I am a 5yr post liver xplant, recently converted to Sirolimus (“Rapamune”), on the strength of human trials successfully converting liver transplant patients from various other immunosuppressive (IS) drugs, onto rapamycin. Rapa modulates --not just suppresses --the adaptive immune cell sub populations (various T, B, Dendritic, etc. cells) in ways that promote tolerance of the transplant organ, by a healthy immune system, with no drugs. Successful IS withdrawal from rapamycin trials are also documented, along with spontaneous tolerance in some IS drug non-compliment patients.
Despite there being large bodies of research on rapa, both as an IS, and as a aging rejuvinator, I can find no Rosetta Stone that explains if there are real, qualitative differences between the effects of the 2 dosing protocols (say, 2mg every day for IS, vs 5mg/wk like the 2013 Novartis vaccine trial, for longevity).
Is the slow, steady drip of rapa IS better than the bigger-dose-less-often longevity dose, at cultivating that tolerant mix of immune cells?
Or is 2mg/day sufficient to reconfigure T-cell populations, but not powerful enough to reach deep down inside every cell that could use an mTOR holiday?
People must have compared these protocols and speculated about the different protocols’ effects.
So, that’s my ask: Any ideas?