Mechanism of Action
Tacrolimus is chemically known as a macrolide. In T-cells, activation of the T-cell receptor normally increases intracellular calcium, which acts via calmodulin to activate calcineurin. Calcineurin then dephosphorylates the transcription factor NF-AT (nuclear factor of activated T-cells), which moves to the nucleus of the T-cell and increases the activity of genes coding for IL-2 and related cytokines. Tacrolimus prevents the dephosphorylation of NF-AT. In detail, Tacrolimus reduces peptidyl-prolyl isomerase activity by binding to the immunophilin FKBP12 (FK506 binding protein) creating a new complex. This FKBP12-FK506 complex interacts with and inhibits calcineurin thus inhibiting both T-lymphocyte signal transduction and IL-2 transcription. Although this activity is similar to ciclosporin, studies have shown that the incidence of acute rejection is reduced by tacrolimus use over ciclosporin. Although short-term immunosuppression concerning patient and graft survival is found to be similar between the two drugs, tacrolimus results in a more favorable lipid profile, and this may have important long-term implications given the prognostic influence of rejection on graft survival.
Read more about this topic: Tacrolimus
Famous quotes containing the words mechanism of, mechanism and/or action:
“Life is an offensive, directed against the repetitious mechanism of the Universe.”
—Alfred North Whitehead (1861–1947)
“I’ve never known a Philadelphian who wasn’t a downright “character;” possibly a defense mechanism resulting from the dullness of their native habitat.”
—Anita Loos (1888–1981)
“Perhaps a modern society can remain stable only by eliminating adolescence, by giving its young, from the age of ten, the skills, responsibilities, and rewards of grownups, and opportunities for action in all spheres of life. Adolescence should be a time of useful action, while book learning and scholarship should be a preoccupation of adults.”
—Eric Hoffer (1902–1983)