PMID- 20070623
OWN - NLM
STAT- MEDLINE
DCOM- 20101025
LR  - 20211203
IS  - 1432-2277 (Electronic)
IS  - 0934-0874 (Linking)
VI  - 23
IP  - 8
DP  - 2010 Aug
TI  - Sirolimus in renal transplant recipients with tuberous sclerosis complex: 
      clinical effectiveness and implications for innate immunity.
PG  - 777-85
LID - 10.1111/j.1432-2277.2009.01041.x [doi]
AB  - Tuberous sclerosis complex (TSC) is caused by constitutively activated mammalian 
      target of rapamycin (mTOR) resulting in nonmalignant tumours of several organs 
      and consequently renal failure. Recent reports suggest a possible beneficial role 
      of the mTOR-inhibitor (mTOR-I) sirolimus for TSC; however, safety and efficiency 
      of sirolimus in TSC patients after renal transplantation, both as primary 
      immunosuppressant as well as anti-proliferative agent, are still undefined. 
      Moreover, it is currently unknown whether the TSC mutation affects the primary 
      immune response in these patients. In this article, we report on three TSC 
      patients after renal transplantation who have been converted from a 
      calcineurin-inhibitor (CNI)-based immunosuppression to sirolimus. During 2 years 
      of follow-up, renal allograft function was stable or even improved, and no 
      significant sirolimus-associated side-effects were noted. Beneficial effects of 
      sirolimus against TSC were detected in the skin, along with improved spirometric 
      measurements and an arrest of astrocytoma progression. We show that the 
      inflammatory immune response was significantly altered in TSC patients as 
      compared with controls and sirolimus potently affected both inflammatory cytokine 
      production and vascular endothelial growth factor levels in these patients. 
      Larger studies are warranted to further examine the relationship between clinical 
      parameters and the molecular response to mTOR-inhibition in TSC patients after 
      renal transplantation.
FAU - Haidinger, Michael
AU  - Haidinger M
AD  - Clinical Division of Nephrology and Dialysis, Department of Internal Medicine 
      III, Medical University of Vienna, Vienna, Austria.
FAU - Hecking, Manfred
AU  - Hecking M
FAU - Weichhart, Thomas
AU  - Weichhart T
FAU - Poglitsch, Marko
AU  - Poglitsch M
FAU - Enkner, Wolfgang
AU  - Enkner W
FAU - Vonbank, Karin
AU  - Vonbank K
FAU - Prayer, Daniela
AU  - Prayer D
FAU - Geusau, Alexandra
AU  - Geusau A
FAU - Oberbauer, Rainer
AU  - Oberbauer R
FAU - Zlabinger, Gerhard J
AU  - Zlabinger GJ
FAU - Soleiman, Afschin
AU  - Soleiman A
FAU - Horl, Walter H
AU  - Horl WH
FAU - Saemann, Marcus D
AU  - Saemann MD
LA  - eng
PT  - Case Reports
PT  - Journal Article
DEP - 20100111
PL  - Switzerland
TA  - Transpl Int
JT  - Transplant international : official journal of the European Society for Organ 
      Transplantation
JID - 8908516
RN  - 0 (Calcineurin Inhibitors)
RN  - 0 (Immunosuppressive Agents)
RN  - 0 (Intracellular Signaling Peptides and Proteins)
RN  - EC 2.7.1.1 (MTOR protein, human)
RN  - EC 2.7.11.1 (Protein Serine-Threonine Kinases)
RN  - EC 2.7.11.1 (TOR Serine-Threonine Kinases)
RN  - W36ZG6FT64 (Sirolimus)
SB  - IM
MH  - Adult
MH  - Calcineurin Inhibitors
MH  - Female
MH  - Graft Rejection/*complications/*drug therapy/immunology
MH  - Humans
MH  - Immune System/drug effects/immunology
MH  - Immunosuppressive Agents/*administration & dosage/adverse effects
MH  - Intracellular Signaling Peptides and Proteins/antagonists & inhibitors
MH  - *Kidney Transplantation
MH  - Lymphangioleiomyomatosis/complications/immunology
MH  - Male
MH  - Protein Serine-Threonine Kinases/antagonists & inhibitors
MH  - Sirolimus/*administration & dosage/adverse effects
MH  - TOR Serine-Threonine Kinases
MH  - Treatment Outcome
MH  - Tuberous Sclerosis/*complications/immunology
EDAT- 2010/01/15 06:00
MHDA- 2010/10/26 06:00
CRDT- 2010/01/15 06:00
PHST- 2010/01/15 06:00 [entrez]
PHST- 2010/01/15 06:00 [pubmed]
PHST- 2010/10/26 06:00 [medline]
AID - TRI1041 [pii]
AID - 10.1111/j.1432-2277.2009.01041.x [doi]
PST - ppublish
SO  - Transpl Int. 2010 Aug;23(8):777-85. doi: 10.1111/j.1432-2277.2009.01041.x. Epub 
      2010 Jan 11.