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humoral rejection treatment

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https://www.readbyqxmd.com/read/28133619/from-humoral-theory-to-performant-risk-stratification-in-kidney-transplantation
#1
REVIEW
C Lefaucheur, D Viglietti, M Mangiola, A Loupy, A Zeevi
The purpose of the present review is to describe how we improve the model for risk stratification of transplant outcomes in kidney transplantation by incorporating the novel insights of donor-specific anti-HLA antibody (DSA) characteristics. The detection of anti-HLA DSA is widely used for the assessment of pre- and posttransplant risks of rejection and allograft loss; however, not all anti-HLA DSA carry the same risk for transplant outcomes. These antibodies have been shown to cause a wide spectrum of effects on allografts, ranging from the absence of injury to indolent or full-blown acute antibody-mediated rejection...
2017: Journal of Immunology Research
https://www.readbyqxmd.com/read/28127210/vanishing-bile-duct-syndrome-in-hodgkin-s-lymphoma-a-case-report-and-literature-review
#2
Mena Bakhit, Thomas R McCarty, Sunhee Park, Basile Njei, Margaret Cho, Raffi Karagozian, AnnMarie Liapakis
Vanishing bile duct syndrome (VBDS) has been described in different pathologic conditions including infection, ischemia, adverse drug reactions, autoimmune diseases, allograft rejection, and humoral factors associated with malignancy. It is an acquired condition characterized by progressive destruction and loss of the intra-hepatic bile ducts leading to cholestasis. Prognosis is variable and partially dependent upon the etiology of bile duct injury. Irreversible bile duct loss leads to significant ductopenia, biliary cirrhosis, liver failure, and death...
January 14, 2017: World Journal of Gastroenterology: WJG
https://www.readbyqxmd.com/read/28110970/-plasma-exchange-in-nephrology-indications-and-technique
#3
Christophe Ridel, Sébastien Kissling, Laurent Mesnard, Alexandre Hertig, Éric Rondeau
Plasma exchange is a non-selective apheresis technique that can be performed by filtration or centrifugation allowing rapid purification of high molecular weight pathogens. An immunosuppressive treatment is generally associated to reduce the rebound effect of the purified substance. Substitution solutes such as human albumin and macromolecules are needed to compensate for plasma extraction. Compensation by viro-attenuated plasma is reserved solely for the treatment of thrombotic microangiopathies or when there is a risk of bleeding, because this product is very allergenic and expensive...
January 16, 2017: Néphrologie & Thérapeutique
https://www.readbyqxmd.com/read/28089409/the-italian-registry-of-therapeutic-apheresis-2015
#4
REVIEW
Giustina De Silvestro
Data collection on apheresis activities in Italy throughout 2015 including techniques, clinical indications and adverse effects was performed by means of a SidEM model questionnaire (aggregate data). These data provided by 67 Apheresis Units from 17 Italian regions, albeit rough, are sufficiently informative, mainly in comparison with previous surveys on these statistics. PEx has been the most frequent technique for plasma removal/treatment (11787 procedures) followed by LDL-apheresis (927 procedures). ECP/photopheresis has been the most frequent cytapheresis procedure: 6,606 session, mainlyby using the off-line technique...
December 29, 2016: Transfusion and Apheresis Science
https://www.readbyqxmd.com/read/28039098/efficacy-and-tolerability-of-interferon-free-antiviral-therapy-in-kidney-transplant-recipients-with-chronic-hepatitis-c
#5
Inmaculada Fernández, Raquel Muñoz-Gómez, Juan M Pascasio, Carme Baliellas, Natalia Polanco, Nuria Esforzado, Ana Arias, Martín Prieto, Lluis Castells, Valentín Cuervas-Mons, Olga Hernández, Javier Crespo, José L Calleja, Xavier Forns, María-Carlota Londoño
BACKGROUND & AIMS: The development of direct-acting antiviral agents (DAAs) is a major step forward in the treatment of hepatitis C (HCV). The aims of the study were to evaluate the efficacy and tolerability of DAAs in kidney transplant (KT) recipients. METHODS: Hepa-C is a Spanish registry of patients treated with DAAs in which clinical, virological and analytical data were prospectively included. We report on the data from 103 KT recipients who received DAAs. RESULTS: The most commonly used DAAs combinations were sofosbuvir/ledipasvir (n=59, 57%) and sofosbuvir+daclatasvir (n=18, 17%)...
December 28, 2016: Journal of Hepatology
https://www.readbyqxmd.com/read/27995324/hla-epitope-matching-in-pediatric-renal-transplantation
#6
Matthew P Sypek, Peter Hughes, Joshua Y Kausman
Chronic graft loss due to antibody-mediated rejection (AMR) and the difficulty of re-transplanting highly sensitized patients are two of the major long-term challenges in pediatric renal transplantation. Treatments for AMR are often ineffective and desensitization protocols can be a high risk, making prevention a highly appealing strategy. Insights into the structural determinants of humoral alloantigenicity present an exciting opportunity to reassess our current paradigm of tissue matching and potentially preventing these complications...
December 19, 2016: Pediatric Nephrology: Journal of the International Pediatric Nephrology Association
https://www.readbyqxmd.com/read/27974559/mtor-promotes-antiviral-humoral-immunity-by-differentially-regulating-cd4-helper-t-cell-and-b-cell-responses
#7
Lilin Ye, Junghwa Lee, Lifan Xu, Ata-Ur-Rasheed Mohammed, Weiyan Li, J Scott Hale, Wendy G Tan, Tuoqi Wu, Carl W Davis, Rafi Ahmed, Koichi Araki
: mTOR has important roles in regulation of both innate and adaptive immunity, but whether and how mTOR modulates humoral immune responses have yet to be fully understood. To address this issue, we examined the effects of rapamycin, a specific inhibitor of mTOR, on B cell and CD4 T cell responses during acute infection with lymphocytic choriomeningitis virus. Rapamycin treatment resulted in suppression of virus-specific B cell responses by inhibiting proliferation of germinal center (GC) B cells...
February 15, 2017: Journal of Virology
https://www.readbyqxmd.com/read/27966460/potent-cd4-t-cell-associated-antitumor-memory-responses-induced-by-trifunctional-bispecific-antibodies-in-combination-with-immune-checkpoint-inhibition
#8
Nina Deppisch, Peter Ruf, Nina Eißler, Horst Lindhofer, Ralph Mocikat
Combinatorial approaches of immunotherapy hold great promise for the treatment of malignant disease. Here, we examined the potential of combining an immune checkpoint inhibitor and trifunctional bispecific antibodies (trAbs) in a preclinical melanoma mouse model using surrogate antibodies of Ipilimumab and Catumaxomab, both of which have already been approved for clinical use. The specific binding arms of trAbs redirect T cells to tumor cells and trigger direct cytotoxicity, while the Fc region activates accessory cells eventually giving rise to a long-lasting immunologic memory...
December 10, 2016: Oncotarget
https://www.readbyqxmd.com/read/27932099/antibody-mediated-rejection-in-kidney-transplantation-without-evidence-of-anti-hla-antibodies
#9
J Irure, M López-Hoyos, E Rodrigo, J Gómez-Román, J C Ruiz, M Arias, D San Segundo
INTRODUCTION: The definition of antibody-mediated rejection (AMR) is based on serologic (presence and/or development of donor-specific anti-HLA antibodies [DSAs]) and histologic (C4d deposition and endothelial damage) criteria. However, several cases of AMR have been described without C4d deposition, and other cases of histologic AMR without DSAs, which could be driven by other non-HLA alloantibodies such as anti-MICA or anti-angiotensin II type I receptor (AT1R). Here we studied clinical and histologic humoral rejection in kidney transplant recipients without evidence of anti-HLA antibodies...
November 2016: Transplantation Proceedings
https://www.readbyqxmd.com/read/27805521/smoking-is-related-to-postoperative-pulmonary-complications-and-graft-outcomes-in-renal-transplant-patients
#10
Balam Er Dedekargınoğlu, Gaye Ulubay, Elif Küpeli, Mahir Kırnap, Füsun Öner Eyüboğlu, Mehmet Haberal
OBJECTIVES: Renal transplant is an important treatment option for end-stage renal disease. A successful kidney transplant improves the quality of life and reduces the mortality risk compared with maintenance dialysis in patients with end-stage renal disease. Several immunologic and nonimmunologic factors are responsible for graft outcomes in renal transplant patients. Our study was performed to evaluate the role of smoking on postoperative pulmonary complications and graft outcomes in renal transplant patients...
2016: Experimental and Clinical Transplantation
https://www.readbyqxmd.com/read/27798373/prolongation-of-cardiac-allograft-survival-by-endometrial-regenerative-cells-focusing-on-b-cell-responses
#11
Xiaoxi Xu, Xiaochun Li, Xiangying Gu, Bai Zhang, Weijun Tian, Hongqiu Han, Peng Sun, Caigan Du, Hao Wang
: : Endometrial regenerative cells (ERCs) have been recently evaluated as an attractive candidate source for emerging stem cell therapies in immunosuppression, but their role in immunoregulation is not fully understood. The present study was designed to investigate their effects, especially on B-cell responses in heart transplantation. In this study, ERCs were noninvasively obtained from menstrual blood. Heart transplantation was performed between C57BL/6 (H-2(b)) donor mice and BALB/c (H-2(d)) recipients...
October 26, 2016: Stem Cells Translational Medicine
https://www.readbyqxmd.com/read/27752765/acute-kidney-transplant-rejection-mediated-by-angiotensin-ii-type-1-receptor-antibodies-in-a-pediatric-hyperimmune-patient
#12
Isabella Guzzo, Federica Morolli, Francesca Diomedi Camassei, Antonina Piazza, Elvira Poggi, Luca Dello Strologo
BACKGROUND: Several cases of severe antibody-mediated rejection (AMR) secondary to antibodies against the angiotensin II type 1 receptor (AT1R-Ab) have been described with variable outcome. CASE-DIAGNOSIS/TREATMENT: We report the case of a 13-year-old boy whose first kidney transplant failed due to steroid-resistant acute cellular rejection, with the subsequent development of sensitization. He received a second kidney transplant which was complicated by early humoral rejection, with weakly positive staining for the complement degradation product C4d...
January 2017: Pediatric Nephrology: Journal of the International Pediatric Nephrology Association
https://www.readbyqxmd.com/read/27602031/the-biological-effects-of-il-21-signaling-on-b-cell-mediated-responses-in-organ-transplantation
#13
REVIEW
Yongkang Wu, Nicole M van Besouw, Yunying Shi, Martin J Hoogduijn, Lanlan Wang, Carla C Baan
Antibody-mediated rejection has emerged as one of the major issues limiting the success of organ transplantation. It exerts a highly negative impact on graft function and outcome, and effective treatment is lacking. The triggers for antibody development, and the mechanisms leading to graft dysfunction and failure, are incompletely understood. The production of antibodies is dependent on instructions from various immunocytes including CD4 T-helper cells that secrete interleukin (IL)-21 and interact with antigen-specific B-cells via costimulatory molecules...
2016: Frontiers in Immunology
https://www.readbyqxmd.com/read/27569927/association-of-c1q-binding-status-with-de-novo-hla-antibody-clinical-features-and-allograft-function-in-kidney-transplantation-patients-during-eight-years-of-dynamic-follow-up
#14
X Wei, X Yuan, M Sun, Z Pan, L Hu, L Wang, J He, J Hou
BACKGROUND: C1q-binding donor-specific antibody (DSA) is detrimental to transplanted kidney function. However, the factors that affect C1q binding status are unclear. METHODS: A total of 519 samples from 129 consecutive kidney transplantation patients during 8 years of dynamic follow-up were collected for HLA antibody (Ab) screening and C1q detection. RESULTS: Among the detected HLA Abs, the majority were class II, and the DQ subtypes composed the highest proportion...
July 2016: Transplantation Proceedings
https://www.readbyqxmd.com/read/27563301/antibody-dependent-nk-cell-activation-is-associated-with-late-kidney-allograft-dysfunction-and-the-complement-independent-alloreactive-potential-of-donor-specific-antibodies
#15
Tristan Legris, Christophe Picard, Dilyana Todorova, Luc Lyonnet, Cathy Laporte, Chloé Dumoulin, Corinne Nicolino-Brunet, Laurent Daniel, Anderson Loundou, Sophie Morange, Stanislas Bataille, Henri Vacher-Coponat, Valérie Moal, Yvon Berland, Francoise Dignat-George, Stéphane Burtey, Pascale Paul
Although kidney transplantation remains the best treatment for end-stage renal failure, it is limited by chronic humoral aggression of the graft vasculature by donor-specific antibodies (DSAs). The complement-independent mechanisms that lead to the antibody-mediated rejection (ABMR) of kidney allografts remain poorly understood. Increasing lines of evidence have revealed the relevance of natural killer (NK) cells as innate immune effectors of antibody-dependent cellular cytotoxicity (ADCC), but few studies have investigated their alloreactive potential in the context of solid organ transplantation...
2016: Frontiers in Immunology
https://www.readbyqxmd.com/read/27549123/vegf-neutralization-plus-ctla-4-blockade-alters-soluble-and-cellular-factors-associated-with-enhancing-lymphocyte-infiltration-and-humoral-recognition-in-melanoma
#16
Xinqi Wu, Anita Giobbie-Hurder, Xiaoyun Liao, Donald Lawrence, David McDermott, Jun Zhou, Scott Rodig, F Stephen Hodi
Immune recognition of tumor targets by specific cytotoxic lymphocytes is essential for the effective rejection of tumors. A phase I clinical trial of ipilimumab (an antibody that blocks CTLA-4 function) in combination with bevacizumab (an antibody that inhibits angiogenesis) in patients with metastatic melanoma found favorable clinical outcomes were associated with increased tumor endothelial activation and lymphocyte infiltration. To better understand the underlying mechanisms, we sought features and factors that changed as a function of treatment in patients...
October 2016: Cancer Immunology Research
https://www.readbyqxmd.com/read/27527166/transcriptomic-insights-into-the-response-of-placenta-and-decidua-basalis-to-the-cpg-oligodeoxynucleotide-stimulation-in-non-obese-diabetic-mice-and-wild-type-controls
#17
Xiao-Rui Liu, Yu-Na Guo, Chuan-Mei Qin, Xiao-Li Qin, Fei Tao, Fei Su, Fu-Ju Tian, Yan Zhang, Yi Lin
Intrauterine infection is one of the most frequent causes of miscarriage. CpG oligodeoxynucleotide (CpG ODN) can mimic intrauterine infection. CpG ODN-induced embryo-resorption was observed consistently in the NK-cell deficient non-obese diabetic (NOD) mice but not in the wild-type (WT) mice. To elucidate the molecular mechanisms of differential pregnancy outcomes, differentially expressed genes (DEGs) in the placenta and decidua basalis was revealed by RNA-Seq with CpG ODN or control ODN treatment. Common DEGs in the WT and NOD mice were enriched in antimicrobial/antibacterial humoral responses that may be activated as a primary response to bacterial infection...
August 5, 2016: International Journal of Molecular Sciences
https://www.readbyqxmd.com/read/27429102/diagnostics-and-treatment-of-a-severe-humoral-rejection-after-liver-transplantation-donor-specific-antibodies-as-a-still-underestimated-cause-of-graft-failure
#18
J Rashidi-Alavijeh, A Heinold, K Willuweit, H A Baba, P A Horn, A Paul, O Witzke, G Gerken, K Herzer
BACKGROUND: Donor-specific antibodies (DSAs) are increasingly being considered a cause of complications after liver transplant (LT). However, neither monitoring of DSAs nor the appropriate therapeutic procedures for humoral graft damage are yet standardized. Here we report a case of DSA-positive humoral rejection after LT that was successfully treated with plasmapheresis and immunoglobulins. METHODS: Human leukocyte antigen (HLA)-specific DSAs were detected by Luminex bead assay...
July 2016: Zeitschrift Für Gastroenterologie
https://www.readbyqxmd.com/read/27367750/failure-of-calcineurin-inhibitor-tacrolimus-weaning-randomized-trial-in-long-term-stable-kidney-transplant-recipients
#19
E Dugast, J-P Soulillou, Y Foucher, E Papuchon, P Guerif, C Paul, D Riochet, M Chesneau, A Cesbron, K Renaudin, J Dantal, M Giral, S Brouard
Long-term renal transplant outcome is limited by side effects of immunosuppressive drugs, particularly calcineurin inhibitor (CNI). We assumed that some patients selected for a "low immunological risk of rejection" could be eligible and benefit from a CNI weaning strategy. We designed a prospective, randomized, multicenter, double-blind placebo-controlled clinical study (Eudract: 2010-019574-33) to analyze the benefit-risk ratio of tacrolimus weaning on highly selected patients (≥4 years of transplantation, normal histology, stable graft function, no anti-HLA immunization)...
November 2016: American Journal of Transplantation
https://www.readbyqxmd.com/read/27362313/mtor-inhibition-suppresses-posttransplant-alloantibody-production-through-direct-inhibition-of-alloprimed-b-cells-and-sparing-of-cd8-antibody-suppressing-t-cells
#20
Christina L Avila, Jason M Zimmerer, Steven M Elzein, Thomas A Pham, Mahmoud Abdel-Rasoul, Ginny L Bumgardner
BACKGROUND: De novo alloantibodies (donor-specific antibody) contribute to antibody-mediated rejection and poor long-term graft survival. Because the development of donor-specific antibody is associated with early graft loss of cell transplants and reduced long-term survival of solid organ transplants, we hypothesized that conventional immunosuppressives, calcineurin inhibitors (CNi), and mammalian target of rapamycin inhibitors (mTORi), may not be as effective for suppression of humoral alloimmunity as for cell-mediated immunity...
September 2016: Transplantation
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