Sirolimus for the Prevention of In-Stent Restenosis in a Coronary Artery

Sirolimus (rapamycin), an inhibitor of in-stent restenosis in the coronary arteries, is having a substantial effect on the care of patients with coronary artery disease, was discovered in a soil sample from Easter Island (known locally as Rapa Nui). A naturally occurring product that is isolated from Streptomyces hygroscopicus, sirolimus is an extremely lipophilic (hydrophobic) macrolide that was initially developed as an antifungal agent on the basis of its ability to inhibit the growth of yeast. However, sirolimus was quickly observed to have potent immunosuppressive activity in mammals, which put a halt to its development as an antibiotic.In 1988, . . .