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https://www.readbyqxmd.com/read/27933700/calcineurin-inhibitor-free-immunosuppression
#1
EDITORIAL
Jacob Simmond, Michael Burch
No abstract text is available yet for this article.
December 9, 2016: Pediatric Transplantation
https://www.readbyqxmd.com/read/27933391/-tapering-and-termination-of-immunosuppressive-treatment-in-spondyloarthritides-including-psoriatic-arthritis
#2
REVIEW
G Scholz, B Möller
BACKGROUND: Immunomodulatory long-term treatment has also become the standard treatment for spondyloarthritides (SpA), including psoriatic arthritis (PsA); however, uncertainty exists about dose reduction or termination of treatment after remission or low disease activity. OBJECTIVE: When is it possible to reduce medication or terminate treatment for SpA? MATERIAL AND METHODS: An extensive non-systematic literature search was performed focusing on practice guidelines, systematic meta-analyses and clinical trials on medicinal long-term treatment and voluntary medication reduction in axial and peripheral SpA, including PsA...
December 8, 2016: Zeitschrift Für Rheumatologie
https://www.readbyqxmd.com/read/27933390/-de-escalation-of-therapy-in-anca-associated-vasculitides
#3
REVIEW
S Schinke, G Riemekasten, P Lamprecht
Antineutrophil cytoplasmic antibody (ANCA)-associated vasculitides (AAV) require a differentiated therapeutic approach depending on the degree of organ dysfunction and disease activity. In organ dysfunction and life-threatening AAV cyclophosphamide and rituximab are recommended for the induction of remission. For remission induction with a lack of organ dysfunction and non-life-threatening AAV, methotrexate or mycophenolate mofetil are recommended. For remission maintenance therapy azathioprine or methotrexate are used...
December 8, 2016: Zeitschrift Für Rheumatologie
https://www.readbyqxmd.com/read/27933198/interferon-ifn-%C3%AE-is-a-potential-mediator-in-lupus-nephritis
#4
Agneta Zickert, Vilija Oke, Ioannis Parodis, Elisabet Svenungsson, Yvonne Sundström, Iva Gunnarsson
OBJECTIVES: Interferon (IFN)-α is thought to be central in the pathogenesis for lupus nephritis (LN) and recent studies also indicate a role for IFNλ. Little is known about these cytokines in the context of treatment response. We studied levels of IFNα and IFNλ in patients with LN in association with clinical and histological response (HR) to treatment. METHODS: Fifty-six patients with active LN were included. Renal biopsies were performed at baseline and after immunosuppressive therapy...
2016: Lupus Science & Medicine
https://www.readbyqxmd.com/read/27932857/vogt-koyanagi-harada-syndrome-current-perspectives
#5
REVIEW
Abeir Baltmr, Sue Lightman, Oren Tomkins-Netzer
Vogt-Koyanagi-Harada syndrome is a cause of noninfectious panuveitis, leading to significant vision loss in many patients. It is an autoimmune disease occurring in genetically susceptible individuals and clinically presents as bilateral panuveitis with serous retinal detachments and hyperemic, swollen optic discs, which are associated with neurological and auditory manifestations. Early diagnosis and prompt and adequate treatment with immunosuppressive agents (corticosteroids and other immunosuppressive drugs) may halt disease progression and prevent recurrences and vision loss...
2016: Clinical Ophthalmology
https://www.readbyqxmd.com/read/27932441/trophoblast-cells-inhibit-neutrophil-extracellular-trap-formation-and-enhance-apoptosis-through-vasoactive-intestinal-peptide-mediated-pathways
#6
Guillermina Calo, Florencia Sabbione, Daiana Vota, Daniel Paparini, Rosanna Ramhorst, Analía Trevani, Claudia Pérez Leirós
STUDY QUESTION: Do human trophoblast cells modulate neutrophil extracellular trap (NET) formation, reactive oxygen species (ROS) synthesis and neutrophil apoptosis through mechanisms involving vasoactive intestinal peptide (VIP)? SUMMARY ANSWER: Trophoblast cells inhibited NET formation and ROS synthesis and enhanced neutrophil apoptosis through VIP-mediated pathways in a model of maternal-placental interaction. WHAT IS KNOWN ALREADY: Immune homeostasis maintenance at the maternal-placental interface is mostly coordinated by trophoblast cells...
December 7, 2016: Human Reproduction
https://www.readbyqxmd.com/read/27932249/toxicologic-effects-of-28-day-dietary-exposure-to-the-flame-retardant-1-2-dibromo-4-1-2-dibromoethyl-cyclohexane-tbech-in-fischer-rats
#7
Ivan H A Curran, Virginia Liston, Andrée Nunnikhoven, Don Caldwell, Matthew J S Scuby, Peter Pantazopoulos, Dorothea F K Rawn, Laurie Coady, Cheryl Armstrong, David E Lefebvre, Genevieve S Bondy
The brominated flame retardant TBECH is used as an additive to delay ignition and inhibit fires in construction materials and consumer goods. Trends in human exposure are not clear, although humans may be exposed to TBECH via indoor dust and air. In birds and fish there is some evidence of disruption in endocrine and reproductive parameters due to TBECH. In vitro studies indicate that TBECH is an androgen receptor agonist. In this study rats were exposed to 0, 10, 50, 250, 1250 or 5000mg/kg technical TBECH for 28days in diet, corresponding to 0, 0...
December 5, 2016: Toxicology
https://www.readbyqxmd.com/read/27932187/successful-t-cell-replete-hematopoietic-stem-cell-boost-without-conditioning-for-late-graft-failure
#8
Y Tsutsumi, T Tateno, S Ito, S Shiratori, T Teshima
Late graft failure is a rare but significant complication after allogeneic stem cell transplantation, which is often complicated by severe infections. We report a case of late graft failure, which was successfully treated with a T-cell replete hematopoietic stem cell boost without conditioning that induced rapid engraftment and relieved the patient of infection. Discontinuation of immunosuppressants and nilotinib administration suppressed the host cells. Achieving full donor chimerism allowed us to administer a peripheral blood stem cell boost without conditioning...
November 2016: Transplantation Proceedings
https://www.readbyqxmd.com/read/27932175/first-attempt-of-sequential-living-donor-liver-and-hematopoietic-stem-cell-transplantation-in-a-child-with-advanced-hepatocellular-carcinoma-case-report
#9
J A Picoraro, N Ovchinsky, M Martinez, S J Lobritto, P Satwani, R Ramphal, M S Cairo, T Kato
Effective therapeutic options for advanced hepatocellular carcinoma are limited. Hematopoietic stem cell transplantation may offer a graft-versus-tumor effect. Combined liver and hematopoietic stem cell transplantation from the same donor with preparatory conditioning may promote tolerogenicity to the liver allograft and offers the potential for immunosuppression withdrawal. We report our experience with the use of this approach in a pediatric patient with invasive hepatocellular carcinoma and pulmonary metastases who underwent a living-donor liver transplantation followed by reduced-toxicity myeloablative conditioning and hematopoietic stem cell transplant from the same parental donor...
November 2016: Transplantation Proceedings
https://www.readbyqxmd.com/read/27932169/invasive-aspergillosis-of-the-stomach-and-co-infection-with-candida-krusei-in-a-patient-with-terminal-liver-failure-a-case-report
#10
B Sulik-Tyszka, W Figiel, M Krawczyk, M Wróblewska
Invasive aspergillosis (IA) is diagnosed almost exclusively in immunocompromised patients. It is located mainly in the lungs or paranasal sinuses, but occasionally other organs and the gastrointestinal tract may also be affected either alone or as a part of a disseminated disease. The main risk factors predisposing to IA are neutropenia, immunosuppressive and steroid therapy, as well as severe underlying disease. Despite progress in diagnostics and therapy of IA, it is still characterized by a high mortality rate...
November 2016: Transplantation Proceedings
https://www.readbyqxmd.com/read/27932167/gangliocytoma-presenting-with-tacrolimus-neurotoxicity-in-a-renal-transplant-recipient-case-report
#11
S Alagoz, S Gulcicek, M Oruc, S Trabulus, N Seyahi
Tacrolimus is a widely used macrolide immunosuppressant in transplant surgery, with mild and major neurologic side effects. A 21-year-old woman had undergone preemptive transplantation of a kidney from her mother. On the 1st postoperative day, the patient had headache, nausea, vomiting, and agitation. Magnetic resonance imaging (MRI) of the brain showed hyperintensity and a lesion in the right mesial temporal lobe. After we switched from tacrolimus to cyclosporine, the symptoms regressed. Persistence of the lesion, confirmed by repeated MRI, required that the patient be operated on...
November 2016: Transplantation Proceedings
https://www.readbyqxmd.com/read/27932166/renal-allograft-failure-after-ipilimumab-therapy-for-metastatic-melanoma-a-case-report-and-review-of-the-literature
#12
A Jose, P Yiannoullou, S Bhutani, H Denley, M Morton, M Picton, A Summers, D van Dellen, T Augustine
Transplant recipients are at an increased risk of malignant melanoma, a result of chronic immunosuppression. Ipilimumab is a newer biological agent targeting T lymphocytes to potentiate an immune response against melanoma, and the use of this agent results in a new adverse effect profile that the clinician must be aware of while a patient is on therapy. We report the case of a male renal transplant recipient who developed graft failure while treated with ipilimumab and minimal immunosuppressive therapy for metastatic ocular melanoma, with biopsy evidence of glomerulonephritis and acute rejection...
November 2016: Transplantation Proceedings
https://www.readbyqxmd.com/read/27932165/lymphangioma-like-kaposi-sarcoma-in-transplant-associated-iatrogenic-immunosuppression-a-case-report
#13
B C Garden, O N Kramer, I K Aronson, M Braniecki
Lymphangioma-like Kaposi sarcoma (LLKS) is a rare histologic presentation of Kaposi sarcoma (KS), with only 28 cases reported in the literature. LLKS has been described in acquired immunodeficiency syndrome and in endemic African-type as well as classic indolent KS. We present the 1st reported case of LLKS in a transplant-associated iatrogenic immunosuppressed patient.
November 2016: Transplantation Proceedings
https://www.readbyqxmd.com/read/27932162/rapidly-fatal-hemophagocytic-lymphohistiocytosis-developing-within-six-days-following-deceased-donor-renal-transplantation-case-report
#14
E J Filippone, P Singh, A M Frank, A Gupta, J L Farber
Hemophagocytic lymphohistiocytosis (HLH) is an often fatal hyperinflammatory syndrome that may complicate malignancy, infection, rheumatic disease, or immunosuppression. HLH after kidney transplantation is most often triggered by infection, usually Herpes viruses such as cytomegalovirus and Epstein-Barr virus (EBV). It usually occurs early after transplantation. We present a case of HLH triggered by reactivation of EBV that pursued a rapidly fatal course within 6 days of receiving a deceased-donor kidney transplant...
November 2016: Transplantation Proceedings
https://www.readbyqxmd.com/read/27932161/sofosbuvir-monotherapy-for-asymptomatic-and-noncirrhotic-hepatitis-c-infection-in-a-renal-retransplantation-recipient-a-case-report
#15
G Deng, J Ma, S Shen, Q Li, L Peng, S Meng, J Zhou, J Wu, D Liu
Renal transplant recipients infected with hepatitis C virus (HCV) have a high risk of progressing to cirrhosis, end-stage liver diseases, and hepatocellular carcinoma. It is also considered as an independent risk for graft loss and is correlated with proteinuria, transplant glomerulopathy, HCV-associated glomerulonephritis, and chronic rejection. Previous therapy involving interferon alfa and ribavirin led to treatment complications, including toxicity, anemia, sepsis, and drug-drug interactions with calcineurin inhibitors, as well as reduced tolerability and efficacy...
November 2016: Transplantation Proceedings
https://www.readbyqxmd.com/read/27932160/successful-short-term-intravenous-treatment-of-disseminated-nocardia-farcinica-infection-with-severe-hyponatremia-after-kidney-transplantation-a-case-report
#16
A L Herzog, C Wanner, K Lopau
BACKGROUND: Nocardia is a genus of gram-positive Actinomycetes that are ubiquitous in decaying organic material, soil, and water. Some Nocardia species can infect humans, mainly by airborne transmission. Several reports describe disseminated infections, which are rare and mostly affect strongly immunocompromised patients because intact T-cell-mediated immunity is the major protective mechanism. CASE REPORT: We report a case of disseminated pulmonary, cerebral, and cutaneous infection with Nocardia farcinica in a 66-year-old kidney transplant recipient treated with low-dose triple immunosuppression...
November 2016: Transplantation Proceedings
https://www.readbyqxmd.com/read/27932158/everolimus-and-advagraf-ab-initio-in-combined-liver-and-kidney-transplant-with-donor-specific-antibodies-a-case-report
#17
L Tariciotti, T M Manzia, D Sforza, A Anselmo, G Tisone
Although donor-specific antibodies are regarded as a contraindication for kidney transplantation, the data available for combined liver and kidney transplantation (cLKTx) are scarce, and there is no established therapeutic approach for this category of transplant recipients. De novo use of everolimus and a reduced dose of calcineurin inhibitor reportedly provides excellent kidney function compared with a standard regimen containing a calcineurin inhibitor. This strategy, however, has been applied in only some recipient categories...
November 2016: Transplantation Proceedings
https://www.readbyqxmd.com/read/27932157/belatacept-and-eculizumab-for-treatment-of-calcineurin-inhibitor-induced-thrombotic-microangiopathy-after-kidney-transplantation-case-report
#18
J Merola, P S Yoo, J Schaub, J D Smith, M I Rodriguez-Davalos, E Tichy, D C Mulligan, W Asch, R Formica, M Kashgarian, S Kulkarni
Thrombotic microangiopathy (TMA) after kidney transplantation is an uncommon and challenging cause of graft dysfunction and is associated with early graft loss. An idiosyncratic endothelial reaction to calcineurin inhibitors (CNIs) has been implicated as a frequent cause of TMA. This reaction is marked by uncontrolled activation of complement and subsequent cellular destruction. Usual therapy consists of withdrawal of the inciting drug and plasmapheresis to minimize levels of circulating complement. Recently, eculizumab, a monoclonal antibody to complement component C5, has been used for the treatment of atypical hemolytic uremic syndrome...
November 2016: Transplantation Proceedings
https://www.readbyqxmd.com/read/27932152/successful-second-allogeneic-stem-cell-transplantation-from-a-sibling-donor-for-relapse-of-myelodysplastic-syndrome-in-a-recipient-of-a-renal-transplant-from-his-mother-case-report
#19
M Ikeda, N Tsukada, H Chikai, M Tasaki, K Saito, Y Nakagawa, K Takahashi, K Suzuki
There have been few reports on allogeneic stem cell transplantation in patients who have previously undergone solid organ transplantation. The clinical course of such patients is not yet well recognized. Therefore, appropriate immunosuppressive prophylaxis for the rejection of a solid organ graft or for graft-versus-host disease has not yet been established. We present the case of a successful allogeneic stem cell transplantation in a patient who relapsed after a first allogeneic stem cell transplantation for myelodysplastic syndrome and who had previously undergone renal transplantation...
November 2016: Transplantation Proceedings
https://www.readbyqxmd.com/read/27932151/kidney-transplantation-with-ultralong-term-42-years-survival-of-a-100-year-old-graft
#20
E Nascimento, F M Lucas-Junior, R A Fabreti-Oliveira, B Vilela, E R F Tavora, J P L Silva, A Salomão-Filho
BACKGROUND: In kidney transplantation, long-term graft survival has improved over the last few decades. Study to understand ultralong-term graft survival with graft functioning is rare, but a few researchers have tried to explain the factors involved in long-term graft survival. In this report, we explore the predictive factors that can be involved in ultralong-term graft survival. MATERIAL AND METHODS: Immunologic evaluations of the patients were performed using crossmatch (XM), serological, and high-resolution HLA typing for 8 loci...
November 2016: Transplantation Proceedings
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