Preapheresis immunosuppressive induction: necessary or harmful?

Strategies to overcome the ABO barrier in kidney transplantation

Kidney transplantation across the ABO blood group barrier was long considered a contraindication for transplantation, but in an effort to increase donor pools, specific regimens for ABO-incompatible (ABOi) transplantation have been developed. These regimens are now widely used as an integral part of the available treatment options. Various desensitization protocols, commonly based on transient depletion of preformed anti-A and/or anti-B antibodies and modulation of B-cell immunity, enable excellent transplant outcomes, even in the long-term. Nevertheless, the molecular mechanisms behind transplant acceptance facilitated by a short course of anti-humoral treatment are still incompletely understood. With the evolution of efficient clinical programmes, tailoring of recipient preconditioning based on individual donor-recipient blood type combinations and the levels of pretransplant anti-A/B antibodies has become possible. In the context of low antibody titres and/or donor A2 phenotype, immunomodulation and/or apheresis might be dispensable. A concern still exists, however, that ABOi kidney transplantation is associated with an increased risk of surgical and infectious complications, partly owing to the effects of extracorporeal treatment and intensified immunosuppression. Nevertheless, a continuous improvement in desensitization strategies, with the aim of minimizing the immunosuppressive burden, might pave the way to clinical outcomes that are comparable to those achieved in ABO-compatible transplantation.

Fullerene C60 modified gold electrode and nanogold modified indium tin oxide electrode for prednisolone determination

The electrochemical determination of prednisolone has been investigated at fullerene-C(60)-modified gold (C(60)/Au) electrode and gold nanoparticles modified indium tin oxide (nano Au/ITO) electrode in phosphate buffer solution (PBS) of pH 7.2. During oxidation of prednisolone, an anodic peak with peak potential (E(p)) at 570 mV and 400 mV appeared at nano Au/ITO and C(60)/Au electrode, respectively. The experimental results revealed that gold nanoparticles as well as fullerene (C(60)) promote the rate of prednisolone oxidation by increasing the peak current (i(p)) and oxidizing at lower peak potentials as compared to the respective bare electrodes due to their electrocatalytic effect. The linear concentration range at both the electrodes was in the range of 1 microM to 0.10 mM. The detection limit obtained at C(60)/Au electrode was 26 nM, while at nano Au/ITO electrode the detection limit was 90 nM. The applicability of the method to direct assays of human urine and whole blood sample is described to use the method for testing cases of doping by athletes.