American Board of Surgery Qualifying Exam (ABS QE) Practice Test

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What is the mechanism of action of Sirolimus?

  1. Inhibits calcineurin

  2. Inhibits mTOR and decreases IL-2

  3. Blocks histamine receptors

  4. Depletes T-cell populations

The correct answer is: Inhibits mTOR and decreases IL-2

Sirolimus, also known as rapamycin, primarily functions as an immunosuppressant by inhibiting the mammalian target of rapamycin (mTOR), which is a crucial regulatory protein involved in cell growth, proliferation, and survival. By blocking mTOR, sirolimus effectively reduces the production of cytokines such as interleukin-2 (IL-2), which is essential for T-cell activation and proliferation. This suppression leads to a decrease in T-cell response, making sirolimus particularly useful in preventing organ transplant rejection and in treating certain malignancies. In understanding this mechanism, it's important to recognize that inhibiting mTOR plays a significant role in modulating the immune response, thereby providing its therapeutic effects. The reduction of IL-2 is a direct consequence of mTOR inhibition, highlighting how sirolimus specifically targets pathways involved in T-cell activation and lymphocyte proliferation.

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