Immunosuppressive drug therapy and subclinical acute renal allograft rejection: impact and effect

Transplantation
Dirk R J Kuypers

Abstract

The incidence of subclinical acute rejection (SCAR) varies between 5% and 15% with current maintenance immunosuppressive drug regimens. Despite many similarities between SCAR and clinical acute rejection exist, the inflammatory activated cell infiltrates are not completely identical while graft cytokine profiles and counteractive immune responses are characterized by subtle differences that could explain why SCAR is not accompanied by immediate graft dysfunction. Evidence that SCAR contributes to chronic allograft damage (interstitial fibrosis and tubular atrophy) and negatively affects graft outcome is counterbalanced by the scarcity of controlled data proving the beneficial effect of SCAR treatment. The development of sensitive and specific noninvasive methods to monitor the immune status of the graft by using mRNA determinations, gene expression analysis (microarrays), proteomic analysis, and magnetic resonance spectroscopy, can help to ultimately replace protocol biopsies and also contribute to the further unraveling of the complex underlying immunological mechanisms responsible for SCAR. The latter would enable clinicians to preemptively make strategic adjustments to immunosuppressive therapy in an attempt to further impro...Continue Reading

References

Jan 1, 1992·Kidney International·H M IsoniemiP Häyry
Oct 1, 1996·American Journal of Kidney Diseases : the Official Journal of the National Kidney Foundation·E J SchweitzerS T Bartlett
Jan 1, 1997·Kidney International·D SerónJ Alsina
May 6, 1998·Nephrology, Dialysis, Transplantation : Official Publication of the European Dialysis and Transplant Association - European Renal Association·O HergesellE Ritz
Sep 18, 1998·American Journal of Kidney Diseases : the Official Journal of the National Kidney Foundation·D KimH Yim
May 26, 1999·Transplantation·D R KuypersB J Nankivell
Mar 22, 2001·Transplantation·B J NankivellJ R Chapman
Jul 20, 2002·Transplantation·James M GloorMark D Stegall
Mar 28, 2003·Journal of the American Society of Nephrology : JASN·Seiichirou ShishidoAkira Hasegawa
Apr 30, 2003·Transplantation·Ruchuang DingManikkam Suthanthiran
May 10, 2003·Nephrology, Dialysis, Transplantation : Official Publication of the European Dialysis and Transplant Association - European Renal Association·W Adam Jurewicz
Aug 16, 2003·American Journal of Transplantation : Official Journal of the American Society of Transplantation and the American Society of Transplant Surgeons·Tania SimonCaner Süsal
Nov 11, 2003·Nephrology, Dialysis, Transplantation : Official Publication of the European Dialysis and Transplant Association - European Renal Association·Donald SilverbergAdrian Iaina
Dec 12, 2003·The New England Journal of Medicine·Brian J NankivellJeremy R Chapman
Dec 25, 2003·Journal of the American Society of Nephrology : JASN·Stefan SchaubPeter Nickerson
Apr 28, 2004·Clinical Transplantation·Mario SénéchalIradj Gandjbakhch
May 15, 2004·Clinical Transplantation·Esther Cristina Aquino DiasRoberto Ceratti Manfro
May 19, 2004·American Journal of Transplantation : Official Journal of the American Society of Transplantation and the American Society of Transplant Surgeons·Elaine S Mansfield, Minnie M Sarwal
May 20, 2004·Kidney International·Ravi Raju TatapudiManikkam Suthanthiran
Jul 23, 2004·American Journal of Transplantation : Official Journal of the American Society of Transplantation and the American Society of Transplant Surgeons·Herwig-Ulf Meier-KriescheBruce Kaplan
Jul 29, 2004·Transplantation·Brian J NankivellJeremy R Chapman
Sep 16, 2004·American Journal of Transplantation : Official Journal of the American Society of Transplantation and the American Society of Transplant Surgeons·Lorraine C RacusenKim Solez
May 13, 2005·American Journal of Transplantation : Official Journal of the American Society of Transplantation and the American Society of Transplant Surgeons·Bum Soon ChoiChul Woo Yang
Jul 6, 2005·American Journal of Transplantation : Official Journal of the American Society of Transplantation and the American Society of Transplant Surgeons·Mysore S Anil KumarAparna Kumar
Aug 27, 2005·The New England Journal of Medicine·Flavio VincentiUNKNOWN Belatacept Study Group
Sep 16, 2005·American Journal of Transplantation : Official Journal of the American Society of Transplantation and the American Society of Transplant Surgeons·Stefan WittkeWilfried Gwinner
Dec 2, 2005·The New England Journal of Medicine·Thangamani MuthukumarManikkam Suthanthiran
Mar 17, 2006·American Journal of Transplantation : Official Journal of the American Society of Transplantation and the American Society of Transplant Surgeons·F MoresoD Serón
Jun 22, 2006·Kidney International·M IbernónD Serón
Jul 11, 2006·American Journal of Transplantation : Official Journal of the American Society of Transplantation and the American Society of Transplant Surgeons·K DahanP Grimbert
Jul 25, 2006·Transplantation·Terence Y-S KeeBrian J Nankivell
Aug 11, 2006·Journal of the American Society of Nephrology : JASN·Eduard M ScholtenJohan W de Fijter

❮ Previous
Next ❯

Citations

Jul 28, 2011·Pediatric Nephrology : Journal of the International Pediatric Nephrology Association·Patricia E Birk
Jul 15, 2009·Néphrologie & thérapeutique·C Legendre
May 6, 2009·Transplant International : Official Journal of the European Society for Organ Transplantation·Nicolas Kozakowski, Heinz Regele
Apr 2, 2009·Biological & Pharmaceutical Bulletin·Takafumi KuzuyaKiyofumi Yamada
Dec 2, 2009·Transplantation·Luis F QuintanaJosep M Campistol
Mar 5, 2015·Nephro-urology Monthly·Mojgan JalalzadehMohammad Hassan Ghadiani

❮ Previous
Next ❯

Related Concepts

Related Feeds

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.