Antibody immunosuppressive therapy in solid organ transplant

Figures & data

Figure 1 Mechanisms of T-cell activation and proliferation targeted by drugs. New agents in transplantation target various mechanisms of T-cell activation and proliferation with the intent to minimize calcineurin inhibitor use and improve long-term outcomes. CD, cluster of differentiation; MHC, major histocompatibility complex; NK, natural killer; PSGL, P-selectin glycoprotein ligand; sCR, soluble complement receptor; TCR, T-cell receptor.

Table 1 Drugs approved or in clinical studies for allograft rejection

	Agents	Target	Indication	Most advanced development phase
Costimulatory pathway	Belatacept	CD80/CD86	Kidney transplantation	US regulatory review
	Efalizumab	LFA-1	Psoriasis	Withdrawn from market
Anti-adhesion agents	Alefacept	CD2	Psoriasis	Marketed
Complement pathway inhibition	Eculizumab	C5a	Paroxysmal Nocturnal Hemoglobinuria	Marketed
	TP-10	sCR3	Cardiac surgery with cardiopulmonary bypass pump	Phase 2
Reperfusion injury target	rPSGL-Ig	P-selectin	Reperfusion injury with kidney and liver transplantation	Phase 2
	Repertaxin	CXCR1/CXCR2	Reperfusion injury with kidney and lung transplantation	Phase 2
	QPI-1002	p53	Reperfusion injury with kidney transplantation	Phase 2
B-cell target	Rituximab	CD20	Hematologic malignancies, rheumatoid arthritis	Marketed
	Epratuzumab	CD22	Hematologic malignancies, systemic lupus erythematosus	Phase 3
	Belimumab	BLyS	Systemic lupus erythematosus	US and EU regulatory review
Cytokine target	Tocilizumab	IL6R	Rheumatoid arthritis	Marketed
	Infliximab	TNF	Crohn disease, ulcerative colitis, psoriatic and rheumatoid arthritis, ankylosing spondylitis	Marketed

Drugs targeting cytokines, co-stimulatory signals, certain surface molecules and various B-cell epitopes involved in the rejection process of allograft. BlyS, B lymphocyte stimulator; CD, cluster of differentiation; IL, interleukin; R, receptor; LFA, leukocyte function-associated antigen; TNF, tumor necrosis factor.