Site-Specific Immunosuppression in Vascularized Composite Allotransplantation: Prospects and Potential

Site-Specific Immunosuppression in Vascularized Composite Allotransplantation: Prospects and Potential

Author Schnider, Jonas T. Google Scholar
Weinstock, Matthias Autor UNIFESP Google Scholar
Plock, Jan A. Google Scholar
Solari, Mario G. Google Scholar
Venkataramanan, Raman Google Scholar
Zheng, Xin Xiao Google Scholar
Gorantla, Vijay S. Google Scholar
Institution Univ Pittsburgh
Universidade Federal de São Paulo (UNIFESP)
Univ Zurich Hosp
Tongji Univ
Dept Plast Surg
Abstract Skin is the most immunogenic component of a vascularized composite allograft (VCA) and is the primary trigger and target of rejection. the skin is directly accessible for visual monitoring of acute rejection (AR) and for directed biopsy, timely therapeutic intervention, and management of AR. Logically, antirejection drugs, biologics, or other agents delivered locally to the VCA may reduce the need for systemic immunosuppression with its adverse effects. Topical FK 506 (tacrolimus) and steroids have been used in clinical VCA as an adjunct to systemic therapy with unclear beneficial effects. However, there are no commercially available topical formulations for other widely used systemic immunosuppressive drugs such as mycophenolic acid, sirolimus, and everolimus. Investigating the site-specific therapeutic effects and efficacy of systemically active agents may enable optimizing the dosing, frequency, and duration of overall immunosuppression in VCA with minimization or elimination of long-term drug-related toxicity.
Language English
Sponsor Swiss National Science Foundation
Date 2013-01-01
Published in Clinical & Developmental Immunology. New York: Hindawi Publishing Corporation, 7 p., 2013.
ISSN 1740-2522 (Sherpa/Romeo, impact factor)
Publisher Hindawi Publishing Corporation
Extent 7
Origin http://dx.doi.org/10.1155/2013/495212
Access rights Open access Open Access
Type Review
Web of Science ID WOS:000315256900001
URI http://repositorio.unifesp.br/handle/11600/35693

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