PMID- 21247219
OWN - NLM
STAT- MEDLINE
DCOM- 20110804
LR  - 20220309
IS  - 1179-1942 (Electronic)
IS  - 0114-5916 (Linking)
VI  - 34
IP  - 2
DP  - 2011 Feb 1
TI  - Mammalian target of rapamycin (mTOR) inhibitors: potential uses and a review of 
      haematological adverse effects.
PG  - 97-115
LID - 10.2165/11585040-000000000-00000 [doi]
AB  - Mammalian target of rapamycin (mTOR) inhibitors (mTORis) constitute a relatively 
      new category of immunosuppressive and antineoplastic drugs. These share a unique 
      mechanism of action that is focused on the inhibition of the mTOR. Their clinical 
      applications have recently expanded significantly to cover a wide spectrum of 
      immune and non-immune-mediated disorders, including, apart from solid organ 
      transplantation, various solid organ and haematological malignancies, 
      rheumatological and auto-immune diseases such as rheumatoid arthritis, systemic 
      lupus erythematosus, fibrotic conditions, e.g. pulmonary and hepatic fibrosis, 
      and even metabolic problems such as diabetes mellitus and obesity. The most 
      challenging and frequent adverse effects of the mTORis are the haematological 
      ones, especially anaemia, leukopenia and thrombocytopenia. A unique 
      characteristic of mTORi-induced anaemia is concurrent marked microcytosis. 
      Recently, mechanisms have been proposed to explain the microcytic appearance of 
      this anaemia; these include globin production defect, erythropoietin resistance, 
      chronic inflammation, dysregulation of cellular iron metabolism and 
      hepcidin-mediated iron homeostasis interference. As the differential diagnosis of 
      microcytic anaemia includes pure iron deficiency, functional iron deficiency and 
      haemoglobinopathies, characterization of the anaemia requires significant 
      investigation, time and costs. Therefore, understanding of the likely interaction 
      between mTORis and patients is valuable in clinical practice. Moreover, this 
      could expand the drugs' therapeutic applications to other disorders, and suggest 
      novel targets for further research.
FAU - Sofroniadou, Sofia
AU  - Sofroniadou S
AD  - Department of Renal Medicine and Transplantation, Guy's and St Thomas' NHS 
      Foundation Trust, King's Health Partners Academic Health Science Centre (AHSC), 
      London, UK.
FAU - Goldsmith, David
AU  - Goldsmith D
LA  - eng
PT  - Journal Article
PL  - New Zealand
TA  - Drug Saf
JT  - Drug safety
JID - 9002928
RN  - 0 (Antineoplastic Agents)
RN  - 0 (Immunosuppressive Agents)
RN  - EC 2.7.11.1 (TOR Serine-Threonine Kinases)
SB  - IM
MH  - Antineoplastic Agents/*adverse effects/*therapeutic use
MH  - Autoimmune Diseases/*drug therapy
MH  - Hematologic Neoplasms/*drug therapy
MH  - Humans
MH  - Immunosuppressive Agents/*adverse effects/*pharmacology
MH  - TOR Serine-Threonine Kinases/*antagonists & inhibitors
EDAT- 2011/01/21 06:00
MHDA- 2011/08/05 06:00
CRDT- 2011/01/21 06:00
PHST- 2011/01/21 06:00 [entrez]
PHST- 2011/01/21 06:00 [pubmed]
PHST- 2011/08/05 06:00 [medline]
AID - 2 [pii]
AID - 10.2165/11585040-000000000-00000 [doi]
PST - ppublish
SO  - Drug Saf. 2011 Feb 1;34(2):97-115. doi: 10.2165/11585040-000000000-00000.