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Introduction to the use of belatacept: a fusion protein for the prevention of posttransplant kidney rejection
The development of new immunosuppressive drugs for kidney transplantation resulted both in better short-term outcomes and in decreased metabolic, cardiovascular, and nephrotoxicity risk. Belatacept belongs to a new class of immunosuppressive drugs that selectively inhibits T-cell activation by preve...
Autores principales: | , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
Dove Medical Press
2012
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3468025/ https://www.ncbi.nlm.nih.gov/pubmed/23055693 http://dx.doi.org/10.2147/BTT.S27565 |
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author | Ippoliti, Giovanbattista D’Armini, Andrea Maria Lucioni, Marco Marjieh, Mazen Viganò, Mario |
author_facet | Ippoliti, Giovanbattista D’Armini, Andrea Maria Lucioni, Marco Marjieh, Mazen Viganò, Mario |
author_sort | Ippoliti, Giovanbattista |
collection | PubMed |
description | The development of new immunosuppressive drugs for kidney transplantation resulted both in better short-term outcomes and in decreased metabolic, cardiovascular, and nephrotoxicity risk. Belatacept belongs to a new class of immunosuppressive drugs that selectively inhibits T-cell activation by preventing CD28 activation and by binding its ligands B7-1 and B7-2. The result is an inactivation of costimulatory pathways. A comparative analysis of the BENEFIT and BENEFIT-EXT datasets showed belatacept regimens resulted in better cardiovascular and metabolic risk profiles than did cyclosporin A (CsA) regimens: belatacept likewise outperformed CsA in terms of lower blood pressure and serum lipids and less new onset diabetes after transplantation. About 20% of belatacept-treated patients developed adverse effects which included anemia, pyrexia, neutropenia, diarrhea, urinary tract infection, headache, and peripheral edema. At present, belatacept does not seem to predispose patients to a higher rate of infection than CsA maintenance immunosuppression. The risk of posttransplant lymphoproliferative diseases was higher in Epstein–Barr virus (EBV)-seronegative patients than in EBV-seropositive patients, but the risk may be reduced by use of a less intensive regimen and avoidance of EBV-negative patients and of patients whose pretransplant EBV serology is unknown. Belatacept provides a new option for immunosuppressive therapy in kidney transplantation, but needs further evaluation in terms of the late effects that may derive from prolonged blockage of the costimulatory system and the induction of tolerance status. |
format | Online Article Text |
id | pubmed-3468025 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2012 |
publisher | Dove Medical Press |
record_format | MEDLINE/PubMed |
spelling | pubmed-34680252012-10-10 Introduction to the use of belatacept: a fusion protein for the prevention of posttransplant kidney rejection Ippoliti, Giovanbattista D’Armini, Andrea Maria Lucioni, Marco Marjieh, Mazen Viganò, Mario Biologics Review The development of new immunosuppressive drugs for kidney transplantation resulted both in better short-term outcomes and in decreased metabolic, cardiovascular, and nephrotoxicity risk. Belatacept belongs to a new class of immunosuppressive drugs that selectively inhibits T-cell activation by preventing CD28 activation and by binding its ligands B7-1 and B7-2. The result is an inactivation of costimulatory pathways. A comparative analysis of the BENEFIT and BENEFIT-EXT datasets showed belatacept regimens resulted in better cardiovascular and metabolic risk profiles than did cyclosporin A (CsA) regimens: belatacept likewise outperformed CsA in terms of lower blood pressure and serum lipids and less new onset diabetes after transplantation. About 20% of belatacept-treated patients developed adverse effects which included anemia, pyrexia, neutropenia, diarrhea, urinary tract infection, headache, and peripheral edema. At present, belatacept does not seem to predispose patients to a higher rate of infection than CsA maintenance immunosuppression. The risk of posttransplant lymphoproliferative diseases was higher in Epstein–Barr virus (EBV)-seronegative patients than in EBV-seropositive patients, but the risk may be reduced by use of a less intensive regimen and avoidance of EBV-negative patients and of patients whose pretransplant EBV serology is unknown. Belatacept provides a new option for immunosuppressive therapy in kidney transplantation, but needs further evaluation in terms of the late effects that may derive from prolonged blockage of the costimulatory system and the induction of tolerance status. Dove Medical Press 2012 2012-10-04 /pmc/articles/PMC3468025/ /pubmed/23055693 http://dx.doi.org/10.2147/BTT.S27565 Text en © 2012 Ippoliti et al, publisher and licensee Dove Medical Press Ltd. This is an Open Access article which permits unrestricted noncommercial use, provided the original work is properly cited. |
spellingShingle | Review Ippoliti, Giovanbattista D’Armini, Andrea Maria Lucioni, Marco Marjieh, Mazen Viganò, Mario Introduction to the use of belatacept: a fusion protein for the prevention of posttransplant kidney rejection |
title | Introduction to the use of belatacept: a fusion protein for the prevention of posttransplant kidney rejection |
title_full | Introduction to the use of belatacept: a fusion protein for the prevention of posttransplant kidney rejection |
title_fullStr | Introduction to the use of belatacept: a fusion protein for the prevention of posttransplant kidney rejection |
title_full_unstemmed | Introduction to the use of belatacept: a fusion protein for the prevention of posttransplant kidney rejection |
title_short | Introduction to the use of belatacept: a fusion protein for the prevention of posttransplant kidney rejection |
title_sort | introduction to the use of belatacept: a fusion protein for the prevention of posttransplant kidney rejection |
topic | Review |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3468025/ https://www.ncbi.nlm.nih.gov/pubmed/23055693 http://dx.doi.org/10.2147/BTT.S27565 |
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