| Theme |
Novel therapeutic strategy for ulcerative colitis |
| Title |
Tacrolimus therapy for ulcerative colitis |
| Author |
Minoru Matsuura |
Department of Gastroenterology and Hepatology, Kyoto University Hospital |
| Author |
Hiroshi Nakase |
Department of Endoscopic Medicine, Kyoto University Hospital |
| Author |
Shuji Yamamoto |
Department of Gastroenterology, Shiga Medical Center for Adults |
| Author |
Takuya Yoshino |
Department of Gastroenterology and Hepatology, Kyoto University Hospital |
| Author |
Tsutomu Chiba |
Department of Gastroenterology and Hepatology, Kyoto University Hospital |
| [ Summary ] |
Tacrolimus is a macrolide antibiotic isolated from Streptomyces tsukubaenesis which has immunomodulatory properties. Although tacrolimus has a similar mechanism of action to ciclosporin (CsA), its immunosuppressive effects are 10-100 times greater than that of CsA and provide more reliable oral absorption. In addition to the efficacy of tacrolimus on prophylaxis and treatment of transplant rejection in various organs, such as the liver, kidneys, heart and bone marrow, several recent reports have indicated that tacrolimus is useful as an induction therapy for patients with ulcerative colitis. Optimizing blood trough levels is most important to obtain maximal therapeutic benefits and prevent adverse events related to tacrolimus. Major adverse events associated with tacrolimus include tremors, hot flashs, headaches, renal function impairment, infections and hyperglycemia. However, further studies are required to determine clinical issues, such as selection of appropriate subjects to be treated with tacrolimus and long-term efficacy. |