Steroid withdrawal or avoidance in renal transplant recipients
Steroids remain an important component of maintenance immunosuppression after renal transplantation. Their anti-inflammatory action is partly due to the sequestration of CD4+ lymphocytes in the reticuloendothelial system. Steroids bind to intracellular receptors and the resulting steroid-receptor c...
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Faculty of Medicine, University of Malaya
2006
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my.um.eprints.244302020-06-01T04:30:04Z http://eprints.um.edu.my/24430/ Steroid withdrawal or avoidance in renal transplant recipients Chang, S.H. Tan, Si Yen R Medicine (General) Steroids remain an important component of maintenance immunosuppression after renal transplantation. Their anti-inflammatory action is partly due to the sequestration of CD4+ lymphocytes in the reticuloendothelial system. Steroids bind to intracellular receptors and the resulting steroid-receptor complex alters the transcription of cytokines by binding to glucocorticoid response elements on DNA. Transcription factors whose actions are altered by glucocorticoids include activating protein-1 (AP-1) and nuclear factor-κB (NF-κB). The main cytokines whose production by antigen-presenting cells is inhibited by steroids are interleukin-1 (IL-1), required for helper T-cell activation, and IL-6, required for B-cell activation. Other pro-inflammatory cytokines such as interferon gamma and tumour necrosis factor are also inhibited. This multiplicity of immunosuppressive actions is not fully replicated by other immunosuppressants. However, there are concerns about the long-term side effects of steroids. This review will examine the attempts at steroid withdrawal or steroid avoidance in renal transplant patients. Faculty of Medicine, University of Malaya 2006 Article PeerReviewed Chang, S.H. and Tan, Si Yen (2006) Steroid withdrawal or avoidance in renal transplant recipients. Journal of the University of Malaya Medical Centre (JUMMEC), 9 (1). pp. 2-6. ISSN 1823-7339 https://jummec.um.edu.my/article/view/4533 |
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R Medicine (General) Chang, S.H. Tan, Si Yen Steroid withdrawal or avoidance in renal transplant recipients |
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Steroids remain an important component of maintenance immunosuppression after renal transplantation. Their anti-inflammatory action is partly due to the sequestration of CD4+ lymphocytes in the reticuloendothelial system. Steroids
bind to intracellular receptors and the resulting steroid-receptor complex alters the transcription of cytokines by binding to glucocorticoid response elements on DNA.
Transcription factors whose actions are altered by glucocorticoids include activating protein-1 (AP-1) and nuclear factor-κB (NF-κB). The main cytokines whose production by antigen-presenting cells is inhibited by steroids are interleukin-1 (IL-1), required for helper T-cell activation, and IL-6, required for B-cell activation. Other pro-inflammatory cytokines such as interferon gamma and tumour necrosis factor are also inhibited. This multiplicity of immunosuppressive actions is not fully replicated by other immunosuppressants. However, there are concerns about the long-term side effects of steroids. This review will examine the attempts at steroid withdrawal or steroid avoidance in renal transplant patients. |
format |
Article |
author |
Chang, S.H. Tan, Si Yen |
author_facet |
Chang, S.H. Tan, Si Yen |
author_sort |
Chang, S.H. |
title |
Steroid withdrawal or avoidance in renal transplant recipients |
title_short |
Steroid withdrawal or avoidance in renal transplant recipients |
title_full |
Steroid withdrawal or avoidance in renal transplant recipients |
title_fullStr |
Steroid withdrawal or avoidance in renal transplant recipients |
title_full_unstemmed |
Steroid withdrawal or avoidance in renal transplant recipients |
title_sort |
steroid withdrawal or avoidance in renal transplant recipients |
publisher |
Faculty of Medicine, University of Malaya |
publishDate |
2006 |
url |
http://eprints.um.edu.my/24430/ https://jummec.um.edu.my/article/view/4533 |
_version_ |
1669008000529989632 |
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13.154949 |