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https://www.readbyqxmd.com/read/29757900/detection-of-complement-binding-donor-specific-antibodies-not-igg-antibody-strength-nor-c4d-status-at-antibody-mediated-rejection-diagnosis-is-an-independent-predictor-of-kidney-graft-failure
#1
Jorge Malheiro, Sofia Santos, Sandra Tafulo, Leonídio Dias, La Salete Martins, Isabel Fonseca, Manuela Almeida, Sofia Pedroso, Idalina Beirão, António Castro-Henriques, António Cabrita
BACKGROUND: Antibody-mediated rejection (ABMR) remains associated with reduced kidney graft survival and no clear prognostic marker is available. METHODS: We investigated whether donor-specific antibodies (DSA) ability to bind C1q in comparison with ABMR C4d status, both indirect signs of complement activation, improve risk stratification at time of ABMR. Hence, among 467 patients in whom ≥1 graft biopsy was performed between 2008 and 2015, we included 56 with ABMR according to Banff'15 criteria...
May 3, 2018: Transplantation
https://www.readbyqxmd.com/read/29752861/immunohistochemical-diagnosis-of-mucous-membrane-pemphigoid
#2
Iakov Shimanovich, Julia Marie Nitz, Mareike Witte, Detlef Zillikens, Christian Rose
BACKGROUND: Mucous membrane pemphigoid (MMP) is an autoimmune subepithelial blistering disease with predominant involvement of mucosal surfaces. It is usually diagnosed by direct immunofluorescence microscopy of frozen biopsies, demonstrating linear deposits of complement, IgG or IgA along the basement membrane. The aim of the present study was to investigate the utility of immunohistochemistry on formalin-fixed, paraffin-embedded tissue biopsies for the diagnosis of MMP and to compare its sensitivity to that of direct immunofluorescence microscopy...
May 12, 2018: Journal of Oral Pathology & Medicine
https://www.readbyqxmd.com/read/29751884/acute-chronic-and-humoral-rejection-pathologic-features-under-current-immunosuppressive-regimes
#3
REVIEW
Jamie Koo, Hanlin L Wang
Under current immunosuppressive regimes, T-cell-mediated acute and chronic rejection remain common and important posttransplant complications. The definition of humoral (antibody-mediated) rejection has been greatly expanded in recent years. The histopathologic assessment of allograft biopsies continues to serve an important role in the diagnosis of rejection and to facilitate patient management. The diagnosis of both acute and chronic antibody-mediated rejection requires integration of the results of donor-specific antibody testing and C4d immunostaining, as well as exclusion of other potential etiologies of allograft dysfunction...
June 2018: Surgical Pathology Clinics
https://www.readbyqxmd.com/read/29729954/complement-activation-in-patients-with-diabetic-nephropathy
#4
X-Q Li, D-Y Chang, M Chen, M-H Zhao
AIM: Emerging evidence has indicated a role of the complement system in the pathogenesis of diabetic nephropathy (DN), although the pathways of complement activation and their clinicopathological relevance in DN are as yet unclear. The present study aimed to investigate levels of various complement components in plasma and urine of DN patients, and their correlation with clinicopathological parameters. METHODS: A total of 68 biopsy-proven DN patients with plasma samples were recruited, including 50 patients who also had urine samples available...
April 16, 2018: Diabetes & Metabolism
https://www.readbyqxmd.com/read/29725647/progressive-iga-nephropathy-is-associated-with-low-circulating-mannan-binding-lectin-associated-serine-protease-3-masp-3-and-increased-glomerular-factor-h-related-protein-5-fhr5-deposition
#5
Nicholas R Medjeral-Thomas, Anne Troldborg, Nicholas Constantinou, Hannah J Lomax-Browne, Annette G Hansen, Michelle Willicombe, Charles D Pusey, H Terence Cook, Steffen Thiel, Matthew C Pickering
Introduction: IgA nephropathy (IgAN) is characterized by glomerular deposition of galactose-deficient IgA1 and complement proteins and leads to renal impairment. Complement deposition through the alternative and lectin activation pathways is associated with renal injury. Methods: To elucidate the contribution of the lectin pathway to IgAN, we measured the 11 plasma lectin pathway components in a well-characterized cohort of patients with IgAN. Results: M-ficolin, L-ficolin, mannan-binding lectin (MBL)-associated serine protease (MASP)-1 and MBL-associated protein (MAp) 19 were increased, whereas plasma MASP-3 levels were decreased in patients with IgAN compared with healthy controls...
March 2018: KI Reports
https://www.readbyqxmd.com/read/29725633/complement-activation-in-patients-with-diabetic-nephropathy
#6
Pascal Bus, Jamie S Chua, Céline Q F Klessens, Malu Zandbergen, Ron Wolterbeek, Cees van Kooten, Leendert A Trouw, Jan A Bruijn, Hans J Baelde
Introduction: Complement activation plays a role in various organs in patients with diabetes. However, in diabetic nephropathy (DN), the role of complement activation is poorly understood. We examined the prevalence and clinical significance of complement deposits in the renal tissue of cases with type 1 and type 2 diabetes with and without DN. Methods: We measured the prevalence of glomerular C4d, C1q, mannose-binding lectin (MBL), and C5b-9 deposits in 101 autopsied diabetic cases with DN, 59 autopsied diabetic cases without DN, and 41 autopsied cases without diabetes or kidney disease...
March 2018: KI Reports
https://www.readbyqxmd.com/read/29713256/primary-glomerulonephritis-with-unique-c4d-deposition-and-concurrent-non-infectious-intermediate-uveitis-a-case-report-and-literature-review
#7
Jong Man Park, Harin Lee, Sangheon Song, Eun Young Seong, Ihm Soo Kwak, Sung Who Park, Young-Keum Kim, Nari Shin, Mee Young Sol
C4 glomerulopathy is a recently introduced entity that presents with bright C4d staining and minimal or absent immunoglobulin and C3 staining. We report a case of a 62-year-old man with C4 glomerulonephritis (GN) and uveitis. He presented to the nephrology department with proteinuria and hematuria. The patient also had intermediate uveitis along with proteinuria and hematuria. A kidney biopsy that was performed in light of continuing proteinuria and hematuria showed a focal proliferative, focal sclerotic glomerulopathy pattern on light microscopy, absent staining for immunoglobulin or C3 by immunofluorescence microscopy, with bright staining for C4d on immunohistochemistry, and electron-dense deposits on electron microscopy...
April 30, 2018: Journal of Korean Medical Science
https://www.readbyqxmd.com/read/29704327/morphological-characterization-of-chronic-antibody-mediated-rejection-in-abo-identical-or-compatible-pediatric-liver-graft-recipients
#8
Myriam Dao, Dalila Habès, Jean-Luc Taupin, Charlotte Mussini, Marie-José Redon, Caroline Suberbielle, Emmanuel Jacquemin, Emmanuel Gonzales, Catherine Guettier
ASBTRACT This study aims to define the morphological profile associated with the presence of donor-specific antibodies (DSA) and/or C4d immunostaining in ABO-identical or compatible pediatric liver grafts. Ten-year protocol liver graft biopsies performed at 131.3 ± 15.3 months post-transplantation in 53 pediatric liver graft recipients were reviewed. Immunostaining for C4d was systematically performed and semi-quantitatively analyzed. DSA were concurrently quantified and results were available for 44 patients...
April 27, 2018: Liver Transplantation
https://www.readbyqxmd.com/read/29685039/online-monitoring-of-bacterial-growth-with-an-electrical-sensor
#9
Xuzhi Zhang, Xiaoyu Jiang, Qianqian Yang, Xiaochun Wang, Yan Zhang, Jun Zhao, Keming Qu, Chuan Zhao
Herein, we developed an automatic electrical bacterial growth sensor (EBGS) based on a multichannel capacitively coupled contactless conductivity detector (C4 D). With the use of the EBGS, up to eight culture samples of E. coli in disposable tubes were online monitored simultaneously in a noninvasive manner. Growth curves with high resolution (on the order of a time scale of seconds) were generated by plotting normalized apparent conductivity value against incubation time. The characteristic data of E. coli growth (e...
May 1, 2018: Analytical Chemistry
https://www.readbyqxmd.com/read/29682370/fatal-pneumococcus-sepsis-after-treatment-of-late-antibody-mediated-kidney-graft-rejection
#10
Gunilla Einecke, Jan Hinrich Bräsen, Nils Hanke, Hermann Haller, Anke Schwarz
Antibody-mediated rejection (ABMR) is a major cause of late renal allograft dysfunction and graft loss. Risks and benefits of treatment of late ABMR have not been evaluated in randomized clinical trials. We report on a 35-year-old patient with deterioration in renal function and progressive proteinuria 15 years after transplantation. Recurrent infections after a splenectomy following traumatic splenic rupture 3 years earlier had led to reduction of immunosuppression. Renal transplant biopsy showed glomerular double contours, 40% fibrosis/tubular atrophy, peritubular capillaritis, and positive C4d staining indicating chronic-active ABMR...
2018: Case Reports in Nephrology
https://www.readbyqxmd.com/read/29672702/the-disappointing-contribution-of-anti-human-leukocyte-antigen-donor-specific-antibodies-characteristics-for-predicting-allograft-loss
#11
Maxime Courant, Jonathan Visentin, Gabriel Linares, Valérie Dubois, Sébastien Lepreux, Gwendaline Guidicelli, Olivier Thaunat, Pierre Merville, Lionel Couzi, Jean-Luc Taupin
Background: Pathogenicity of donor-specific antibodies (DSAs) can be assessed using the single-antigen flow beads (SAFB) assays through mean fluorescence intensity (MFI) with or without serum ethylenediaminetetraacetic acid (EDTA) treatment, measurement of C1q or C3d binding and/or their intragraft detection [graft-bound donor-specific antibody (gDSA)]. We aimed to investigate which of these markers best associates with antibody-mediated rejection (ABMR) and kidney allograft loss at the time of a for-cause biopsy...
April 17, 2018: Nephrology, Dialysis, Transplantation
https://www.readbyqxmd.com/read/29620612/tofacitinib-halts-progression-of-graft-dysfunction-in-a-rat-model-of-mixed-cellular-and-humoral-rejection
#12
Jordi Rovira, María J Ramírez-Bajo, Elisenda Banon-Maneus, Marta Lazo-Rodríguez, Daniel Moya-Rull, Natalia Hierro-Garcia, Valeria Tubita, Gastón J Piñeiro, Ignacio Revuelta, Pedro Ventura-Aguiar, David Cucchiari, Federico Oppenheimer, Mercè Brunet, Josep M Campistol, Fritz Diekmann
BACKGROUND: The progression from acute to chronic antibody-mediated rejection in kidney transplant recipients is usually not prevented by current therapeutic options. Here, we investigated whether the use of tofacinitib, a Janus kinase 3 inhibitor, was capable of preventing the progression of allograft dysfunction in a Fisher-to-Lewis rat model of kidney transplantation. METHODS: Rats were treated from the third week after transplantation in order to allow the development of rejection...
April 3, 2018: Transplantation
https://www.readbyqxmd.com/read/29602372/-the-pathology-of-renal-transplants
#13
Eduardo Vazquez Martul
In order to make an objective assessment of the histopathology of a renal biopsy during a kidney transplant, all the various elements involved in the process must be understood. It is important to know the characteristics of the donor organ, especially if the donor is older than 65. The histopathological features of the donor biopsy, especially its vascular status, are often related to an initial poor function of the transplanted kidney. The T lymphocyte inflammatory response is characteristic in acute cellular rejection; the degree of tubulitis, together with the amount of affected parenchyme, are important factors...
April 2018: Revista Española de Patología
https://www.readbyqxmd.com/read/29577962/correlations-between-donor-specific-antibodies-and-non-adherence-with-chronic-active-antibody-mediated-rejection-phenotypes-and-their-impact-on-kidney-graft-survival
#14
Jorge Malheiro, Sofia Santos, Sandra Tafulo, Leonídio Dias, La Salete Martins, Isabel Fonseca, Manuela Almeida, Sofia Pedroso, Idalina Beirão, António Castro-Henriques, António Cabrita
Chronic-active antibody-mediated rejection (CAABMR) is associated with poor kidney graft survival and has no clear effective treatment. Forty-one cases of CAABMR were detected in indication graft biopsies and evaluated according to current Banff classification. We investigated the impact of concurrent donor-specific antibodies (DSA) and their characteristics, together with non-adherence regarding immunosuppression on CAABMR histopathological phenotypes and prognosis. Twenty-four (59%) patients had detectable DSA at biopsy, with 15 of them being considered non-adherent...
March 22, 2018: Human Immunology
https://www.readbyqxmd.com/read/29577436/preformed-donor-specific-antibodies-do-not-affect-the-one-year-allograft-survival-in-living-donor-liver-transplantation
#15
Hyeyoung Kim, Nam-Joon Yi, Eun Young Song, Kyoungbun Lee, Kwang-Woong Lee, Hae Won Lee, Hye Young Ahn, Kyung Chul Yoon, Suk Kyun Hong, Kyung-Suk Suh
The effect of preformed donor-specific antibodies (DSAs) on liver transplantation (LT) remains unclear, especially in the field of living donor LT (LDLT). Herein, we evaluated the prevalence of preformed DSAs and their effect on graft outcome in LDLT in the first year following surgery. Using the Luminex® Single Antigen assay, we analyzed the preoperative sera of 61 adult LDLT recipients between 2014 and 2015. Clinical outcomes and pathologic findings including complement component 4d (C4d) expression in the first year after LT were retrospectively reviewed...
March 26, 2018: Clinical Transplantation
https://www.readbyqxmd.com/read/29570868/chronic-active-antibody-mediated-rejection-with-or-without-dsa-has-similar-histomorphology-and-clinical-outcome
#16
Kasia A Sablik, Marian C Clahsen-van Groningen, Caspar W N Looman, Jeffrey Damman, Dave L Roelen, Madelon van Agteren, Michiel G H Betjes
Chronic-active antibody mediated rejection (c-aABMR) is defined as histological evidence of chronic endothelial injury (cg), also known as transplant glomerulopathy, and either microvascular inflammation (MVI) or positivity for C4d. Importantly, the presence of donor specific antibodies (DSA) is currently still mandatory for the diagnosis of c-aABMR. This retrospective study of 41 c-aABMR patients investigates whether cases suspicious for c-aABMR (DSA negative, n=24) differ from cases of c-aABMR (DSA positive, n=17) with respect to renal histology, allograft function and long-term graft survival...
March 23, 2018: Transplant International: Official Journal of the European Society for Organ Transplantation
https://www.readbyqxmd.com/read/29536028/rituximab-and-monitoring-strategies-for-late-antibody-mediated-rejection-after-kidney-transplantation
#17
Sandesh Parajuli, Didier A Mandelbrot, Brenda Muth, Maha Mohamed, Neetika Garg, Fahad Aziz, Robert R Redfield, Weixiong Zhong, Brad C Astor, Arjang Djamali
Background: There is limited information on treatment strategies and monitoring strategies for late antibody-mediated rejection (ABMR) after kidney transplantation. Methods: In this observational and nonrandomized study, we compared 78 patients diagnosed with late ABMR (>3 months after transplant) who were treated with standard of care steroids/IVIG (n = 38) ± rituximab (n = 40) at our center between March 1, 2013 and December 31, 2016. All patients had follow-up biopsy and donor-specific antibodies (DSA) monitoring within 3 to 12 weeks...
December 2017: Transplantation Direct
https://www.readbyqxmd.com/read/29534716/genetic-variation-in-clusterin-and-risk-of-dementia-and-ischemic-vascular-disease-in-the-general-population-cohort-studies-and-meta-analyses-of-362-338-individuals
#18
Liv Tybjærg Nordestgaard, Anne Tybjærg-Hansen, Katrine Laura Rasmussen, Børge G Nordestgaard, Ruth Frikke-Schmidt
BACKGROUND: Clusterin, also known as apolipoprotein J (apoJ), is one of the most abundantly expressed apolipoproteins in the brain after apolipoprotein E (apoE). Like the ε4 allele of the apolipoprotein E gene (APOE), the clusterin gene (CLU) is a risk locus for Alzheimer's disease, and may play additional roles in atherosclerosis pathogenesis. We tested whether genetic variation in CLU was associated with either Alzheimer's disease or atherosclerosis-related diseases. METHODS: We studied individual data on 103,987 participants from the Copenhagen General Population Study (CGPS) and the Copenhagen City Heart Study (CCHS)...
March 14, 2018: BMC Medicine
https://www.readbyqxmd.com/read/29534659/refractory-cd20-positive-cellular-rejection-in-living-kidney-transplant-a-case-report-and-review-of-literature
#19
Ahmed I Akl, Hussein A Sheashaa, Mona Abdel Rahim, Muhammed A El Hadedy, Ayman F Refaie
Transplant is the optimal therapy for patients with end-stage renal disease. Acute cellular rejection refractory to treatment remains a major risk factor for graft loss and poor outcomes. In this study, we describe a 39-year-old man who received a living-related kidney transplant. Two days after transplant, the patient displayed acute deterioration of graft function. Conventional anti-rejection therapy was initiated, but graft function did not improve. Biopsy revealed acute cellular rejection (grade IIA), and C4d and HLA antibodies were negative...
March 9, 2018: Experimental and Clinical Transplantation
https://www.readbyqxmd.com/read/29528010/de-novo-thrombotic-microangiopathy-in-renal-transplant-patients
#20
B Handan Özdemir, Alev Ok Atılgan, Eda Yılmaz Akçay, Gökçe Özdemir, Ebru Ayvazoğlu Soy, Aydıncan Akdur, Mehmet Haberal
OBJECTIVES: Thrombotic microangiopathy is a form of renal capillary injury possibly associated with calcineurin inhibitor toxicity, acute humoral rejection, infections, and recurrent diseases. Here, we examined its incidence in patients diagnosed with acute and chronic active humoral rejection, polyomavirus nephropathy, acute cellular rejection, and immunoglobulin A recurrence. MATERIALS AND METHODS: In total, 272 renal allograft recipients who met the inclusion criteria were reevaluated for presence of renal thrombotic microangiopathy...
March 2018: Experimental and Clinical Transplantation
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