Quest for new immunosuppressive drugs

Transplantology is getting more and more important in medicine. Development of surgical techniques and immunosuppressive treatment enabled to establish successful transplantations with various organs and tissues. However, allografts are recognized as foreign tissues and stimulate rejection, i.e. a strong immunological response which, if not stopped, results in complete destruction of the transplanted tissue. In order to prevent the rejection patients have to be treated with immunosuppressive drugs after transplantation. Unfortunately, such a damping of immune system poses a risk of cancer or severe infections. The treatment itself is also toxic, notably when applied in a long-term maintenance therapy. Currently, adverse effects of immunosuppressive drugs are recognized as the ones to be involved significantly in chronic rejection and limitation of long survival of grafted tissues. Whereas prevention of acute rejection is mostly successful, there is still no efficient treatment for chronic graft rejection. Reduction of a dose of immunosuppressive drugs or an invention of new active substances is considered the most promising solution. Nowadays, immunosuppressive drugs can be divided into the three main groups: agents which inhibit production of cytokines taking part in cells’ activation (glicocorticosteroids, calcineurine inhibitors, mTOR inhibitors), antiproliferative compounds (azathiopirin, mycophenolate mofetil, mycophenolic acid sodium salt), and antibodies. In this article we present new investigations towards immunosuppressive drugs, their structures and synthetic methods