Purpose: In recent years, many new immunosuppressive drugs have been discovered and developed for clinical use in transplantation. This review focuses on new drugs and novel strategies that have been shown to have immunosuppressive activity in patients. Materials and Methods: The literature was reviewed. The introduction of cyclosporine in the early 1980s improved renal allograft survival by approximately 15 percent at one year post transplant. However, cyclosporine failed to enhance long term graft survival. In addition, transplant recipients are at risk of significant side effects due to immunosuppression, including infection, cardiovascular disease, hypertension and malignancy. The limitations constitute the rational for the continued development of new immunosuppressive agents. Conclusion: The therapeutic armamentarium for transplant immunosuppression continues to broaden and become more complex, as does the variety of potential drug combinations or protocols. Further studies in a large number of individuals is required to clarify the role of new immunosuppressive agents and novel strategies in transplant recipients.

Contact hypersensitivity (CHS) mouse model induced by 2, 4-dinitrofluorobenzene (DNFB) is thought to be a T helper 1 (Th1)-dominant response and used for investigating anti-inflammatory and immunosuppressive agents. However, it is hardly used for screening large-scale drugs because of the large number of animals and complex mechanisms involved in-vivo. In this study, we focused on whether T lymphocytes from CHS mouse model could maintain the state of immune response in-vitro and explored a suitable time for drugs screening. The results showed that CD4+ T cells of CHS mice were higher compared with those in normal group. The expression of T-bet and GATA3 showed a Th1 shift and the levels of interleukin (IL)-2 and IL-4 also showed similar trend. Furthermore, IL-6 produced by T lymphocytes from CHS mice had a high level too. Then, we detected the effects of dexamethasone (DEX), cyclosporine A (CsA) and mycophenolate mofetil (MMF) on T lymphocytes in-vitro, and the data displayed that these immunosuppressive drugs could all inhibit the proliferation of T lymphocytes significantly. These findings suggested that T lymphocytes from CHS mice could mimic a similar immune response in-vitro, and it’s also a suitable method for screening anti-inflammatory and immunosuppressive agents.

Introduction. Childhood idiopathic nephrotic syndrome is characterized by frequent relapsing courses or steroid dependency. Levamisole is a popular drug for treatment of these patients. The purpose of this study was to evaluate levamisole in children with steroid-dependent nephrotic syndrome.Materials and Methods. We retrospectively studied 304 children with a diagnosis of steroid-dependent nephritic syndrome or frequently relapsing nephrotic syndrome. The mean age at the time of diagnosis was 4.84 years. Following induction of complete remission with steroid therapy based on the International Study of Kidney Disease in Children’s protocol and when they were taking alternative days of steroid, 2.5 mg/kg of levamisole was administered.Results. The steroid dose was significantly decreased (mean reduction of 0.39 ± 0.46 g to 0.33 ± 0.38 g) after treatment with levamisole (P < .001). The number of relapses also significantly decreased (mean reduction of 0.92 ± 0.98 episodes to 1.07±1.20 relapses per year; P < .001). The 14.5-month administration of levamizole had a sensitivity of 67.5% and a specificity of 71.9% to reach a dose reduction of more than 50% in steroid therapy. The duration of levamizole treatment was associated with more than 50% reduction in the number of relapses (P < .001). A 14.5-month treatment with levamizole had a sensitivity of 62.3% and a specificity of 63.6% to reach a relapse reduction of more than 50%. Conclusions. Levamisole appears to be effective in prolonging the duration of remission and decreasing the steroid dose in children with steroid-dependent nephrotic syndrome.

Background: Immunosuppressive drugs that are widely used to prevent acute and chronic organ rejections, predispose organ transplant patients to a variety of diseases including skin problems. This study aimed to determine the prevalence of skin lesions and to investigate their association with demographic characteristics in renal transplant patients. Methods: This cross-sectional study was performed on 100 patients who were referred to the nephrology clinic of Baqiyatallah Hospital, Tehran, Iran and underwent kidney transplantation within a year (from the first working day of the Iranian Hijri calendar in April 2015 until the last working day in March 2016). Patients were referred to a dermatologist in case of any skin lesions. Patients' data were collected in a researchermade questionnaire and were analyzed using SPSS software, version 18. The p values less than 5% were considered to be significant. Results: The mean and standard deviation (SD) of the patients' age was 50. 4±, 11. 8 years. The average time of incidence of skin lesion after transplantation has been 8. 1±, 5. 7 weeks. The most common types of non-melanoma cancers were squamous cell carcinoma (2%) and Kaposi's sarcoma (4%) and there was no significant difference between men and women (p>0. 05). Sixty-six percent of the patients had skin infections and the most common skin infections were wart (34%) and tinea versicolor (11%). The relative frequency of skin infections was significantly higher in male patients than in females (p=0. 004). Considering all other confounding variables including smoking, hypertension, diabetes and other infectious diseases, the only noteworthy finding was the higher relative frequency of tinea versicolor in diabetic compared with non-diabetic patients (p=0. 046). Conclusion: This study showed that skin complications including various neoplastic (Sarcoma and Carcinoma), infectious (fungal and viral), and other (Acne and Hypertrichosis) diseases are common in patients with kidney transplantation who are taking immunosuppressive drugs. Informing these patients and medical staff about skin problems leads to an early referral of patients and increases their life expectancy and improves their quality of life.