Long-term immunosuppression is necessary for almost all kidney transplant patients. However, patients react differently to the individual immunosuppressants. Therefore, the optimal therapy must be found for each patient in order to avoid too much immunosuppression with side effects (toxicity, infections, tumors) and too little immunosuppression with the risk of rejection episodes.
In general, immunosuppressive therapy is monitored using pharmacokinetic parameters (e.g. trough levels). These provide indirect information about the pharmacological activity of a substance in the patient's body. Monitoring and adjusting the therapy based on the direct biological effect (pharmacodynamics, immune monitoring) is one way of optimizing immunosuppressive therapy.
In translational research projects, immunodiagnostic parameters are investigated on the basis of differential gene expression and multispectral flow cytometry, and pharmacodynamic biomarkers are identified to optimize immunosuppressive therapy.
With the immune marker "residual NFAT-regulated gene expression", a marker for the efficacy of calcineurin inhibitors was identified, validated in translational clinical studies and transferred to clinical use for individualized immunosuppression.
Further studies focus on markers for individualized therapy with mycophenolic acid and mTOR inhibitors after transplantation and mycophenolic acid in autoimmune diseases.
Prof. Dr. med. Claudia Sommerer, MSc
claudia.sommerer@med.uni-heidelberg.de
+49 6221 9112 0
Prof. Dr. Thomas Giese (Institute of Immunology, Heidelberg University Hospital)
Prof. Dr. med. Stefan Meuer (Institute of Immunology, Heidelberg University Hospital)
Prof. Dr. med. Burkhard Tönshoff (Pediatric Nephrology, Heidelberg University Hospital)
Prof. Dr. med. David Czock (Clinical Pharmacology and Pharmacoepidemiology, Heidelberg University Hospital)
Prof. Dr. med. Dr. med. Klemens Budde, Dr. rer. nat. Petra Glander (Nephrology, Charite University Medicine, Berlin)
Prof. Dr. Merce Brunet, Dr. Olga Millan (Pharmacology and Toxicology Laboratory, Hospital Clinic of Barcelona, University of Barcelona, Spain)
Prof. Dr. Lluis Guirado Perich (Renal Transplant Unit, Fundació Puigvert, Barcelona, Spain)