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medicines to prevent rejection

Mirela Maier, Tomoko Takano, Ruth Sapir-Pichhadze
PURPOSE OF REVIEW: P4 medicine denotes an evolving field of medicine encompassing predictive, preventive, personalized, and participatory medicine. Using the example of kidney allograft rejection because of donor-recipient incompatibility in human leukocyte antigens, this review outlines P4 medicine's relevance to the various stages of the kidney transplant cycle. SOURCES OF INFORMATION: A search for English articles was conducted in Medline via OvidSP (up to August 18, 2016) using a combination of subject headings (MeSH) and free text in titles, abstracts, and author keywords for the concepts kidney transplantation and P4 medicine...
2017: Canadian Journal of Kidney Health and Disease
Kiran K Khush
PURPOSE OF REVIEW: We are entering the era of personalized medicine, in which pharmacogenomics and biomarker-based assays can be used to tailor diagnostic tests and drug therapies to individual patients. This new approach to patient-specific care offers the potential to maximize the efficacy of available medical treatments while reducing the incidence of adverse side effects. Here, we present approaches to personalize the care of heart transplant recipients. RECENT FINDINGS: Four strategies for personalized posttransplant care are described, including use of pharmacogenomic data to individualize the use of immunosuppressive drugs, immune monitoring to prevent acute rejection while reducing the long-term consequences of over immunosuppression, noninvasive surveillance for acute rejection, and targeted prophylaxis against opportunistic infections...
March 6, 2017: Current Opinion in Organ Transplantation
Janne Cadamuro, Ana-Maria Simundic, Eva Ajzner, Sverre Sandberg
Sample rejection due to preanalytical errors is very common in many medical laboratories worldwide, though the decision when and how to refrain from analyzing such samples is handled very heterogeneously. As a rational, it is mostly stated that it is done to prevent the patient from being harmed by wrong medical decisions based on such values. But when thinking of the consequences of laboratory results instead of their quality being important per se, the rejection of preanalytically altered samples might be harming the patient by the need of re-collection and timely delay...
February 2, 2017: Clinical Biochemistry
Klaus Rose, Philip D Walson
PURPOSE: US pediatric legislation was introduced in 1997 and was followed by European Union pediatric legislation that, since 2007, requires a European Medicines Agency (EMA)-approved pediatric investigation plan (PIP) for registration of new medicines unless they are PIP exempted. In 2008, the EMA decided that enough adolescent patients with melanoma existed and removed melanoma from the list of PIP-exempted diseases (class waiver list). We examined the logic and the results of this decision...
February 2017: Clinical Therapeutics
Vedran Radojcic, Ivan Maillard
Solid organ and allogeneic hematopoietic cell transplantation have become standard therapeutic interventions that save patient lives and improve quality of life. Our enhanced understanding of transplantation immunobiology has refined clinical management and improved outcomes. However, organ rejection and graft-versus-host disease remain major obstacles to the broader successful application of these therapeutic procedures. Notch signaling regulates multiple aspects of adaptive and innate immunity. Preclinical studies identified Notch signaling as a promising target in autoimmune diseases, as well as after allogeneic hematopoietic cell and solid organ transplantation...
December 2016: Transplantation
Gustavo A Vásquez-Montoya, Juan S Danobeitia, Luis A Fernández, Juan P Hernández-Ortiz
Organ transplantation and regenerative medicine are adopted platforms that provide replacement tissues and organs from natural or engineered sources. Acceptance, tolerance and rejection depend greatly on the proper control of the immune response against graft antigens, motivating the development of immunological and genetical therapies that prevent organ failure. They rely on a complete, or partial, understanding of the immune system. Ultimately, they are innovative technologies that ensure permanent graft tolerance and indefinite graft survival through the modulation of the immune system...
October 2016: Transplantation Reviews
Dejin Zheng, Xiaofang Wang, Ren-He Xu
With ongoing clinical trials, human embryonic stem cells (hESCs) have shown substantial potential for regenerative medicine. However, due to the mismatch of human leukocyte antigens (HLAs) between hESC-derived allografts and recipients, immunosuppressant regimens must be used to prevent immune rejection of the grafts. Considerable efforts have been devoted to overcoming this hurdle via the derivation and banking of human nuclear transfer ESCs, parthenogenetic ESCs, and induced pluripotent stem cells. However, ethical and safety concerns remain, hindering the application of these types of pluripotent cells...
September 2016: Stem Cells
(no author information available yet)
The pHealth 2016 Conference is the 13th in a series of scientific events bringing together expertise from medical, technological, political, administrative, legal and social domains. pHealth 2016 opens a new chapter in the success story of the series of international conferences on wearable or implantable micro, nano and biotechnologies for personalized health. Starting in 2003 with personal health management systems, pHealth has continuously extended its scope evolving to a truly interdisciplinary event by covering technological and biomedical facilities, legal, ethical, social, and organizational requirements and impacts as well as necessary basic research for enabling the future proof care paradigms...
2016: Studies in Health Technology and Informatics
Nazmi Mutlu Karakas, Ilkay Erdogan, Beril Ozdemir, Atilla Sezgin
For patients with late congenital heart diseases and advanced heart failure, heart transplant is the one of the most effective known treatment methods. With the development of immunosuppressive medicines, it is possible to prevent and treat rejection, and survival after organ transplant has increased rapidly. Calcineurin inhibitors (tacrolimus and cyclosporine), mycophenolate mofetil, and corticosteroids are used together in many centers as immunosuppressive medications. Although the use of calcineurin inhibitors is essential, therapy is switched to sirolimus in some specific cases and when significant adverse effects occur...
May 17, 2016: Experimental and Clinical Transplantation
Maja Račić, Svjetlana Eremija, Srđan Mašić, Bojan N Joksimović, Kosana Stanetić
BACKGROUND: Despite considerable efforts to promote and support clinical practice guidelines (CPGs) use, adherence has often been suboptimal universally. OBJECTIVES: The aim of this study was to assess to which extent family physicians (FPs) in Republic of Srpska (RS), Bosnia and Herzegovina (BiH) accept or reject the concept and practice of CPGs and evidence-based medicine (EBM). METHODS: A cross-sectional survey was conducted among FPs from the RS, BiH in the period between January and March 2014...
September 2016: European Journal of General Practice
Anh Thu Nguyen-Lefebvre, Ashwin Ajith, Vera Portik-Dobos, Daniel D Horuzsko, Laura L Mulloy, Anatolij Horuzsko
HLA-G was described originally as a tolerogenic molecule that allows the semiallogeneic fetus to escape from recognition by the maternal immune response. This review will discuss different steps in the study of HLA-G expression and functions in vivo, starting with analyses of expression of the HLA-G gene and its receptors in transgenic mice, and continuing with applications of HLA-G and its receptors in prevention of allograft rejection, transplantation tolerance, and controlling the development of infection...
September 2016: Human Immunology
Muhammad M Mohiuddin, Avneesh K Singh, Philip C Corcoran, Marvin L Thomas, Tannia Clark, Billeta G Lewis, Robert F Hoyt, Michael Eckhaus, Richard N Pierson, Aaron J Belli, Eckhard Wolf, Nikolai Klymiuk, Carol Phelps, Keith A Reimann, David Ayares, Keith A Horvath
Preventing xenograft rejection is one of the greatest challenges of transplantation medicine. Here, we describe a reproducible, long-term survival of cardiac xenografts from alpha 1-3 galactosyltransferase gene knockout pigs, which express human complement regulatory protein CD46 and human thrombomodulin (GTKO.hCD46.hTBM), that were transplanted into baboons. Our immunomodulatory drug regimen includes induction with anti-thymocyte globulin and αCD20 antibody, followed by maintenance with mycophenolate mofetil and an intensively dosed αCD40 (2C10R4) antibody...
April 5, 2016: Nature Communications
Melissa Guada, Ana Beloqui, M N V Ravi Kumar, Véronique Préat, Maria Del Carmen Dios-Viéitez, Maria J Blanco-Prieto
Cyclosporine A (CsA) is a well-known immunosuppressive agent that gained considerable importance in transplant medicine in the late 1970s due to its selective and reversible inhibition of T-lymphocytes. While CsA has been widely used to prevent graft rejection in patients undergoing organ transplant it was also used to treat several systemic and local autoimmune disorders. Currently, the neuro- and cardio-protective effects of CsA (CiCloMulsion®; NeuroSTAT®) are being tested in phase II and III trials respectively and NeuroSTAT® received orphan drug status from US FDA and Europe in 2010...
March 10, 2016: Journal of Controlled Release: Official Journal of the Controlled Release Society
H Burkhardt, P Weisenseel, M A Radtke, K Krüger
For the clinical practice there is uncertainty as to what degree the therapeutic immunomodulation of rheumatoid arthritis (RA) is associated with a weakening of protective tumor immunity. Neoplasms of the skin in particular are known to exhibit increased incidence rates in association with therapeutic immunosuppression in transplantation medicine; however, the immunosuppression required for the prevention of allogenic graft rejection is much more intensive and thus not directly transferable to the potential risks for an onset or relapse of melanoma or non-melanoma skin cancers (NMSC), e...
February 2016: Zeitschrift Für Rheumatologie
Arnaud Del Bello, Olivier Marion, David Milongo, Lionel Rostaing, Nassim Kamar
End-stage renal disease is a major health problem worldwide, with kidney transplantation being the treatment of choice. Calcineurin inhibitors are still the cornerstone of immunosuppressive therapy. However, they have well-known nephrotoxic affects and increase the risk of cardiovascular disease and cancer. In contrast, belatacept is a biological immunosuppressive agent that inhibits the T-cell co-stimulation. It is approved by the US Food and Drug Administration and the European Medicine Agency for use in adult kidney-transplant recipients to prevent acute rejection...
2016: Expert Review of Clinical Pharmacology
Mihaela Mateescu, Sébastien Baixe, Tony Garnier, Loic Jierry, Vincent Ball, Youssef Haikel, Marie Hélène Metz-Boutigue, Michel Nardin, Pierre Schaaf, Olivier Etienne, Philippe Lavalle
Implanted medical devices are prone to infection. Designing new strategies to reduce infection and implant rejection are an important challenge for modern medicine. To this end, in the last few years many hydrogels have been designed as matrices for antimicrobial molecules destined to fight frequent infection found in moist environments like the oral cavity. In this study, two types of original hydrogels containing the antimicrobial peptide Cateslytin have been designed. The first hydrogel is based on alginate modified with catechol moieties (AC gel)...
2015: PloS One
Ann Tsukamoto, Stewart E Abbot, Lisa C Kadyk, Natalie D DeWitt, David V Schaffer, Jason A Wertheim, Kevin J Whittlesey, Michael J Werner
UNLABELLED: The aging population in the U.S. and other developed countries has led to a large increase in the number of patients suffering from degenerative diseases. Transplantation surgery has been a successful therapeutic option for certain patients; however, the availability of suitable donor organs and tissues significantly limits the number of patients who can benefit from this approach. Regenerative medicine has witnessed numerous recent and spectacular advances, making the repair or replacement of dysfunctional organs and tissues an achievable goal...
January 2016: Stem Cells Translational Medicine
Maria Siemionow
Over the past 20 years, the fields of biomaterial sciences and tissue engineering have evolved into new clinically relevant applications including regenerative medicine and cell based therapies. Tissue engineering therapies are based on different types of materials and scaffolds combined with cells and submitted to engineering processes in order to create bio-scaffolds which will improve or replace biological functions. Despite the effort, only a few therapies, such as bone, cartilage and nerve, succeeded in clinical applications...
December 2015: Journal of Materials Science. Materials in Medicine
Tao Hong, Minghua Zhang, Junming Fan
BACKGROUND: Kidney transplantation is the treatment of choice for patients with end-stage kidney disease (ESKD). Rising ESKD prevalence has substantially increased numbers of kidney transplants performed. Maintenance immunosuppression is long-term treatment to prevent acute rejection and deterioration of graft function. Although immunosuppressive treatment using drugs such as calcineurin inhibitors (CNIs, such as cyclosporin A (CsA) or tacrolimus) reduce acute rejection rates, long-term allograft survival rates are not significantly enhanced...
2015: Cochrane Database of Systematic Reviews
Toshimi Kaido, Tsuyoshi Shimamura, Yasuhiko Sugawara, Hiroshi Sadamori, Ken Shirabe, Michio Yamamoto, Shinji Uemoto
INTRODUCTION: This multicentre randomised controlled clinical trial will aim to determine the ability of an extract (TJ-100) of Daikenchuto (traditional Japanese herbal medicine; Kampo) to prevent bowel dysfunction in at least 110 patients after liver transplantation (LT). METHODS AND ANALYSIS: The following co-primary end points will be evaluated on postoperative day 7: total oral and enteral caloric intake, abdominal distension and abdominal pain. The secondary end points will comprise sequential changes of total oral and enteral caloric intake after LT, sequential changes in numeric rating scales for abdominal distension and pain, elapsed time to the first postoperative passage of stool, quality of life assessment using the Gastrointestinal Symptom Rating Scale score (Japanese version), postoperative liver function, liver regeneration rate, incidence of bacteraemia and bacterial strain, trough level of immunosuppressants, occurrence of acute cellular rejection, discharge or not within 2 months after LT, sequential changes of portal venous flow to the graft and ascites discharge...
2015: BMJ Open
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