Rapamycin soon not necessary any longer as immunosuppression drug?

Maybe in a few years, if we are to believe Alice Bertaina, MD, Ph.D., associate professor of pediatrics lead author of a report describing a new transplant system, DISOT, for “dual immune/solid organ transplant”:

Stanford pediatricians transplant kidneys without need for immune-suppressing drugs | News Center | Stanford Medicine

Physicians at Stanford Medicine have developed a way to provide pediatric kidney transplants without immune-suppressing drugs. Their key innovation is a safe method to transplant the donor’s immune system to the patient before surgeons implant the kidney.

The medical team has named the two-transplant combination a “dual immune/solid organ transplant,” or DISOT. A scientific paper describing the first three DISOT cases, all performed at Lucile Packard Children’s Hospital Stanford, published online June 15 in the New England Journal of Medicine . The journal also ran an editorial about the research.
(…)
Adults whose bodies have rejected an initial kidney transplant or have an immune disease that attacks the kidneys could receive DISOT in the future, she said.

The team also plans to investigate how to adapt their approach to other solid organ transplants, including from deceased donors.

“That’s a challenge, but it’s not impossible,” Bertaina said. “We’ll need three to five years of research to get that working well.”

What would be the consequences for rapamycin (sirolimus)? Would it be more easily available, would studies on its other vertues become more financially interesting?

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well that should be interesting…sounds difficult and full of danger

[previously] they had unacceptably high risks of severe GVHD.
The Stanford pediatric team introduced refinements that greatly improve the success of the two-transplant combination with much lower risk. Their key innovation is a change in how the donor’s stem cells are processed.

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Over here it’s also registered for treating lymphangioleiomyomatosis (im just a simple md and i have never heard of that but my gf who’s a doctor of internal medicine said that if they asked questions why i was prescribed i should say that) otherwise it could indeed end up in the orphaned drugs (as everolimus already is iirc) but as it’s of patent and there is a demand other companies could start producing. What this will do for the price, I have no idea, cheapest i could find in Europe was already over 8 euro per 2mg tablet (fortunately my health insurance pays since I got a prescription :grin:)

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Arhu, welcome to the site and thanks for joining in the conversation. We hear from numerous Europeans that rapamycin is more difficult to get over there. Can you share what country you are in, and how you managed to get Rapamycin (and covered by health insurance no less) - thats great news, and it would be good if we could help our friends in Europe figure out some of the best ways to get access to rapamycin. Any commentary on this greatly appreciated.

I just asked a friend for a prescription. I could probably self prescribe too but this way just raises less eyebrows

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Ah - the benefits of being a doctor.

Did your friend take much convincing when it comes to rapamycin, is he also convinced by the data, or was his approach more like “its your body, you can do what you want”?

Oddly enough he was the one that first mentioned rapamycin somewhere in 2019 which first got my mind to it but it always seemed like a bad idea, taking an immuno-suppressant…Then I started learning more and more about rapamycin and the more I read the more convinced I became it’s not just an immuno-suppressant at all. This friend of mine hesitantly agreed to prescribe because he doesn’t like to draw attention for these weird prescriptions.

My girl-friend regularly prescribes rapalogs to her patients but for now she outright refuses to prescribe me “are you crazy taking an immuno-suppressant during a pandemic?” . I said to her in low doses rapamycin doesn’t suppress the immune system but actually strengthens it. She then had an aha erlebnis, as it turns out she was first author on a paper that found that a certain rapalog although it attenuated the immune response to self like (ie transplanted kisneys), it strengthened the response to foreign (like viruses). She still doesn’t want to prescribe “enjoy your mouth ulcers and glossitis” (i make her sound like a bitch but she really isn’t, she’s very sweet)

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