Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
Review
. 2022:272:27-38.
doi: 10.1007/164_2021_549.

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

Lydia R Engwenyu  1   2 , Allen S Anderson  3
Affiliations
Review

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

Lydia R Engwenyu et al. Handb Exp Pharmacol. 2022.

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.

Keywords: Calcineurin inhibitors; Complications of immunosuppression; Heart transplantation; Immunosuppression.

PubMed Disclaimer

References

    1. Ahuja SS, Shrivastav S, Danielpour D, Balow JE, Boumpas DT (1995) Regulation of transforming growth-factor b1 and its receptor by cyclosporine in human T lymphocytes. Transplantation 60:718–723 - PubMed - DOI
    1. Anghel D, Tanasescu R, Campeanu A, Lupescu I, Podda G, Bajenaru O (2013) Neurotoxicity of immunosuppressive therapies in organ transplantation. Maedica (Bucur) 8(2):170–175
    1. Arnold R, Pussell BA, Pianta TJ, Lin CS, Kiernan MC, Krishnan AV (2013) Association between calcineurin inhibitor treatment and peripheral nerve dysfunction in renal transplant recipients. Am J Transplant 13(9):2426–2432 - PubMed - DOI
    1. Borel JF, Feurer C, Gubler HU, Stähelin H (1994) Biological effects of cyclosporin A: a new antilymphocytic agent. Agents Actions 43:179–186 - PubMed - DOI
    1. Brigham MD, Milgroom A, Lenco MO, Wang Z, Kent JD, LaMoreaux B, Johnson RJ, Mandell BF, Hadker N, Sanchez H, Francis K, Radeck LP, Miyasato G, Li JW (2020) Immunosuppressant use and gout in the prevalent solid organ transplantation population. Prog Transplant 30(2):103–110 - PubMed - DOI

MeSH terms

LinkOut - more resources