transplantation]

New approaches to successful prevention and management of transplant rejection include the use of biological immunosuppressants, such as monoclonal antibodies targeting the CD3 and CD4 molecules on native T cells, the interleukin 2 receptor on activated T cells, monocytes and B cells, and adhesion molecules. Several new drugs have been found to be effective immunosuppressive agents: FK 506, a macrolid antibiotic inhibiting lymphokine gene transcription, lymphokine production and secretion, rapamycin, which blocks effects of lymphokine-induced signal transduction, and RS 61443, brequinar and mizoribine, which inhibit DNA/RNA synthesis and lymphocyte proliferation. Initial experience with these drugs clinical protocols currently in use and already devised for use in the near future to test these and other emerging immunosuppressants are reviewed.