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The Impact of Immunosuppressive Drugs on the Analysis of T-Cell Activation

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The discovery of the immunosuppressive properties of cyclosporin A (CSA) and its successful utilisation in organ transplantation was a milestone in clinics. CSA has revolutionised transplantation both in term of efficiency and quality-of-life of the patient. In addition, the analysis of the mode of action of CSA has been rewarding in the understanding the mecha-nisms leading to T lymphocytes activation. CSA binds to a family of cytosolic receptors, the cyclophilins, a highly conserved family of proteins. Once this complex is formed, a third protein, the calcineurin, is recruited. The calcineurin, a calcium-dependent phosphatase, loose its activity when complexed. Dephosphorylation of NFAT, a substrate of calcineurin is a mandatory step for its translocation to the nucleus where NFAT acts as a transactivator involved in the regulation of the genes encoding many cytokines. CSA preventing NFAT dephosphorylation blocks cytokine production this in turn allowing for a better engrafting. The resolution of the tertiary structure of CSA alone or complexed with cyclophilin and calcineurin has important implication in the modelling of new drugs devoid of its side effects. Indeed, the high incidence of cancer is one of the main problems linked to CSA utilisation. Recent data suggest that CSA may promote cancer inducing the transcription of the gene encoding transforming growth factor b. Other molecules sharing with CSA its immunosuppressive activity were later described. Some of them, as FK506, have the some mode of action others, as rapamycin, mycophenolate mofetil or leflunomide, act at different steps of T cell activation.
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Keywords: CSA FK506 sensitive; CSA receptors; IL2 gene expression; T cell activation; apoptosis; calcineurin; cyclophilins; cyclosporin A CSA; dephosphorylation; immunosuppressive durgs; immunosuppressor immunophilin complex; mycobhenolate mofetil MM; rapamycin; t lymphocyte activation; thymic selection; tridimensional structure

Document Type: Review Article

Publication date: 2000-07-01

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  • Current Medicinal Chemistry covers all the latest and outstanding developments in medicinal chemistry and rational drug design. Each issue contains a series of timely in-depth reviews written by leaders in the field covering a range of the current topics in medicinal chemistry. Current Medicinal Chemistry is an essential journal for every medicinal chemist who wishes to be kept informed and up-to-date with the latest and most important developments.
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