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tolerance in transplantation

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https://www.readbyqxmd.com/read/28429246/comparison-of-efficacy-and-safety-of-caspofungin-versus-micafungin-in-pediatric-allogeneic-stem-cell-transplant-recipients-a-retrospective-analysis
#1
Natalia Maximova, Giulia Schillani, Roberto Simeone, Alessandra Maestro, Davide Zanon
INTRODUCTION: The high morbidity and mortality associated with invasive fungal infections (IFIs) provide the rationale for antifungal prophylaxis in immuno-compromised pediatric patients undergoing hematopoietic stem cell transplantation (HSCT). Caspofungin and micafungin are antifungal agents of interest for prophylaxis of IFIs because of their potency against Candida and minimal toxicity or interactions with other drugs. Few studies have demonstrated the safety and efficacy of such echinocandins as prophylaxis for IFIs in patients undergoing HSCT...
April 20, 2017: Advances in Therapy
https://www.readbyqxmd.com/read/28428556/treatment-of-donor-corneal-tissue-with-immunomodulatory-cytokines-a-novel-strategy-to-promote-graft-survival-in-high-risk-corneal-transplantation
#2
Maryam Tahvildari, Parisa Emami-Naeini, Masahiro Omoto, Alireza Mashaghi, Sunil K Chauhan, Reza Dana
Antigen-presenting cells (APCs) play an important role in transplant rejection and tolerance. In high-risk corneal transplantation, where the graft bed is inflamed and vascularized, immature APCs in the donor corneal stroma quickly mature and migrate to lymphoid tissues to sensitize host T cells. In this study, using a mouse model of corneal transplantation, we investigated whether enrichment of tolerogenic APCs (tolAPCs) in donor corneas can enhance graft survival in corneal allograft recipients with inflamed graft beds...
April 20, 2017: Scientific Reports
https://www.readbyqxmd.com/read/28426448/clinical-and-ethical-challenges-in-heart-transplantation-from-donation-after-circulatory-determined-death-donors
#3
Stephen Large, Steven Tsui, Simon Messer
PURPOSE OF REVIEW: The aim of this study was to describe the development of a clinical programme of heart transplantation from nonheart beating (or donation after circulatory determined death, DCD) donors. DCD is an established practice in abdominal and lung transplantation. The opportunity for sufferers of advanced heart failure provided by DCD heart transplantation is described. RECENT FINDINGS: Work shows that the arrested DCD heart is viable and has a 30-min tolerance to anoxia at normal body temperature making transplantation possible...
April 19, 2017: Current Opinion in Organ Transplantation
https://www.readbyqxmd.com/read/28425206/considering-tangible-benefit-for-interdependent-donors-extending-a-risk-benefit-framework-in-donor-selection
#4
Sarah E Van Pilsum Rasmussen, Macey L Henderson, Jeffrey Kahn, Dorry Segev
From its infancy, live donor transplantation has operated within a framework of acceptable risk to donors. Such a framework presumes that risks of living donation are experienced by the donor while all benefits are realized by the recipient, creating an inequitable distribution that demands minimization of donor risk. We suggest that this risk-tolerance framework ignores tangible benefits to donor. A previously proposed framework more fully considers potential benefits to the donor and argues that risks and benefits must be balanced...
April 20, 2017: American Journal of Transplantation
https://www.readbyqxmd.com/read/28422925/dynamics-of-b-cell-recovery-following-kidney-bone-marrow-transplant-recipients
#5
Baoshan Gao, Yiming Gu, Chunshu Rong, Carolina Moore, Fabrice Porcheray, Waichi Wong, Frederic Preffer, Susan L Saidman, Yaowen Fu, Benedict Cosimi, David H Sachs, Tatsuo Kawai, Megan Sykes, Emmanuel Zorn
BACKGROUND: Previous studies identified B cell gene signatures and predominance of specific B cell subsets as a marker of operational tolerance following kidney transplantation. These findings suggested a role for B cells in the establishment or maintenance of tolerance. Here we analyzed B cell recovery in 4 subjects, 3 of whom achieved tolerance after combined kidney/bone marrow transplantation. METHODS: Peripheral B cell subsets were examined longitudinally by flow cytometry...
April 19, 2017: Transplantation
https://www.readbyqxmd.com/read/28422836/fecal-microbiota-transplantation-is-a-rescue-treatment-modality-for-refractory-ulcerative-colitis
#6
Ahmet Uygun, Kadir Ozturk, Hakan Demirci, Cem Oger, Ismail Yasar Avci, Turker Turker, Mustafa Gulsen
BACKGROUND: Fecal microbial transplantation (FMT) provides to replace beneficial bacteria with more favorable microbiomes in recipient with dysbiosis. The aim of the present study was to prospectively investigate the efficacy of FMT by assessing the clinical and endoscopic response in patients with ulcerative colitis (UC) who had failed anti-inflammatory and immunosuppressive therapy. METHODS: In this prospective and uncontrolled study, 30 patients with UC were included...
April 2017: Medicine (Baltimore)
https://www.readbyqxmd.com/read/28422403/blood-chimerism-in-dizygotic-monochorionic-twins-during-five-years-observation
#7
Morten Hanefeld Dziegiel, Morten Høgh Hansen, Sofie Haedersdal, Angela Natalie Barrett, Klaus Rieneck, Katharina Maria Main, Anne Todsen Hansen, Frederik Banch Clausen
Dizygotic monochorionic twin pregnancies can result in blood chimerism due to in utero twin-to-twin exchange of stem cells. In this case, we examined the proportion of allogeneic red blood cells (RBCs) by flow cytometry and the proportion of allogeneic nucleated cells by digital PCR at seven months and again at five years. We found an increase in the proportion of allogeneic cells from 63% to 89% in one twin, and a similar increase in autologous cells in the other twin from 57% to 84%. A paradigm for stem cell therapy could be modelled on this case: induction of tolerance and chimerism by antenatal transfusion of donor stem cells...
April 19, 2017: American Journal of Transplantation
https://www.readbyqxmd.com/read/28422316/regulatory-t-cells-tolerance-induction-in-solid-organ-transplantation
#8
REVIEW
Trishan Vaikunthanathan, Niloufar Safinia, Dominic Boardman, Robert I Lechler, Giovanna Lombardi
The concept of regulatory T cell (Treg) therapy in transplantation is now a reality. Significant advances in science and technology have enabled us to isolate human Tregs, expand them to clinically relevant numbers and infuse them into human transplant recipients. With several Phase I/II trials underway investigating Treg safety and efficacy it is now more crucial than ever to understand their complex biology. However, our journey is by no means complete, results from these trials will undoubtedly provoke both further knowledge and enquiry, which, alongside evolving science will continue to drive the optimization of Treg therapy in the pursuit of transplantation tolerance...
April 19, 2017: Clinical and Experimental Immunology
https://www.readbyqxmd.com/read/28419684/should-organs-from-hepatitis-c-virus-infected-donors-be-used-for-transplantation-in-the-era-of-daas
#9
Hideki Ohdan
Hepatitis C virus (HCV) infection has been demonstrated to deleteriously impact both patient and graft survival following non-hepatic organ transplantation [1, 2]. Interferon (IFN)-based therapies prior to non-hepatic transplant in HCV-infected patients improved their survival, however, tolerability and low cure rates practically limited those therapies [3]. In addition, due to the risk of allograft rejection, IFN-based therapy following non-hepatic solid organ transplant is not generally recommended. This article is protected by copyright...
April 18, 2017: Transplant International: Official Journal of the European Society for Organ Transplantation
https://www.readbyqxmd.com/read/28415767/unique-properties-of-thymic-antigen-presenting-cells-promote-epigenetic-imprinting-of-alloantigen-specific-regulatory-t-cells
#10
Garima Garg, Eirini Nikolouli, Matthias Hardtke-Wolenski, Aras Toker, Naganari Ohkura, Michael Beckstette, Takahisa Miyao, Robert Geffers, Stefan Floess, Norbert Gerdes, Esther Lutgens, Anke Osterloh, Shohei Hori, Shimon Sakaguchi, Elmar Jaeckel, Jochen Huehn
Regulatory T cells (Tregs) are potential immunotherapeutic candidates to induce transplantation tolerance. However, stability of Tregs still remains contentious and may potentially restrict their clinical use. Recent work suggested that epigenetic imprinting of Foxp3 and other Treg-specific signature genes is crucial for stabilization of immunosuppressive properties of Foxp3+ Tregs, and that these events are initiated already during early stages of thymic Treg development. However, the mechanisms governing this process remain largely unknown...
March 15, 2017: Oncotarget
https://www.readbyqxmd.com/read/28415669/micro-rna-98-suppresses-interleukin-10-in-peripheral-b-cells-in-patient-post-cardio-transplantation
#11
Jiangping Song, Wenjun Su, Xiao Chen, Qian Zhao, Ningning Zhang, Mao-Gang Li, Ping-Chang Yang, Liqing Wang
The immune tolerance to the transplant heart survival is critical. Regulatory B cells are one of the major immune regulatory cell populations in the immune tolerance. Micro RNAs (miR) can regulate the activities of immune cells, such as the expression of interleukin (IL)-10 by B cells. This study tests a hypothesis that micro RNA (miR)-98 plays a role in the regulation of interleukin (IL)-10 expression in B cells (B10 cell) after heart transplantation. In this study, the peripheral blood samples were collected from patients before and after heart transplantation...
March 8, 2017: Oncotarget
https://www.readbyqxmd.com/read/28412754/efficacy-and-safety-of-a-reduced-calcineurin-inhibitor-dose-combined-with-mycophenolate-mofetil-in-liver-transplant-patients-with-chronic-renal-dysfunction
#12
Pusen Wang, Weitao Que, Hao Li, Lvnan Yan, Zhiren Fu, Qifa Ye, Guihua Chen, Kefeng Dou, Shichun Lu, Zhanyu Yang, Zhijun Zhu, Zhihai Peng, Lin Zhong
Calcineurin inhibitors (CNIs) are frequently given at a reduced dose in combination with mycophenolate mofetil (MMF) to avoid nephrotoxicity, but the optimal reduction in CNI dose has not been established. In this prospective, open-label, multicenter study, liver transplant recipients with chronic renal dysfunction who were administered a CNI-based immunosuppressive regimen were included in the intent-to-treat (ITT) population. The primary endpoint was declination in renal function, which was defined as a ≥ 20% decrease in the glomerular filtration rate during the year following regimen adjustment...
February 18, 2017: Oncotarget
https://www.readbyqxmd.com/read/28408615/phase-ii-study-of-bortezomib-in-combination-with-cyclophosphamide-and-rituximab-for-relapsed-or-refractory-mantle-cell-lymphoma
#13
Hun Ju Lee, Jorge E Romaguera, Lei Feng, Aakash P Desai, Liang Zhang, Michelle Fanale, Felipe Samaniego, Fredrick B Hagemeister, Luis E Fayad, Maria A Rodriguez, Jeffrey L Medeiros, Kimberly Hartig, Krystle Nomie, Makhdum Ahmed, Maria Badillo, Haige Ye, Yasuhiro Oki, Pei Lin, Loretta Nastoupil, Jason Westin, Michael Wang
BACKGROUND: Relapsed or refractory mantle cell lymphoma (MCL) has a poor prognosis. The best outcome is achieved in patients who have a partial or complete response to salvage treatment and proceed to allogeneic stem cell transplant. PATIENTS AND METHODS: Twenty-one patients were given a combination regimen of bortezomib, cyclophosphamide, and rituximab at MD Anderson Cancer Center as part of a single-arm, prospective, open-label phase II clinical trial. The median age was 66 years, with a median number of prior treatments of three...
April 13, 2017: Oncologist
https://www.readbyqxmd.com/read/28407130/impact-of-end-stage-renal-disease-on-glucose-metabolism-a-matched-cohort-analysis
#14
Martina Guthoff, Robert Wagner, Dorothea Vosseler, Andreas Peter, Silvio Nadalin, Hans-Ulrich Häring, Andreas Fritsche, Nils Heyne
Background: . Renal function is known to affect glucose metabolism. The aim of this study was to assess glucose metabolism in end-stage renal disease (ESRD) patients and in matched controls with normal renal function and to delineate its underlying pathophysiology. Methods: . ESRD patients without diabetes mellitus on the active kidney transplant waiting list of a large European university hospital were metabolically phenotyped by an oral glucose tolerance test (OGTT) and by calculating insulin sensitivity and secretion indices...
April 1, 2017: Nephrology, Dialysis, Transplantation
https://www.readbyqxmd.com/read/28404756/infusion-compatible-antibiotic-formulations-for-rapid-administration-to-improve-outcomes-in-cancer-outpatients-with-severe-sepsis-and-septic-shock-the-sepsis-stat-pack
#15
Jason D Goldman, Amelia Gallaher, Rupali Jain, Zach Stednick, Manoj Menon, Michael J Boeckh, Paul S Pottinger, Stephen M Schwartz, Corey Casper
Background: Patients with cancer are at high risk for severe sepsis and septic shock (SS/SSh), and a delay in receiving effective antibiotics is strongly associated with mortality. Delays are due to logistics of clinic flow and drug delivery. In an era of increasing antimicrobial resistance, combination therapy may be superior to monotherapy for patients with SS/SSh. Patients and Methods: At the Seattle Cancer Care Alliance, we implemented the Sepsis STAT Pack (SSP) program to simplify timely and effective provision of empiric antibiotics and other resuscitative care to outpatients with cancer with suspected SS/SSh before hospitalization...
April 2017: Journal of the National Comprehensive Cancer Network: JNCCN
https://www.readbyqxmd.com/read/28404073/optimum-timing-of-treatment-for-hepatitis-c-infection-relative-to-liver-transplantation
#16
REVIEW
Audrey Coilly, Bruno Roche, Jean-Charles Duclos-Vallée, Didier Samuel
The approval of direct-acting antiviral agents that may be given orally in an interferon-free regimen has greatly changed the landscape of treatment for hepatitis C virus (HCV) infection, especially for patients with the most severe disease, who have decompensated cirrhosis, or who are waiting for or have undergone liver transplantation. Treatment with interferon proved to be ineffective and poorly tolerated because of high risks of infection and transplant rejection. The availability of new drugs poses new questions about the optimum time to give treatment to prevent HCV recurrence, taking into account efficacy, tolerance, and drug-drug interactions...
October 2016: Lancet. Gastroenterology & Hepatology
https://www.readbyqxmd.com/read/28402253/immunoregulatory-role-of-b-lymphocytes-in-alloresponse-to-kidney-transplant
#17
Tomasz Baran, Maria Boratyńska
B cells are a group of diverse phenotype and function subsets, which can both stimulate and inhibit the immune response to an allograft. They participate in the rejection process by influencing differentiation, proliferation and effector functions of T lymphocytes. B cells injure the graft via the ADCC (antibody-dependent cellular cytotoxicity) reaction and humoral rejection through plasmocyte production of donor-specific antibodies. A converse, suppressive mode of B cells can attribute to the development of tolerance and protect the graft from rejection...
April 12, 2017: Postȩpy Higieny i Medycyny Doświadczalnej
https://www.readbyqxmd.com/read/28396749/an-hcv-positive-recipient-of-an-hcv-positive-donor-liver-successfully-treated-before-and-immediately-after-liver-transplant-with-daclatasvir-sofosbuvir-and-ribavirin
#18
Fred Poordad, Eric Lawitz, Julio A Gutierrez, Juan Guerrero, Kermit Speeg, Eugene S Swenson
This case suggests that initiation of HCV therapy immediately after liver transplantation with well-tolerated, all-oral regimens may achieve a virologic cure in HCV-positive recipients, thus preventing post-transplant HCV recurrence and associated disease progression. This strategy may broaden utilization of HCV-positive donor livers, potentially including HCV-negative transplant recipients.
April 2017: Clinical Case Reports
https://www.readbyqxmd.com/read/28396715/immunomodulatory-oligonucleotide-imt504-effects-on-mesenchymal-stem-cells-as-a-first-in-class-immunoprotective-immunoregenerative-therapy
#19
REVIEW
Jorge Zorzopulos, Steven M Opal, Andrés Hernando-Insúa, Juan M Rodriguez, Fernanda Elías, Juan Fló, Ricardo A López, Norma A Chasseing, Victoria A Lux-Lantos, Maria F Coronel, Raul Franco, Alejandro D Montaner, David L Horn
The immune responses of humans and animals to insults (i.e., infections, traumas, tumoral transformation and radiation) are based on an intricate network of cells and chemical messengers. Abnormally high inflammation immediately after insult or abnormally prolonged pro-inflammatory stimuli bringing about chronic inflammation can lead to life-threatening or severely debilitating diseases. Mesenchymal stem cell (MSC) transplant has proved to be an effective therapy in preclinical studies which evaluated a vast diversity of inflammatory conditions...
March 26, 2017: World Journal of Stem Cells
https://www.readbyqxmd.com/read/28396162/phase-i-study-of-clofarabine-and-2-gy-total-body-irradiation-as-a-non-myeloablative-preparative-regimen-for-hematopoietic-stem-cell-transplantation-hsct-in-pediatric-patients-with-hematologic-malignancies-a-therapeutic-advances-in-childhood-leukemia-tacl-consortium
#20
Sandeep Soni, Hisham Abdel-Azim, Meghann McManus, Eneida Nemecek, Richard Sposto, Ann Woolfrey, Haydar Frangoul
Clofarabine is a purine nucleoside analog with immunosuppressive and anti-leukemic activity and its inclusion in reduced intensity regimens could potentially improve outcomes. We performed a prospective Phase I study of clofarabine combined with 2 Gy total body irradiation (TBI) as a non-myeloablative (NMA) preparative regimen for allogeneic stem cell transplantation in pediatric patients, who were considered at high risk of mortality from standard myeloablative regimens. The main goal of the study was to delineate the maximum feasible dose (MFD) of clofarabine in combination with 2 Gy TBI...
April 7, 2017: Biology of Blood and Marrow Transplantation
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