Introduction to the use of belatacept: a fusion protein for the prevention of posttransplant kidney rejection

Giovanbattista Ippoliti,1,2 Andrea Maria D&#39;Armini,2 Marco Lucioni,3 Mazen Marjieh,1 Mario Vigan&ograve;21UO Medicina Interna, Policlinico di Monza, Monza, Italy; 2Department of Surgical Sciences, Charles Dubost Transplant Center, Fondazione IRCCS San Matteo Hospital, 3Anatomic Pa...

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Autores principales:	Ippoliti G, D&#39;Armini AM, Lucioni M, Marjieh M, Vigan&ograve; M
Formato:	article
Lenguaje:	EN
Publicado:	Dove Medical Press 2012
Materias:	Medicine (General) R5-920
Acceso en línea:	https://doaj.org/article/64eab19c9c1d493690ca47e1a28b6f7f
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spelling	oai:doaj.org-article:64eab19c9c1d493690ca47e1a28b6f7f2021-12-02T01:15:09ZIntroduction to the use of belatacept: a fusion protein for the prevention of posttransplant kidney rejection1177-54751177-5491https://doaj.org/article/64eab19c9c1d493690ca47e1a28b6f7f2012-10-01T00:00:00Zhttp://www.dovepress.com/introduction-to-the-use-of-belatacept-a-fusion-protein-for-the-prevent-a11167https://doaj.org/toc/1177-5475https://doaj.org/toc/1177-5491Giovanbattista Ippoliti,1,2 Andrea Maria D&#39;Armini,2 Marco Lucioni,3 Mazen Marjieh,1 Mario Vigan&ograve;21UO Medicina Interna, Policlinico di Monza, Monza, Italy; 2Department of Surgical Sciences, Charles Dubost Transplant Center, Fondazione IRCCS San Matteo Hospital, 3Anatomic Pathology, Foundation IRCCS Policlinico San Matteo, University of Pavia, Pavia, ItalyAbstract: The development of new immunosuppressive drugs for kidney transplantation resulted both in better short-term outcomes and in decreased metabolic, cardiovascular, and nephrotoxicity risk. Belatacept belongs to a new class of immunosuppressive drugs that selectively inhibits T-cell activation by preventing CD28 activation and by binding its ligands B7-1 and B7-2. The result is an inactivation of costimulatory pathways. A comparative analysis of the BENEFIT and BENEFIT-EXT datasets showed belatacept regimens resulted in better cardiovascular and metabolic risk profiles than did cyclosporin A (CsA) regimens: belatacept likewise outperformed CsA in terms of lower blood pressure and serum lipids and less new onset diabetes after transplantation. About 20% of belatacept-treated patients developed adverse effects which included anemia, pyrexia, neutropenia, diarrhea, urinary tract infection, headache, and peripheral edema. At present, belatacept does not seem to predispose patients to a higher rate of infection than CsA maintenance immunosuppression. The risk of posttransplant lymphoproliferative diseases was higher in Epstein&ndash;Barr virus (EBV)-seronegative patients than in EBV-seropositive patients, but the risk may be reduced by use of a less intensive regimen and avoidance of EBV-negative patients and of patients whose pretransplant EBV serology is unknown. Belatacept provides a new option for immunosuppressive therapy in kidney transplantation, but needs further evaluation in terms of the late effects that may derive from prolonged blockage of the costimulatory system and the induction of tolerance status.Keywords: costimulation, organ transplantation, belataceptIppoliti GD&#39;Armini AMLucioni MMarjieh MVigan&ograve; MDove Medical PressarticleMedicine (General)R5-920ENBiologics: Targets & Therapy, Vol 2012, Iss default, Pp 355-362 (2012)
institution	DOAJ
collection	DOAJ
language	EN
topic	Medicine (General) R5-920
spellingShingle	Medicine (General) R5-920 Ippoliti G D&#39;Armini AM Lucioni M Marjieh M Vigan&ograve; M Introduction to the use of belatacept: a fusion protein for the prevention of posttransplant kidney rejection
description	Giovanbattista Ippoliti,1,2 Andrea Maria D&#39;Armini,2 Marco Lucioni,3 Mazen Marjieh,1 Mario Vigan&ograve;21UO Medicina Interna, Policlinico di Monza, Monza, Italy; 2Department of Surgical Sciences, Charles Dubost Transplant Center, Fondazione IRCCS San Matteo Hospital, 3Anatomic Pathology, Foundation IRCCS Policlinico San Matteo, University of Pavia, Pavia, ItalyAbstract: The development of new immunosuppressive drugs for kidney transplantation resulted both in better short-term outcomes and in decreased metabolic, cardiovascular, and nephrotoxicity risk. Belatacept belongs to a new class of immunosuppressive drugs that selectively inhibits T-cell activation by preventing CD28 activation and by binding its ligands B7-1 and B7-2. The result is an inactivation of costimulatory pathways. A comparative analysis of the BENEFIT and BENEFIT-EXT datasets showed belatacept regimens resulted in better cardiovascular and metabolic risk profiles than did cyclosporin A (CsA) regimens: belatacept likewise outperformed CsA in terms of lower blood pressure and serum lipids and less new onset diabetes after transplantation. About 20% of belatacept-treated patients developed adverse effects which included anemia, pyrexia, neutropenia, diarrhea, urinary tract infection, headache, and peripheral edema. At present, belatacept does not seem to predispose patients to a higher rate of infection than CsA maintenance immunosuppression. The risk of posttransplant lymphoproliferative diseases was higher in Epstein&ndash;Barr virus (EBV)-seronegative patients than in EBV-seropositive patients, but the risk may be reduced by use of a less intensive regimen and avoidance of EBV-negative patients and of patients whose pretransplant EBV serology is unknown. Belatacept provides a new option for immunosuppressive therapy in kidney transplantation, but needs further evaluation in terms of the late effects that may derive from prolonged blockage of the costimulatory system and the induction of tolerance status.Keywords: costimulation, organ transplantation, belatacept
format	article
author	Ippoliti G D&#39;Armini AM Lucioni M Marjieh M Vigan&ograve; M
author_facet	Ippoliti G D&#39;Armini AM Lucioni M Marjieh M Vigan&ograve; M
author_sort	Ippoliti G
title	Introduction to the use of belatacept: a fusion protein for the prevention of posttransplant kidney rejection
title_short	Introduction to the use of belatacept: a fusion protein for the prevention of posttransplant kidney rejection
title_full	Introduction to the use of belatacept: a fusion protein for the prevention of posttransplant kidney rejection
title_fullStr	Introduction to the use of belatacept: a fusion protein for the prevention of posttransplant kidney rejection
title_full_unstemmed	Introduction to the use of belatacept: a fusion protein for the prevention of posttransplant kidney rejection
title_sort	introduction to the use of belatacept: a fusion protein for the prevention of posttransplant kidney rejection
publisher	Dove Medical Press
publishDate	2012
url	https://doaj.org/article/64eab19c9c1d493690ca47e1a28b6f7f
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Introduction to the use of belatacept: a fusion protein for the prevention of posttransplant kidney rejection

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