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https://www.readbyqxmd.com/read/28800262/risk-factors-predisposing-to-the-development-of-hypogammaglobulinemia-and-infections-post-rituximab
#1
Evangelos A A Christou, Giuliana Giardino, Austen Worth, Fani Ladomenou
Rituximab (RTX) is a monoclonal antibody against CD20, commonly used in the treatment of hematological malignancies and autoimmune diseases. The use of RTX is related to the development of hypogammaglobulinemia and infections. Aim of this review is to summarize the evidence supporting the association of specific risk factors with the development of hypogammaglobulinemia and infections post-RTX. Immunological complications are more common in patients with malignant diseases as compared to non-malignant diseases...
August 11, 2017: International Reviews of Immunology
https://www.readbyqxmd.com/read/28795150/the-effects-of-tacrolimus-on-t-cell-proliferation-are-short-lived-a-pilot-analysis-of-immune-function-testing
#2
Benjamin L Laskin, Jing Jiao, H Jorge Baluarte, Sandra Amaral, Susan L Furth, Tatiana Akimova, Wayne W Hancock, Matthew H Levine, Peter P Reese, Ulf H Beier
BACKGROUND: Optimal immunosuppression after organ transplant should balance the risks of rejection, infection, and malignancy while minimizing barriers to adherence including frequent or time-sensitive dosing. There is currently no reliable immune function assay to directly measure the degree of immunosuppression after transplantation. METHODS: We developed an immune function assay to mea//sure T-cell proliferation after exposure to immunosuppression in vivo. We tested the assay in mice, and then piloted the approach using single time point samples, 11 pediatric kidney transplant recipients prescribed tacrolimus, mycophenolate, and prednisone 6 months to 5 years posttransplant, with no history of rejection, opportunistic infection, or cancer...
August 2017: Transplantation Direct
https://www.readbyqxmd.com/read/28767349/igg-endopeptidase-in-highly-sensitized-patients-undergoing-transplantation
#3
MULTICENTER STUDY
Stanley C Jordan, Tomas Lorant, Jua Choi, Christian Kjellman, Lena Winstedt, Mats Bengtsson, Xiaohai Zhang, Torsten Eich, Mieko Toyoda, Britt-Marie Eriksson, Shili Ge, Alice Peng, Sofia Järnum, Kathryn J Wood, Torbjorn Lundgren, Lars Wennberg, Lars Bäckman, Erik Larsson, Rafael Villicana, Joe Kahwaji, Sabrina Louie, Alexis Kang, Mark Haas, Cynthia Nast, Ashley Vo, Gunnar Tufveson
BACKGROUND: Donor-specific antibodies create an immunologic barrier to transplantation. Current therapies to modify donor-specific antibodies are limited and ineffective in the most highly HLA-sensitized patients. The IgG-degrading enzyme derived from Streptococcus pyogenes (IdeS), an endopeptidase, cleaves human IgG into F(ab')2 and Fc fragments inhibiting complement-dependent cytotoxicity and antibody-dependent cellular cytotoxicity, which suggests that IdeS might be useful for desensitization...
August 3, 2017: New England Journal of Medicine
https://www.readbyqxmd.com/read/28760751/multitarget-therapy-for-maintenance-treatment-of-lupus-nephritis
#4
Haitao Zhang, Zhengzhao Liu, Minlin Zhou, Zhangsuo Liu, Jianghua Chen, Changying Xing, Hongli Lin, Zhaohui Ni, Ping Fu, Fuyou Liu, Nan Chen, Yongcheng He, Jianshe Liu, Caihong Zeng, Zhihong Liu
Our previous studies showed that multitarget therapy is superior in efficacy to intravenous cyclophosphamide as an induction treatment for lupus nephritis in Asian populations. We conducted an open label, multicenter study for 18 months as an extension of the prior induction therapy trial in 19 renal centers in China to assess the efficacy and safety of multitarget maintenance therapy in patients who had responded at 24 weeks during the induction phase. Patients who had undergone multitarget induction therapy continued to receive multitarget therapy (tacrolimus, 2-3 mg/d; mycophenolate mofetil, 0...
July 31, 2017: Journal of the American Society of Nephrology: JASN
https://www.readbyqxmd.com/read/28756384/treatment-and-clinicopathological-characteristics-of-lupus-nephritis-with-anti-neutrophil-cytoplasmic-antibody-positivity-a-case-control-study
#5
Cui Li, Min-Lin Zhou, Dan-Dan Liang, Jing-Jing Wang, Jing Yang, Cai-Hong Zeng, Zhi-Hong Liu, Hai-Tao Zhang
OBJECTIVE: To assess the clinical features, pathological presentations, treatments and outcomes of lupus nephritis (LN) with anti-neutrophil cytoplasmic antibody (ANCA) positivity. DESIGN: A case-control study. METHODS: Patients (n=49) were retrospectively included from Jinling Hospital in China if presenting with biopsy-proven ANCA-positive LN between 1985 and 2008. Clinicopathological characteristics and outcomes were analysed and compared with those of a control group (n=1279)...
July 28, 2017: BMJ Open
https://www.readbyqxmd.com/read/28733752/generic-immunosuppressants
#6
Mara Medeiros, Julia Lumini, Noah Stern, Gilberto Castañeda-Hernández, Guido Filler
Immunosuppressive drugs for solid organ transplantation are critical dose drugs with a narrow therapeutic index. Many of the most commonly used innovator drugs are off patent and have been replicated by generic counterparts, often at substantial cost-savings to the patient. However, serious adverse events caused by the transition from innovator to generic medications, specifically in pediatric solid organ transplant recipients, have questioned these autosubstitutions. The purpose of this review is to summarize the criteria set forth by the regulatory bodies, and to examine how major immunosuppressive drugs conform to these recommendations...
July 21, 2017: Pediatric Nephrology: Journal of the International Pediatric Nephrology Association
https://www.readbyqxmd.com/read/28700996/immunosuppressive-treatment-in-c3-glomerulopathy-is-it-really-effective
#7
Yasar Caliskan, Ege Sinan Torun, Tarik Onur Tiryaki, Aysegul Oruc, Yasemin Ozluk, Sebahat Usta Akgul, Sonay Temurhan, Nida Oztop, Isin Kilicaslan, Mehmet Sukru Sever
BACKGROUND: C3 glomerulopathy (C3GP) is a recently identified and described disease that has a high risk of progressing into end-stage renal disease. We aimed to evaluate the effects of various immunosuppressive regimens on C3GP progression because there are conflicting data on the treatment modalities. METHODS: In this retrospective study of 66 patients with C3GP, 27 patients received mycophenolate mofetil (MMF)-based treatment, 23 received non-MMF-based treatment (prednisolone or cyclophosphamide), and 16 received conservative care...
July 13, 2017: American Journal of Nephrology
https://www.readbyqxmd.com/read/28699031/effectiveness-and-nephrotoxicity-of-a-2-year-medium-dose-of-cyclosporine-in-pediatric-patients-with-steroid-dependent-nephrotic-syndrome-determination-of-the-need-for-follow-up-kidney-biopsy
#8
Yoshiyuki Kuroyanagi, Yoshimitsu Gotoh, Katsuaki Kasahara, China Nagano, Naoya Fujita, Satoshi Yamakawa, Masaki Yamamoto, Asami Takeda, Osamu Uemura
BACKGROUND: High dose of cyclosporine (CyA) for ≥2 years in children with steroid-dependent nephrotic syndrome (SDNS) increases the risk for nephropathy. Considering this, risk can be lowered with lower doses of CyA; we evaluated the effects of a medium dose of CyA, with target serum level, C2, of 450 ng/ml, over a 2-year period of observation, to determine the need for follow-up kidney biopsy. METHODS: We retrospectively evaluated C2 levels in 38 patients (17 males, 5...
July 11, 2017: Clinical and Experimental Nephrology
https://www.readbyqxmd.com/read/28683697/assessment-of-off-label-prescribing-profile-evidence-and-evolution
#9
Encarnación Blanco-Reina, Azucena Muñoz-García, Manuel Jesús Cárdenas-Aranzana, Ricardo Ocaña-Riola, José Ramón Del Prado-Llergo
OBJECTIVES: The objectives of the study were to describe the extent and profile of off-label prescriptions, to evaluate the level of evidence supporting these indications, to assess the research activity in these conditions, and to determine to what extent these were authorized as new indications five years after the application. METHODS: A cross-sectional study including all applications conducted in the Hospital Universitario Reina Sofía in Córdoba during 2010...
July 1, 2017: Farmacia Hospitalaria
https://www.readbyqxmd.com/read/28683654/efficacy-and-safety-of-multitarget-therapy-with-cyclophosphamide-and-tacrolimus-for-lupus-nephritis-a-prospective-single-arm-single-centre-open-label-pilot-study-in-japan
#10
R Sakai, T Kurasawa, E Nishi, T Kondo, Y Okada, A Shibata, K Nishimura, K Chino, A Okuyama, H Takei, H Nagasawa, K Amano
Background Pulsed cyclophosphamide or mycophenolate mofetil for lupus nephritis has limited efficacy. We previously reported a case of mixed-class IV + V lupus nephritis successfully treated with cyclophosphamide and tacrolimus. This study assessed the efficacy and safety of multitarget therapy with cyclophosphamide and tacrolimus for the treatment of lupus nephritis. Methods In a prospective, single-arm, open label pilot study, we recruited 15 patients aged 18-64 years with active lupus nephritis who met the American College of Rheumatology criteria for a diagnosis of systemic lupus erythematosus (1997)...
January 1, 2017: Lupus
https://www.readbyqxmd.com/read/28667664/tacrolimus-and-mycophenolate-regimen-and-subclinical-tubulo-interstitial-inflammation-in-low-immunological-risk-renal-transplants
#11
Irina B Torres, Anna V Reisaeter, Francesc Moreso, Anders Âsberg, Marta Vidal, Clara Garcia-Carro, Karsten Midtvedt, Finn P Reinholt, Helge Scott, Eva Castellà, Maite Salcedo, Christina Dörje, Joana Sellarés, Maria A Azancot, Manel Perello, Hallvard Holdaas, Daniel Serón
The aim was to evaluate the relationship between maintenance immunosuppression, subclinical tubulo-interstitial inflammation and interstitial fibrosis/tubular atrophy (IF/TA) in surveillance biopsies performed in low immunological risk renal transplants at two transplant centers. The Barcelona cohort consisted of 109 early and 66 late biopsies in patients receiving high tacrolimus (TAC-C0 target at 1-year 6-10 ng/ml) and reduced MMF dose (500 mg bid at 1-year). The Oslo cohort consisted of 262 early and 237 late biopsies performed in patients treated with low TAC-C0 (target 3-7 ng/ml) and standard MMF dose (750 mg bid)...
July 1, 2017: Transplant International: Official Journal of the European Society for Organ Transplantation
https://www.readbyqxmd.com/read/28664822/passenger-lymphocyte-syndrome-in-the-abo-incompatible-kidney-transplant-recipient-receiving-rituximab
#12
Shunji Nishide, Junji Uchida, Kazuya Kabei, Tomoaki Iwai, Nobuyuki Kuwabara, Toshihide Naganuma, Norihiko Kumada, Yoshiaki Takemoto, Tatsuya Nakatani
Passenger lymphocyte syndrome is a rare but important disease in which the donor lymphocytes produce antibodies to the red blood cell antigens of the recipient, causing alloimmune hemolysis. It occurs in ABO blood group-mismatched solid-organ and/or bone marrow transplant. We report a case of passenger lymphocyte syndrome occurring after ABO-incompatible kidney transplant. The recipient received rituximab as a desensitization protocol. On posttransplant day 18, the recipient showed a fall in her hemoglobin levels without identifiable bleeding source and an elevation of total bilirubin...
June 28, 2017: Experimental and Clinical Transplantation
https://www.readbyqxmd.com/read/28646113/aerosolization-of-mycotoxins-after-growth-of-toxinogenic-fungi-on-wallpaper
#13
Brankica Aleksic, Marjorie Draghi, Sebastien Ritoux, Sylviane Bailly, Marlène Lacroix, Isabelle P Oswald, Jean-Denis Bailly, Enric Robine
Many fungi can develop on building material in indoor environments if moisture is high enough. Among species that are frequently observed, some are known to be potent mycotoxin producers. This presence of toxinogenic fungi in indoor environments raises the question of the possible exposure of occupants to these toxic compounds by inhalation after aerosolization.This study investigated the mycotoxin production by Penicillium brevicompactum, Aspergillus versicolor and Stachybotrys chartarum during their growth on wallpaper and the possible subsequent aerosolization of produced mycotoxins from contaminated substrates...
June 23, 2017: Applied and Environmental Microbiology
https://www.readbyqxmd.com/read/28622464/the-impact-of-drugs-on-male-fertility-a-review
#14
REVIEW
M Semet, M Paci, J Saïas-Magnan, C Metzler-Guillemain, R Boissier, H Lejeune, J Perrin
Beside cytotoxic drugs, other drugs can impact men's fertility through various mechanisms. Via the modification of the hypothalamic-pituitary-gonadal axis hormones or by non-hormonal mechanisms, drugs may directly and indirectly induce sexual dysfunction and spermatogenesis impairment and alteration of epididymal maturation. This systematic literature review summarizes existing data about the negative impact and associations of pharmacological treatments on male fertility (excluding cytotoxic drugs), with a view to making these data more readily available for medical staff...
July 2017: Andrology
https://www.readbyqxmd.com/read/28613375/study-on-the-association-of-ugt1a9-gene-c-98t-c-polymorphism-and-mycophenolic-acid-plasma-levels-in-renal-transplant-patients
#15
L R Ruschel, V M Schmitt, A B Silva, C S A Oliveira, K Flach, D O d'Avila, F V Thiesen
Mycophenolate mofetil (MMF) is a prodrug active only after its hydrolysis to mycophenolic acid (MPA). The UGT1A9 enzyme is of special interest since it is the main enzyme involved in the glucuronidation of MPA. Single nucleotide polymorphisms (SNPs) in the UGT1A9 gene may be responsible for individual differences in the pharmacokinetics of MMF. Expression levels and the activity of UGT1A9 may depend on the presence of some SNPs located in the gene promoter region (-2152C>T and -275T>A), as well as changes in the coding region (c...
May 31, 2017: Genetics and Molecular Research: GMR
https://www.readbyqxmd.com/read/28611384/the-correlation-between-the-expression-of-genes-involved-in-drug-metabolism-and-the-blood-level-of-tacrolimus-in-liver-transplant-receipts
#16
Jianhai Wang, Keqiu Li, Xiaoning Zhang, Dahong Teng, Mingyan Ju, Yaqing Jing, Yuxia Zhao, Guang Li
Immunosuppressive medications, such as tacrolimus and mycophenolate mofetil, are commonly used for reducing the risk of organ rejection in receipts of allogeneic organ transplant. The optimal dosages of these drugs are required for preventing rejection and avoiding toxicity to receipts. This study aimed to identify the correlation between the expression profiling of genes involved in drug metabolism and the blood level of tacrolimus in liver transplant receipts. Sixty-four liver transplant receipts were enrolled in this retrospective study...
June 13, 2017: Scientific Reports
https://www.readbyqxmd.com/read/28552512/immune-response-to-pneumococcal-conjugate-vaccine-in-patients-with-systemic-vasculitis-receiving-standard-of-care-therapy
#17
Per Nived, Johanna Nagel, Tore Saxne, Pierre Geborek, Göran Jönsson, Lillemor Skattum, Meliha C Kapetanovic
AIM: To study the effect of standard of care therapy on antibody response and functionality following immunization with 13-valent pneumococcal conjugate vaccine (PCV13) in patients with primary systemic vasculitis compared to healthy controls. METHODS: 49 patients with vasculitis and 49 controls received a single dose (0.5ml) PCV13 intramuscularly. Ongoing treatments: azathioprine (AZA; n=11), cyclophosphamide (CYC; n=6), methotrexate (MTX; n=9), rituximab (n=3); anti-TNF (n=2), mycophenolate mofetil (n=2), prednisolone alone (n=15) and no active treatment (n=2)...
June 22, 2017: Vaccine
https://www.readbyqxmd.com/read/28550399/addition-of-second-line-steroid-sparing-immunosuppressants-like-mycophenolate-mofetil-improves-outcome-of-immunoglobulin-g4-related-disease-igg4-rd-a-series-from-a-tertiary-care-teaching-hospital-in-south-india
#18
Nikhil Gupta, John Mathew, Hindhumathi Mohan, Sudipta Dhar Chowdhury, Reuben Thomas Kurien, D J Christopher, Balamugesh Thangakunam, Mathew Alexander, Ajith Sivadasan, V Tamilarasi, Anna T Valson, Mahasampath Gowri, Jayakanthan Kabeerdoss, Debashish Danda
IgG4-related disease (IgG4-RD) is a systemic fibro-inflammatory disease. This disease may be associated with elevated serum and tissue IgG4 levels. Early treatment prevents fibrosis and organ damage. We retrospectively studied the clinicopathologic correlation and outcome of treatment in IgG4-RD. This single-center retrospective study was done using electronic records of patients subjected to assay of serum IgG4 levels in our laboratory by nephelometry. There were 473 patients with suspected IgG4-RD. Of them, 41 patients fulfilled comprehensive diagnostic criteria for IgG4-RD and 432 had diseases other than IgG4-RD...
May 26, 2017: Rheumatology International
https://www.readbyqxmd.com/read/28542523/impact-of-maintenance-immunosuppressive-therapy-on-the-fecal-microbiome-of-renal-transplant-recipients-comparison-between-an-everolimus-and-a-standard-tacrolimus-based-regimen
#19
Gianluigi Zaza, Alessandra Dalla Gassa, Giovanna Felis, Simona Granata, Sandra Torriani, Antonio Lupo
BACKGROUND: The gut microbiome is the full set of microbes living in the gastrointestinal tract and is emerging as an important dynamic/fluid system that, if altered by environmental, dietetic or pharmacological factors, could considerably influence drug response. However, the immunosuppressive drug-induced modifications of this system are still poorly defined. METHODS: We employed an innovative bioinformatics approach to assess differences in the whole-gut microbial metagenomic profile of 20 renal transplant recipients undergoing maintenance treatment with two different immunosuppressive protocols...
2017: PloS One
https://www.readbyqxmd.com/read/28540172/nonlinear-relationship-between-enteric-coated-mycophenolate-sodium-dose-and-mycophenolic-acid-exposure-in-han-kidney-transplantation-recipients
#20
Jun Zhang, Mengmeng Jia, Lihua Zuo, Na Li, Yonggang Luo, Zhi Sun, Xiaojian Zhang, Zhenfeng Zhu
The aim of the research was to investigate the pharmacokinetics (PK) of enteric-coated mycophenolate sodium (EC-MPS) by quantification of the active metabolite of mycophenolic acid (MPA) after multiple escalating oral doses in Han kidney transplant recipients. A total of 28 Han postoperative kidney transplant recipients were given a multiple-dose of 540, 720 or 900 mg of EC-MPS two times a day in combination with tacrolimus for 6 days. Blood specimens were collected at each time point from 0 to 12 h after EC-MPS administration...
May 2017: Acta Pharmaceutica Sinica. B
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