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immunosuppression minimization

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https://www.readbyqxmd.com/read/28211192/racial-differences-in-incident-de-novo-donor-specific-anti-hla-antibody-among-primary-renal-allograft-recipients
#1
Matthew J Everly, Kimberly P Briley, Carl E Haisch, Georg Dieplinger, Paul Bolin, Scott A Kendrick, Claire Morgan, Angela Q Maldonado, Lorita M Rebellato
Controversy exists as to whether African American (AA) transplant recipients are at risk for developing de novo donor-specific anti-human leukocyte antigen (HLA) antibody (dnDSA). We studied 341 HLA-mismatched, primary renal allograft recipients who were consecutively transplanted between 3/1999 and 12/2010. Sera were collected sequentially pre- and post-transplant and tested for anti-HLA immunoglobulin G (IgG) via single antigen bead assay. Of the 341 transplant patients (225 AA and 116 non-AA), 107 developed dnDSA at a median of 9...
February 17, 2017: Transplant International: Official Journal of the European Society for Organ Transplantation
https://www.readbyqxmd.com/read/28206810/safety-of-oral-and-intravenous-mycophenolate-mofetil-in-healthy-cats
#2
Jennifer E Slovak, Nicolas F Villarino
Objectives The aim of this study was to evaluate the safety and clinical effects of intravenous (IV) and oral mycophenolate mofetil (MMF) in healthy cats. Methods A total of 24 healthy adult cats weighing >3.5 kg were either administered IV MMF (over a 2 h infusion) or oral MMF. The dosages used were as follows: 5 mg/kg IV once (n = 2), 10 mg/kg q12h IV for 1 day (n = 1), 20 mg/kg q12h IV for 1 day (n = 6) and 10 mg/kg q12h IV for 3 days (n = 5). Blood was collected from each cat at intervals of up to 12 h from the last dose for analysis purposes...
February 1, 2017: Journal of Feline Medicine and Surgery
https://www.readbyqxmd.com/read/28205445/severe-hypertriglyceridemia-induced-by-sirolimus-treated-with-medical-management-without-plasmapheresis
#3
Kazuhiko Kido, Rickey A Evans, Anil Gopinath, Jeremy D Flynn
: Hypertriglyceridemia and hyperlipidemia are the most remarkable metabolic complications seen with long-term sirolimus therapy. We report the case of a 36-year-old woman status post bilateral lung transplantation on a maintenance immunosuppression regimen of sirolimus, tacrolimus, and prednisone who presented with status migrainosus, chest pain, abdominal discomfort, and triglyceride levels greater than 4425 mg/dL. In previously reported cases of severe hypertriglyceridemia that developed on maintenance sirolimus therapy, plasmapheresis has been utilized as an early strategy to rapidly lower triglycerides in order to minimize the risk of acute complications such as pancreatitis, but our case was managed medically without plasmapheresis...
January 1, 2017: Journal of Pharmacy Practice
https://www.readbyqxmd.com/read/28186091/topical-tacrolimus-for-the-treatment-of-secondary-lymphedema
#4
Jason C Gardenier, Raghu P Kataru, Geoffrey E Hespe, Ira L Savetsky, Jeremy S Torrisi, Gabriela D García Nores, Dawit K Jowhar, Matthew D Nitti, Ryan C Schofield, Dean C Carlow, Babak J Mehrara
Secondary lymphedema, a life-long complication of cancer treatment, currently has no cure. Lymphedema patients have decreased quality of life and recurrent infections with treatments limited to palliative measures. Accumulating evidence indicates that T cells play a key role in the pathology of lymphedema by promoting tissue fibrosis and inhibiting lymphangiogenesis. Here using mouse models, we show that topical therapy with tacrolimus, an anti-T-cell immunosuppressive drug, is highly effective in preventing lymphedema development and treating established lymphedema...
February 10, 2017: Nature Communications
https://www.readbyqxmd.com/read/28184367/novel-immunotherapies-for-autoimmune-hepatitis
#5
REVIEW
Shamir Cassim, Marc Bilodeau, Catherine Vincent, Pascal Lapierre
Autoimmune hepatitis (AIH) is a multifactorial autoimmune disease of unknown pathogenesis, characterized by a loss of immunological tolerance against liver autoantigens resulting in the progressive destruction of the hepatic parenchyma. Current treatments are based on non-specific immunosuppressive drugs. Although tremendous progress has been made using specific biological agents in other inflammatory diseases, progress has been slow to come for AIH patients. While current treatments are successful in the majority of patients, treatment discontinuation is difficult to achieve, and relapses are frequent...
2017: Frontiers in Pediatrics
https://www.readbyqxmd.com/read/28183144/rapid-deterioration-of-latent-hbv-hepatitis-during-cushing-disease-and-posttraumatic-stress-disorder-after-earthquake
#6
Ryosuke Tashiro, Yoshikazu Ogawa, Teiji Tominaga
Reactivation of the hepatitis B virus (HBV) is a risk in the 350 million HBV carriers worldwide. HBV reactivation may cause hepatocellular carcinoma, cirrhosis, and fulminant hepatitis, and HBV reactivation accompanied with malignant tumor and/or chemotherapy is a critical problem for patients with chronic HBV infection. Multiple risk factors causing an immunosuppressive state can also induce HBV reactivation.We present a case of HBV reactivation during an immunosuppressive state caused by Cushing disease and physical and psychological stress after a disaster...
February 9, 2017: Journal of Neurological Surgery. Part A, Central European Neurosurgery
https://www.readbyqxmd.com/read/28181315/emodin-a-natural-inhibitor-of-protein-kinase-ck2-suppresses-growth-hyphal-development-and-biofilm-formation-of-candida-albicans
#7
Monika Janeczko, Maciej Masłyk, Konrad Kubiński, Hieronim Golczyk
Emodin (1,3,8-trihydroxy-6-methyl-anthraquinone) is a natural secondary plant product, originally isolated from the rhizomes of Rheum palmatum. Many reports show its diuretic, vasorelaxant, anti-bacterial, anti-viral, anti-ulcerogenic, immunosuppressive, hepatoprotective, anti-inflammatory, and anti-cancer potential. Emodin is a pleiotropic molecule capable of interacting with several major molecular targets, e.g. NF-κB, AKT/mTOR, and STAT3. The compound can also act as an inhibitor of some protein kinases, with special affinity to protein kinase CK2...
February 8, 2017: Yeast
https://www.readbyqxmd.com/read/28170133/optimal-strategies-for-the-diagnosis-of-community-onset-diarrhea-in-solid-organ-transplant-recipients-less-is-more
#8
Sonya A Trinh, Ignacio A Echenique, Sudhir Penugonda, Michael P Angarone
BACKGROUND: Diarrhea, a common complication after solid organ transplant (SOT), is associated with allograft failure and death. No evidence-based guidelines exist for the evaluation of diarrhea in SOT recipients. We performed a cost-analysis to derive a testing algorithm for the diagnosis of community-onset diarrhea that minimizes costs without compromising diagnostic yields. DESIGN: A cost-analysis was performed on a retrospective cohort of 422 SOT admissions for community-onset diarrhea over an 18-month period...
February 7, 2017: Transplant Infectious Disease: An Official Journal of the Transplantation Society
https://www.readbyqxmd.com/read/28167553/troponoids-can-inhibit-growth-of-the-human-fungal-pathogen-cryptococcus-neoformans
#9
Maureen J Donlin, Anthony Zunica, Ashlyn Lipnicky, Aswin K Garimallaprabhakaran, Alex J Berkowitz, Alexandre Grigoryan, Marvin J Meyers, John E Tavis, Ryan P Murelli
Cryptococcus neoformans is a common pathogen of the immunosuppressed. It can be treated with amphotericin B and fluconazole, but the mortality rate remains 15-30%, thus novel and more effective anti-cryptococcal therapies are needed. The troponoids are based on natural products isolated from Western redcedar and have broad antimicrobial activity. Extracts of Western redcedar inhibit growth of several fungal species, but neither Western redcedar extracts nor troponoid derivatives have been tested against C. neoformans...
February 6, 2017: Antimicrobial Agents and Chemotherapy
https://www.readbyqxmd.com/read/28149213/using-decision-analysis-to-understand-the-indications-for-unilateral-hand-transplantation
#10
Brett McClelland, Christine B Novak, Steven Hanna, Steven J McCabe
Background: Upper extremity transplantation has been performed to improve quality of life, the benefit which must be traded off for the risk created by life-long immunosuppression. We believe the process of decision analysis is well suited to improve our understanding of these trade-offs. Method: We created a decision tree to include a branch point to illustrate the expected recovery of useful function in the transplant, using the best estimates for utility and probability that exist. Results: Our model revealed that when the probability of achieving a good result, graded as Chen level one or two is greater than 73%, transplantation is preferred over no transplantation...
December 2016: Hand: Official Journal of the American Association for Hand Surgery
https://www.readbyqxmd.com/read/28144952/unique-clinical-courses-of-transfusion-transmitted-hepatitis-e-in-patients-with-immunosuppression
#11
Masahiro Satake, Keiji Matsubayashi, Yuji Hoshi, Rikizo Taira, Yasumi Furui, Norihiro Kokudo, Nobuhisa Akamatsu, Tomoharu Yoshizumi, Nobuhiro Ohkohchi, Hiroaki Okamoto, Masato Miyoshi, Akinori Tamura, Kyoko Fuse, Kenji Tadokoro
BACKGROUND: The high prevalence of specific immunoglobulin G for hepatitis E virus (HEV) in Japanese people raises the possibility of a high incidence of HEV-viremic blood donors and therefore frequent transfusion-transmitted HEV (TT-HEV). STUDY DESIGN AND METHODS: TT-HEV cases established in Japan through hemovigilance and those published in the literature were collected. Infectivity of HEV-contaminated blood components and disease severity in relation to immunosuppression were investigated...
January 31, 2017: Transfusion
https://www.readbyqxmd.com/read/28133934/a-novel-immune-function-biomarker-identifies-patients-at-risk-of-clinical-events-early-following-liver-transplantation
#12
Siddharth Sood, Craig Haifer, Lijia Yu, Julie Pavlovic, Leonid Churilov, Paul J Gow, Robert M Jones, Peter W Angus, Kumar Visvanathan, Adam G Testro
: Balancing immunosuppression after liver transplant is difficult, with clinical events common. We investigate whether a novel immune biomarker based on a laboratory platform with widespread availability that measures interferon gamma (IFNγ) after stimulation with a lyophilized ball containing an adaptive and innate immune stimulant can predict events following transplantation. 75 adult transplant recipients were prospectively monitored in a blinded, observational study. 55/75 (73.3%) patients experienced a total 89 clinical events...
January 30, 2017: Liver Transplantation
https://www.readbyqxmd.com/read/28130881/transplantation-of-hepatocytes-from-genetically-engineered-pigs-into-baboons
#13
Hayato Iwase, Hong Liu, Eva Schmelzer, Mohamed Ezzelarab, Martin Wijkstrom, Hidetaka Hara, Whayoung Lee, Jagjit Singh, Cassandra Long, Eric Lagasse, Jörg C Gerlach, David K C Cooper, Bruno Gridelli
BACKGROUND: Some patients with acute or acute-on-chronic hepatic failure die before a suitable human liver allograft becomes available. Encouraging results have been achieved in such patients by the transplantation of human hepatocyte progenitor cells from fetal liver tissue. The aim of the study was to explore survival of hepatocytes from genetically engineered pigs after direct injection into the spleen and other selected sites in immunosuppressed baboons to monitor the immune response and the metabolic function and survival of the transplanted hepatocytes...
January 28, 2017: Xenotransplantation
https://www.readbyqxmd.com/read/28128850/transplantation-tolerance-the-big-picture-where-do-we-stand-where-should-we-go
#14
Herman Waldmann
A major goal in organ transplantation has been to safely exploit the natural processes of immune tolerance so as to minimize the dose and duration of drug immunosuppression. In this commentary, I argue that we can learn from how tumours avoid rejection, and propose a three stage tolerance-inducing strategy for transplanted tissues. This article is protected by copyright. All rights reserved.
January 27, 2017: Clinical and Experimental Immunology
https://www.readbyqxmd.com/read/28125536/wound-morbidity-in-minimally-invasive-anterior-component-separation-compared-to-transversus-abdominis-release
#15
Brodie Parent, Dara Horn, Lauren Jacobson, Rebecca P Petersen, Marcelo Hinojosa, Robert Yates, Andrew S Wright, Otway Louie
BACKGROUND: Transversus abdominis release is a novel approach for myofascial advancement in ventral hernia repair and has been hypothesized to have lower rates of wound complication than anterior component separation. METHODS: Patients who had a ventral hernia repair with either transversus abdominis release or minimally invasive anterior component separation from January of 2010 to January of 2016 were enrolled in this retrospective cohort study. Patient characteristics were collected through chart review...
February 2017: Plastic and Reconstructive Surgery
https://www.readbyqxmd.com/read/28124967/-a-rare-and-mortal-infection-agent-in-patients-with-hematological-malignancies-saprochaete-capitata
#16
Lale Aydın Kaynar, Zübeyde Nur Özkurt, Burcu Ülküden, Özlem Güzel Tunçcan, Gülbin Aygencel, Nalan Akyürek, Ayşe Kalkancı
Saprochaete capitata (formerly known as Geotrichum capitatum and Blastoschizomyces capitatus) is a rare invasive fungal agent that may lead to mortal clinical course in patients with hematological malignancies. This agent can be colonized in skin, lungs and intestines, and it can cause major opportunistic infections. Invasive systemic infections due to S.capitata have been reported in immunosuppressed patients. In this report, two patients with invasive S.capitata infections detected during the course of persistent neutropenic fever in acute leukemia, were presented...
October 2016: Mikrobiyoloji Bülteni
https://www.readbyqxmd.com/read/28119255/limitations-of-current-liver-transplant-immunosuppressive-regimens-renal-considerations
#17
Wei Zhang, John Fung
BACKGROUND: The use of calcineurin inhibitor (CNI)-based immunosuppressive regimens following liver transplantation (LTx) has improved the outcomes of the recipients. However, CNI has nephrotoxicity and causes short- and long-term renal complications. The progressive structural changes can be irreversible in the long-term, leading to chronic kidney dysfunction. The present review was to evaluate the different strategies of CNI application to renal function in liver recipients. DATA SOURCES: PubMed database was searched for relevant articles in English on the issue of immunosuppressive regimen and kidney injury that related to early minimization of CNI after LTx...
February 2017: Hepatobiliary & Pancreatic Diseases International: HBPD INT
https://www.readbyqxmd.com/read/28109928/fdg-uptake-by-prosthetic-arterial-grafts-in-large-vessel-vasculitis-is-not%C3%A2-specific-for-active-disease
#18
Taryn Youngstein, Enrico Tombetti, Jaita Mukherjee, Tara D Barwick, Adil Al-Nahhas, Emyr Humphreys, Julian Nash, Jacqueline Andrews, Elena Incerti, Elisabetta Tombolini, Annalaura Salerno, Silvia Sartorelli, Giuseppe A Ramirez, Maurizio Papa, Maria Grazia Sabbadini, Luigi Gianolli, Francesco De Cobelli, Federico Fallanca, Elena Baldissera, Angelo A Manfredi, Maria Picchio, Justin C Mason
OBJECTIVES: This study investigated the incidence and clinical significance of arterial graft-associated uptake of fluorodeoxyglucose in large-vessel vasculitis (LVV). BACKGROUND: The role of (18)F-labeled fluorodeoxyglucose-positron emission tomography/computed tomography ([(18)F]FDG-PET/CT) in the management of LVV remains to be defined. Although [(18)F]FDG uptake at arterial graft sites raises concerns regarding active arteritis or infection, its clinical significance in LVV has never been formally studied...
January 11, 2017: JACC. Cardiovascular Imaging
https://www.readbyqxmd.com/read/28104155/immunosuppression-modification-by-everolimus-with-minimization-of-calcineurin-inhibitors-recovers-kidney-graft-function-even-in-patients-with-very-late-conversion-and-also-with-poor-graft-function
#19
M Nojima, Y Yamada, Y Higuchi, K Shimatani, A Kanematsu, S Yamamoto
BACKGROUND: Although kidney graft survival within 5 years after transplantation is now achieved in >95% of recipients, chronic graft deterioration remains a factor limiting long-term survival. Chronic nephrotoxicity induced by calcineurin inhibitors (CNIs) is one of the major causes of chronic graft injury; thus, minimization of CNIs by administration of everolimus (EVR) is expected to relieve their toxic effects. METHODS: Fifty-six kidney transplant recipients receiving CNI-based immunosuppression (tacrolimus, n = 34; cyclosporine, n = 22) were analyzed...
January 2017: Transplantation Proceedings
https://www.readbyqxmd.com/read/28100001/transplantation-tolerance-don-t-forget-about-the-b-cells
#20
REVIEW
Anita S Chong, Stella H Khiew
Establishing a state of transplantation tolerance that leads to indefinite graft survival without the need for lifelong immunosuppression has been successfully achieved in limited numbers of transplant recipients in the clinic. These successes led to studies aimed at identifying potential biomarkers that diagnose allograft tolerance and identify the patients most amenable to drug minimization, and implicated an enriched B cell signature of tolerance. The emergence of a specialized subset of regulatory B cell (Bregs) that possess immune-modulatory function in inflammation and autoimmune disease, raised the possibility that Bregs play critical roles in the promotion of transplantation tolerance and that Bregs are the underlying explanation for the B cell signature of tolerance...
January 18, 2017: Clinical and Experimental Immunology
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