CNI + mycophenolate mofetil + steroids + azathioprine

This regimen is a combination immunosuppressive therapy used primarily in organ transplantation and certain autoimmune diseases. It consists of: - A calcineurin inhibitor (CNI), such as cyclosporine or tacrolimus, which inhibits T-cell activation by blocking the phosphatase activity of calcineurin. - Mycophenolate mofetil, an antimetabolite that inhibits inosine monophosphate dehydrogenase, suppressing lymphocyte proliferation. - Steroids (corticosteroids), which broadly suppress immune responses through multiple mechanisms including inhibition of cytokine production and lymphocyte proliferation. - Azathioprine, a purine analog that interferes with DNA synthesis in rapidly dividing cells like lymphocytes. This combination is designed to prevent acute and chronic rejection after solid organ transplantation (kidney, liver, heart) and may be used in severe autoimmune conditions such as lupus nephritis. The use of multiple agents allows for lower doses of each drug to minimize toxicity while maximizing immunosuppression[1][2][3][4].