What is calcineurin?
Calcineurin is a cellular enzyme that catalyses some processes in activated T-lymphocytes.
What are calcineurin inhibitors?
Calcineurin inhibitors stop calcineurin working, by binding to proteins in the cells called immunophilins. The results are:
- Reduced release of the cytokine interleukin-2 from the T cells
- Reduced T-cell proliferation
What are they used for in Dermatology?
Calcineurin inhibitors are used topically and systemically to treat various inflammatory skin diseases, especially:
What are the topical calcineurin inhibitors?
What are the oral calcineurin inhibitors?
What are the risks of calcineurin inhibitors?
Side effects and risks of the specific calcineurin inhibitors are described in the individual topics.
As a class of drug, the main concern is the effect of calcineurin on kidney function. Suspected reasons for nephrotoxicity include:
- Increased endothelin-1, a vascoconstrictor
- Decreased nitric acid, a vasodilator
- Increased transforming growth factor beta 1, a cause of interstitial fibrosis
The risk of nephrotoxicity is reduced by:
- Keeping the dose of calcineurin inhibitor as low as possible
- Adding or replacing it with another immune suppressive medication with different side effects and risks