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mycophenolate mofetil

Jun Zhang, YongGang Luo, ZhenFeng Zhu, GuiWen Feng, Zhi Sun, XiaoJian Zhang
BACKGROUND: The aim of this study was to investigate and compare the pharmacokinetic (PK) characteristics of mycophenolate mofetil (MMF) capsule and MMF dispersible tablet by detecting the active metabolite of mycophenolic acid (MPA) in Chinese kidney transplant recipients. METHODS: In the prospective, randomized, open-label study, the renal transplant patients were given a multiple-dose of either MMF capsule or MMF dispersible tablet combination with tacrolimus (Tac)...
June 12, 2018: Therapeutic Drug Monitoring
Liu Yang, Honglang Xie, Zhengzhao Liu, Yinghua Chen, Jinquan Wang, Haitao Zhang, Yongchun Ge, Weixin Hu
BACKGROUND: Severe infections are common complications of immunosuppressive treatment for antineutrophil cytoplasmic antibody (ANCA)-associated vasculitis (AAV) with renal involvement. We investigated the clinical characteristics and risk factors of severe infection in Chinese patients with AAV after immunosuppressive therapy. METHODS: A total of 248 patients with a new diagnosis of ANCA-associated vasculitis were included in this study. The incidence, time, site, and risk factors of severe infection by the induction therapies were analysed...
June 14, 2018: BMC Nephrology
Ondrej Zenata, Zdenek Dvorak, Radim Vrzal
Mycophenolate Mofetil (MYC) is a transplant drug used to prevent rejection in heart and kidneys transplant patients. Inosine monophosphate dehydrogenase (IMPDH), an enzyme involved in de novo synthesis of guanosine nucleotides, was considered as a primary target for MYC. Recently, we described that MYC was activates aryl hydrocarbon receptor and it antagonizes glucocorticoid receptor. Here we describe an androgen receptor (AR) as another off-target for MYC. We found that MYC increased basal and dihydrotestosterone (DHT)-inducible AR-dependent luciferase activity in AIZ-AR cells...
2018: Journal of Cancer
Farhad Khimani, George B McDonald, Howard M Shulman, Brian Betts, Frederick Locke, Hugo Fernandez, Claudio Anasetti, Joseph Pidala
Sirolimus-based graft vs. host disease (GVHD) prophylaxis is associated with higher incidence of veno-occlusive disease/sinusoidal obstruction syndrome (VOD/SOS) after allogeneic hematopoietic cell transplantation (HCT). However, whether the clinical manifestations and prognosis of VOD/SOS differs when diagnosed in the setting of sirolimus-based GVHD prophylaxis is not well studied. To address this question, we examined presenting features and treatment outcome of VOD/SOS cases identified in a large retrospective cohort of consecutive HCT procedures (n = 818 total, sirolimus (SIR)/tacrolimus (TAC) n = 308, and methotrexate (MTX) or mycophenolate mofetil (MMF)/TAC n = 510)...
June 12, 2018: Bone Marrow Transplantation
Christina A Serret, Stephanie Wang, Amanda Marsch, Claudia Hernandez
We report the case of a 62-year-old black man who was on a maintenance immunosuppressive regimen that included mycophenolate mofetil and cyclosporine following renal transplantation 9 years prior. He presented to the dermatology department for evaluation of a pigmented longitudinal streak on the left third finger adjacent to the lateral nail fold that had been present for several months. He noted that the streak was increasing in size, and his fingertip had recently become tender. The pigmented band was biopsied, and histopathology showed atypia of the epidermis consistent with pigmented squamous cell carcinoma (pSCC)...
May 2018: Cutis; Cutaneous Medicine for the Practitioner
Warren H Chan, Daniel J Lewis, Esther J Kim, Phyu P Aung, Madeleine Duvic
Generalized morphea is associated with epoxy resin vapors and is characterized by the development of lesions shortly after exposure. Morphea presenting along with eosinophilic fasciitis (EF), or morphea/EF overlap, is rare and an indicator of poor prognosis and resistance to treatment. Here we present a case of generalized morphea/EF overlap linked to epoxy exposure. Our patient received multiple therapies-ultraviolet A1 phototherapy, prednisone, methotrexate, azathioprine, mycophenolate mofetil, cyclophosphamide, cyclosporine, and rituximab-none of which led to a significant response...
March 2018: JAAD Case Reports
Apurva D Patel, Brian Lowes, Mohammed A Chamsi-Pasha, Stanley J Radio, Marshall Hyden, Ronald Zolty
CLINICAL FEATURES: Giant cell myocarditis (GCM) is a rare and a rapidly progressive disorder with fatal outcomes such that patients often require heart transplantation. We present a case of recurrent GCM in a transplanted patient with a history of Crohn disease requiring a novel therapeutic approach. THERAPEUTIC CHALLENGE: After the orthotopic heart transplantation, GCM recurred on aggressive immunosuppression over the months, which included corticosteroids, basiliximab, tacrolimus, antithymocyte globulin, and rituximab...
May 30, 2018: American Journal of Therapeutics
Barbacki Ariane, Peter G Maliha, Marie Hudson, David Small
Immune checkpoint inhibitors have revolutionized cancer therapy. Given their mechanism of action, immune-related adverse events have been associated with their use. We present the first documented case of pembrolizumab-induced grade IV neutropenia. A 73-year-old women known for myositis, Crohn's disease, and hypothyroidism and diagnosed with PD-L1 positive stage IV pulmonary adenocarcinoma is treated with Pembrolizumab. She develops grade IV neutropenia 2 weeks after her second infusion. She is therefore hospitalized and treated initially with corticosteroids, granulocyte colony-stimulating factor, and intravenous immunoglobulins...
June 8, 2018: Anti-cancer Drugs
Bruce E Gelb, J Rodrigo Diaz-Siso, Natalie M Plana, Adam Jacoby, William J Rifkin, Kimberly S Khouri, Daniel J Ceradini, Eduardo D Rodriguez
Background: Donor-specific antibodies (DSA) to human leukocyte antigen increase the risk of accelerated rejection and allograft damage and reduce the likelihood of successful transplantation. Patients with full-thickness facial burns may benefit from facial allotransplantation. However, they are at a high risk of developing DSA due to standard features of their acute care. Case Presentation: A 41-year-old male with severe disfigurement from facial burns consented to facial allotransplantation in 2014; panel reactive antibody score was 0%...
2018: Case Reports in Transplantation
Lola Sitruk, Cécile Couchoud, Maryvonne Hourmant, Philippe Tuppin, Marie-Alice Macher, Camille Legeai
The aim of this study was to describe the drug dispensing of maintenance immunosuppression treatment in 2014 for patients who received a kidney transplant in 2012, based on the data of the French national health insurance and to compare those results with the information collected in the national database for kidney recipients. For each patient, are considered all drugs dispensing with their dates of issue, the molecules and their presentations (number of pills and dosage). Among 2463 transplanted adults in 2012, 73% have received tacrolimus monohydrate, 59% mycophenolate mofetil, 54% prednisone and 20% cyclosporin in 2014...
June 7, 2018: Néphrologie & Thérapeutique
Udit Chaddha, Pradnya D Patil, Ashraf Omar, Rajat Walia, Tanmay S Panchabhai
A 47-year-old man who was a redo double lung transplant recipient (cytomegalovirus [CMV] status: donor positive/recipient positive; Epstein-Barr virus status: donor positive/recipient positive) presented to the hospital with 1 week of generalized malaise, low-grade fevers, and dry cough. His redo lung transplantation was necessitated by bronchiolitis obliterans syndrome, and his previous lung transplantation 5 years earlier was for silicosis-related progressive massive fibrosis. He denied any difficulty breathing or chest pain...
June 2018: Chest
Monika Turska, Jolanta Parada-Turska
Cutaneous polyarteritis nodosa is a rare disease that affects vessels of the deep skin and the subcutaneous tissue. Its etiopathology remains unknown. It predominantly affects skin, and the main cutaneous symptoms are subcutaneous nodules, livedo reticularis, and ulcerations that are mainly located on legs. Cutaneous polyarteritis nodosa can also cause extracutaneous symptoms (fever, malaise, myalgias, arthralgias, neuropathy). It is a chronic benign disease with a relapsing course. Diagnostic criteria for this disease were recently proposed and both clinical and typical histological features must be present to confirm the diagnosis...
2018: Wiadomości Lekarskie: Organ Polskiego Towarzystwa Lekarskiego
Y K Son, H Kwon, H W Lee, E G Jeong, S M Lee, S E Kim, Y Park, W S An
BACKGROUND: Modifications of erythrocyte membrane fatty acid (FA) contents may affect cellular function or transmembrane receptors. One cross-sectional study has shown that kidney transplant (KTP) recipients have lower erythrocyte membrane oleic acid content than dialysis patients do. Therefore, we prospectively tested whether erythrocyte membrane contents of FA including oleic acid change after KTP. METHODS: We recruited 23 KTP recipients (September 2011 through May 2014)...
June 2018: Transplantation Proceedings
Kuo-Tung Tang, Chien-Hua Tseng, Tsu-Yi Hsieh, Der-Yuan Chen
AIM: Membranous lupus glomerulonephritis (MLN) is associated with morbidities such as thromboembolism, peripheral edema and/or hyperlipidemia. However, treatment of MLN remains elusive. METHODS: We performed systematic searches on MEDLINE, EMBASE and Cochrane Library database up to November, 2017. Eligible studies included randomized trials or cohort studies which evaluated different immunosuppressants in adult patients with pathologically proved MLN. No language restrictions were applied...
June 2018: International Journal of Rheumatic Diseases
Jing Fang, Wenge Li, Min Tan, Xiangxin Peng, Zhao Tan, Wenbo Wang
AIM: To analyze whether different hepatitis B virus (HBV) infection status influenced the prognosis of patients with lupus nephritis (LN) under immunosuppressive therapy. METHODS: A retrospective study enrolled 177 adults with active LN (Classes III, IV, V or mixed), and divided them into three groups: (i) HBV-free group (n = 93), antibodies to hepatitis B surface antigen positive only or all items negative; (ii) occult HBV infection group (n = 68), hepatitis B surface antigen (HBsAg) negative and antibody to hepatitis B core antigen positive with undetectable HBV DNA; and (iii) HBV infection group (n = 16), HBsAg-positive...
May 2018: International Journal of Rheumatic Diseases
S D Hwang, J H Lee, S W Lee, J K Kim, M-J Kim, J H Song
BACKGROUND: Reactivation of BK polyomavirus causes destructive virus allograft nephropathy; however, treatment options are limited. Herein, we report a case in which a patient with T cell-mediated rejection was treated with steroid therapy. The patient subsequently developed BK viremia and was successfully treated by using intravenous immunoglobulin (IVIG) after failing to respond to conventional treatment. CASE PRESENTATION: A 54-year-old man had been undergoing peritoneal dialysis for 3 years before kidney transplantation...
June 2, 2018: Transplantation Proceedings
Michael J Ammar, Anton M Kolomeyer, Nirali Bhatt, Madhura A Tamhankar, Michael T Mullen, Alexander J Brucker
PURPOSE: We report a patient with branch retinal artery occlusion predominant Susac syndrome and review the literature on current diagnostic modalities and therapeutic approaches for this rare condition. METHODS: Case report. RESULTS: A 23-year-old white male presented with a 5-month history of a scotoma in his right eye vision, headaches, and intermittent paresthesias of the lower extremities. Ophthalmic examination was normal with the exception of a hypopigmented small retinal area inferonasal to the fovea in the right eye...
May 30, 2018: Retinal Cases & Brief Reports
Firuz G Feturi, Matthias Weinstock, Wenchen Zhao, Wei Zhang, Jonas T Schnider, Vasil E Erbas, Sinan Oksuz, Jan A Plock, Lisa Rohan, Alexander M Spiess, Lydia M Ferreira, Mario G Solari, Raman Venkataramanan, Vijay S Gorantla
Mycophenolic acid (MPA), is the active form of the ester prodrug mycophenolate mofetil (MMF). MMF is an FDA approved immunosuppressive drug that has been successfully used in systemic therapy in combination with other agents for the prevention of acute rejection (AR) following solid organ transplantation (SOT) as well as in vascularized composite allotransplantation (VCA). Systemic use of MMF is associated with gastrointestinal adverse effects. Topical delivery of the prodrug could thus provide graft-targeted immunosuppression while minimizing systemic drug exposure...
2018: Frontiers in Surgery
Arthur D Moes, David Severs, Koen Verdonk, Nils van der Lubbe, Robert Zietse, A H J Danser, Ewout J Hoorn
Inflammation is increasingly recognized as a driver of hypertension. Both genetic and pharmacological inhibition of B and T cells attenuates most forms of experimental hypertension. Accordingly, the immunosuppressive drug mycophenolate mofetil (MMF) reduces blood pressure in the deoxycorticosterone acetate (DOCA-) salt model. However, the mechanisms by which MMF prevent hypertension in the DOCA-salt model remain unclear. Recent studies indicate that immunosuppression can inhibit sodium transporter activity in the kidney, but its effect on vascular tone is not well characterized...
2018: Frontiers in Physiology
Cheng Zhang, Pei-Yan Kong, Shiqi Li, Ting Chen, Xun Ni, Yunyan Li, Meiling Wang, Yao Liu, Lei Gao, Li Gao, Xian-Gui Peng, Ai-Hua Sun, Ping Wang, Zhi Yang, Xi Zhang, Cheng Qian
BACKGROUND: Reduced-intensity conditioning (RIC) regimens with low tolerable toxicities have been used for allogeneic hematopoietic stem cell transplantation (allo-HSCT). However, the relapse rate by this treatment is high. Treatment of CD19 B-cell relapsed/refractory acute lymphoblastic leukemia (r/r ALL) with allogeneic chimeric antigen receptor-modified T (CAR-T) cells is safe and effective. Use of allogeneic CD19-CAR-T cells as a part of RIC regimens for treatment of r/r ALL patients with haploidentical HSCT has not been investigated yet...
July 2018: Journal of Immunotherapy
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