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Chronic antibody rejection

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https://www.readbyqxmd.com/read/29344912/capillary-leak-syndrome-as-a-complication-of-antibody-mediated-rejection-treatment-a-case-report
#1
Juan C Ramirez-Sandoval, Ricardo Varela-Jimenez, Luis E Morales-Buenrostro
We report a case of capillary leak that developed during treatment of antibody-mediated rejection in a kidney transplant recipient. A 53-year-old female transplant recipient experienced an increase in serum creatinine from 1.1 to 1.8 mg/dL. Antibody-mediated rejection was diagnosed by graft biopsy. She was treated with five plasmapheresis sessions (on alternate days with albumin replacement), five doses of immunoglobulin (5 g/dose at 100 mg/kg), a single dose of rituximab (500 mg), and four doses of bortezomib on days 1, 4, 7, and 10 (1...
January 17, 2018: CEN Case Reports
https://www.readbyqxmd.com/read/29337451/-nephrology
#2
Sophie De Seigneux, Belen Ponte, Karine Hadaya, Yassine Bouatou, Patrick Saudan
New antidiabetic drugs which slow effectively the course of diabetic nephropathy are now available. There is no benefit of prophylactic hydratation to prevent contrast nephropathy in patients with moderate chronic kidney disease. In elderly hemodialysis patients, hemodiafiltration seems better tolerated than conventional hemodialysis, although there is a similar dialysis-induced myocardial stress with both methods. Role of de novo donor-specific antibodies is better characterized, which may subsequently lead to new treatments of graft rejection...
January 10, 2018: Revue Médicale Suisse
https://www.readbyqxmd.com/read/29327261/chronic-rejection-after-intestinal-transplant-where-are-we-in-order-to-avert-it
#3
REVIEW
Augusto Lauro, Mihai Oltean, Ignazio R Marino
Chronic rejection affects the long-term survival of all solid organ transplants and, among intestinal allografts, occurs in up to 10% of the recipients. The insidious clinical evolution of the chronic allograft enteropathy, the absence of noninvasive biomarkers, and the late endoscopic findings delay its diagnosis. No pharmacological approach has been proven effective, and allograft removal nowadays still represents the only available therapy. The inclusion of the liver in the visceral allograft appears to be the only intervention affecting the development of chronic rejection, as revealed by large-center studies and registry reports...
January 11, 2018: Digestive Diseases and Sciences
https://www.readbyqxmd.com/read/29319177/characterization-of-ectopic-lymphoid-structures-in-different-types-of-acute-renal-allograft-rejection
#4
Kitty de Leur, Marian C Clahsen-van Groningen, Thierry P P van den Bosch, Gretchen N de Graav, Dennis A Hesselink, Janneke N Samsom, Carla C Baan, Karin Boer
BACKGROUND: We hypothesize that T cells such as IL-21+BCL6+ T follicular helper cells can regulate B cell mediated immunity within the allograft during acute T-cell mediated rejection, this process may feed chronic allograft rejection on long term. To investigate this mechanism we determined the presence and activation status of organized T and B cells in so-called ectopic lymphoid structures (ELSs) in different types of acute renal allograft rejection. METHODS: Biopsies showing the following primary diagnosis were included: acute/active antibody-mediated rejection, C4d+ (a/aABMR), acute T cell-mediated rejection grade I (aTCMRI), and acute T cell-mediated rejection grade II (aTCMRII)...
January 10, 2018: Clinical and Experimental Immunology
https://www.readbyqxmd.com/read/29317703/modeling-tumor-immunity-of-mouse-glioblastoma-by-exhausted-cd8-t-cells
#5
Hiroshi Nakashima, Quazim A Alayo, Pablo Penaloza-MacMaster, Gordon J Freeman, Vijay K Kuchroo, David A Reardon, Soledad Fernandez, Michael Caligiuri, E Antonio Chiocca
T cell exhaustion occurs during chronic infection and cancers. Programmed cell death protein-1 (PD-1) is a major inhibitory checkpoint receptor involved in T cell exhaustion. Blocking antibodies (Abs) against PD-1 or its ligand, PD-L1, have been shown to reverse T cell exhaustion during chronic infection and cancers, leading to improved control of persistent antigen. However, modeling tumor-specific T cell responses in mouse has been difficult due to the lack of reagents to detect and phenotype tumor-specific immune responses...
January 9, 2018: Scientific Reports
https://www.readbyqxmd.com/read/29312755/acute-rejection
#6
REVIEW
Mark Benzimra, Greg L Calligaro, Allan R Glanville
Despite induction immunosuppression and the use of aggressive maintenance immunosuppressive regimens, acute allograft rejection following lung transplantation is still a problem with important diagnostic and therapeutic challenges. As well as causing early graft loss and mortality, acute rejection also initiates the chronic alloimmune responses and airway-centred inflammation that predispose to bronchiolitis obliterans syndrome (BOS), also known as chronic lung allograft dysfunction (CLAD), which is a major source of morbidity and mortality after lung transplantation...
December 2017: Journal of Thoracic Disease
https://www.readbyqxmd.com/read/29300898/impact-of-human-leukocyte-antigen-mismatch-on-lung-transplant-outcome
#7
Yoshito Yamada, Tim Langner, Ilhan Inci, Christian Benden, Macé Schuurmans, Walter Weder, Wolfgang Jungraithmayr
OBJECTIVES: Human leucocyte antigen (HLA) mismatch between donor and recipient has a differential impact on the outcome after transplant (Tx) among transplantable solid organs. Although the lung is considered a highly antigenic organ, the impact of HLA matching between the donor and the recipient has been shown to be heterogeneous on lung Tx outcome. To provide further evidence that HLA matching should be considered in the decision process prior to lung Tx, we evaluated the impact of donor/recipient HLA mismatch on the outcome after lung Tx at our institution...
January 2, 2018: Interactive Cardiovascular and Thoracic Surgery
https://www.readbyqxmd.com/read/29300203/evolving-criteria-for-the-diagnosis-of-antibody-mediated-rejection-in-renal-allografts
#8
Mark Haas
PURPOSE OF REVIEW: To review changes in the Banff schema for antibody-mediated renal allograft rejection over the past decade, including key revisions agreed upon during and immediately subsequent to the 2017 Banff Conference on Allograft Pathology. RECENT FINDINGS: The original Banff schema for diagnosis of acute and chronic active antibody-mediated rejection (ABMR) in renal allografts was formulated at the 2001 and 2007 Banff Conferences, and required histologic (primarily microvascular inflammation and transplant glomerulopathy), immunohistologic (C4d in peritubular capillaries), and serologic [circulating donor-specific antibodies (DSA)] evidence for a definitive diagnosis of ABMR...
January 2, 2018: Current Opinion in Nephrology and Hypertension
https://www.readbyqxmd.com/read/29288556/rna-expression-profiling-of-non-human-primate-renal-allograft-rejection-identifies-tolerance
#9
R N Smith, M Matsunami, B A Adam, I A Rosales, T Oura, A B Cosimi, T Kawai, M Mengel, R B Colvin
Tolerance induction to prevent allograft rejection is a long standing clinical goal. However, convincing and dependable tolerance identification remains elusive. Hypothesizing that intragraft RNA expression is informative in both rejection and tolerance, we profile intra-renal allograft RNA expression in a mixed chimerism renal allograft model of Cynomolgus monkeys and identify biologically significant tolerance. Analysis of 67 genes identified three dominant factors, each with a different pattern of gene expressions, relating to T cell mediated rejection (TCMR), chronic antibody mediated rejection (CAMR), or Tolerance...
December 29, 2017: American Journal of Transplantation
https://www.readbyqxmd.com/read/29286578/rna-expression-profiling-of-renal-allografts-in-a-non-human-primate-identifies-variation-in-nk-and-endothelial-gene-expression
#10
R N Smith, B A Adam, I A Rosales, M Matsunami, T Oura, A B Cosimi, T Kawai, M Mengel, R B Colvin
RNA transcript expression estimates are a promising method to study the mechanisms and classification of renal allograft rejections. Here we use the Nanostring platform to profile RNA expression in renal allografts in a non-human primate (NHP), the Cynomolgus monkey. We analyzed protocol and indication 278 archival renal allograft samples, both protocol and indication from 76 animals with diagnoses of chronic antibody (CAMR), acute cellular rejection (TCMR) and MIXED (both CAMR and TCMR), plus normals and samples with no pathological rejection using a Cynomolgus specific probe set of 67 genes...
December 29, 2017: American Journal of Transplantation
https://www.readbyqxmd.com/read/29258420/renal-allograft-rejection-lymphocyte-infiltration-and-de-novo-donor-specific-antibodies-in-a-novel-model-of-non-adherence-to-immunosuppressive-therapy
#11
Louisa Kühne, Bettina Jung, Helen Poth, Antonia Schuster, Simone Wurm, Petra Ruemmele, Bernhard Banas, Tobias Bergler
BACKGROUND: Non-adherence has been associated with reduced graft survival. The aim of this study was to investigate the immunological mechanisms underlying chronic renal allograft rejection using a model of non-adherence to immunosuppressive therapy. We used a MHC (major histocompatibility complex) -mismatched rat model of renal transplantation (Brown Norway to Lewis), in which rats received daily oral cyclosporine A. In analogy to non-adherence to therapy, one group received cyclosporine A on alternating days only...
December 19, 2017: BMC Immunology
https://www.readbyqxmd.com/read/29243394/the-banff-2017-kidney-meeting-report-revised-diagnostic-criteria-for-chronic-active-t-cell-mediated-rejection-antibody-mediated-rejection-and-prospects-for-integrative-endpoints-for-next-generation-clinical-trials
#12
M Haas, A Loupy, C Lefaucheur, C Roufosse, D Glotz, D Seron, B J Nankivell, P F Halloran, R B Colvin, N Alachkar, S Bagnasco, Y Bouatou, J U Becker, L Cornell, J P Duong van Huyen, I Gibson, R Mannon, M Naesens, V Nickeleit, P Nickerson, D L Segev, H K Singh, M Stegall, P Randhawa, L Racusen, K Solez, M Mengel
The kidney sessions of the 2017 Banff Conference focused on two areas: clinical implications of inflammation in areas of interstitial fibrosis and tubular atrophy (i-IFTA) and its relationship to T cell-mediated rejection (TCMR), and the continued evolution of molecular diagnostics, particularly in the diagnosis of antibody-mediated rejection (ABMR). In confirmation of previous studies, it was independently demonstrated by two groups that i-IFTA is associated with reduced graft survival. Furthermore, these groups presented that i-IFTA, particularly when involving >25% of sclerotic cortex in association with tubulitis, is often a sequela of acute TCMR in association with under-immunosuppression...
December 15, 2017: American Journal of Transplantation
https://www.readbyqxmd.com/read/29234201/acute-and-chronic-rejection-after-liver-transplantation-what-a-clinician-needs-to-know
#13
REVIEW
Narendra S Choudhary, Sanjiv Saigal, Rinkesh K Bansal, Neeraj Saraf, Dheeraj Gautam, Arvinder S Soin
While antibody mediated hyper-acute vasculitic rejection is rare in liver transplant recipients, acute and chronic rejection have clinical significance. The liver allograft behaves differently to other solid organ transplants as acute rejection generally does not impair graft survival and chronic rejection (CR) is uncommon. The incidence of acute and chronic rejection has declined in current era due to improved immunosuppressive regimens. Acute rejection generally improves with steroid boluses and steroid resistant rejection is uncommon...
December 2017: Journal of Clinical and Experimental Hepatology
https://www.readbyqxmd.com/read/29229189/immunoproteasome-inhibition-prevents-chronic-antibody-mediated-allograft-rejection-in-renal%C3%A2-transplantation
#14
Jun Li, Michael Basler, Gerardo Alvarez, Thomas Brunner, Christopher J Kirk, Marcus Groettrup
Chronic antibody-mediated rejection is the major cause of fading allograft function and loss after renal transplantation. Currently, pharmacological agents for the suppression of chronic antibody-mediated rejection are lacking. Non-selective proteasome inhibitors suppress antibody-mediated allograft rejection. However, extensive adverse side effects of these inhibitors severely limit their application. In contrast, immunoproteasome inhibition is effective in preclinical models of autoimmune diseases and was applied over weeks without obvious adverse side effects...
December 4, 2017: Kidney International
https://www.readbyqxmd.com/read/29208861/etiology-of-early-renal-allograft-dysfunction-and-comparison-between-dysfunction-and-function-group-a-single-center-study
#15
K M Hadiuzzaman, S F Islam, M O Faroque, R M Hossain, M Munirunnessa, S I Selim, M Morshed
Over a period of two years thirty five renal allograft recipients & donors were evaluated to find out the aetiology of early renal allograft dysfunction, in the Department of Nephrology, Bangabandhu Sheikh Mujib Medical University, Dhaka, Bangladesh from March 2010 to February 2012. A comparison was made between dysfunction & functioning graft group. Mean age of recipients were (36.4±9.4) years, mean age of donors were (41.7±8.3) years, with a male and female ratio of 3:1. Fifty percent recipients showed one heliotype match, ninety percent recipients were anti CMV antibody IgG positive, few were anti CMV antibody IgM positive...
October 2017: Mymensingh Medical Journal: MMJ
https://www.readbyqxmd.com/read/29198928/lung-autoantibodies-ready-for-prime-time
#16
EDITORIAL
Luke Milross, Ramsey Hachem, Deborah Levine, Allan R Glanville
Despite advances in our understanding of the immunology of lung allograft tolerance and a reduction in the rate of acute allograft rejection using contemporary immunosuppressive protocols, the rate of chronic lung allograft dysfunction (CLAD), both obstructive and restrictive, remains unacceptably high. CLAD, particularly the restrictive phenotype, is a harbinger of a foreshortened survival. The development of a consensus approach to the diagnosis of antibody-mediated rejection by the International Society for Heart and Lung Transplantation has highlighted the need for a uniform approach toward the investigation, diagnosis, implications and management of both human leukocyte antigen (HLA) and non-HLA-related antibody formation...
November 8, 2017: Journal of Heart and Lung Transplantation
https://www.readbyqxmd.com/read/29191293/cardiac-transplantation-current-outcomes-and-contemporary-controversies
#17
REVIEW
Michelle M Kittleson, Jon A Kobashigawa
Despite advances in pharmacologic and device treatment of chronic heart failure, long-term morbidity and mortality remain high, and many patients progress to end-stage heart failure. Over the last 5 decades, heart transplantation (HTx) has become the preferred therapy for select patients with end-stage heart disease. However, although HTx has become standard of care for the management of end-stage heart failure, challenges continue to exist. The number of patients with end-stage heart failure is increasing, whereas the number of donor organs remains constant and a limiting factor in HTx...
December 2017: JACC. Heart Failure
https://www.readbyqxmd.com/read/29189293/mechanisms-of-rejection-in-vascular-composite-allotransplantation
#18
Joanna W Etra, Giorgio Raimondi, Gerald Brandacher
PURPOSE OF REVIEW: For patients with devastating injuries in whom standard reconstruction is not an option, vascularized composite allotransplantation (VCA) has become a viable means of restoring form and function. However, immunological rejection continues to be a problem in VCA and has not yet been fully characterized. As the field is relatively new, much of the data on rejection and immunosuppression have been extrapolated from that of solid organ transplantation. In this review, we cover the basic mechanisms of rejection as they relate specifically to VCA with analysis of recent literature and future directions...
November 18, 2017: Current Opinion in Organ Transplantation
https://www.readbyqxmd.com/read/29146602/donor-specific-and-nonspecific-hla-antibodies-and-outcome-post-lung-transplantation
#19
Stijn E Verleden, Bart M Vanaudenaerde, Marie-Paul Emonds, Dirk E Van Raemdonck, Arne P Neyrinck, Geert M Verleden, Robin Vos
Donor-specific antibodies (DSAs) against human leukocyte antigen (HLA) are associated with chronic lung allograft dysfunction (CLAD) and mortality post lung transplantation, but data concerning prevalence, time of onset, persistence and effects on long-term outcome remain scarce.We assessed the association between HLA antibodies and CLAD-free and graft survival in a cohort of 362 patients. We stratified our analysis according to DSA status, persistence of antibodies and timing of antibodies (pre-transplant, early or late post-transplant)...
November 2017: European Respiratory Journal: Official Journal of the European Society for Clinical Respiratory Physiology
https://www.readbyqxmd.com/read/29135832/prognostic-value-of-the-persistence-of-c1q-binding-anti-hla-antibodies-in-acute-antibody-mediated-rejection-in-kidney-transplantation
#20
Elodie Bailly, Dany Anglicheau, Gilles Blancho, Philippe Gatault, Vincent Vuiblet, Valérie Chatelet, Emmanuel Morelon, Paolo Malvezzi, Anne Parissiadis, Jérôme Tourret, Gwendaline Guidicelli, Johnny Sayegh, Christiane Mousson, Philippe Grimbert, Isabelle Top, Moglie Le Quintrec, Raj Purgus, Pierre François Westeel, Barbara Proust, Valérie Chabot, Yvon Lebranchu, Frédéric Dehaut, Matthias Büchler
BACKGROUND: The differential pathogenicity of anti-HLA donor-specific antibodies (DSAs) is not fully understood. The presence of complement-binding DSAs help better defining the prognosis of acute antibody-mediated rejection (ABMR). The evolution of these antibodies after the treatment of ABMR is unknown. METHODS: We included patients from the French multicenter RITUX ERAH study diagnosed with acute antibody-mediated rejection (ABMR) within the first year of renal transplantation, with circulating anti-HLA DSAs and treated randomly by rituximab or placebo (and intravenous immunoglobulins, plasma exchange)...
November 13, 2017: Transplantation
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