Efficacy Comparison of mRNA Based and Conventional Immunosuppressants in Chronic Kidney Disease

Abstract

Chronic kidney disease (CKD) is a major cause of morbidity and mortality across the world, and kidney transplantation is the most effective form of treatment for end-stage renal failure. The immunosuppressive treatment plays a vital role in the prevention of graft rejection after the transplant; however, the use of traditional immunosuppressants may cause some issues, such as nephrotoxicity. There has also recently been the development of a new immunosuppressant, mRNA-based, which could be more effective and have fewer side effects. This research would provide a comparison of the efficacy of mRNA-based immunosuppressants and the conventional therapies used in CKD patients undergoing renal transplantation. It was a prospective, randomized controlled trial study involving 120 patients who underwent renal transplants and were divided into two groups: the first group, which was administered mRNA-immunosuppressants, and the second group, which was administered conventional immunosuppressive therapy. The main outcome measure was grafting survival at 12 months, and secondary outcome measures were renal function (serum creatinine levels), immune response markers, and renal response rejection episodes. The findings showed that patients under treatment provided with mRNA therapy had much better renal functioning (mean serum creatinine of 1.1 mg/dL vs. 1.5 mg/dL in the traditional group, p < 0.05) and a lower number of rejection episodes (10% vs. 25, p < 0.05). Survival rates of the grafts were better in the mRNA group (95 vs. 85, p < 0.05). These results indicate that immunosuppressants based on mRNA have a similar or superior efficacy and fewer adverse effects compared to traditional treatments, and it may be proposed to change the paradigm of post-transplant immunosuppressive therapy. These advantages require further long-term investigation to affirm these claims and discover how these improvements may be replicated in molecular biology through investigating the mechanism of action of mRNA-based immunosuppressants.