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rabbit antithymocyte globulin + ciclosporin is an immunosuppressive combination therapy used primarily for the treatment of acquired severe aplastic anemia (SAA). Rabbit antithymocyte globulin (specifically the brand Thymoglobuline) is a polyclonal antibody derived from rabbits immunized with human thymocytes; it acts by depleting T-lymphocytes through complement-dependent cytotoxicity and apoptosis, thereby halting the immune-mediated destruction of bone marrow stem cells. Ciclosporin is a calcineurin inhibitor that binds to cyclophilin, forming a complex that inhibits the phosphatase activity of calcineurin. This inhibition blocks the translocation of the nuclear factor of activated T-cells (NFAT) and the subsequent production of pro-inflammatory cytokines like interleukin-2. This dual approach is a standard first-line immunosuppressive regimen for patients with SAA who are not candidates for hematopoietic stem cell transplantation.
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