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Muneza AB, Linden DW, Montgomery RA, Dickman AJ, Roloff GJ, Macdonald DW, Fennessy JT. Examining disease prevalence for species of conservation concern using non-invasive spatial capture-recapture techniques. J Appl Ecol 2016. [DOI: 10.1111/1365-2664.12796] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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Orandi BJ, Lonze BE, Jackson A, Terezakis S, Kraus ES, Alachkar N, Bagnasco SM, Segev DL, Orens JB, Montgomery RA. Splenic Irradiation for the Treatment of Severe Antibody-Mediated Rejection. Am J Transplant 2016; 16:3041-3045. [PMID: 27214874 DOI: 10.1111/ajt.13882] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/06/2016] [Revised: 05/06/2016] [Accepted: 05/17/2016] [Indexed: 01/25/2023]
Abstract
Patients requiring desensitization prior to renal transplantation are at risk for developing severe antibody-mediated rejection (AMR) refractory to treatment with plasmapheresis and intravenous immunoglobulin (PP/IVIg). We have previously reported success at graft salvage, long-term graft survival and protection against transplant glomerulopathy with the use of eculizumab and splenectomy in addition to PP/IVIg. Splenectomy may be an important component of this combination therapy and is itself associated with a marked reduction in donor-specific antibody (DSA) production. However, splenectomy represents a major operation, and some patients with severe AMR have comorbid conditions that substantially increase their risk of complications during and after surgery. In an effort to spare recipients the morbidity of a second operation, we used splenic irradiation in lieu of splenectomy in two incompatible live donor kidney transplant recipients with severe AMR in addition to PP/IVIg, rituximab and eculizumab. This novel approach to the treatment of severe AMR was associated with allograft salvage, excellent graft function and no short- or medium-term adverse effects of the radiation therapy. One-year surveillance biopsies did not show transplant glomerulopathy (tg) on light microscopy, but microcirculation inflammation and tg were present on electron microscopy.
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Hu X, Okabayashi T, Cameron AM, Wang Y, Hisada M, Li J, Raccusen LC, Zheng Q, Montgomery RA, Williams GM, Sun Z. Chimeric Allografts Induced by Short-Term Treatment With Stem Cell-Mobilizing Agents Result in Long-Term Kidney Transplant Survival Without Immunosuppression: A Study in Rats. Am J Transplant 2016; 16:2055-65. [PMID: 26749344 PMCID: PMC4925175 DOI: 10.1111/ajt.13706] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/13/2015] [Revised: 12/21/2015] [Accepted: 12/27/2015] [Indexed: 01/25/2023]
Abstract
Transplant tolerance allowing the elimination of lifelong immunosuppression has been the goal of research for 60 years. The induction of mixed chimerism has shown promise and has been extended successfully to large animals and to the clinic; however, it remains cumbersome and requires heavy early immunosuppression. In this study, we reported that four injections of AMD3100, a CXCR4 antagonist, plus eight injections of low-dose FK506 (0.05 mg/kg per day) in the first week after kidney transplantation extended survival, but death from renal failure occurred at 30-90 days. Repeating the same course of AMD3100 and FK506 at 1, 2 and 3 mo after transplant resulted in 92% allograft acceptance (n = 12) at 7 mo, normal kidney function and histology with no further treatment. Transplant acceptance was associated with the influx of host stem cells, resulting in a hybrid kidney and a modulated host immune response. Confirmation of these results could initiate a paradigm shift in posttransplant therapy.
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Cameron AM, Wesson RN, Ahmadi AR, Singer AL, Hu X, Okabayashi T, Wang Y, Shigoka M, Fu Y, Gao W, Raccusen LC, Montgomery RA, Williams GM, Sun Z. Chimeric Allografts Induced by Short-Term Treatment With Stem Cell Mobilizing Agents Result in Long-Term Kidney Transplant Survival Without Immunosuppression: II, Study in Miniature Swine. Am J Transplant 2016; 16:2066-76. [PMID: 26748958 DOI: 10.1111/ajt.13703] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/13/2015] [Revised: 12/21/2015] [Accepted: 12/27/2015] [Indexed: 01/25/2023]
Abstract
Transplantation is now lifesaving therapy for patients with end-stage organ failure but requires lifelong immunosuppression with resultant morbidity. Current immunosuppressive strategies inhibit T cell activation and prevent donor-recipient engagement. Therefore, it is not surprising that few host cells are demonstrated in donor grafts. However, our recent small animal studies found large numbers of recipient stem cells present after transplantation and pharmacological mobilization, resulting in a chimeric, repopulated organ. We now confirm these findings in a well-characterized large animal preclinical model. Here, we show that AMD3100 and FK506 mobilization of endogenous stem cells immediately post kidney transplantation combined with repeat therapy at 1, 2, and 3 months led to drug-free long-term survival in maximally immunologically mismatched swine. Three long-term recipients have stable chimeric transplants, preserved antidonor skin graft responses, and normal serum creatinine levels despite withdrawal of all medication for 3 years.
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Montgomery RA. Therapeutics for Antibody-Mediated Rejection: A Slippery Slope Into Confusion. Am J Transplant 2016; 16:1350-1. [PMID: 26773799 DOI: 10.1111/ajt.13721] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/15/2015] [Revised: 01/01/2016] [Accepted: 01/02/2016] [Indexed: 01/25/2023]
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Clements AD, Fletcher TR, Childress LD, Montgomery RA, Bailey BA. Social support, religious commitment, and depressive symptoms in pregnant and postpartum women. J Reprod Infant Psychol 2016. [DOI: 10.1080/02646838.2016.1152626] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
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Orandi BJ, Luo X, Massie AB, Garonzik-Wang JM, Lonze BE, Ahmed R, Van Arendonk KJ, Stegall MD, Jordan SC, Oberholzer J, Dunn TB, Ratner LE, Kapur S, Pelletier RP, Roberts JP, Melcher ML, Singh P, Sudan DL, Posner MP, El-Amm JM, Shapiro R, Cooper M, Lipkowitz GS, Rees MA, Marsh CL, Sankari BR, Gerber DA, Nelson PW, Wellen J, Bozorgzadeh A, Gaber AO, Montgomery RA, Segev DL. Survival Benefit with Kidney Transplants from HLA-Incompatible Live Donors. N Engl J Med 2016; 374:940-50. [PMID: 26962729 PMCID: PMC4841939 DOI: 10.1056/nejmoa1508380] [Citation(s) in RCA: 242] [Impact Index Per Article: 30.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/15/2023]
Abstract
BACKGROUND A report from a high-volume single center indicated a survival benefit of receiving a kidney transplant from an HLA-incompatible live donor as compared with remaining on the waiting list, whether or not a kidney from a deceased donor was received. The generalizability of that finding is unclear. METHODS In a 22-center study, we estimated the survival benefit for 1025 recipients of kidney transplants from HLA-incompatible live donors who were matched with controls who remained on the waiting list or received a transplant from a deceased donor (waiting-list-or-transplant control group) and controls who remained on the waiting list but did not receive a transplant (waiting-list-only control group). We analyzed the data with and without patients from the highest-volume center in the study. RESULTS Recipients of kidney transplants from incompatible live donors had a higher survival rate than either control group at 1 year (95.0%, vs. 94.0% for the waiting-list-or-transplant control group and 89.6% for the waiting-list-only control group), 3 years (91.7% vs. 83.6% and 72.7%, respectively), 5 years (86.0% vs. 74.4% and 59.2%), and 8 years (76.5% vs. 62.9% and 43.9%) (P<0.001 for all comparisons with the two control groups). The survival benefit was significant at 8 years across all levels of donor-specific antibody: 89.2% for recipients of kidney transplants from incompatible live donors who had a positive Luminex assay for anti-HLA antibody but a negative flow-cytometric cross-match versus 65.0% for the waiting-list-or-transplant control group and 47.1% for the waiting-list-only control group; 76.3% for recipients with a positive flow-cytometric cross-match but a negative cytotoxic cross-match versus 63.3% and 43.0% in the two control groups, respectively; and 71.0% for recipients with a positive cytotoxic cross-match versus 61.5% and 43.7%, respectively. The findings did not change when patients from the highest-volume center were excluded. CONCLUSIONS This multicenter study validated single-center evidence that patients who received kidney transplants from HLA-incompatible live donors had a substantial survival benefit as compared with patients who did not undergo transplantation and those who waited for transplants from deceased donors. (Funded by the National Institute of Diabetes and Digestive and Kidney Diseases.).
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King KE, Montgomery RA. Therapeutic plasma exchange for kidney transplantation: the problem of antibody-mediated rejection. Transfusion 2016; 55:696-9. [PMID: 26840785 DOI: 10.1111/trf.13068] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/02/2015] [Accepted: 02/03/2015] [Indexed: 11/29/2022]
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Salazar RD, Montgomery RA, Thresher SE, Macdonald DW. Mapping the Relative Probability of Common Toad Occurrence in Terrestrial Lowland Farm Habitat in the United Kingdom. PLoS One 2016; 11:e0148269. [PMID: 26841108 PMCID: PMC4739741 DOI: 10.1371/journal.pone.0148269] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/23/2015] [Accepted: 01/16/2016] [Indexed: 11/18/2022] Open
Abstract
INTRODUCTION The common toad (Bufo bufo) is of increasing conservation concern in the United Kingdom (UK) due to dramatic population declines occurring in the past century. Many of these population declines coincided with reductions in both terrestrial and aquatic habitat availability and quality and have been primarily attributed to the effect of agricultural land conversion (of natural and semi-natural habitats to arable and pasture fields) and pond drainage. However, there is little evidence available to link habitat availability with common toad population declines, especially when examined at a broad landscape scale. Assessing such patterns of population declines at the landscape scale, for instance, require an understanding of how this species uses terrestrial habitat. METHODS We intensively studied the terrestrial resource selection of a large population of common toads in Oxfordshire, England, UK. Adult common toads were fitted with passive integrated transponder (PIT) tags to allow detection in the terrestrial environment using a portable PIT antenna once toads left the pond and before going into hibernation (April/May-October 2012 and 2013). We developed a population-level resource selection function (RSF) to assess the relative probability of toad occurrence in the terrestrial environment by collecting location data for 90 recaptured toads. RESULTS The predicted relative probability of toad occurrence for this population was greatest in wooded habitat near to water bodies; relative probability of occurrence declined dramatically > 50 m from these habitats. Toads also tended to select habitat near to their breeding pond and toad occurrence was negatively related to urban environments.
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Moll RJ, Killion AK, Montgomery RA, Tambling CJ, Hayward MW. Spatial patterns of African ungulate aggregation reveal complex but limited risk effects from reintroduced carnivores. Ecology 2016. [DOI: 10.1890/15-0707] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
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Hayward MW, Kamler JF, Montgomery RA, Newlove A, Rostro-García S, Sales LP, Van Valkenburgh B. Prey Preferences of the Jaguar Panthera onca Reflect the Post-Pleistocene Demise of Large Prey. Front Ecol Evol 2016. [DOI: 10.3389/fevo.2015.00148] [Citation(s) in RCA: 39] [Impact Index Per Article: 4.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
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Alasfar S, Carter-Monroe N, Rosenberg AZ, Montgomery RA, Alachkar N. Membranoproliferative glomerulonephritis recurrence after kidney transplantation: using the new classification. BMC Nephrol 2016; 17:7. [PMID: 26754737 PMCID: PMC4709883 DOI: 10.1186/s12882-015-0219-x] [Citation(s) in RCA: 26] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/06/2015] [Accepted: 12/28/2015] [Indexed: 02/06/2023] Open
Abstract
Background Membranoproliferative glomerulonephritis (MPGN) is an uncommon glomerular disorder that may lead to end stage renal disease (ESRD). With new understanding of the disease pathogenesis, the classical classification as MPGN types I, II, III has changed. Data on post-transplant MPGN, in particular with the newly refined classification, is limited. We present our center’s experience of MPGN after kidney transplantation using the new classification. Methods This is a retrospective study of 34 patients with ESRD due to MPGN who received 40 kidney transplants between 1994 and 2014. We reviewed the available biopsies’ data using the new classification. We assessed post transplantation recurrence rate, risk factors of recurrence, the response to therapy and allografts’ survival. Results Median time of follow up was 5.3 years (range 0.5–14 years). Using the new classification, we found that pre-transplant MPGN disease was due to immune complex-mediated glomerulonephritis (ICGN) in 89 % of cases and complement-mediated glomerulonephritis (CGN) in 11 %. Recurrence was detected in 18 transplants (45 %). Living related allografts (P = 0.045), preemptive transplantations (P = 0.018), low complement level (P = 0.006), and the presence of monoclonal gammopathy (P = 0.010) were associated with higher recurrence rate in ICGN cases. Half of the patients with recurrence lost their allografts. The use of ACEi/ARB was associated with a trend toward less allograft loss. Conclusions MPGN recurs at a high rate after kidney transplantation. The risk of MPGN recurrence increases with preemptive transplantation, living related donation, low complement level, and the presence of monoclonal gammopathy. Recurrence of MPGN leads to allograft failure in half of the cases.
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Sue PK, Pisanic N, Heaney CD, Forman M, Valsamakis A, Jackson AM, Ticehurst JR, Montgomery RA, Schwarz KB, Nelson KE, Karnsakul W. Hepatitis E Virus Infection Among Solid Organ Transplant Recipients at a North American Transplant Center. Open Forum Infect Dis 2016; 3:ofw006. [PMID: 27014710 PMCID: PMC4804338 DOI: 10.1093/ofid/ofw006] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/25/2015] [Accepted: 01/12/2016] [Indexed: 02/07/2023] Open
Abstract
Background. Autochthonous hepatitis E virus (HEV) infection has been reported in over 200 solid organ transplant (SOT) recipients since 2006, yet little is known about the burden of HEV among SOT recipients in North America. We performed a retrospective, cross-sectional study to investigate the prevalence and risk factors associated with HEV infection among SOT recipients at our institution. Methods. Children and adults (n = 311) who received allografts between 1988 and 2012 at the Johns Hopkins Hospital were assessed for evidence of HEV infection by testing posttransplantation serum samples for HEV antibody by enzyme immunoassay and HEV RNA by reverse transcription quantitative polymerase chain reaction. Individuals with evidence of posttransplant HEV infection (presence of anti-HEV immunoglobulin [Ig]M antibody, anti-HEV IgG seroconversion, or HEV RNA) were compared with individuals without evidence of infection and assessed for risk factors associated with infection. Results. Twelve individuals (4%) developed posttransplant HEV infection. Posttransplant HEV infection was associated with an increased risk for graft rejection (odds ratio, 14.2; P = .03). No individuals developed chronic infection. Conclusions. Solid organ transplant recipients in the United States are at risk for posttransplant HEV infection. Further studies are needed to characterize environmental risk factors and the risk of HEV infection after SOT in North America.
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Orandi BJ, Alachkar N, Kraus ES, Naqvi F, Lonze BE, Lees L, Van Arendonk KJ, Wickliffe C, Bagnasco SM, Zachary A, Segev DL, Montgomery RA. Presentation and Outcomes of C4d-Negative Antibody-Mediated Rejection After Kidney Transplantation. Am J Transplant 2016; 16:213-20. [PMID: 26317487 PMCID: PMC6114097 DOI: 10.1111/ajt.13434] [Citation(s) in RCA: 51] [Impact Index Per Article: 6.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/26/2014] [Revised: 06/02/2015] [Accepted: 06/14/2015] [Indexed: 01/25/2023]
Abstract
The updated Banff classification allows for the diagnosis of antibody-mediated rejection (AMR) in the absence of peritubular capillary C4d staining. Our objective was to quantify allograft loss risk in patients with consistently C4d-negative AMR (n = 51) compared with C4d-positive AMR patients (n = 156) and matched control subjects without AMR. All first-year posttransplant biopsy results from January 2004 through June 2014 were reviewed and correlated with the presence of donor-specific antibody (DSA). C4d-negative AMR patients were not different from C4d-positive AMR patients on any baseline characteristics, including immunologic risk factors (panel reactive antibody, prior transplant, HLA mismatch, donor type, DSA class, and anti-HLA/ABO-incompatibility). C4d-positive AMR patients were significantly more likely to have a clinical presentation (85.3% vs. 54.9%, p < 0.001), and those patients presented substantially earlier posttransplantation (median 14 [interquartile range 8-32] days vs. 46 [interquartile range 20-191], p < 0.001) and were three times more common (7.8% vs 2.5%). One- and 2-year post-AMR-defining biopsy graft survival in C4d-negative AMR patients was 93.4% and 90.2% versus 86.8% and 82.6% in C4d-positive AMR patients, respectively (p = 0.4). C4d-negative AMR was associated with a 2.56-fold (95% confidence interval, 1.08-6.05, p = 0.033) increased risk of graft loss compared with AMR-free matched controls. No clinical characteristics were identified that reliably distinguished C4d-negative from C4d-positive AMR. However, both phenotypes are associated with increased graft loss and thus warrant consideration for intervention.
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Moll RJ, Killion AK, Montgomery RA, Tambling CJ, Hayward MW. Spatial patterns of African ungulate aggregation reveal complex but limited risk effects from reintroduced carnivores. Ecology 2015; 97:1123-34. [DOI: 10.1890/15-0707.1] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
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Jo HS, Girod FX, Avakian H, Burkert VD, Garçon M, Guidal M, Kubarovsky V, Niccolai S, Stoler P, Adhikari KP, Adikaram D, Amaryan MJ, Anderson MD, Anefalos Pereira S, Ball J, Baltzell NA, Battaglieri M, Batourine V, Bedlinskiy I, Biselli AS, Boiarinov S, Briscoe WJ, Brooks WK, Carman DS, Celentano A, Chandavar S, Charles G, Colaneri L, Cole PL, Compton N, Contalbrigo M, Crede V, D'Angelo A, Dashyan N, De Vita R, De Sanctis E, Deur A, Djalali C, Dupre R, Alaoui AE, Fassi LE, Elouadrhiri L, Fedotov G, Fegan S, Filippi A, Fleming JA, Garillon B, Gevorgyan N, Ghandilyan Y, Gilfoyle GP, Giovanetti KL, Goetz JT, Golovatch E, Gothe RW, Griffioen KA, Guegan B, Guler N, Guo L, Hafidi K, Hakobyan H, Harrison N, Hattawy M, Hicks K, Hirlinger Saylor N, Ho D, Holtrop M, Hughes SM, Ilieva Y, Ireland DG, Ishkhanov BS, Jenkins D, Joo K, Joosten S, Keller D, Khachatryan G, Khandaker M, Kim A, Kim W, Klein A, Klein FJ, Kuhn SE, Kuleshov SV, Lenisa P, Livingston K, Lu HY, MacGregor IJD, McKinnon B, Meziani ZE, Mirazita M, Mokeev V, Montgomery RA, Moutarde H, Movsisyan A, Munevar E, Munoz Camacho C, Nadel-Turonski P, Net LA, Niculescu G, Osipenko M, Ostrovidov AI, Paolone M, Park K, Pasyuk E, Phillips JJ, Pisano S, Pogorelko O, Price JW, Procureur S, Prok Y, Puckett AJR, Raue BA, Ripani M, Rizzo A, Rosner G, Rossi P, Roy P, Sabatié F, Salgado C, Schott D, Schumacher RA, Seder E, Simonyan A, Skorodumina I, Smith GD, Sokhan D, Sparveris N, Stepanyan S, Strakovsky II, Strauch S, Sytnik V, Tian Y, Tkachenko S, Ungaro M, Voskanyan H, Voutier E, Walford NK, Watts DP, Wei X, Weinstein LB, Wood MH, Zachariou N, Zana L, Zhang J, Zhao ZW, Zonta I. Cross Sections for the Exclusive Photon Electroproduction on the Proton and Generalized Parton Distributions. PHYSICAL REVIEW LETTERS 2015; 115:212003. [PMID: 26636848 DOI: 10.1103/physrevlett.115.212003] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/08/2015] [Indexed: 06/05/2023]
Abstract
Unpolarized and beam-polarized fourfold cross sections (d^{4}σ/dQ^{2}dx_{B}dtdϕ) for the ep→e^{'}p^{'}γ reaction were measured using the CLAS detector and the 5.75-GeV polarized electron beam of the Jefferson Lab accelerator, for 110 (Q^{2},x_{B},t) bins over the widest phase space ever explored in the valence-quark region. Several models of generalized parton distributions (GPDs) describe the data well at most of our kinematics. This increases our confidence that we understand the GPD H, expected to be the dominant contributor to these observables. Through a leading-twist extraction of Compton form factors, these results support the model predictions of a larger nucleon size at lower quark-momentum fraction x_{B}.
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Kilshaw K, Montgomery RA, Campbell RD, Hetherington DA, Johnson PJ, Kitchener AC, Macdonald DW, Millspaugh JJ. Mapping the spatial configuration of hybridization risk for an endangered population of the European wildcat (Felis silvestris silvestris) in Scotland. MAMMAL RES 2015. [DOI: 10.1007/s13364-015-0253-x] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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Keller BJ, Montgomery RA, Campa HR, Beyer DE, Winterstein SR, Hansen LP, Millspaugh JJ. A review of vital rates and cause-specific mortality of elk C
ervus elaphus
populations in eastern North America. Mamm Rev 2015. [DOI: 10.1111/mam.12041] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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Knabel MK, Ramachandran K, Karhadkar S, Hwang HW, Creamer TJ, Chivukula RR, Sheikh F, Clark KR, Torbenson M, Montgomery RA, Cameron AM, Mendell JT, Warren DS. Systemic Delivery of scAAV8-Encoded MiR-29a Ameliorates Hepatic Fibrosis in Carbon Tetrachloride-Treated Mice. PLoS One 2015; 10:e0124411. [PMID: 25923107 PMCID: PMC4414421 DOI: 10.1371/journal.pone.0124411] [Citation(s) in RCA: 35] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/29/2014] [Accepted: 03/14/2015] [Indexed: 02/06/2023] Open
Abstract
Fibrosis refers to the accumulation of excess extracellular matrix (ECM) components and represents a key feature of many chronic inflammatory diseases. Unfortunately, no currently available treatments specifically target this important pathogenic mechanism. MicroRNAs (miRNAs) are short, non-coding RNAs that post-transcriptionally repress target gene expression and the development of miRNA-based therapeutics is being actively pursued for a diverse array of diseases. Because a single miRNA can target multiple genes, often within the same pathway, variations in the level of individual miRNAs can potently influence disease phenotypes. Members of the miR-29 family, which include miR-29a, miR-29b and miR-29c, are strong inhibitors of ECM synthesis and fibrosis-associated decreases in miR-29 have been reported in multiple organs. We observed downregulation of miR-29a/b/c in fibrotic livers of carbon tetrachloride (CCl4) treated mice as well as in isolated human hepatocytes exposed to the pro-fibrotic cytokine TGF-β. Importantly, we demonstrate that a single systemic injection of a miR-29a expressing adeno-associated virus (AAV) can prevent and even reverse histologic and biochemical evidence of fibrosis despite continued exposure to CCl4. The observed therapeutic benefits were associated with AAV transduction of hepatocytes but not hepatic stellate cells, which are the main ECM producing cells in fibroproliferative liver diseases. Our data therefore demonstrate that delivery of miR-29 to the hepatic parenchyma using a clinically relevant gene delivery platform protects injured livers against fibrosis and, given the consistent fibrosis-associated downregulation of miR-29, suggests AAV-miR-29 based therapies may be effective in treating a variety of fibroproliferative disorders.
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Petrunenko YK, Montgomery RA, Seryodkin IV, Zaumyslova OY, Miquelle DG, Macdonald DW. Spatial variation in the density and vulnerability of preferred prey in the landscape shape patterns of Amur tiger habitat use. OIKOS 2015. [DOI: 10.1111/oik.01803] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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Adikaram D, Rimal D, Weinstein LB, Raue B, Khetarpal P, Bennett RP, Arrington J, Brooks WK, Adhikari KP, Afanasev AV, Amaryan MJ, Anderson MD, Anefalos Pereira S, Avakian H, Ball J, Battaglieri M, Bedlinskiy I, Biselli AS, Bono J, Boiarinov S, Briscoe WJ, Burkert VD, Carman DS, Careccia S, Celentano A, Chandavar S, Charles G, Colaneri L, Cole PL, Contalbrigo M, Crede V, D'Angelo A, Dashyan N, De Vita R, De Sanctis E, Deur A, Djalali C, Dodge GE, Dupre R, Egiyan H, El Alaoui A, El Fassi L, Elouadrhiri L, Eugenio P, Fedotov G, Fegan S, Filippi A, Fleming JA, Fradi A, Garillon B, Gilfoyle GP, Giovanetti KL, Girod FX, Goetz JT, Gohn W, Golovatch E, Gothe RW, Griffioen KA, Guegan B, Guidal M, Guo L, Hafidi K, Hakobyan H, Hanretty C, Harrison N, Hattawy M, Hicks K, Holtrop M, Hughes SM, Hyde CE, Ilieva Y, Ireland DG, Ishkhanov BS, Jenkins D, Jiang H, Jo HS, Joo K, Joosten S, Kalantarians N, Keller D, Khandaker M, Kim A, Kim W, Klein A, Klein FJ, Koirala S, Kubarovsky V, Kuhn SE, Livingston K, Lu HY, MacGregor IJD, Markov N, Mattione P, Mayer M, McKinnon B, Mestayer MD, Meyer CA, Mirazita M, Mokeev V, Montgomery RA, Moody CI, Moutarde H, Movsisyan A, Camacho CM, Nadel-Turonski P, Niccolai S, Niculescu G, Osipenko M, Ostrovidov AI, Park K, Pasyuk E, Peña C, Pisano S, Pogorelko O, Price JW, Procureur S, Prok Y, Protopopescu D, Puckett AJR, Ripani M, Rizzo A, Rosner G, Rossi P, Roy P, Sabatié F, Salgado C, Schott D, Schumacher RA, Seder E, Sharabian YG, Simonyan A, Skorodumina I, Smith ES, Smith GD, Sober DI, Sokhan D, Sparveris N, Stepanyan S, Stoler P, Strauch S, Sytnik V, Taiuti M, Tian Y, Trivedi A, Ungaro M, Voskanyan H, Voutier E, Walford NK, Watts DP, Wei X, Wood MH, Zachariou N, Zana L, Zhang J, Zhao ZW, Zonta I. Towards a resolution of the proton form factor problem: new electron and positron scattering data. PHYSICAL REVIEW LETTERS 2015; 114:062003. [PMID: 25723209 DOI: 10.1103/physrevlett.114.062003] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/25/2014] [Indexed: 06/04/2023]
Abstract
There is a significant discrepancy between the values of the proton electric form factor, G(E)(p), extracted using unpolarized and polarized electron scattering. Calculations predict that small two-photon exchange (TPE) contributions can significantly affect the extraction of G(E)(p) from the unpolarized electron-proton cross sections. We determined the TPE contribution by measuring the ratio of positron-proton to electron-proton elastic scattering cross sections using a simultaneous, tertiary electron-positron beam incident on a liquid hydrogen target and detecting the scattered particles in the Jefferson Lab CLAS detector. This novel technique allowed us to cover a wide range in virtual photon polarization (ϵ) and momentum transfer (Q(2)) simultaneously, as well as to cancel luminosity-related systematic errors. The cross section ratio increases with decreasing ϵ at Q(2)=1.45 GeV(2). This measurement is consistent with the size of the form factor discrepancy at Q(2)≈1.75 GeV(2) and with hadronic calculations including nucleon and Δ intermediate states, which have been shown to resolve the discrepancy up to 2-3 GeV(2).
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Orandi BJ, Chow EHK, Hsu A, Gupta N, Van Arendonk KJ, Garonzik-Wang JM, Montgomery JR, Wickliffe C, Lonze BE, Bagnasco SM, Alachkar N, Kraus ES, Jackson AM, Montgomery RA, Segev DL. Quantifying renal allograft loss following early antibody-mediated rejection. Am J Transplant 2015; 15:489-98. [PMID: 25611786 PMCID: PMC4304875 DOI: 10.1111/ajt.12982] [Citation(s) in RCA: 84] [Impact Index Per Article: 9.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/31/2014] [Revised: 07/24/2014] [Accepted: 08/12/2014] [Indexed: 01/25/2023]
Abstract
Unlike antibody-mediated rejection (AMR) with clinical features, it remains unclear whether subclinical AMR should be treated, as its effect on allograft loss is unknown. It is also uncertain if AMR's effect is homogeneous across donor (deceased/live) and (HLA/ABO) antibody types. We compared 219 patients with AMR (77 subclinical, 142 clinical) to controls matched on HLA/ABO-compatibility, donor type, prior transplant, panel reactive antibody (PRA), age and year. One and 5-year graft survival in subclinical AMR was 95.9% and 75.7%, compared to 96.8% and 88.4% in matched controls (p = 0.0097). Subclinical AMR was independently associated with a 2.15-fold increased risk of graft loss (95% CI: 1.19-3.91; p = 0.012) compared to matched controls, but not different from clinical AMR (p = 0.13). Fifty three point two percent of subclinical AMR patients were treated with plasmapheresis within 3 days of their AMR-defining biopsy. Treated subclinical AMR patients had no difference in graft loss compared to matched controls (HR 1.73; 95% CI: 0.73-4.05; p = 0.21), but untreated subclinical AMR patients did (HR 3.34; 95% CI: 1.37-8.11; p = 0.008). AMR's effect on graft loss was heterogeneous when stratified by compatible deceased donor (HR = 4.73; 95% CI: 1.57-14.26; p = 0.006), HLA-incompatible deceased donor (HR = 2.39; 95% CI: 1.10-5.19; p = 0.028), compatible live donor (no AMR patients experienced graft loss), ABO-incompatible live donor (HR = 6.13; 95% CI: 0.55-67.70; p = 0.14) and HLA-incompatible live donor (HR = 6.29; 95% CI: 3.81-10.39; p < 0.001) transplant. Subclinical AMR substantially increases graft loss, and treatment seems warranted.
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Berli JU, Montgomery JR, Segev DL, Ratner LE, Maley WR, Cooper M, Melancon JK, Burdick J, Desai NM, Dagher NN, Lonze BE, Nazarian SM, Montgomery RA. Surgical management of early and late ureteral complications after renal transplantation: techniques and outcomes. Clin Transplant 2014; 29:26-33. [PMID: 25312804 DOI: 10.1111/ctr.12478] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/10/2014] [Indexed: 11/27/2022]
Abstract
BACKGROUND In this study, we present our experience with ureteral complications requiring revision surgery after renal transplantation and compare our results to a matched control population. METHODS We performed a retrospective analysis of our database between 1997 and 2012. We divided the cases into early (<60 d) and late repairs. Kaplan-Meier and Cox proportional hazards models were used to compare graft survival between the intervention cohort and controls generated from the Scientific Registry of Transplant Recipients data set. RESULTS Of 2671 kidney transplantations, 51 patients were identified as to having undergone 53 ureteral revision procedures; 43.4% of cases were performed within 60 d of the transplant and were all associated with urinary leaks, and 49% demonstrated ureteral stenosis. Reflux allograft pyelonephritis and ureterolithiasis were each the indication for intervention in 3.8%; 15.1% of the lesions were located at the anastomotic site, 37.7% in the distal segment, 7.5% in the middle segment, 5.7% proximal ureter, and 15.1% had a long segmental stenosis. In 18.9%, the location was not specified. Techniques used included ureterocystostomy (30.2%), ureteroureterostomy (34%), ureteropyelostomy (30.1%), pyeloileostomy (1.9%), and ureteroileostomy (3.8%). No difference in overall graft survival (HR 1.24 95% CI 0.33-4.64, p = 0.7) was detected when compared to the matched control group. CONCLUSION Using a variety of techniques designed to re-establish effective urinary flow, we have been able to salvage a high percentage of these allografts. When performed by an experienced team, a ureteric complication does not significantly impact graft survival or function as compared to a matched control group.
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Jackson AM, Sigdel TK, Delville M, Hsieh SC, Dai H, Bagnasco S, Montgomery RA, Sarwal MM. Endothelial cell antibodies associated with novel targets and increased rejection. J Am Soc Nephrol 2014; 26:1161-71. [PMID: 25381426 DOI: 10.1681/asn.2013121277] [Citation(s) in RCA: 91] [Impact Index Per Article: 9.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/06/2013] [Accepted: 08/19/2014] [Indexed: 11/03/2022] Open
Abstract
The initial contact point between a recipient's immune system and a transplanted graft is the vascular endothelium. Clinical studies suggest a pathogenic role for non-HLA antiendothelial cell antibodies (AECAs) in allograft rejection; however, evidence linking AECAs of known specificity to in vivo vascular injury is lacking. Here, we used high-density protein arrays to identify target antigens for AECAs isolated from the sera of recipients of kidney transplants experiencing antibody-mediated rejection in the absence of donor-specific HLA antibodies. Four antigenic targets expressed on endothelial cells were identified: endoglin, Fms-like tyrosine kinase-3 ligand, EGF-like repeats and discoidin I-like domains 3, and intercellular adhesion molecule 4; the first three have been implicated in endothelial cell activation and leukocyte extravasation. To validate these findings, ELISAs were constructed, and sera from an additional 150 renal recipients were tested. All four AECAs were detected in 24% of pretransplant sera, and they were associated with post-transplant donor-specific HLA antibodies, antibody-mediated rejection, and early transplant glomerulopathy. AECA stimulation of endothelial cell cultures increased adhesion molecule expression and production of inflammatory cytokines: regulated on activation, normal T cell expressed and secreted PDGF and RESISTIN. These correlations between in vitro experiments and in vivo histopathology suggest that AECAs activate the vascular endothelium, amplifying the alloimmune response and increasing microvascular damage. Given the growing number of transplant candidates, a better understanding of the antigenic targets, beyond HLA, and mechanisms of immune injury will be essential for improving long-term allograft survival.
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