Lack of effect of rapamycin in anti-CCP antibody production in a rheumatoid arthritis kidney allograft recipient

Autoimmune diseases may lead to end-stage renal disease and, as a consequence, kidney transplantation. Classical immunosuppressive drugs, such as cyclosporine or corticosteroids, are well-established therapies for both transplantation and autoimmune diseases. Rapamycin is a new immunosuppressant use...

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Bibliographic Details
Published in:Clinical and experimental rheumatology 2005-07, Vol.23 (4), p.529-531
Main Authors: Lopez-Hoyos, M, Rodrigo, E, Fernandez-Fresnedo, G, Martinez-Taboada, V M, Valero, R, Arias, M
Format: Article
Language:English
Subjects:
Aged
Arthritis, Rheumatoid - blood
Arthritis, Rheumatoid - etiology
Arthritis, Rheumatoid - immunology
Autoantibodies - blood
Cyclosporine - therapeutic use
Female
Humans
Immunocompromised Host
Immunosuppressive Agents - blood
Immunosuppressive Agents - therapeutic use
Kidney Transplantation
Peptides, Cyclic - immunology
Rheumatoid Factor - blood
Sirolimus - blood
Sirolimus - therapeutic use
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Summary:Autoimmune diseases may lead to end-stage renal disease and, as a consequence, kidney transplantation. Classical immunosuppressive drugs, such as cyclosporine or corticosteroids, are well-established therapies for both transplantation and autoimmune diseases. Rapamycin is a new immunosuppressant useful for allograft transplantation and with a promising future for autoimmune diseases, although it has not been extensively studied in humans. Here the case of a patient diagnosed with rheumatoid arthritis (RA) who received a renal allograft is reported. She was started on prednisolone, azathioprine and cyclosporine immunosuppression and changed to rapamycin instead of cyclosporine 4 years after transplantation, because of chronic allograft nephropathy. At present, the patient has a functioning graft. However, the arthritis symptoms reappeared after the change in immunosuppressant. Titers of RA-specific anti-cyclic citrullinated peptides antibodies increased whereas rheumatoid factor titers decreased. This case report suggests that rapamycin used for kidney transplantation might have a different influence on the spectrum of RA autoantibodies.
ISSN:0392-856X
1593-098X