The Effect of Bortezomib on Antibody-Mediated Rejection after Kidney Transplantation
2
조회
0
다운로드
3
인용
0
참고문헌
키워드
초록
Purpose: Recently, bortezomib has been used to treat antibody-mediated rejection (AMR) refractory to conventional treatmentsuch as plasmapheresis, intravenous immunoglobulin, and rituximab. The authors aimed to describe their experiences whenbortezomib was used to treat refractory AMR. Materials and Methods: Eleven refractory AMR episodes treated with bortezomib were included in this study. The patients receivedone or two cycles of bortezomib (1.3 mg/m2) on days 1, 4, 8, and 11. Results: Bortezomib effectively reduced antibodies against various targets, including human leukocyte antigen (HLA) class I andII, ABO blood group antigen, and angiotensin II type 1 receptor. Antibodies were depleted or reduced significantly in eight AMRepisodes. Overall, there was a significant improvement in the mean estimated glomerular filtration rate (eGFR) at 3 months aftertherapy (36.91±22.15 mL/min/1.73 m2) versus eGFR at time of AMR diagnosis (17.00±9.25 mL/min/1.73 m2; p=0.007). All six early-onset AMR episodes (within 6 months post-transplantation) showed full recovery of allograft function. Additionally, three ofthe five late-onset AMR episodes (>6 months post-transplantation) showed improved allograft function. Conclusion: Anti-humoral treatment based on bortezomib might be an effective strategy against refractory AMR caused by varioustypes of antibodies. Notably, this treatment could be more effective in early-onset AMR than in late-onset AMR.
Abstract
Purpose: Recently, bortezomib has been used to treat antibody-mediated rejection (AMR) refractory to conventional treatmentsuch as plasmapheresis, intravenous immunoglobulin, and rituximab. The authors aimed to describe their experiences whenbortezomib was used to treat refractory AMR. Materials and Methods: Eleven refractory AMR episodes treated with bortezomib were included in this study. The patients receivedone or two cycles of bortezomib (1.3 mg/m2) on days 1, 4, 8, and 11. Results: Bortezomib effectively reduced antibodies against various targets, including human leukocyte antigen (HLA) class I andII, ABO blood group antigen, and angiotensin II type 1 receptor. Antibodies were depleted or reduced significantly in eight AMRepisodes. Overall, there was a significant improvement in the mean estimated glomerular filtration rate (eGFR) at 3 months aftertherapy (36.91±22.15 mL/min/1.73 m2) versus eGFR at time of AMR diagnosis (17.00±9.25 mL/min/1.73 m2; p=0.007). All six early-onset AMR episodes (within 6 months post-transplantation) showed full recovery of allograft function. Additionally, three ofthe five late-onset AMR episodes (>6 months post-transplantation) showed improved allograft function. Conclusion: Anti-humoral treatment based on bortezomib might be an effective strategy against refractory AMR caused by varioustypes of antibodies. Notably, this treatment could be more effective in early-onset AMR than in late-onset AMR.
참고문헌 (18)
- Sellarés J, "Understanding the causes of kidney transplant failure: the dominant role of antibody-mediated rejection and nonadherence", Am J Transplant, 12, pp.388~399 (2012)
- Djamali A, "Diagnosis and management of antibody-mediated rejection:current status and novel approaches", Am J Transplant, 14, pp.255~271 (2014)
- Ejaz NS, "Review of bortezomib treatment of antibody-mediated rejection in renal transplantation", Antioxid Redox Signal, 21, pp.2401~2418 (2014)
- Walsh RC, "Proteasome inhibitor-based therapy for antibody-mediated rejection", Kidney Int, 81, pp.1067~1074 (2012)
- Walsh RC, "Early and late acute antibody-mediated rejection differ immunologically and in response to proteasome inhibition", Transplantation, 91, pp.1218~1226 (2011)
- 양근석, "Use of Bortezomib as Anti-Humoral Therapy in Kidney Transplantation", Journal of Korean Medical Science, 29(5), pp.648~651 (2014), 대한의학회
- Kim MG, "Outcomes of combination therapy for chronic antibody-mediated rejection in renal transplantation", Nephrology (Carlton), 18, pp.820~826 (2013)
- Kumar SK, "Improved survival in multiple myeloma and the impact of novel therapies", Blood, 111, pp.2516~2520 (2008)
- Gupta G, "Late antibody-mediated rejection in renal allografts:outcome after conventional and novel therapies", Transplantation, 97, pp.1240~1246 (2014)
- Philogene MC, "Differential effect of bortezomib on HLA class I and class II antibody", Transplantation, 98, pp.660~665 (2014)
- Gertz MA, "Immunoglobulin light chain amyloidosis: 2014 update on diagnosis, prognosis, and treatment", Am J Hematol, 89, pp.1132~1140 (2014)
- Neubert K, "The proteasome inhibitor bortezomib depletes plasma cells and protects mice with lupus-like disease from nephritis", Nat Med, 14, pp.748~755 (2008)
- Mengel M, "Banff 2011 Meeting report: new concepts in antibody-mediated rejection", Am J Transplant, 12, pp.563~570 (2012)
- Soohun Yoo, "Role of Plasma Exchange in ABO-incompatible Kidney Transplantation", Annals of Laboratory Medicine, 32(4), pp.283~288 (2012), 대한진단검사의학회
- Westphal S, "Successful treatment of severe ABO antibody-mediated rejection using bortezomib: a case report", Transplant Proc, 45, pp.1213~1215 (2013)
- Loupy A, "Duong van Huyen JP, Mooney N, et al. Complement-binding anti-HLA antibodies and kidney-allograft survival", N Engl J Med, 369, pp.1215~1226 (2013)
- Gloor JM, "Transplant glomerulopathy: subclinical incidence and association with alloantibody", Am J Transplant, 7, pp.2124~2132 (2007)
- Loupy A, "Significance of C4d Banff scores in early protocol biopsies of kidney transplant recipients with preformed donor-specific antibodies (DSA)", Am J Transplant, 11, pp.56~65 (2011)