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Cytokine-targeted therapy for the management of solid organ transplant recipients
Authors:Amanda Szczepanik  Carlo J. Iasella  John F. McDyer  Christopher R. Ensor
Affiliation:1. University Hospitals Cleveland Medical Center, 11100 Euclid Avenue Mather B400, Cleveland, OH 44106, United States;2. University of Pittsburgh, Department of Medicine, Division of Pulmonary, Allergy, and Critical Care Medicine, 200 Lothrop St, Pittsburgh, PA 15261, United States;3. Florida Hospital Transplant Institute, AdventHealth Orlando, 601 East Rollins St, Orlando, FL 32707, United States
Abstract:IntroductionThe number of solid organ transplants completed annually continues to trend upwards each year. Despite this, maintenance immunosuppression available on the market has remained relatively stagnant. Standard triple immunosuppression, composed typically of tacrolimus, mycophenolate, and steroids, lead to many side effects that limit the use of these medications. Tacrolimus, specifically, causes nephrotoxicity that can lead to renal dysfunction requiring a kidney transplant down the road. Alternative therapies for the management of immunosuppression need to be identified to try to mitigate these adverse effects.BodyCytokines are responsible for facilitating T cell differentiation and lead to the activation of inflammatory mediators that can contribute to graft damage and ultimately rejection. IL-4, IL-6, IL-12/23, and IL-15 are attractive targets for medications to try to ameliorate graft rejection. Various cytokine-targeted medications are currently available on the market for the treatment of inflammatory and autoimmune conditions such as rheumatoid arthritis, psoriatic arthritis, Crohn’s, and multiple sclerosis.ConclusionThis article reviews cytokine involvement in alloimmunity and the potential role cytokine-targeted therapy may play in prevention of allograft rejection in solid organ transplant recipients.
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