Mechanistic Target of Rapamycin (mTOR) Inhibitor (see Mechanistic Target of Rapamycin Inhibitors, [[Mechanistic Target of Rapamycin Inhibitors]]): unlike tacrolimus, sirolimus is not a calcineurin inhibitor
Antiproliferative Properties
Immunosuppressive Properties
Inhibits Response to IL-2 -> blocks activation of T- and B-cells
Treatment: typically resolves with discontinuation of sirolimus
Renal Adverse Effects
Chronic Kidney Disease (CKD) (see Chronic Kidney Disease, [[Chronic Kidney Disease]]): when used in combination with cyclosporine A, sirolimus + cyclosporine had higher Cr than cyclosporine alone
Tubular toxicity in sirolimus- and cyclosporine-based transplant immunosuppression strategies: an ancillary study from a randomized controlled trial. Am J Kidney Dis. 2010 Feb;55(2):335-43. Epub 2009 Nov 17
Is sirolimus a therapeutic option for patients with progressive pulmonary lymphangioleiomyomatosis? Respir Res. 2011;12:66. Epub 2011 May 21 [MEDLINE]
MILES Trial. Efficacy and safety of sirolimus in lymphangioleiomyomatosis. N Engl J Med 2011;364:1595-1606 [MEDLINE]
Current management of lymphangioleiomyomatosis. Curr Opin Pulm Med. 2011 Sep;17(5):374-8. doi: 10.1097/MCP.0b013e328349ac8c [MEDLINE]