Microbial transformation of azacarbazoles. I. N-methylation of alpha-, beta-, and gamma-carbolines by Kitasatosporia setae strain

Microbial transformation of selected azacarbazoles, compounds noted for their activity as antitumor agents, conducted with Kitasatosporia setae strain resulted in N-methylation of pyridine nucleus of alpha-, beta- and gamma-carboline molecule. Formed quaternized intermediates were converted in alkaline conditions into corresponding iso-carbolines. The structure of the final products, alpha-, beta- and gamma-iso-carbolines have been established on the basis of spectral data and confirmed by chemical synthesis.     

Sirolimus and mycophenolate mofetil as calcineurin inhibitor-free immunosuppression in a cardiac transplant patient with chronic renal failure.

Chronic renal failure triggered by calcineurin inhibitor (CNI)-based immunosuppression is a common complication after cardiac transplantation. Sirolimus and mycophenolate mofetil (MMF) are 2 newer immunosuppressive agents with no documented nephrotoxic side effects. This case report describes a patient with ongoing chronic renal failure 10 months after cardiac transplantation on cyclosporine-based immunosuppressive therapy. Conversion of the immunosuppressive regimen from cyclosporine to sirolimus and MMF resulted in freedom from acute rejection, excellent cardiac graft function and consistently improved renal function. This case illustrates the beneficial potential of sirolimus and MMF as CNI-free and safe long-term immunosuppression in a patient with chronic renal failure after heart transplantation.