The mechanism of action of cyclosporine: a perspective for the 90's.

The introduction of cyclosporine (CyA) as a pharmacological agent has resulted not only in a dramatic improvement in the clinical management of transplant recipients but also in a better understanding of the molecular basis of the immune response, especially T cell function. Knowledge of the mechanism of action of CyA has led to exciting areas of study. Among these are the sequence of regulatory events leading to T cell activation, the potential relevance of isomerases in signal transduction pathways (as the receptor for CyA, cyclophilin has been shown to be an isomerase), the blocking effect of CyA on the development of multidrug resistance, and the striking parallelism between CyA and the newer immunosuppressive agent FK-506. These fields promise to be relevant in solving some of the crucial questions in transplantation immunology, and developing better strategies for immunosuppression.