CALCINEURIN - A NEW ERA OF IMMUNITY

Calcineurin is a calcium/calmodulin dependent serine/threonine protein phosphatase which plays a significant role in regulating cellular responses and is also responsible for organ development. Calcineurin inhibitors (CNIs) such as cyclosporine, tacrolimus, pimecrolimus, and voclosporin, are immunosuppressant drugs primarily used in prevention of organ rejection in transplantation and managing autoimmune disorders. These agents act by inhibiting the transcription of cytokines, thereby disrupting T-cell proliferation and differentiation. In the context of oral health, topical CNIs have emerged as effective treatments for autoimmune conditions like oral lichen planus (OLP), they act as an alternative for patients who don't respond to traditional corticosteroids. Cyclosporine and tacrolimus have demonstrated significant efficacy in managing OLP, with tacrolimus being particularly noted for its effectiveness in recalcitrant cases. While both CNIs and corticosteroids have their respective advantages and disadvantages, CNIs may be preferred for long-term management due to their favorable safety profile and reduced systemic side effects. In addition, further research is necessary to assess the long-term efficacy and safety of CNIs in diverse patient populations, emphasizing the need for ongoing monitoring and individualized treatment strategies.