Table 1.
Agent | Molecular target | Molecular effect | Specific side effects | Comments |
ATG/ALG | Binds multiple antigens on lymphoid cells | Complement-mediated lysis | Serum sickness | Batch variability |
Opsonization and clearance | Thrombocytopenia | |||
Modification of cell surface receptor | Granulocytopenia | |||
OKT3 | Binds T cell CD3 | Complement mediated lysis | Cytokine release syndrome | Tachyphylaxis due to anti-idiotypic antibodies |
Opsonization and clearance | (eg fever, chills, headache, and pulmonary edema) | |||
Modification of CD3 receptor | ||||
Daclizumab | Binds α-subunit of interleukin-2 receptor | Down-regulation of receptor | No major side effects reported so far | Humanized antibody |
? CD4 T cell depletion | Long half-life (20 days) | |||
Five-dose regimen | ||||
Basiliximab | Binds α-subunit of interleukin-2 receptor | Down-regulation of receptor | No major side effects reported so far | Chimeric antibody |
? CD4 T cell depletion | Long half-life (10-14 days) | |||
Two-dose regimen |
ALG, antilymphocyte globulin; ATG, antithymocyte globulin.