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SIDE EFFECTS

It is obvious from the table below that there are numerous side effects associated with immunosuppressant drugs. Among the most significant of these side effects are opportunistic infections and transplant-related malignancies. Many of these side effects are due in part to the weakened immune system of transplant recipients. Because of the high amount of redundancy in immune cells, immunosuppressants, which aim to decrease immunologic rejection of the transplant, inadvertently handicap the ability of the immune system as a whole. The immune system therefore has a decreased capacity to protect the individual from microorganisms and cancerous cells. Other side effects are caused by unintended drug interactions with the body. These side effects make immunosuppression difficult for the patient, and significantly affect quality of life, as immunosuppressant therapy is often life-long.

 

Transplant related malignancies are one of the most substantial side effects related to immunosuppressive therapy.

The overall extent of side effects due to immunosuppressants serves to remind us that there is still a lot lacking in immunosuppressants. While they become more and more effective in preventing transplant rejection, research should aim at creating immunosuppressants that are increasingly precise for transplant-specific immune cells. This would allow individuals to get rid of rejection-initiating lymphocytes, while not affecting the immune system as a whole. Current research with monoclonal and polyclonal antibodies seek to meet these aims, but new immunosuppressive approaches give rise to unexpected complications. For example, the HAMA (human anti-Murine Antibody) reaction has accompanied introduction to many of the antibodies available. In this reaction, the human body detects the murine (mouse) components of the antibodies and creates anti-mouse immunoglobulins specific for the constant region of the antibody. This results in the patient's immune system clearing the potential treatment from circulation, thus rendering it ineffective. The HAMA reaction develops within 10-14 days of treatment (other therapy may delay onset of the HAMA reaction), and comes with its share of side effects. Circumvention of this complication includes humanizing (also referred to as chimerizing) the antibody by replacing these trouble constant regions in favor of more acceptable human regions. This results in noticeable better results, as can be seen from the progression from 70%/30% human:murine drug Muromonab-CD3 to the experimental 90%/10% human:murine drugs Basiliximab and Daclizumab (both currently in clinical trials).

Another resolution would be to step away from immunosuppressants entirely, whether through induction of tolerance, the use of autographic transplants derived through tissue engineering, stem cell therapy, or genetically engineered xenotransplants. These options, which will be discussed briefly in another section of the website, are not currently available, but are possible aspirations for the future and are being heavily researched.

Side Effects Mentioned:

alopecia - loss of hair, baldness
anemia - a pathological deficiency in the oxygen carrying compound of the blood
arthralgias - pain experienced in the joints
bone marrow depletion - a depletion of bone marrow (a soft, fatty, vascular tissue that fills most bone cavities - it is the source of blood cells)
coronary artery disease - a stage of arteriosclerosis involving fatty deposits inside the artery walls that feed the heart
cushingoid appearance - moon face, buffalo hump, centripetal obesity
gastrointestinal upsets - discomfort spurring from the stomach and/or intestines
gingival hyperplasia - an increase in the amount of gum tissue in the mouth
glaucoma - eye diseases characterized by high intraocular fluid pressure, damaged optic disk, hardening of the eyeball, and loss of vision
hepatoxicity - damage to the liver
hirsutism - excess facial and body hair
hypercholesterolemia - the presence of excess cholesterol in blood
hyperglycemia - the presence of excess sugar in the blood
hyperkalemia - a condition where potassium levels are too high in the body
hyperlipidemia - the presence of excess fat or lipids in the blood
hypertension - abnormally high blood pressure - especially arterial blood pressure
hypertricosis - excessive hair growth
hypertriglyceridemia - a disorder due to disturbances in synthesis and/or degradation of triglycerides-rich plasma lipoprotiens
hyperuricemia - the presence of excess uric acid in the blood
hypomagnesemia - a deficiency of magnesium in the blood
leucopenia - a decrease in the total number of white blood cells in circulating blood
malignancy - presence of a tumor (cancer)
nausea - extreme disgust with an urge to vomit
nephrotoxicity - damage or poisoning to the kidneys
neoplasia - the formation of tumors
opportunistic infection - any infection caused by a microorganism that does not normally cause disease in humans
osteoporosis - a condition characterized by decrease in bone mass and bone density
pancreatitis - inflammation of the pancreas
pruritis - a sensation of itchiness on the skin
thrombocytopenia
- decrease in the number of blood platelets that is often associated with hemorrhage conditions
tremor - trembling or shaking, usually from physical weakness and disease
ulcer formation - development of a break in the skin or mucous membrane with loss of surface tissue

 

 

Specific Immunosuppressants
Corticosteriods
Calcineurine Inhibitors Antiproliferative Agents Monoclonal Antibodies Polyclonal Antibodies
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Side Effects Drug Efficacy