TY - JOUR
T1 - Effect of maintenance immunosuppressive drugs on virus pathobiology
T2 - Evidence and potential mechanisms
AU - Brennan, Daniel C.
AU - Aguado, José M.
AU - Potena, Luciano
AU - Jardine, Alan G.
AU - Legendre, Christophe
AU - Säemann, Marcus D.
AU - Mueller, Nicolas J.
AU - Merville, Pierre
AU - Emery, Vincent
AU - Nashan, Björn
PY - 2013/3
Y1 - 2013/3
N2 - Recent evidence suggesting a potential anti-CMV effect of mTORis is of great interest to the transplant community. However, the concept of an immunosuppressant with antiviral properties is not new, with many accounts of the antiviral properties of several agents over the years. Despite these reports, to date, there has been little effort to collate the evidence into a fuller picture. This manuscript was developed to gather the evidence of antiviral activity of the agents that comprise a typical immunosuppressive regimen against viruses that commonly reactivate following transplant (HHV1 and 2, VZV, EBV, CMV and HHV6, 7, and 8, HCV, HBV, BKV, HIV, HPV, and parvovirus). Appropriate immunosuppressive regimens posttransplant that avoid acute rejection while reducing risk of viral reactivation are also reviewed. The existing literature was disparate in nature, although indicating a possible stimulatory effect of tacrolimus on BKV, potentiation of viral reactivation by steroids, and a potential advantage of mammalian target of rapamycin (mTOR) inhibition in several viral infections, including BKV, HPV, and several herpesviruses.
AB - Recent evidence suggesting a potential anti-CMV effect of mTORis is of great interest to the transplant community. However, the concept of an immunosuppressant with antiviral properties is not new, with many accounts of the antiviral properties of several agents over the years. Despite these reports, to date, there has been little effort to collate the evidence into a fuller picture. This manuscript was developed to gather the evidence of antiviral activity of the agents that comprise a typical immunosuppressive regimen against viruses that commonly reactivate following transplant (HHV1 and 2, VZV, EBV, CMV and HHV6, 7, and 8, HCV, HBV, BKV, HIV, HPV, and parvovirus). Appropriate immunosuppressive regimens posttransplant that avoid acute rejection while reducing risk of viral reactivation are also reviewed. The existing literature was disparate in nature, although indicating a possible stimulatory effect of tacrolimus on BKV, potentiation of viral reactivation by steroids, and a potential advantage of mammalian target of rapamycin (mTOR) inhibition in several viral infections, including BKV, HPV, and several herpesviruses.
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U2 - 10.1002/rmv.1733
DO - 10.1002/rmv.1733
M3 - Review article
C2 - 23165654
AN - SCOPUS:84874718381
SN - 1052-9276
VL - 23
SP - 97
EP - 125
JO - Reviews in Medical Virology
JF - Reviews in Medical Virology
IS - 2
ER -