Abstract

Although the immunomodulator cyclosporin A (CsA, 1)1 has engendered dramatic progress in organ transplantation, recurrent clinical complications have stimulated an ongoing search for more potent and less toxic agents. The discovery of FK506 (2)2 and the reinvestigation of rapamycin (3)3 and demethoxyrapamycin (4)4 heralded major advances in immunosuppressant research; not only are these natural products more potent than CsA, but they also selectively inhibit two distinct steps in the immune response. CsA and FK506, bound to immunophilins cyclophilin A and FKBP, respectively, prevent cells from entering the G1 phase of the cell cycle, whereas the rapamycin-FKBP complex blocks progression into the S phase. The molecular biology, immunology and phar-

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