Mechanisms and management of acute renal allograft rejection

The Surgical Clinics of North America
M Suthanthiran, T B Strom

Abstract

We used RT-PCR for the molecular characterization of human renal graft rejection. The studies showed that intragraft display of mRNA encoding cytotoxic attack molecule granzyme B, and immunoregulatory cytokines IL-10 or IL-2 are correlates of acute rejection, and intrarenal expression of TGF-1 mRNA, of chronic rejection. The current immunosuppressive protocol involves the use of multiple drugs, each directed at a discrete site in the T-cell activation cascade and each with distinct side effects. The immunosuppressants can be classified as inhibitors of: transcription (CsA, tacrolimus); nucleotide synthesis (azathioprine, mycophenolate mofetil, and mizoribine); growth factor signal transduction (sirolimus); and differentiation (DSG). Polyclonal antibodies and monoclonal antibodies directed at cell surface proteins are quite effective as induction therapy or anti-rejection drugs.

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Citations

Sep 25, 2002·Transplantation Proceedings·A StephanA M Masri
Aug 14, 2001·Transplant International : Official Journal of the European Society for Organ Transplantation·Q W ZhangH Yasui
Dec 23, 2004·Transplant International : Official Journal of the European Society for Organ Transplantation·Allan D KirkDouglas A Hale
Oct 29, 2004·International Journal of Urology : Official Journal of the Japanese Urological Association·Masaki MuramatsuAkira Hasegawa
Oct 27, 2004·The Journal of Surgical Research·Dinesh RanjanMoolky Nagabhushan
May 30, 2003·Pharmacological Reviews·K AsadullahH D Volk

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