Lead to the determination of risk assessment for TB, however, new laboratory tests, such as IGRA studies and for screening donor effectively validated. Although SOT-receiver Be regarded singer, an hour Have higher risk for tuberculosis, have defined only a few clear risk factors. Among the risk factors that have been described, age, non-renal Transplantatabsto Are Syk Signaling Pathway UNG, and the type of immunosuppressive therapy such as OKT-Antique Rpern and T-cell-depleting positive TST, radiographic evidence of previous tuberculosis, is an H hemodialysis is not for L Ngere time, infection with hepatitis C chronic liver disease and other coexisting infections such as fungal infections, cytomegalovirus, Pneumocystis carinii, Nocardia or treated. However, most previous data were either from a kidney transplant or report on clinical experience and descriptive studies.
In a recent prospective cohort study from Spain, the age and receiving a lung transplant have been Lacosamide identified as risk factors ungsreaktionen w During pre-transplant chronic lung, liver or kidney disease, diabetes repulsion, And not the type of immunosuppression appears to hen the risk of tuberculosis increased. In our study, a di t tacrolimuscontaining and considered CMV infection in prior months leading risk factors for tuberculosis. Our results differ materially from historical studies that show no association of tacrolimus with tuberculosis. One explanation Tion for this is that the design studies and comparative analyzes were different. In theprevious studies, there was a prospective cohort study, the other a retrospective case-control.
However, there have been few descriptions of the association of tacrolimus with the infection. Tacrolimus module has two cellmediated and humoral immune responses, particularly by the activity Of calcineurin and subsequent t End production of interleukin and istimes effective than cyclosporine in their immunosuppressive effect. So it may have inhibitory effects on cyclosporine lower than T-cell immune function, which is an important defense mechanism against tuberculosis. In a systematic review of TB in SOT-receiver singer, tacrolimus with early-onset transplant within months of tuberculosis compared with azathioprine or cyclosporine alone was associated P.. Tacrolimuscontaining regime seems to be the increased risk of P. Hen jirovecii in renal transplant patients.
However, a meta-analysis showed that compared to cyclosporine after heart transplantation, tacrolimus was no significant difference in infections between tacrolimus and cyclosporine relative risk CI, p. Calcineurin inhibitors have also been reported to agentsin the risk of invasive fungal infections such as Cryptococcus and zygomycetes to reduce the, and interact synergistically with antifungal agents SOT receiver singer. Despite these controversial data regarding the effect of tacrolimus on infection, the results of this study indicate that tacrolimus is a significant risk factor for tuberculosis, especially in view of the pathogenesis of tuberculosis and a high activity t immunosuppressant tacrolimus. We also observed that previous CMV infection was h More common in TB patients. CMV infection in the tr Gt to the deterioration of T cellmediated immunity t, often in front of a superinfection with other opportunistic infections such as pneumonia. However, we could not