Antibody-mediated rejection

Current Opinion in Organ Transplantation
Alessandro Amore

Abstract

Over the last five decades, the attention of nephrologists has focused on cellular rejection which was considered to be responsible for the early loss of function of the transplanted kidney. The use of new drugs in different combinations with steroids resulted in an improved short-term survival of the graft, which has significantly reduced the incidence of acute rejections. The main problem now, however, is ensuring the long-term survival of the transplanted kidney. This has become the challenge of the new millennium. The current literature clearly focuses on donor-specific alloantibodies, directed against human leukocyte antigen (HLA) and non-HLA antigens [donor-specific antibodies (DSA)], which have been shown to play an important role in graft dysfunction, longevity, and loss. To mitigate allograft loss due to antibodies, it is important to treat the source of antibody production, the plasma cells. Drugs used prior to 2007, such as Rituximab, intravenous immunoglobulins, and plasmapheresis, lack effects on these long-lived plasma cells. Their ability to remove DSA is incomplete and/or cost prohibitive. Since 2007, Bortezomib, a proteasome inhibitor, has been used to deplete plasma cells, thus eliminating the synthesis of DSA...Continue Reading

References

Jul 1, 1993·Proceedings of the National Academy of Sciences of the United States of America·J L AmbrusR J Ford
Nov 2, 2004·Clinical Transplantation·Philip G ThomasKristene K Gugliuzza
Dec 24, 2008·Transplantation·Matthew J EverlyE Steve Woodle
Jun 13, 2009·Nature Reviews. Immunology·Fabienne Mackay, Pascal Schneider
Aug 18, 2009·American Journal of Transplantation : Official Journal of the American Society of Transplantation and the American Society of Transplant Surgeons·Banu SisPhilip F Halloran
Jul 20, 2010·American Journal of Transplantation : Official Journal of the American Society of Transplantation and the American Society of Transplant Surgeons·B E LonzeR A Montgomery
Apr 28, 2011·American Journal of Transplantation : Official Journal of the American Society of Transplantation and the American Society of Transplant Surgeons·P ArchdeaconR Albrecht
Jun 24, 2011·Transplant International : Official Journal of the European Society for Organ Transplantation·Ali-Reza BiglarniaGunnar Tufveson
Feb 4, 2012·American Journal of Transplantation : Official Journal of the American Society of Transplantation and the American Society of Transplant Surgeons·J O Medina PestanaA Durrbach
Feb 4, 2012·American Journal of Transplantation : Official Journal of the American Society of Transplantation and the American Society of Transplant Surgeons·M MengelUNKNOWN Banff meeting report writing committee
Jun 12, 2012·American Journal of Transplantation : Official Journal of the American Society of Transplantation and the American Society of Transplant Surgeons·D NooneC Licht
Aug 14, 2012·American Journal of Transplantation : Official Journal of the American Society of Transplantation and the American Society of Transplant Surgeons·A Thibault-EspitiaS Brouard
Aug 18, 2012·Transplant International : Official Journal of the European Society for Organ Transplantation·Heiko BillingBurkhard Tönshoff
Sep 11, 2012·American Journal of Transplantation : Official Journal of the American Society of Transplantation and the American Society of Transplant Surgeons·F GinevriF Poli
Feb 28, 2013·Pediatric Transplantation·Michael M KaabakAlan K Zokoev
Mar 2, 2013·Journal of the American Society of Nephrology : JASN·Abanti ChaudhuriMinnie M Sarwal
Oct 30, 2013·Pediatric Transplantation·Jennifer SungAmira Al-Uzri
Apr 2, 2014·American Journal of Transplantation : Official Journal of the American Society of Transplantation and the American Society of Transplant Surgeons·A D KirkT C Pearson
Oct 9, 2014·Immunological Investigations·Oleh PankewyczMark R Laftavi
Dec 30, 2014·World Journal of Transplantation·Licia PeruzziRosanna Coppo

❮ Previous
Next ❯

Methods Mentioned

BETA
ELISA
flow cytometry
biopsies

Clinical Trials Mentioned

NCT01025193

Related Concepts

Related Feeds

Antibody Specificity

Antibodies produced by B cells are highly specific for antigen as a result of random gene recombination and somatic hypermutation and affinity maturation. As the main effector of the humoral immune system, antibodies can neutralize foreign cells. Find the latest research on antibody specificity here.

Allogenic & Autologous Therapies

Allogenic therapies are generated in large batches from unrelated donor tissues such as bone marrow. In contrast, autologous therapies are manufactures as a single lot from the patient being treated. Here is the latest research on allogenic and autologous therapies.

B cell Differentiation

Depending on the signal received through the B cell receptor and other receptors, B cells differentiate into follicular or marginal zone B cells. Here is the latest research pertaining to this differentiation process.

Antibodies: Complement Activation

The complement system can be activated by antigen-associated antibody. In the classical pathway of complement activation, C1q, C4b, and C3b are all able to bind to the Fc portion of IgG or IgM. Find the latest research on antibodies and complement activation here.