From its modest beginning as a metabolite of a newly discovered fungus from Norway, cyclosporine has made its way steadily to medical prominence as the prototype of a new generation of immunopharmacologic agents.
"It must be pointed out that cyclosporine is no panacea," says immunologist Jean F. Borel, PhD, of Sandoz Ltd, in Basel, Switzerland, who discovered the agent's immunosuppressive properties in 1972. "It has nevertheless been shown to be the most potent and specific immunosuppressant so far discovered and to have an acceptable incidence of side effects."
Since 1978, numerous clinical trials have demonstrated that cyclosporine is as good as or significantly better than the conventional azathioprine-prednisone therapy used by most (solid) organ transplantation teams. In general, transplant recipients given cyclosporine retain their grafts longer and have fewer rejection episodes and serious infections than patients given conventional therapy.
Although concomitant prednisone therapy is necessary to help suppress macrophage-mediated immunity