In addition to efficacious immunosuppression for the benefit of organ transplantation, tacrolimus has diverse actions that result in amelioration of ischemia-reperfusion injury. Knowledge is accumulating rapidly on the mechanisms through which tacrolimus exerts these cytoprotective effects, including alterations in microcirculation, free radical metabolism, calcium-activated pathways, inflammatory cascades, mitochondrial stability, apoptosis, stress-response proteins, and tissue recovery. Within the nucleus, actions mediating the effects of tacrolimus appear to be dominantly influenced by interactions with the transcription factor, nuclear factor-kappaB. Because tacrolimus is a cornerstone agent in immunosuppression regimens throughout the world and knowledge of its cellular mechanisms is evolving, it is important to update the clinical literature with this information. We reviewed the published literature with intent to portray the interactions of tacrolimus in the intricate cellular mechanisms initiated by ischemia and reperfusion.
Liver transplantation : official publication of the American Association for the Study of Liver Diseases and the International Liver Transplantation Society
Adenosine Triphosphate; Animals; Antioxidants; Calcium; Cell Communication; Cytokines; Free Radicals; Humans; Immunosuppressive Agents; Microcirculation; Neutrophils; Platelet Activation; Reperfusion Injury; Tacrolimus
Immunosuppressive agents; Tacrolimus
St Peter, S. D., Moss, A. A., Mulligan, D. C. Effects of tacrolimus on ischemia-reperfusion injury. Liver transplantation : official publication of the American Association for the Study of Liver Diseases and the International Liver Transplantation Society 9, 105-116 (2003).