Sirolimus and ciclosporin for renal transplantation

Abstract

Rapamycin was isolated from fungi found in soil samples brought from Rapa Nui (Easter Islands) by the Canadian Medical Research Expedition (December, 1964, to February, 1965). But despite being discovered at about the same time as ciclosporin, 1 Borel JF Feurer C Gubler HJ Stahelin H Biological effects of cyclosporin A: a new antilymphocytic agent. Agents and Actions. 1976; 6: 468-475 Crossref PubMed Scopus (1199) Google Scholar rapamycin, which was initially noted to have antifungal properties, 2 Vézina C Kudelski A Sehgal SN Rapamycin (AY-22,989), a new antifungal antibiotic. I. Taxonomy of the producing streptomycete and isolation of the active principle. J Antibiot (Tokyo). 1975; 28: 721-726 Crossref PubMed Scopus (1266) Google Scholar , 3 Sehgal SN Baker H Vézina C Rapamycin (AY-22,989), a new antifungal antibiotic. II. Fermentation, isolation and characterization. J Antibiot (Tokyo). 1975; 28: 727-732 Crossref PubMed Scopus (812) Google Scholar took nearly two decades longer to be developed as an immunosuppressive agent. The pivotal clinical trial of rapamycin in renal transplantation reported by Barry Kahan and colleagues in this issue of The Lancet highlights many novel features of this drug. Efficacy of sirolimus compared with azathioprine for reduction of acute renal allograft rejection: a randomised multicentre studyUse of sirolimus reduced occurrence and severity of biopsy-confirmed acute rejection episodes with no increase in complications. Further studies are needed to establish the optimum doses for the combined regimen. Full-Text PDF