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Effect of maintenance immunosuppressive drugs on virus pathobiology: evidence and potential mechanisms
Author(s) -
Brennan Daniel C.,
Aguado José M.,
Potena Luciano,
Jardine Alan G.,
Legendre Christophe,
Säemann Marcus D.,
Mueller Nicolas J.,
Merville Pierre,
Emery Vincent,
Nashan Björn
Publication year - 2013
Publication title -
reviews in medical virology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 2.06
H-Index - 90
eISSN - 1099-1654
pISSN - 1052-9276
DOI - 10.1002/rmv.1733
Subject(s) - medicine , intensive care medicine , virus , immunology , virology , bioinformatics , computational biology , biology
SUMMARY 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. Copyright © 2012 John Wiley & Sons, Ltd.