Table 3.
Mechanisms and adverse effects of currently used immunosuppression drugs in VCA.
| Drug | Mechanism | Timing | Main adverse effects |
|---|---|---|---|
| IMMUNOSUPPRESSION IN VCA | |||
| Alemtuzumab | CD52 mAB | Induction | Hypersensitivity reaction, anemia, neutropenia, thrombocytopenia (52–54) |
| Antithymocyte globulin (ATG) | T-cell depletion (polyclonal antibody against CD2,CD3,CD4,CD8) | Induction | Leukopenia, thrombocytopenia, serum sickness, cytokine release syndrome (55, 56) |
| Basiliximab | IL-2R mAB | Induction | Hypersensitivity reaction (mild or anaphylaxis) (57–59) |
| Belatacept | CD28—B7 blockade | Maintenance | Post-transplantation lymphoproliferative disorder (PTLD) (40, 60) |
| Corticosteroids | Lymphocytolysis | Maintenance | Infection, myopathy, DM, hyperlipidemia, osteoporosis (61–63) |
| Cyclosporine | Calcineurin inhibitor | Maintenance | Nephrotoxicity, DM, dyslipidemia (64–66) |
| MMF | IMPDH inhibitor | Maintenance | Abdominal pain, vomiting, leukocytopenia, diarrhea (63) |
| Sirolimus, Everolimus | mTOR Inhibitor | Maintenance | Hypertriglyceridemia, mouth ulcers, leukopenia, anemia, thrombocytopenia, impaired wound healing, drug-induced pneumonitis (67–69) |
| Tacrolimus | Calcineurin inhibitor | Maintenance | Nephrotoxicity, DM, dyslipidemia (64–66) |