An immunosuppressive agent used in combination with cyclophosphamide and hydroxychloroquine in the treatment of rheumatoid arthritis. According to the Fourth Annual Report on Carcinogens (NTP 85-002, 1985), this substance has been listed as a known carcinogen. (Merck Index, 11th ed)
An antimetabolite antineoplastic agent with immunosuppressant properties. It interferes with nucleic acid synthesis by inhibiting purine metabolism and is used, usually in combination with other drugs, in the treatment of or in remission maintenance programs for leukemia.
Agents that suppress immune function by one of several mechanisms of action. Classical cytotoxic immunosuppressants act by inhibiting DNA synthesis. Others may act through activation of T-CELLS or by inhibiting the activation of HELPER CELLS. While immunosuppression has been brought about in the past primarily to prevent rejection of transplanted organs, new applications involving mediation of the effects of INTERLEUKINS and other CYTOKINES are emerging.
A glucocorticoid with the general properties of the corticosteroids. It is the drug of choice for all conditions in which routine systemic corticosteroid therapy is indicated, except adrenal deficiency states.
An antibiotic substance derived from Penicillium stoloniferum, and related species. It blocks de novo biosynthesis of purine nucleotides by inhibition of the enzyme inosine monophosphate dehydrogenase. Mycophenolic acid is important because of its selective effects on the immune system. It prevents the proliferation of T-cells, lymphocytes, and the formation of antibodies from B-cells. It also may inhibit recruitment of leukocytes to inflammatory sites. (From Gilman et al., Goodman and Gilman's The Pharmacological Basis of Therapeutics, 9th ed, p1301)
A subclass of enzymes of the transferase class that catalyze the transfer of a methyl group from one compound to another. (Dorland, 28th ed) EC 2.1.1.
Chronic, non-specific inflammation of the GASTROINTESTINAL TRACT. Etiology may be genetic or environmental. This term includes CROHN DISEASE and ULCERATIVE COLITIS.
A chronic transmural inflammation that may involve any part of the DIGESTIVE TRACT from MOUTH to ANUS, mostly found in the ILEUM, the CECUM, and the COLON. In Crohn disease, the inflammation, extending through the intestinal wall from the MUCOSA to the serosa, is characteristically asymmetric and segmental. Epithelioid GRANULOMAS may be seen in some patients.
The transference of a kidney from one human or animal to another.
A cyclic undecapeptide from an extract of soil fungi. It is a powerful immunosupressant with a specific action on T-lymphocytes. It is used for the prophylaxis of graft rejection in organ and tissue transplantation. (From Martindale, The Extra Pharmacopoeia, 30th ed).
A chronic self-perpetuating hepatocellular INFLAMMATION of unknown cause, usually with HYPERGAMMAGLOBULINEMIA and serum AUTOANTIBODIES.
An antineoplastic compound which also has antimetabolite action. The drug is used in the therapy of acute leukemia.
A synthetic anti-inflammatory glucocorticoid derived from CORTISONE. It is biologically inert and converted to PREDNISOLONE in the liver.
Inflammation of the COLON that is predominantly confined to the MUCOSA. Its major symptoms include DIARRHEA, rectal BLEEDING, the passage of MUCUS, and ABDOMINAL PAIN.
Therapy with two or more separate preparations given for a combined effect.
Adrenal cortex hormones are steroid hormones produced by the outer portion of the adrenal gland, consisting of glucocorticoids, mineralocorticoids, and androgens, which play crucial roles in various physiological processes such as metabolism regulation, stress response, electrolyte balance, and sexual development and function.
An immune response with both cellular and humoral components, directed against an allogeneic transplant, whose tissue antigens are not compatible with those of the recipient.
Deliberate prevention or diminution of the host's immune response. It may be nonspecific as in the administration of immunosuppressive agents (drugs or radiation) or by lymphocyte depletion or may be specific as in desensitization or the simultaneous administration of antigen and immunosuppressive drugs.
Leukopenia is a condition characterized by an abnormally low white blood cell count (less than 4,000 cells per microliter of blood) in peripheral blood, increasing the risk of infection due to decreased immune defense.
A PREDNISOLONE derivative with similar anti-inflammatory action.
Drugs used for their effects on the gastrointestinal system, as to control gastric acidity, regulate gastrointestinal motility and water flow, and improve digestion.
An anti-inflammatory agent, structurally related to the SALICYLATES, which is active in INFLAMMATORY BOWEL DISEASE. It is considered to be the active moiety of SULPHASALAZINE. (From Martindale, The Extra Pharmacopoeia, 30th ed)
Drugs that are chemically similar to naturally occurring metabolites, but differ enough to interfere with normal metabolic pathways. (From AMA Drug Evaluations Annual, 1994, p2033)
Substances that reduce or suppress INFLAMMATION.
A group of 2-hydroxybenzoic acids that can be substituted by amino groups at any of the 3-, 4-, 5-, or 6-positions.
A group of closely related cyclic undecapeptides from the fungi Trichoderma polysporum and Cylindocarpon lucidum. They have some antineoplastic and antifungal action and significant immunosuppressive effects. Cyclosporins have been proposed as adjuvants in tissue and organ transplantation to suppress graft rejection.
An antischistosomal agent that has become obsolete.
Evaluation undertaken to assess the results or consequences of management and procedures used in combating disease in order to determine the efficacy, effectiveness, safety, and practicability of these interventions in individual cases or series.
A drug that is used in the management of inflammatory bowel diseases. Its activity is generally considered to lie in its metabolic breakdown product, 5-aminosalicylic acid (see MESALAMINE) released in the colon. (From Martindale, The Extra Pharmacopoeia, 30th ed, p907)
Glomerulonephritis associated with autoimmune disease SYSTEMIC LUPUS ERYTHEMATOSUS. Lupus nephritis is histologically classified into 6 classes: class I - normal glomeruli, class II - pure mesangial alterations, class III - focal segmental glomerulonephritis, class IV - diffuse glomerulonephritis, class V - diffuse membranous glomerulonephritis, and class VI - advanced sclerosing glomerulonephritis (The World Health Organization classification 1982).
Guanine nucleotides are cyclic or linear molecules that consist of a guanine base, a pentose sugar (ribose in the cyclic form, deoxyribose in the linear form), and one or more phosphate groups, playing crucial roles in signal transduction, protein synthesis, and regulation of enzymatic activities.
Administration of high doses of pharmaceuticals over short periods of time.
A group of CORTICOSTEROIDS that affect carbohydrate metabolism (GLUCONEOGENESIS, liver glycogen deposition, elevation of BLOOD SUGAR), inhibit ADRENOCORTICOTROPIC HORMONE secretion, and possess pronounced anti-inflammatory activity. They also play a role in fat and protein metabolism, maintenance of arterial blood pressure, alteration of the connective tissue response to injury, reduction in the number of circulating lymphocytes, and functioning of the central nervous system.
Nucleotides in which the base moiety is substituted with one or more sulfur atoms.
The survival of a graft in a host, the factors responsible for the survival and the changes occurring within the graft during growth in the host.
A macrolide isolated from the culture broth of a strain of Streptomyces tsukubaensis that has strong immunosuppressive activity in vivo and prevents the activation of T-lymphocytes in response to antigenic or mitogenic stimulation in vitro.

Primary biliary cirrhosis associated with membranous glomerulonephritis. (1/943)

A 33-year-old woman was admitted to our department for evaluation of liver dysfunction and proteinuria. A liver biopsy specimen showed ductular proliferation and moderate portal fibrosis indicating stage II primary biliary cirrhosis. A renal biopsy specimen showed mild to moderate mesangial cell proliferation without crescent formation or interstitial nephritis. Immunofluorescent staining revealed deposition of immunoglobulin G (IgG), third component of complement (C3), and Clq on glomerular basement membranes. The findings indicated stage I membranous glomerulonephritis. Administration of ursodesoxycholic acid together with prednisolone, azathioprine, and dipyridamole decreased proteinuria and improved cholestatic liver dysfunction.  (+info)

Reduced kidney transplant rejection rate and pharmacoeconomic advantage of mycophenolate mofetil. (2/943)

BACKGROUND: Several multinational controlled clinical trials have shown that triple therapy immunosuppressive regimens which include mycophenolate mofetil (MMF), cyclosporin A (CSA) and steroids (S) are superior compared with conventional regimens which include azathioprine (AZA), CSA and S, mainly because MMF reduces the rate of acute rejection episodes in the first 6 months after kidney transplantation. Post-marketing studies are useful to evaluate the general applicability and costs of MMF-based immunosuppressive regimens. METHODS: Based on the excellent results of the published controlled clinical trials, we have changed the standard triple therapy immunosuppressive protocol (AZA+CSA+S) to an MMF-based regimen (MMF+CSA+S) at our centre. To analyse the impact of this change in regimen, we have monitored 6-month patient and graft survival, rejection rate, serum creatinine and CSA levels, as well as the costs of the immunosuppressive and anti-rejection treatments, in 40 consecutive renal transplant recipients (MMF group) and have compared the data with 40 consecutive patients transplanted immediately prior to the change in regimen (AZA group). RESULTS: Recipient and donor characteristics were similar in the AZA and MMF groups. Patient survival (37/40; 92.5% in the AZA group vs 38/40; 95% in the MMF group), graft survival (36/40 vs 36/40; both 90%) and serum creatinine (137+/-56 vs 139+/-44 micromol/l) after 6 months were not significantly different. However, the rate of acute rejection episodes (defined as a rise in creatinine without other obvious cause and treated at least with pulse steroids) was significantly reduced with MMF from 60 to 20% (P=0.0005). The resulting cost for rejection treatment was lowered 8-fold (from sFr. 2113 to 259 averaged per patient) and the number of transplant biopsies was lowered > 3-fold in the MMF group. The cost for the immunosuppressive therapy was increased 1.5-fold with MMF (from sFr. 5906 to 9231 per patient for the first 6 months). CONCLUSIONS: The change from AZA to MMF resulted in a significant reduction in early rejection episodes, resulting in fewer diagnostic procedures and rehospitalizations. The optimal long-term regimen in terms of patient and pharmacoeconomic benefits remains to be defined.  (+info)

Long-term results of pancreas transplantation under tacrolius immunosuppression. (3/943)

BACKGROUND: The long-term safety and efficacy of tacrolimus in pancreas transplantation has not yet been demonstrated. The observation of prolonged pancreatic graft function under tacrolimus would indicate that any potential islet toxicity is short-lived and clinically insignificant. We report herein the results of pancreas transplantation in patients receiving primary tacrolimus immunosuppression for a minimum of 2 years. METHODS: From July 4, 1994 until April 18, 1996, 60 patients received either simultaneous pancreas-kidney transplant (n=55), pancreas transplant only (n=4), or pancreas after kidney transplantation (n=1). Baseline immunosuppression consisted of tacrolimus and steroids without antilymphocyte induction. Azathioprine was used as a third agent in 51 patients and mycophenolate mofetil in 9. Rejection episodes within the first 6 months occurred in 48 (80%) patients and were treated with high-dose corticosteroids. Antilymphocyte antibody was required in eight (13%) patients with steroid-resistant rejection. RESULTS: With a mean follow-up of 35.1+/-5.9 months (range: 24.3-45.7 months), 6-month and 1-, 2-, and 33-year graft survival is 88%, 82%, 80%, and 80% (pancreas) and 98%, 96%, 93%, and 91% (kidney), respectively. Six-month and 1-, 2-, and 3-year patient survival is 100%, 98%, 98%, and 96.5%. Mean fasting glucose is 91.6+/-13.8 mg/dl, and mean glycosylated hemoglobin is 5.1+/-0.7% (normal range: 4.3-6.1%). Mean tacrolimus dose is 6.5+/-2.6 mg/day and mean prednisone dose 2.0+/-2.9 mg/day at follow-up. Complete steroid withdrawal was possible in 31 (65%) of the 48 patients with functioning pancreases. CONCLUSIONS: These data show for the first time that tacrolimus is a safe and effective long-term primary agent in pancreas transplantation and provides excellent long-term islet function without evidence of toxicity while permitting steroid withdrawal in the majority of patients.  (+info)

Pediatric renal transplantation under tacrolimus-based immunosuppression. (4/943)

BACKGROUND: Tacrolimus has been used as a primary immunosuppressive agent in adult and pediatric renal transplant recipients, with reasonable outcomes. Methods. Between December 14, 1989 and December 31, 1996, 82 pediatric renal transplantations alone were performed under tacrolimus-based immunosuppression without induction anti-lymphocyte antibody therapy. Patients undergoing concomitant or prior liver and/or intestinal transplantation were not included in the analysis. The mean recipient age was 10.6+/-5.2 years (range: 0.7-17.9). Eighteen (22%) cases were repeat transplantations, and 6 (7%) were in patients with panel-reactive antibody levels over 40%. Thirty-four (41%) cases were with living donors, and 48 (59%) were with cadaveric donors. The mean donor age was 27.3+/-14.6 years (range: 0.7-50), and the mean cold ischemia time in the cadaveric cases was 26.5+/-8.8 hr. The mean number of HLA matches and mismatches was 2.8+/-1.2 and 2.9+/-1.3; there were five (6%) O-Ag mismatches. The mean follow-up was 4.0+/-0.2 years. RESULTS: The 1- and 4-year actuarial patient survival was 99% and 94%. The 1- and 4-year actuarial graft survival was 98% and 84%. The mean serum creatinine was 1.1+/-0.5 mg/dl, and the corresponding calculated creatinine clearance was 88+/-25 ml/min/1.73 m2. A total of 66% of successfully transplanted patients were withdrawn from prednisone. In children who were withdrawn from steroids, the mean standard deviation height scores (Z-score) at the time of transplantation and at 1 and 4 years were -2.3+/-2.0, -1.7+/-1.0, and +0.36+/-1.5. Eighty-six percent of successfully transplanted patients were not taking anti-hypertensive medications. The incidence of acute rejection was 44%; between December 1989 and December 1993, it was 63%, and between January 1994 and December 1996, it was 23% (P=0.0003). The incidence of steroid-resistant rejection was 5%. The incidence of delayed graft function was 5%, and 2% of patients required dialysis within 1 week of transplantation. The incidence of cytomegalovirus was 13%; between December 1989 and December 1992, it was 17%, and between January 1993 and December 1996, it was 12%. The incidence of early Epstein-Barr virus-related posttransplant lymphoproliferative disorder (PTLD) was 9%; between December 1989 and December 1992, it was 17%, and between January 1993 and December 1996, it was 4%. All of the early PTLD cases were treated successfully with temporary cessation of immunosuppression and institution of antiviral therapy, without patient or graft loss. CONCLUSIONS: These data demonstrate the short- and medium-term efficacy of tacrolimus-based immunosuppression in pediatric renal transplant recipients, with reasonable patient and graft survival, routine achievement of steroid and anti-hypertensive medication withdrawal, gratifying increases in growth, and, with further experience, a decreasing incidence of both rejection and PTLD.  (+info)

Global biventricular dysfunction in patients with asymptomatic coronary artery disease may be caused by myocarditis. (5/943)

BACKGROUND: The causal role of asymptomatic critical coronary artery obstruction in patients presenting with severe global biventricular dysfunction but no evidence of myocardial infarction is uncertain. METHODS AND RESULTS: Among 291 patients aged >40 years undergoing a noninvasive (2-dimensional echocardiography) and invasive (catheterization, coronary angiography, and biventricular endomyocardial biopsy, 6 to 8 samples/patient) cardiac study because of progressive heart failure (New York Heart Association functional class III or IV) with global biventricular dysfunction and no history of myocardial ischemic events, 7 patients (2.4%; 7 men; mean age, 49+/-6.9 years) had severe coronary artery disease (3 vessels in 4 patients; 2 vessels in 1 patient, proximal occlusion of left anterior descending coronary artery in 2 patients). Left ventricular end-diastolic diameter and ejection fraction by 2-dimensional echocardiography were 73+/-10.5 mm and 23+/-6.5%, respectively, and right ventricular end-diastolic diameter and ejection fraction were 39+/-7 mm and 29+/-7.2%, respectively. Biopsy specimens showed extensive lymphocytic infiltrates with focal myocytolysis meeting the Dallas criteria for myocarditis in all patients (in 5 patients with and 2 patients without fibrosis). Cardiac autoantibodies were detected with indirect immunofluorescence in the serum of 2 patients with active myocarditis. The 2 patients with active inflammation received prednisone (1 mg. kg-1. d-1 for 4 weeks followed by 0.33 mg. kg-1. d-1 for 5 months) and azathioprine (2 mg. kg-1. d-1 for 5 months) in addition to conventional drug therapy for heart failure. At 8-month overall follow-up, cardiac volume and function improved considerably in immunosuppressed patients but remained unchanged in conventionally treated patients, of whom 1 died. CONCLUSIONS: Global biventricular dysfunction in patients with severe asymptomatic coronary artery disease and no evidence of previous myocardial infarction may be caused by myocarditis. Histologic findings may influence the treatment.  (+info)

Randomised trial of mycophenolate mofetil versus azathioprine for treatment of chronic active Crohn's disease. (6/943)

BACKGROUND: Crohn's disease is a chronic inflammatory disease of the alimentary tract. Azathioprine is an effective agent in the management of chronic active Crohn's disease leading to long term remission of disease activity. Such treatment leads to limited efficacy or side effects in a small subset of patients. AIMS: To compare efficacy and side effects of treatment with azathioprine plus corticosteroids versus mycophenolate mofetil (MMF) plus corticosteroids in patients with chronic active Crohn's disease. METHODS: Seventy patients with chronic active Crohn's disease (Crohn's disease activity index (CDAI) greater than 150) were randomised for treatment with azathioprine/cortisone or MMF/cortisone. Corticosteroid dosage was tapered according to a standard protocol. Disease activity was monitored by clinical scores after one, two, three, and six months. RESULTS: Treatment of patients with moderately active (CDAI 150-300) Crohn's disease with MMF/cortisone led to a significant reduction in clinical activity scores comparable to treatment with azathioprine/cortisone. Treatment of patients with highly active Crohn's disease (CDAI greater than 300) with MMF/cortisone caused significant suppression of clinical activity earlier than azathioprine/cortisone treatment. Treatment with MMF/cortisone was associated with few adverse effects. CONCLUSION: Treatment of chronic active Crohn's disease with MMF plus cortisone appears to be effective and well tolerated and should be considered in patients allergic to azathioprine or in whom azathioprine has failed.  (+info)

Intestinal T lymphocytes of different rat strains in immunotoxicity. (7/943)

In order to study the intestinal mucosal immune cells, with emphasis on single T lymphocytes, an inventory was made of single and organized lymphocytes in the epithelium and lamina propria of the small intestines of untreated Wistar, Fischer 344, and Lewis rats. The single and organized lymphocytes were examined microscopically. In addition, the single lymphocytes in the epithelium (IEL) and lamina propria (LPL) were analyzed by flow cytometry. Next, the use of flow cytometry analysis was explored to detect changes in the IEL T-lymphocyte population in subacute oral studies with the immunomodulating agents azathioprine and hexachlorobenzene. Untreated random-bred Wistar rats exhibited a large interindividual variability in IEL composition, while the variability was small in inbred Fischer 344 and Lewis rats. The explorative study with the 2 model immunomodulating compounds demonstrated that hexachlorobenzene increased the number of intraepithelial T lymphocytes with CD8+ phenotype at the cost of T cells with CD4+ phenotype in Lewis rats. Azathioprine did not induce distinct effects on the percentages of IEL. The data indicate that the intraepithelial lymphocytes in the intestines are a potential target for orally administered immunomodulating compounds and should therefore receive more attention in toxicologic pathology studies.  (+info)

Bone loss in long-term renal transplantation: histopathology and densitometry analysis. (8/943)

BACKGROUND: There is little information of the spectrum and factors implicated in the bone loss in long-term renal transplantation, and virtually no data using both histomorphometric and densitometric analysis. METHODS: Twenty-three males and 22 females (13 postmenopausal) were studied with a bone biopsy and densitometry. Sixteen patients were on cyclosporine A monotherapy, 20 on azathioprine + prednisolone, and 9 on cyclosporine A + prednisolone or triple therapy. The mean time after transplantation was 127 +/- 70 months. RESULTS: No group had a significant decrease in bone mineral density (BMD) of the axial skeleton compared with an age- and sex-matched normal population. Compared with sex-matched young controls, osteopenia was observed in all groups at the femoral neck (except premenopausal women and triple therapy) and in the triple-therapy group at the L1-L4 spine region. At the distal radius, osteopenia was found in all the groups. Histopathological diagnosis was mixed uremic osteodystrophy in 46.5%, adynamic bone in 23.2%, hyperparathyroid disease in 13.9%, and normal bone in 16.3%. The diagnosis was not different according to immunosuppressive therapy, but men tended to show more mixed uremic bone disease. There was no significant difference in BMD between histopathological subtypes. In general, patients showed slight osteoclast function increase, osteoblast function decrease, and marked retardation of dynamic parameters. The cyclosporine A monotherapy group had a significantly lower appositional rate than azathioprine + prednisolone. Men had a significantly lower bone volume than women, and premenopausal women had a significantly lower mineralizing surface than postmenopausal women and men. In the multivariate analysis, male gender, time after transplantation, old age, and time on dialysis prior to transplantation were significant predictive factors for a negative effect on bone mass. CONCLUSIONS: Long-term renal transplant-patients showed reduced BMD in both trabecular and cortical bone. This reduction in BMD was not as severe as in short-term reports and was associated with osteoclast stimulation, osteoblast suppression, and retardation of mineral apposition and bone formation rates. Bone mass loss was not different between the immunosuppression therapy groups. Male gender and age were the strongest predictive factors for low bone mass.  (+info)

Azathioprine is an immunosuppressive medication that is used to prevent the rejection of transplanted organs and to treat autoimmune diseases such as rheumatoid arthritis, lupus, and inflammatory bowel disease. It works by suppressing the activity of the immune system, which helps to reduce inflammation and prevent the body from attacking its own tissues.

Azathioprine is a prodrug that is converted into its active form, 6-mercaptopurine, in the body. This medication can have significant side effects, including decreased white blood cell count, increased risk of infection, and liver damage. It may also increase the risk of certain types of cancer, particularly skin cancer and lymphoma.

Healthcare professionals must carefully monitor patients taking azathioprine for these potential side effects. They may need to adjust the dosage or stop the medication altogether if serious side effects occur. Patients should also take steps to reduce their risk of infection and skin cancer, such as practicing good hygiene, avoiding sun exposure, and using sunscreen.

6-Mercaptopurine (6-MP) is a medication used primarily in the treatment of cancer, specifically acute lymphoblastic leukemia (ALL), and to prevent rejection in organ transplantation. It is an antimetabolite that works by interfering with the synthesis of DNA and RNA, thereby inhibiting cell division and growth.

6-MP is a prodrug, meaning it requires metabolic activation in the body to exert its therapeutic effects. Once absorbed, 6-MP is converted into several active metabolites, including thioguanine nucleotides (TGN), which are incorporated into DNA and RNA, leading to cytotoxicity and cell death.

Common side effects of 6-MP include nausea, vomiting, diarrhea, mouth sores, and increased susceptibility to infections. Long-term use of the medication can also lead to liver toxicity, pancreatitis, and anemia. Regular monitoring of blood counts, liver function tests, and TGN levels is necessary during treatment with 6-MP to minimize potential side effects and ensure safe and effective dosing.

Immunosuppressive agents are medications that decrease the activity of the immune system. They are often used to prevent the rejection of transplanted organs and to treat autoimmune diseases, where the immune system mistakenly attacks the body's own tissues. These drugs work by interfering with the immune system's normal responses, which helps to reduce inflammation and damage to tissues. However, because they suppress the immune system, people who take immunosuppressive agents are at increased risk for infections and other complications. Examples of immunosuppressive agents include corticosteroids, azathioprine, cyclophosphamide, mycophenolate mofetil, tacrolimus, and sirolimus.

Prednisolone is a synthetic glucocorticoid drug, which is a class of steroid hormones. It is commonly used in the treatment of various inflammatory and autoimmune conditions due to its potent anti-inflammatory and immunosuppressive effects. Prednisolone works by binding to specific receptors in cells, leading to changes in gene expression that reduce the production of substances involved in inflammation, such as cytokines and prostaglandins.

Prednisolone is available in various forms, including tablets, syrups, and injectable solutions. It can be used to treat a wide range of medical conditions, including asthma, rheumatoid arthritis, inflammatory bowel disease, allergies, skin conditions, and certain types of cancer.

Like other steroid medications, prednisolone can have significant side effects if used in high doses or for long periods of time. These may include weight gain, mood changes, increased risk of infections, osteoporosis, diabetes, and adrenal suppression. As a result, the use of prednisolone should be closely monitored by a healthcare professional to ensure that its benefits outweigh its risks.

Mycophenolic Acid (MPA) is an immunosuppressive drug that is primarily used to prevent rejection in organ transplantation. It works by inhibiting the enzyme inosine monophosphate dehydrogenase, which is a key enzyme for the de novo synthesis of guanosine nucleotides, an essential component for the proliferation of T and B lymphocytes. By doing this, MPA reduces the activity of the immune system, thereby preventing it from attacking the transplanted organ.

Mycophenolic Acid is available in two forms: as the sodium salt (Mycophenolate Sodium) and as the morpholinoethyl ester (Mycophenolate Mofetil), which is rapidly hydrolyzed to Mycophenolic Acid after oral administration. Common side effects of MPA include gastrointestinal symptoms such as diarrhea, nausea, and vomiting, as well as an increased risk of infections due to its immunosuppressive effects.

Methyltransferases are a class of enzymes that catalyze the transfer of a methyl group (-CH3) from a donor molecule to an acceptor molecule, which is often a protein, DNA, or RNA. This transfer of a methyl group can modify the chemical and physical properties of the acceptor molecule, playing a crucial role in various cellular processes such as gene expression, signal transduction, and DNA repair.

In biochemistry, methyltransferases are classified based on the type of donor molecule they use for the transfer of the methyl group. The most common methyl donor is S-adenosylmethionine (SAM), a universal methyl group donor found in many organisms. Methyltransferases that utilize SAM as a cofactor are called SAM-dependent methyltransferases.

Abnormal regulation or function of methyltransferases has been implicated in several diseases, including cancer and neurological disorders. Therefore, understanding the structure, function, and regulation of these enzymes is essential for developing targeted therapies to treat these conditions.

Inflammatory Bowel Diseases (IBD) are a group of chronic inflammatory conditions primarily affecting the gastrointestinal tract. The two main types of IBD are Crohn's disease and ulcerative colitis.

Crohn's disease can cause inflammation in any part of the digestive system, from the mouth to the anus, but it most commonly affects the lower part of the small intestine (the ileum) and/or the colon. The inflammation caused by Crohn's disease often spreads deep into the layers of affected bowel tissue.

Ulcerative colitis, on the other hand, is limited to the colon, specifically the innermost lining of the colon. It causes long-lasting inflammation and sores (ulcers) in the lining of the large intestine (colon) and rectum.

Symptoms can vary depending on the severity and location of inflammation but often include abdominal pain, diarrhea, fatigue, weight loss, and reduced appetite. IBD is not the same as irritable bowel syndrome (IBS), which is a functional gastrointestinal disorder.

The exact cause of IBD remains unknown, but it's thought to be a combination of genetic factors, an abnormal immune response, and environmental triggers. There is no cure for IBD, but treatments can help manage symptoms and reduce inflammation, potentially leading to long-term remission.

Crohn's disease is a type of inflammatory bowel disease (IBD) that can affect any part of the gastrointestinal tract, from the mouth to the anus. It is characterized by chronic inflammation of the digestive tract, which can lead to symptoms such as abdominal pain, diarrhea, fatigue, weight loss, and malnutrition.

The specific causes of Crohn's disease are not fully understood, but it is believed to be related to a combination of genetic, environmental, and immune system factors. The disease can affect people of any age, but it is most commonly diagnosed in young adults between the ages of 15 and 35.

There is no cure for Crohn's disease, but treatments such as medications, lifestyle changes, and surgery can help manage symptoms and prevent complications. Treatment options depend on the severity and location of the disease, as well as the individual patient's needs and preferences.

Kidney transplantation is a surgical procedure where a healthy kidney from a deceased or living donor is implanted into a patient with end-stage renal disease (ESRD) or permanent kidney failure. The new kidney takes over the functions of filtering waste and excess fluids from the blood, producing urine, and maintaining the body's electrolyte balance.

The transplanted kidney is typically placed in the lower abdomen, with its blood vessels connected to the recipient's iliac artery and vein. The ureter of the new kidney is then attached to the recipient's bladder to ensure proper urine flow. Following the surgery, the patient will require lifelong immunosuppressive therapy to prevent rejection of the transplanted organ by their immune system.

Cyclosporine is a medication that belongs to a class of drugs called immunosuppressants. It is primarily used to prevent the rejection of transplanted organs, such as kidneys, livers, and hearts. Cyclosporine works by suppressing the activity of the immune system, which helps to reduce the risk of the body attacking the transplanted organ.

In addition to its use in organ transplantation, cyclosporine may also be used to treat certain autoimmune diseases, such as rheumatoid arthritis and psoriasis. It does this by suppressing the overactive immune response that contributes to these conditions.

Cyclosporine is available in capsule, oral solution, and injectable forms. Common side effects of the medication include kidney problems, high blood pressure, tremors, headache, and nausea. Long-term use of cyclosporine can also increase the risk of certain types of cancer and infections.

It is important to note that cyclosporine should only be used under the close supervision of a healthcare provider, as it requires regular monitoring of blood levels and kidney function.

Autoimmune hepatitis is a chronic (long-term) disease in which the body's immune system mistakenly attacks the liver, leading to inflammation and damage. This results in decreased liver function over time if not treated. The exact cause of autoimmune hepatitis is unknown, but it is believed to be associated with genetic factors and exposure to certain environmental triggers, such as viral infections or medications.

There are two main types of autoimmune hepatitis:

1. Type 1 (classic) autoimmune hepatitis: This form can affect both adults and children, and it is more common in women than men. People with this type may also have other autoimmune disorders, such as rheumatoid arthritis, thyroid disease, or ulcerative colitis.
2. Type 2 autoimmune hepatitis: This form primarily affects children and young women. It is less common than type 1 and tends to be more severe. People with this type may also have other autoimmune disorders, such as celiac disease or chronic candidiasis.

Symptoms of autoimmune hepatitis can vary widely, from mild to severe. They may include fatigue, loss of appetite, nausea, vomiting, abdominal pain, joint pain, jaundice (yellowing of the skin and eyes), dark urine, and light-colored stools.

Diagnosis typically involves blood tests, imaging studies, and sometimes a liver biopsy to assess the extent of damage. Treatment usually includes medications that suppress the immune system, such as corticosteroids and immunosuppressants, which can help reduce inflammation and slow or stop liver damage. In some cases, lifestyle changes and supportive care may also be necessary.

Thioguanine is a medication that belongs to a class of drugs called antimetabolites. It is primarily used in the treatment of acute myeloid leukemia (AML) and other various types of cancer.

In medical terms, thioguanine is a purine analogue that gets metabolically converted into active thiopurine nucleotides, which then get incorporated into DNA and RNA, thereby interfering with the synthesis of genetic material in cancer cells. This interference leads to inhibition of cell division and growth, ultimately resulting in cell death (apoptosis) of the cancer cells.

It is important to note that thioguanine can also affect normal cells in the body, leading to various side effects. Therefore, it should be administered under the close supervision of a healthcare professional who can monitor its effectiveness and potential side effects.

Prednisone is a synthetic glucocorticoid, which is a type of corticosteroid hormone. It is primarily used to reduce inflammation in various conditions such as asthma, allergies, arthritis, and autoimmune disorders. Prednisone works by mimicking the effects of natural hormones produced by the adrenal glands, suppressing the immune system's response and reducing the release of substances that cause inflammation.

It is available in oral tablet form and is typically prescribed to be taken at specific times during the day, depending on the condition being treated. Common side effects of prednisone include increased appetite, weight gain, mood changes, insomnia, and easy bruising. Long-term use or high doses can lead to more serious side effects such as osteoporosis, diabetes, cataracts, and increased susceptibility to infections.

Healthcare providers closely monitor patients taking prednisone for extended periods to minimize the risk of adverse effects. It is essential to follow the prescribed dosage regimen and not discontinue the medication abruptly without medical supervision, as this can lead to withdrawal symptoms or a rebound of the underlying condition.

Ulcerative colitis is a type of inflammatory bowel disease (IBD) that affects the lining of the large intestine (colon) and rectum. In ulcerative colitis, the lining of the colon becomes inflamed and develops ulcers or open sores that produce pus and mucous. The symptoms of ulcerative colitis include diarrhea, abdominal pain, and rectal bleeding.

The exact cause of ulcerative colitis is not known, but it is thought to be related to an abnormal immune response in which the body's immune system attacks the cells in the digestive tract. The inflammation can be triggered by environmental factors such as diet, stress, and infections.

Ulcerative colitis is a chronic condition that can cause symptoms ranging from mild to severe. It can also lead to complications such as anemia, malnutrition, and colon cancer. There is no cure for ulcerative colitis, but treatment options such as medications, lifestyle changes, and surgery can help manage the symptoms and prevent complications.

Combination drug therapy is a treatment approach that involves the use of multiple medications with different mechanisms of action to achieve better therapeutic outcomes. This approach is often used in the management of complex medical conditions such as cancer, HIV/AIDS, and cardiovascular diseases. The goal of combination drug therapy is to improve efficacy, reduce the risk of drug resistance, decrease the likelihood of adverse effects, and enhance the overall quality of life for patients.

In combining drugs, healthcare providers aim to target various pathways involved in the disease process, which may help to:

1. Increase the effectiveness of treatment by attacking the disease from multiple angles.
2. Decrease the dosage of individual medications, reducing the risk and severity of side effects.
3. Slow down or prevent the development of drug resistance, a common problem in chronic diseases like HIV/AIDS and cancer.
4. Improve patient compliance by simplifying dosing schedules and reducing pill burden.

Examples of combination drug therapy include:

1. Antiretroviral therapy (ART) for HIV treatment, which typically involves three or more drugs from different classes to suppress viral replication and prevent the development of drug resistance.
2. Chemotherapy regimens for cancer treatment, where multiple cytotoxic agents are used to target various stages of the cell cycle and reduce the likelihood of tumor cells developing resistance.
3. Cardiovascular disease management, which may involve combining medications such as angiotensin-converting enzyme (ACE) inhibitors, beta-blockers, diuretics, and statins to control blood pressure, heart rate, fluid balance, and cholesterol levels.
4. Treatment of tuberculosis, which often involves a combination of several antibiotics to target different aspects of the bacterial life cycle and prevent the development of drug-resistant strains.

When prescribing combination drug therapy, healthcare providers must carefully consider factors such as potential drug interactions, dosing schedules, adverse effects, and contraindications to ensure safe and effective treatment. Regular monitoring of patients is essential to assess treatment response, manage side effects, and adjust the treatment plan as needed.

The adrenal cortex hormones are a group of steroid hormones produced and released by the outer portion (cortex) of the adrenal glands, which are located on top of each kidney. These hormones play crucial roles in regulating various physiological processes, including:

1. Glucose metabolism: Cortisol helps control blood sugar levels by increasing glucose production in the liver and reducing its uptake in peripheral tissues.
2. Protein and fat metabolism: Cortisol promotes protein breakdown and fatty acid mobilization, providing essential building blocks for energy production during stressful situations.
3. Immune response regulation: Cortisol suppresses immune function to prevent overactivation and potential damage to the body during stress.
4. Cardiovascular function: Aldosterone regulates electrolyte balance and blood pressure by promoting sodium reabsorption and potassium excretion in the kidneys.
5. Sex hormone production: The adrenal cortex produces small amounts of sex hormones, such as androgens and estrogens, which contribute to sexual development and function.
6. Growth and development: Cortisol plays a role in normal growth and development by influencing the activity of growth-promoting hormones like insulin-like growth factor 1 (IGF-1).

The main adrenal cortex hormones include:

1. Glucocorticoids: Cortisol is the primary glucocorticoid, responsible for regulating metabolism and stress response.
2. Mineralocorticoids: Aldosterone is the primary mineralocorticoid, involved in electrolyte balance and blood pressure regulation.
3. Androgens: Dehydroepiandrosterone (DHEA) and its sulfate derivative (DHEAS) are the most abundant adrenal androgens, contributing to sexual development and function.
4. Estrogens: Small amounts of estrogens are produced by the adrenal cortex, mainly in women.

Disorders related to impaired adrenal cortex hormone production or regulation can lead to various clinical manifestations, such as Addison's disease (adrenal insufficiency), Cushing's syndrome (hypercortisolism), and congenital adrenal hyperplasia (CAH).

Graft rejection is an immune response that occurs when transplanted tissue or organ (the graft) is recognized as foreign by the recipient's immune system, leading to the activation of immune cells to attack and destroy the graft. This results in the failure of the transplant and the need for additional medical intervention or another transplant. There are three types of graft rejection: hyperacute, acute, and chronic. Hyperacute rejection occurs immediately or soon after transplantation due to pre-existing antibodies against the graft. Acute rejection typically occurs within weeks to months post-transplant and is characterized by the infiltration of T-cells into the graft. Chronic rejection, which can occur months to years after transplantation, is a slow and progressive process characterized by fibrosis and tissue damage due to ongoing immune responses against the graft.

Immunosuppression is a state in which the immune system's ability to mount an immune response is reduced, compromised or inhibited. This can be caused by certain medications (such as those used to prevent rejection of transplanted organs), diseases (like HIV/AIDS), or genetic disorders. As a result, the body becomes more susceptible to infections and cancer development. It's important to note that immunosuppression should not be confused with immunity, which refers to the body's ability to resist and fight off infections and diseases.

Leukopenia is a medical term used to describe an abnormally low white blood cell (WBC) count in the blood. White blood cells are crucial components of the body's immune system, helping to fight infections and diseases. A normal WBC count ranges from 4,500 to 11,000 cells per microliter (μL) of blood in most laboratories. Leukopenia is typically diagnosed when the WBC count falls below 4,500 cells/μL.

There are several types of white blood cells, including neutrophils, lymphocytes, monocytes, eosinophils, and basophils. Neutropenia, a specific type of leukopenia, refers to an abnormally low neutrophil count (less than 1,500 cells/μL). Neutropenia increases the risk of bacterial and fungal infections since neutrophils play a significant role in combating these types of pathogens.

Leukopenia can result from various factors, such as viral infections, certain medications (like chemotherapy or radiation therapy), bone marrow disorders, autoimmune diseases, or congenital conditions affecting white blood cell production. It is essential to identify the underlying cause of leukopenia to provide appropriate treatment and prevent complications.

Methylprednisolone is a synthetic glucocorticoid drug, which is a class of hormones that naturally occur in the body and are produced by the adrenal gland. It is often used to treat various medical conditions such as inflammation, allergies, and autoimmune disorders. Methylprednisolone works by reducing the activity of the immune system, which helps to reduce symptoms such as swelling, pain, and redness.

Methylprednisolone is available in several forms, including tablets, oral suspension, and injectable solutions. It may be used for short-term or long-term treatment, depending on the condition being treated. Common side effects of methylprednisolone include increased appetite, weight gain, insomnia, mood changes, and increased susceptibility to infections. Long-term use of methylprednisolone can lead to more serious side effects such as osteoporosis, cataracts, and adrenal suppression.

It is important to note that methylprednisolone should be used under the close supervision of a healthcare provider, as it can cause serious side effects if not used properly. The dosage and duration of treatment will depend on various factors such as the patient's age, weight, medical history, and the condition being treated.

Gastrointestinal agents are a class of pharmaceutical drugs that affect the gastrointestinal (GI) tract, which includes the organs involved in digestion such as the mouth, esophagus, stomach, small intestine, large intestine, and anus. These agents can have various effects on the GI tract, including:

1. Increasing gastric motility (promoting bowel movements) - laxatives, prokinetics
2. Decreasing gastric motility (reducing bowel movements) - antidiarrheal agents
3. Neutralizing gastric acid - antacids
4. Reducing gastric acid secretion - H2-blockers, proton pump inhibitors
5. Protecting the mucosal lining of the GI tract - sucralfate, misoprostol
6. Relieving symptoms associated with GI disorders such as bloating, abdominal pain, and nausea - antispasmodics, antiemetics

Examples of gastrointestinal agents include:

* Laxatives (e.g., psyllium, docusate)
* Prokinetics (e.g., metoclopramide)
* Antacids (e.g., calcium carbonate, aluminum hydroxide)
* H2-blockers (e.g., ranitidine, famotidine)
* Proton pump inhibitors (e.g., omeprazole, lansoprazole)
* Sucralfate
* Misoprostol
* Antispasmodics (e.g., hyoscyamine, dicyclomine)
* Antiemetics (e.g., ondansetron, promethazine)

It is important to note that gastrointestinal agents can have both therapeutic and adverse effects, and their use should be based on a careful evaluation of the patient's condition and medical history.

Mesalamine is an anti-inflammatory drug that is primarily used to treat inflammatory bowel diseases (IBD), such as ulcerative colitis and Crohn's disease. It works by reducing inflammation in the intestines, which can help alleviate symptoms like diarrhea, abdominal pain, and rectal bleeding.

Mesalamine is available in various forms, including oral tablets, capsules, suppositories, and enemas. The specific formulation and dosage may vary depending on the severity and location of the inflammation in the gut.

The drug's anti-inflammatory effects are thought to be mediated by its ability to inhibit the activity of certain enzymes involved in the inflammatory response, such as cyclooxygenase and lipoxygenase. By reducing inflammation, mesalamine can help promote healing and prevent recurrences of IBD symptoms.

It's important to note that mesalamine may cause side effects, including headache, nausea, vomiting, and abdominal pain. In rare cases, it may also cause more serious side effects like kidney damage or allergic reactions. Patients should talk to their healthcare provider about the potential risks and benefits of taking mesalamine.

Antimetabolites are a class of drugs that interfere with the normal metabolic processes of cells, particularly those involved in DNA replication and cell division. They are commonly used as chemotherapeutic agents to treat various types of cancer because many cancer cells divide more rapidly than normal cells. Antimetabolites work by mimicking natural substances needed for cell growth and division, such as nucleotides or amino acids, and getting incorporated into the growing cells' DNA or protein structures, which ultimately leads to the termination of cell division and death of the cancer cells. Examples of antimetabolites include methotrexate, 5-fluorouracil, and capecitabine.

Anti-inflammatory agents are a class of drugs or substances that reduce inflammation in the body. They work by inhibiting the production of inflammatory mediators, such as prostaglandins and leukotrienes, which are released during an immune response and contribute to symptoms like pain, swelling, redness, and warmth.

There are two main types of anti-inflammatory agents: steroidal and nonsteroidal. Steroidal anti-inflammatory drugs (SAIDs) include corticosteroids, which mimic the effects of hormones produced by the adrenal gland. Nonsteroidal anti-inflammatory drugs (NSAIDs) are a larger group that includes both prescription and over-the-counter medications, such as aspirin, ibuprofen, naproxen, and celecoxib.

While both types of anti-inflammatory agents can be effective in reducing inflammation and relieving symptoms, they differ in their mechanisms of action, side effects, and potential risks. Long-term use of NSAIDs, for example, can increase the risk of gastrointestinal bleeding, kidney damage, and cardiovascular events. Corticosteroids can have significant side effects as well, particularly with long-term use, including weight gain, mood changes, and increased susceptibility to infections.

It's important to use anti-inflammatory agents only as directed by a healthcare provider, and to be aware of potential risks and interactions with other medications or health conditions.

Aminosalicylic acids are a group of medications that contain a chemical structure related to salicylic acid, which is the active ingredient in aspirin. These medications are primarily used to treat inflammatory bowel diseases (IBD), such as Crohn's disease and ulcerative colitis. The most common aminosalicylates used for IBD include mesalamine, sulfasalazine, and olsalazine.

These drugs work by reducing the production of chemicals in the body that cause inflammation in the lining of the intestines. By decreasing inflammation, they can help alleviate symptoms such as diarrhea, abdominal pain, and rectal bleeding associated with IBD. Additionally, aminosalicylates may also have a protective effect on the lining of the intestines, helping to prevent further damage.

Aminosalicylates are available in various forms, including tablets, capsules, suppositories, and enemas, depending on the specific medication and the location of the inflammation within the digestive tract. While these medications are generally well-tolerated, they can cause side effects such as headache, nausea, vomiting, and abdominal pain in some individuals. It is essential to follow the prescribing physician's instructions carefully when taking aminosalicylates to ensure their safe and effective use.

Cyclosporins are a group of cyclic undecapeptides that have immunosuppressive properties. The most well-known and widely used cyclosporin is cyclosporine A, which is commonly used in organ transplantation to prevent rejection. It works by inhibiting the activation of T-cells, a type of white blood cell that plays a central role in the immune response. By suppressing the activity of T-cells, cyclosporine A reduces the risk of an immune response against the transplanted organ.

Cyclosporins are also used in the treatment of autoimmune diseases, such as rheumatoid arthritis and psoriasis, where they help to reduce inflammation and prevent damage to tissues. Like all immunosuppressive drugs, cyclosporins can increase the risk of infection and cancer, so they must be used with caution and under close medical supervision.

Niridazole is an anti-parasitic medication that was previously used to treat infections caused by parasites such as schistosomiasis (also known as bilharzia or snail fever) and loiasis (also known as African eye worm). It works by inhibiting the metabolism of the parasites, leading to their death. However, due to its side effects, including neurotoxicity and potential for causing optic neuritis, it is no longer commonly used in clinical practice.

Treatment outcome is a term used to describe the result or effect of medical treatment on a patient's health status. It can be measured in various ways, such as through symptoms improvement, disease remission, reduced disability, improved quality of life, or survival rates. The treatment outcome helps healthcare providers evaluate the effectiveness of a particular treatment plan and make informed decisions about future care. It is also used in clinical research to compare the efficacy of different treatments and improve patient care.

Sulfasalazine is defined as a medication that is commonly used to treat inflammatory bowel disease (IBD), such as ulcerative colitis and Crohn's disease. It is also used in the treatment of rheumatoid arthritis. Sulfasalazine has an anti-inflammatory effect, which helps to reduce inflammation in the gut or joints.

The medication contains two components: sulfapyridine and 5-aminosalicylic acid (5-ASA). The sulfapyridine component is an antibiotic that may help to reduce the number of harmful bacteria in the gut, while the 5-ASA component is responsible for the anti-inflammatory effect.

Sulfasalazine works by being broken down into its two components after it is ingested. The 5-ASA component then acts directly on the lining of the gut to reduce inflammation, while the sulfapyridine component is absorbed into the bloodstream and excreted in the urine.

Common side effects of sulfasalazine include nausea, vomiting, heartburn, headache, and loss of appetite. Less common but more serious side effects may include allergic reactions, liver or kidney problems, and blood disorders. It is important to take sulfasalazine exactly as directed by a healthcare provider and to report any concerning symptoms promptly.

Lupus nephritis is a type of kidney inflammation (nephritis) that can occur in people with systemic lupus erythematosus (SLE), an autoimmune disease. In lupus nephritis, the immune system produces abnormal antibodies that attack the tissues of the kidneys, leading to inflammation and damage. The condition can cause a range of symptoms, including proteinuria (protein in the urine), hematuria (blood in the urine), hypertension (high blood pressure), and eventually kidney failure if left untreated. Lupus nephritis is typically diagnosed through a combination of medical history, physical examination, laboratory tests, and imaging studies. Treatment may include medications to suppress the immune system and control inflammation, such as corticosteroids and immunosuppressive drugs.

Guanine nucleotides are molecules that play a crucial role in intracellular signaling, cellular regulation, and various biological processes within cells. They consist of a guanine base, a sugar (ribose or deoxyribose), and one or more phosphate groups. The most common guanine nucleotides are GDP (guanosine diphosphate) and GTP (guanosine triphosphate).

GTP is hydrolyzed to GDP and inorganic phosphate by certain enzymes called GTPases, releasing energy that drives various cellular functions such as protein synthesis, signal transduction, vesicle transport, and cell division. On the other hand, GDP can be rephosphorylated back to GTP by nucleotide diphosphate kinases, allowing for the recycling of these molecules within the cell.

In addition to their role in signaling and regulation, guanine nucleotides also serve as building blocks for RNA (ribonucleic acid) synthesis during transcription, where they pair with cytosine nucleotides via hydrogen bonds to form base pairs in the resulting RNA molecule.

Pulse therapy, in the context of drug treatment, refers to a therapeutic regimen where a medication is administered in large doses for a short period of time, followed by a break or "drug-free" interval before the next dose. This cycle is then repeated at regular intervals. The goal of pulse therapy is to achieve high concentrations of the drug in the body to maximize its therapeutic effect while minimizing overall exposure and potential side effects.

This approach is often used for drugs that have a long half-life or slow clearance, as it allows for periodic "washing out" of the drug from the body. Pulse therapy can also help reduce the risk of developing drug resistance in certain conditions like rheumatoid arthritis and tuberculosis. Common examples include pulse methotrexate for rheumatoid arthritis and intermittent preventive treatment with anti-malarial drugs.

It is important to note that the use of pulse therapy should be based on a thorough understanding of the drug's pharmacokinetics, therapeutic index, and potential adverse effects. Close monitoring of patients undergoing pulse therapy is essential to ensure safety and efficacy.

Glucocorticoids are a class of steroid hormones that are naturally produced in the adrenal gland, or can be synthetically manufactured. They play an essential role in the metabolism of carbohydrates, proteins, and fats, and have significant anti-inflammatory effects. Glucocorticoids suppress immune responses and inflammation by inhibiting the release of inflammatory mediators from various cells, such as mast cells, eosinophils, and lymphocytes. They are frequently used in medical treatment for a wide range of conditions, including allergies, asthma, rheumatoid arthritis, dermatological disorders, and certain cancers. Prolonged use or high doses of glucocorticoids can lead to several side effects, such as weight gain, mood changes, osteoporosis, and increased susceptibility to infections.

Thionucleotides are chemical compounds that are analogs of nucleotides, which are the building blocks of DNA and RNA. In thionucleotides, one or more of the oxygen atoms in the nucleotide's chemical structure is replaced by a sulfur atom. This modification can affect the way the thionucleotide interacts with other molecules, including enzymes that work with nucleotides and nucleic acids.

Thionucleotides are sometimes used in research to study the biochemistry of nucleic acids and their interactions with other molecules. They can also be used as inhibitors of certain enzymes, such as reverse transcriptase, which is an important target for HIV/AIDS therapy. However, thionucleotides are not normally found in natural biological systems and are not themselves components of DNA or RNA.

Graft survival, in medical terms, refers to the success of a transplanted tissue or organ in continuing to function and integrate with the recipient's body over time. It is the opposite of graft rejection, which occurs when the recipient's immune system recognizes the transplanted tissue as foreign and attacks it, leading to its failure.

Graft survival depends on various factors, including the compatibility between the donor and recipient, the type and location of the graft, the use of immunosuppressive drugs to prevent rejection, and the overall health of the recipient. A successful graft survival implies that the transplanted tissue or organ has been accepted by the recipient's body and is functioning properly, providing the necessary physiological support for the recipient's survival and improved quality of life.

Tacrolimus is an immunosuppressant drug that is primarily used to prevent the rejection of transplanted organs. It works by inhibiting the activity of T-cells, which are a type of white blood cell that plays a central role in the body's immune response. By suppressing the activity of these cells, tacrolimus helps to reduce the risk of an immune response being mounted against the transplanted organ.

Tacrolimus is often used in combination with other immunosuppressive drugs, such as corticosteroids and mycophenolate mofetil, to provide a comprehensive approach to preventing organ rejection. It is available in various forms, including capsules, oral solution, and intravenous injection.

The drug was first approved for use in the United States in 1994 and has since become a widely used immunosuppressant in transplant medicine. Tacrolimus is also being studied as a potential treatment for a variety of other conditions, including autoimmune diseases and cancer.

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  • Azathioprine Side Effects & Safe Alternatives Of Azathioprine In Ayurveda Abstract Azoran comes under the brand Imuran which is an immunosuppressive medication. (planetayurveda.com)
  • Azathioprine is produced by a number of generic manufacturers and as branded names (Azasan by Salix in the U.S., Imuran by GlaxoSmithKline in Canada and the U.S., Australia and UK, Azamun in Finland and Imurel in Scandinavia). (arthritis-unplugged.com)
  • consumer medicine information (cmi) about imuran tablets (azathioprine) intended for persons living in australia. (id.st)
  • imuran (azathioprine) has proven to be effective in the treatment of rheumatoid arthritis. (id.st)
  • Azathioprine is an immunosuppressive drug that is marketed under the brand names Imuran and others. (mobilityforesights.com)
  • Azathioprine OR Methotrexate for Vasculitis? (nejs.app)
  • These include azathioprine, methotrexate, and mycophenolate. (medlineplus.gov)
  • A second-line treatment, mainly low-dose methotrexate and azathioprine, is indicated in case of corticosteroid resistance, intolerance, or contraindication or more often as a corticosteroid-sparing agent when a prolonged treatment of more than 10 mg/d equivalent prednisone is expected. (medscape.com)
  • Being a disease-modifying antirheumatic drug (DMARD), azathioprine has been used for the management of the signs and symptoms of adult rheumatoid arthritis. (wikipedia.org)
  • Azathioprine is an immunosuppressant used to help renal transplant rejection, and treat rheumatoid arthritis, Crohn's complaint, and ulcerative colitis. (eczemafree.org)
  • Azathioprine is an immunosuppressant used in organ transplantation, autoimmune disease such as rheumatoid arthritis and pemphigus or inflammatory bowel disease such as Crohn's disease and ulcerative colitis as well as multiple sclerosis. (arthritis-unplugged.com)
  • However, acute myelogenous leukemia as well as solid tumors have been reported in patients with rheumatoid arthritis who have received Azathioprine. (arthritis-unplugged.com)
  • Azathioprine can be used to treat inflammatory bowel disease, immune mediated anemia, colitis, immune mediated skin disease, certain types of kidney disease, lupus, and rheumatoid arthritis. (hardypaw.com)
  • Azathioprine is used to treat a variety of autoimmune illnesses, including rheumatoid arthritis, pemphigus, and pemphigus vulgaris, as well as to avoid rejection after organ transplantation. (mobilityforesights.com)
  • Despite the development new agents for inflammatory bowel disease (IBD) therapy, azathioprine (AZA) is widely used as both as monotherapy and as combination therapy for induction and maintenance of remission both Crohn's disease (CD) and ulcerative colitis (UC). (ecco-ibd.eu)
  • CONCLUSIONS: Modulation of autophagy via mTORC1 and the UPR may contribute to the therapeutic efficacy of azathioprine in IBD. (brighton.ac.uk)
  • According to the guidelines, the first-line therapy choices for achieving immunosuppression after transplantation are tacrolimus , cyclosporine , mycophenolic acid , azathioprine , sirolimus , everolimus " and corticosteroids . (bvsalud.org)
  • Azathioprine is in the purine analogue and antimetabolite family of medications. (wikipedia.org)
  • Azathioprine antagonizes purine metabolism and inhibits synthesis of DNA, RNA, and proteins. (medscape.com)
  • Le service médical rendu par IMUREL reste important dans les indications de l'AMM à l'exception de la Polyarthrite où le SMR sera défini lors de la réévaluation qui est en cours. (has-sante.fr)
  • Fass environmental information for Imurel (azathioprine) from Aspen Nordic (downloaded 2024-02-01). (janusinfo.se)
  • The environmental information for azathioprine is from Aspen Nordic for Imurel. (janusinfo.se)
  • On average Azathioprine costs 59.95 for 30 mg, and 50 MG tablets depending on where you stop. (eczemafree.org)
  • Severe leukopenia, thrombocytopenia, macrocytic anemia, and/or pancytopenia may occur in patients being treated with Azathioprine tablets. (arthritis-unplugged.com)
  • Patients with intermediate thiopurine S-methyl transferase (TPMT) activity may be at an increased risk of myelotoxicity if receiving conventional doses of Azathioprine tablets. (arthritis-unplugged.com)
  • Patients with low or absent TPMT activity are at an increased risk of developing severe, life-threatening myelotoxicity if receiving conventional doses of Azathioprine tablets. (arthritis-unplugged.com)
  • TPMT genotyping or phenotyping can help identify patients who are at an increased risk for developing Azathioprine tablets toxicity2-9. (arthritis-unplugged.com)
  • It is suggested that patients on Azathioprine tablets have complete blood counts, including platelet counts, weekly during the first month, twice monthly for the second and third months of treatment, then monthly or more frequently if dosage alterations or other therapy changes are necessary. (arthritis-unplugged.com)
  • Azathioprine tablets are mutagenic in animals and humans, carcinogenic in animals, and may increase the patient's risk of neoplasia. (arthritis-unplugged.com)
  • It has not been possible to define the precise risk of neoplasia due to Azathioprine tablets. (arthritis-unplugged.com)
  • Data on neoplasia in patients receiving Azathioprine tablets can be found under ADVERSE REACTIONS. (arthritis-unplugged.com)
  • A 2007 Cochrane review found that azathioprine reduced the number of relapses in the first year of treatment and disease progression in the first two to three years and did not find an increase in cancer, and noted the need for direct comparison of azathioprine and interferon beta, conflicting conclusions regarding cancer, and the potential for long-term risks. (wikipedia.org)
  • Conclusions: This study shows that azathioprine withdrawal is not equivalent to continued therapy with azathioprine for maintenance of remission in patients with Crohn's disease who have been in remission on azathioprine for ≥3.5 years. (rxisk.org)
  • CONCLUSIONS: Azathioprine does not seem to affect bone mineral density by itself. (lu.se)
  • Azathioprine belongs to a class of medicines known as an immunosuppressant. (eczemafree.org)
  • Azathioprine (AZA), an oral immunosuppressant, is safe during pregnancy. (pasteur.fr)
  • Azathioprine has been used in the management of moderate to severe chronically active Crohn's disease, to maintain clinical remission (absence of disease activity) in corticosteroid-dependent patients, and to provide benefit in people with fistulizing Crohn's disease. (wikipedia.org)
  • Azathioprine treatment is associated with an increased risk of lymphoma, but if this is due to the drug or a predisposition related to Crohn's disease is unclear. (wikipedia.org)
  • Lower doses of azathioprine are used as a therapy in children with refractory or corticosteroid-dependent Crohn's disease, without causing many side effects. (wikipedia.org)
  • I found myself browsing the second or third page of azathioprine related google results and an abstract about withdrawing from azathioprine when Crohn's is in remission. (rxisk.org)
  • Background & Aims: An open study reported that patients with Crohn's disease in remission who have taken azathioprine for longer than 3.5 years are at low risk of relapse when azathioprine is discontinued. (rxisk.org)
  • Based on the evidence here's the conclusion I would think is more responsible to give a Crohn's patient: There was as trial done which included a fairly small number of patients and it showed that if you've been in remission (a Crohn's Disease Activity Index score of less than 150) for at least 42 months and are still taking azathioprine then you can consider stopping. (rxisk.org)
  • OBJECTIVES: To ascertain whether patients with Crohn's disease treated with azathioprine maintained bone mineral mass better than patients treated with steroids alone. (lu.se)
  • Evidence Central , evidence.unboundmedicine.com/evidence/view/EBMG/453402/all/Azathioprine_or_6_mercaptopurine_for_maintaining_remission_in_Crohn's_disease. (unboundmedicine.com)
  • Azathioprine is also used to maintain remission in people who have granulomatosis with polyangiitis. (wikipedia.org)
  • Combined immunosuppressive regimen with steroids and azathioprine led to prolonged clinical and biological remission with a respective 2 years and 7 months follow up. (nih.gov)
  • Methods: Patients who were in clinical remission on azathioprine for ≥42 months were randomized to continue azathioprine or to receive an equivalent placebo for 18 months. (rxisk.org)
  • You stand an absolute chance of 9 out of 43 (21%) of coming out of remission but only a 6 out of 43 chance (14%) of coming out of remission because you stopped azathioprine. (rxisk.org)
  • Further consider you're one of the 34 patients in the placebo group who remained in remission for 18 months and then your doctor tells you that you were in the placebo group but to start taking your azathioprine again. (rxisk.org)
  • The role of the immune response in autoimmune hepatitis has not been studied before and after prednisone and azathioprine treatment. (medsci.org)
  • Allopurinol interferes with the metabolism of azathioprine, adding the tube situations of 6 mercaptopurine which may affect potentially fatal blood dyscrasia. (eczemafree.org)
  • febuxostat increases levels of azathioprine by decreasing metabolism. (medscape.com)
  • allopurinol increases levels of azathioprine by decreasing metabolism. (medscape.com)
  • Thiopurine methyltransferase (TPMT) is the main enzyme responsible for inactivating toxic products of azathioprine (AZA) metabolism. (gbs-cidp.org)
  • Jayempi has been developed to substitute for approved azathioprine oral tablet products. (janusinfo.se)
  • Azathioprine-associated interstitial pneumonitis. (pneumotox.com)
  • Azathioprine is sometimes used in systemic lupus erythematosus, requiring a maintenance dose of 15 mg or higher of prednisone in those who experience recurrent flares. (wikipedia.org)
  • A widely used therapy for idiopathic pulmonary fibrosis was azathioprine in combination with prednisone and N-acetylcysteine. (wikipedia.org)
  • Nonsteroidal anti-inflammatory drugs and corticosteroids may be combined or continued (if they were already in use) with azathioprine, but the combination with other DMARDs is not recommended. (wikipedia.org)
  • Concomitant use of azathioprine (AZA) in patients treated with IFX is recommended. (ecco-ibd.eu)
  • azathioprine decreases effects of adenovirus types 4 and 7 live, oral by pharmacodynamic antagonism. (medscape.com)
  • azathioprine decreases effects of anthrax vaccine by pharmacodynamic antagonism. (medscape.com)
  • Azathioprine is used to prevent rejections of kidney or liver allografts, usually in conjunction with other therapies including corticosteroids, other immunosuppressants, and local radiation therapy. (wikipedia.org)
  • Among numerous immunosuppressants, azathioprine (AZA) is a well-established medication that plays a useful role in the treatment of various autoimmune diseases, and recent studies have confirmed its efficacy in patients with BS, particularly in individuals with ocular pathology. (researchsquare.com)
  • Cases taking azathioprine treatment may have a slightly adding number of common infections similar as coughs, snap, and cold blisters. (eczemafree.org)
  • Time courses of HEV viral load (A) and infliximab and azathioprine treatment (B) in pregnant woman with chronic hepatitis E who was undergoing immunosuppressive treatment for ulcerative colitis. (cdc.gov)
  • I get in the treatment to tecfidera for MS abut 2 years, then into azathioprine for lupus about 6 months and Chlorpromazine HCL for my nerve system about a month ago, I have a routine blood work done and my Rheumatology doctor nurse call me to tell me the doctor want me to stop the azathioprine because my white blood cell is some kind of low. (crohnsforum.com)
  • Cialis is indicated for the treatment of erectile dysfunction azathioprine buy no prescription .4014. (fumitakeuchida.com)
  • Azathioprine is a prescription medication used in dogs and cats for the treatment of autoimmune diseases in dogs and cats. (hardypaw.com)
  • Let's look at the azathioprine group, they experienced 3 relapses out of 40. (rxisk.org)
  • Farmacia online - farmacia en linea sin receta medica, para mas pildoras sin receta, sin guardar los medicamentos recetados en linea azathioprine buy no prescription. (healthactionnm.org)
  • The ethyl acetate extract of Rosa centifolia was administered orally to evaluate the immunostimulant activity against azathioprine induced immunosuppression. (rjppd.org)
  • Data were collected retrospectively on disease-related characteristics and events including severity, recurrence, relapse, recovery and flare-up, as well as on azathioprine dosage and the duration of use. (researchsquare.com)
  • Reduction of Azathioprine dosage and/or use of other drugs should be considered. (arthritis-unplugged.com)
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  • First- "Should we test TPMT enzyme levels before starting azathioprine? (gbs-cidp.org)
  • The Global Azathioprine Market accounted for $XX Billion in 2022 and is anticipated to reach $XX Billion by 2030, registering a CAGR of XX% from 2023 to 2030. (mobilityforesights.com)
  • At 18 months, 3 patients had a relapse in the azathioprine group, and 9 had a relapse in the placebo group. (rxisk.org)
  • To stop the rejection of a transplanted kidney, azathioprine is utilised. (mobilityforesights.com)
  • Azathioprine will reduce a patient's natural immunity after transplantation in order to prevent rejection of the new kidney. (mobilityforesights.com)
  • Buy best quality generic Viagra with 100% satisfaction guaranteed generic Sildenafil Citrate is safe and secure, buy Viagra online azathioprine buy no prescription . (healthactionnm.org)
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  • In this case the "wonder drug" is NOT taking the azathioprine and, unfortunately, there is no marketing department to call for that. (rxisk.org)
  • Second: "Azathioprine may increase your risk of developing certain types of cancer, especially skin cancer and lymphoma (cancer that begins in the cells that fight infection). (gbs-cidp.org)
  • If you apply that knowledge to the placebo group it implies that not 9 people relapsed because of azathioprine withdrawal but only 6 relapsed. (rxisk.org)
  • Azathioprine withdrawal or dose reduction was needed in 47 (21%) patients. (ecco-ibd.eu)
  • If you have questions about logging in to our online pharmacy, or don't have a refill on file, please give us a call at 1-800-226-3784 - we would be pleased to azathioprine buy no prescription . (fumitakeuchida.com)
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  • Azathioprine did not negatively influence the steroid effect on bone mineral density. (lu.se)
  • Also, "Azathioprine can cause a decrease in the number of blood cells in your bone marrow, which may cause serious or life-threatening" infections. (gbs-cidp.org)
  • Some azathioprine side effects can be serious. (arthritis-unplugged.com)
  • 29 aug 2015 having been reading side effects of azathioprine. (id.st)
  • Induction of autophagy with azathioprine correlated with the enhanced clearance of AIEC and dampened AIEC-induced increases in TNFα. (brighton.ac.uk)
  • This was justified by the applicant as the introduction of Jayempi manufactured by Nova Laboratories Ireland Limited is considered unlikely to result in any significant increase in the combined sales volumes for all azathioprine containing products and the exposure of the environment to the active substance. (janusinfo.se)
  • In utero exposure to Azathioprine in autoimmune disease. (pasteur.fr)
  • Assessment report for Jayempi (azathioprine), 22 April 2021, EMA/303143/2021. (janusinfo.se)
  • Risk of environmental impact of azathioprine cannot be excluded, due to the lack of environmental toxicity data. (janusinfo.se)
  • Thus, azathioprine maintenance therapy should be continued beyond 3.5 years. (rxisk.org)