Corticosteroids / prednisone

Corticosteroids in transplant

Corticosteroids are commonly given to transplant patients as prednisone, which is converted in the body to its biological active compound prednisolone. Corticosteroids inhibit IL-1 and IL-6 production from antigen presenting cells (APC’s), a number of events associated with T cell activation, and IL-2 production. They interfere with the action of IL-2 and IL-2 receptor on activated T-cells, resulting in the inhibition of helper

and suppressor T cell function. Corticosteroids also inhibit secretion of IL-3, 4 and 6 and interferon-γ by activated T cells. They can inhibit early B cells proliferation but have minimal effect on activated B cells.

The well-known adverse effects of corticosteroids include hypertension, hyperlipidemia, ulcer disease, diabetes, osteoporosis, obesity, cataracts, and susceptibility to infection. Most transplant patients are maintained on low doses of corticosteroids for the life of the transplant, though some protocols are eliminating the use of corticosteroids. Otherwise, they are used as part of an acute rejection treatment plan.

1

The primary purpose of immunosuppressive therapy is to