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Rousse J, Royer PJ, Evanno G, Lheriteau E, Ciron C, Salama A, Shneiker F, Duchi R, Perota A, Galli C, Cozzi E, Blancho G, Duvaux O, Brouard S, Soulillou JP, Bach JM, Vanhove B. LIS1, a glyco-humanized swine polyclonal anti-lymphocyte globulin, as a novel induction treatment in solid organ transplantation. Front Immunol 2023; 14:1137629. [PMID: 36875084 PMCID: PMC9978386 DOI: 10.3389/fimmu.2023.1137629] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/04/2023] [Accepted: 02/03/2023] [Indexed: 02/18/2023] Open
Abstract
Anti-thymocyte or anti-lymphocyte globulins (ATGs/ALGs) are immunosuppressive drugs used in induction therapies to prevent acute rejection in solid organ transplantation. Because animal-derived, ATGs/ALGs contain highly immunogenic carbohydrate xenoantigens eliciting antibodies that are associated with subclinical inflammatory events, possibly impacting long-term graft survival. Their strong and long-lasting lymphodepleting activity also increases the risk for infections. We investigated here the in vitro and in vivo activity of LIS1, a glyco-humanized ALG (GH-ALG) produced in pigs knocked out for the two major xeno-antigens αGal and Neu5Gc. It differs from other ATGs/ALGs by its mechanism of action excluding antibody-dependent cell-mediated cytotoxicity and being restricted to complement-mediated cytotoxicity, phagocyte-mediated cytotoxicity, apoptosis and antigen masking, resulting in profound inhibition of T-cell alloreactivity in mixed leucocyte reactions. Preclinical evaluation in non-human primates showed that GH-ALG dramatically reduced CD4+ (p=0.0005,***), CD8+ effector T cells (p=0.0002,***) or myeloid cells (p=0.0007,***) but not T-reg (p=0.65, ns) or B cells (p=0.65, ns). Compared with rabbit ATG, GH-ALG induced transient depletion (less than one week) of target T cells in the peripheral blood (<100 lymphocytes/L) but was equivalent in preventing allograft rejection in a skin allograft model. The novel therapeutic modality of GH-ALG might present advantages in induction treatment during organ transplantation by shortening the T-cell depletion period while maintaining adequate immunosuppression and reducing immunogenicity.
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Affiliation(s)
| | | | | | | | - Carine Ciron
- Research and Development, Xenothera, Nantes, France
| | - Apolline Salama
- Nantes Université, Inserm, University Hospital Center CHU Nantes, Center for Research in Transplantation and Translational Immunology, UMR 1064, ITUN, Nantes, France
| | | | - Roberto Duchi
- Transplantation Immunology Unit, Padua University Hospital, Padova, Italy
| | - Andrea Perota
- Transplantation Immunology Unit, Padua University Hospital, Padova, Italy
| | - Cesare Galli
- Transplantation Immunology Unit, Padua University Hospital, Padova, Italy
| | - Emmanuele Cozzi
- Avantea, Laboratorio di Tecnologie della Riproduzione, Cremona, Italy
| | - Gilles Blancho
- Nantes Université, Inserm, University Hospital Center CHU Nantes, Center for Research in Transplantation and Translational Immunology, UMR 1064, ITUN, Nantes, France
| | - Odile Duvaux
- Research and Development, Xenothera, Nantes, France
| | - Sophie Brouard
- Nantes Université, Inserm, University Hospital Center CHU Nantes, Center for Research in Transplantation and Translational Immunology, UMR 1064, ITUN, Nantes, France
| | - Jean-Paul Soulillou
- Nantes Université, Inserm, University Hospital Center CHU Nantes, Center for Research in Transplantation and Translational Immunology, UMR 1064, ITUN, Nantes, France
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Clinical Relevance of Isoagglutinin Rebound in Adult ABO-Incompatible Living Donor Liver Transplantation. J Pers Med 2021; 11:jpm11121300. [PMID: 34945772 PMCID: PMC8709009 DOI: 10.3390/jpm11121300] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/21/2021] [Revised: 11/22/2021] [Accepted: 11/24/2021] [Indexed: 11/17/2022] Open
Abstract
ABO-incompatible (ABO-I) living donor liver transplantation (LDLT) can be performed successfully. However, anti-ABO isoagglutinin rebound may cause antibody-mediated rejection (AMR) and graft loss. The risk threshold of isoagglutinin rebound is still not defined. 76 ABO-I LDLT recipients were divided into group A (n = 56) with low isoagglutinin titers (<1:256), and group B (n = 20) with high isoagglutinin titers (≥1:256), at initial assessment for liver transplantation. The last 12 patients in group B received a modified desensitization regimen by adding bortezomib to deplete plasma cells. Six (10.7%) patients in group A and 10 (50.0%) patients in group B had postoperative isoagglutinin rebound (p < 0.001). Three patients (5.54%) in group A and two patients (10%) in group B developed clinical AMR (p = 0.602). The cutoff value of postoperative isoagglutinin rebound to cause clinical AMR was ≥1:1024. Among the 12 patients in group B with bortezomib administration, isoagglutinin rebounded up to 1:128 only, and no clinical AMR occurred. In conclusion, the patients with high isoagglutinin titers had a higher rate of postoperative isoagglutinin rebound. Isoagglutinin rebound ≥1:1024 is risky for developing clinical AMR. Adding bortezomib into the desensitization regimen may mitigate isoagglutinin rebound, and avoid clinical AMR.
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Guo Y, Fang J, Ma J, Li G, Zhang L, He J, Xu L, Lai X, Yin W, Xiong Y, Liu L, Zhang Y, Pan G, Chen Z. Correlation between use of immunosuppressive agents and transplant-acquired allergies in renal transplant recipients. Transl Androl Urol 2019; 8:442-447. [PMID: 31807421 DOI: 10.21037/tau.2019.09.24] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022] Open
Abstract
Background Although immunosuppressive agents used in recipients of organ transplants can suppress T cell immune responses, type I allergy to ingested or inhaled allergens after organ transplantation have frequently been reported in pediatric patients. This study aims to investigate the relationship between the use of immunosuppressive agents and the transplant-acquired allergy (TAA) in adult renal transplant recipients (RTRs). Methods Seventy-nine RTRs treated in our hospital from February 2015 to February 2016 were interviewed for allergic diseases by using a standard questionnaire. UniCAP allergen screening tests were performed to detect total IgE and specific IgE levels before and after renal transplantation after the use of calcineurin inhibitor tacrolimus (FK506) or cyclosporin A (CsA). The follow-up visits were scheduled for 6 months, 1 year, 2 years, and 3 years after transplantation. Results Allergen sensitization occurred in 9 of 79 patients. Among them, the sensitization occurred in 2 cases within 6 months after renal transplantation, in 1 case from 6 months to 1 year, in 3 cases from 1 to 2 years, and in 3 cases from 2 to 3 years. The majority of sensitization was induced by inhaled allergens (n=7), among whom 3 patients (3/79, 3.8%) had a history of type I allergy, which occurred within 6 months after transplantation in 2 cases (allergic dermatitis) and from 2 to 3 years in 1 case (diarrhea after peanut allergy). The total IgE levels of RTRs using immunosuppressive agents at different time points including 6 months, 1 year, 2 years, and 3 years after renal transplantation were significantly lower than that before surgery (all P<0.05). Sensitization occurred in 8 RTRs using FK506 and in 1 patient treated with CsA (P=0.432), and allergies occurred in 3 RTRs using FK506 and were not found among CsA users (P=0.561). Conclusions Administration of immunosuppressive agents in adult RTRs cannot wholly prevent allergy or sensitization. Studies with larger sample sizes and more extended follow-up periods are still required to further explore the potential association between the use of FK506 and CSA and the allergies or sensitization.
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Affiliation(s)
- Yuhe Guo
- Organ Transplantation Center, the Second Affiliated Hospital of Guangzhou Medical University, Guangzhou 511447, China
| | - Jiali Fang
- Organ Transplantation Center, the Second Affiliated Hospital of Guangzhou Medical University, Guangzhou 511447, China
| | - Junjie Ma
- Organ Transplantation Center, the Second Affiliated Hospital of Guangzhou Medical University, Guangzhou 511447, China
| | - Guanghui Li
- Organ Transplantation Center, the Second Affiliated Hospital of Guangzhou Medical University, Guangzhou 511447, China
| | - Lei Zhang
- Organ Transplantation Center, the Second Affiliated Hospital of Guangzhou Medical University, Guangzhou 511447, China
| | - Jingwen He
- Organ Transplantation Center, the Second Affiliated Hospital of Guangzhou Medical University, Guangzhou 511447, China
| | - Lu Xu
- Organ Transplantation Center, the Second Affiliated Hospital of Guangzhou Medical University, Guangzhou 511447, China
| | - Xingqiang Lai
- Organ Transplantation Center, the Second Affiliated Hospital of Guangzhou Medical University, Guangzhou 511447, China
| | - Wei Yin
- Organ Transplantation Center, the Second Affiliated Hospital of Guangzhou Medical University, Guangzhou 511447, China
| | - Yunyi Xiong
- Organ Transplantation Center, the Second Affiliated Hospital of Guangzhou Medical University, Guangzhou 511447, China
| | - Luhao Liu
- Organ Transplantation Center, the Second Affiliated Hospital of Guangzhou Medical University, Guangzhou 511447, China
| | - Yirui Zhang
- Organ Transplantation Center, the Second Affiliated Hospital of Guangzhou Medical University, Guangzhou 511447, China
| | - Guanghui Pan
- Organ Transplantation Center, the Second Affiliated Hospital of Guangzhou Medical University, Guangzhou 511447, China
| | - Zheng Chen
- Organ Transplantation Center, the Second Affiliated Hospital of Guangzhou Medical University, Guangzhou 511447, China
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Liu XG, Liu Y, Chen F. Soluble fibrinogen like protein 2 (sFGL2), the novel effector molecule for immunoregulation. Oncotarget 2018; 8:3711-3723. [PMID: 27732962 PMCID: PMC5356913 DOI: 10.18632/oncotarget.12533] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/25/2016] [Accepted: 09/29/2016] [Indexed: 02/07/2023] Open
Abstract
Soluble fibrinogen-like protein 2 (sFGL2) is the soluble form of fibrinogen-like protein 2 belonging to the fibrinogen-related protein superfamily. It is now well characterized that sFGL2 is mainly secreted by regulatory T cell (Treg) populations, and exerts potently immunosuppressive activities. By repressing not only the differentiation and proliferation of T cells but also the maturation of dendritic cells (DCs), sFGL2 acts largely as an immunosuppressant. Moreover, sFGL2 also induces apoptosis of B cells, tubular epithelial cells (TECs), sinusoidal endothelial cells (SECs), and hepatocytes. This mini-review focuses primarily on the recent literature with respect to the signaling mechanism of sFGL2 in immunomodulation, and discusses the clinical implications of sFGL2 in transplantation, hepatitis, autoimmunity, and tumors.
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Affiliation(s)
- Xin-Guang Liu
- Department of Hematology, Qilu Hospital, Shandong University, Jinan, P. R. China
| | - Yu Liu
- School of Chemistry and Pharmaceutical Engineering, Qilu University of Technology, Jinan, P. R. China
| | - Feng Chen
- Department of Hematology, Qilu Hospital, Shandong University, Jinan, P. R. China.,Capital Medical University Cancer Center, Beijing Shijitan Hospital, Beijing Key Laboratory for Therapeutic Cancer Vaccines, Beijing, China
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Cytolytic Induction Therapy Improves Clinical Outcomes in African-American Kidney Transplant Recipients. Ann Surg 2017; 266:450-456. [PMID: 28654544 DOI: 10.1097/sla.0000000000002366] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/30/2023]
Abstract
OBJECTIVE Determine the impact of cytolytic versus IL-2 receptor antibody (IL-2RA) induction on acute rejection, graft loss and death in African-American (AA) kidney transplant (KTX) recipients. BACKGROUND AAs are underrepresented in clinical trials in transplantation; thus, there is controversy regarding the optimal choice of perioperative antibody induction in KTX to improve outcomes. METHODS National cohort study using US transplant registry data from January 1, 2000 to December 31, 2009 in adult solitary AA KTX recipients, with at least 5 years of follow-up. Multivariable logistic and Cox regression were utilized to assess the outcomes of acute rejection, graft loss, and mortality, with interaction terms to assess effect modification. RESULTS Twenty-five thousand eighty-four adult AAs receiving solitary KTX were included, 16,927 (67.5%) received cytolytic induction and 8157 (32.5%) received IL-2RA induction. After adjustment for recipient sociodemographics, donor, and transplant characteristics, the use of cytolytic induction therapy reduced the risk of acute rejection by 32% (OR 0.68, 0.62-0.75), graft loss by 9% (HR 0.91, 0.86-0.97), and death by 12% (HR 0.88, 0.83-0.94). There were a number of significant effect modifiers, including public insurance, panel reactive antibody, delayed graft function, and steroid withdrawal; in these groups, cytolytic induction substantially improved clinical outcomes. CONCLUSIONS These data demonstrate that cytolytic induction therapy, as compared with IL-2RA, reduces the risk of rejection, graft loss, and death in adult AA KTX recipients, particularly in those who are sensitized, receive public insurance, develop delayed graft function, or undergo steroid withdrawal.
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Françoso A, Simioni PU. Immunotherapy for the treatment of colorectal tumors: focus on approved and in-clinical-trial monoclonal antibodies. DRUG DESIGN DEVELOPMENT AND THERAPY 2017; 11:177-184. [PMID: 28138221 PMCID: PMC5241129 DOI: 10.2147/dddt.s119036] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Subscribe] [Scholar Register] [Indexed: 12/22/2022]
Abstract
Colorectal cancer is considered a disease of the elderly population. Since the number of geriatric patients continues to rise, monoclonal antibody therapy is the most promising therapy in the recent research. Presently, the monoclonal antibodies most frequently used in the treatment of colorectal tumors are bevacizumab, cetuximab, panitumumab, and ramucirumab. Bevacizumab is a monoclonal antibody that acts on VEGF. Cetuximab and panitumumab act on EGFR. Ramucirumab binds directly to the ligand-binding pocket of VEGFR-2 to block the binding of VEGF-A, VEGF-C, and VEGF-D. These monoclonal antibodies, alone or in association with radiotherapy or chemotherapy, are presenting good results and are increasing patient survival, despite the side effects. Due to the limited number of molecules available, several studies are trying to develop new monoclonal antibodies for the treatment of colorectal tumors. Among those being studied, some recent molecules are in phase I and/or II trials and are yielding advantageous results, such as anti-DR5, anti-Fn14, anti-IGF-1R, anti-EGFR, anti-NRP1, and anti-A33 antibodies. This has been successful in reducing side effects and in treating nonresponsive patients.
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Affiliation(s)
- Alex Françoso
- Department of Biomedical Science, Faculty of Americana, Americana
| | - Patricia Ucelli Simioni
- Department of Biomedical Science, Faculty of Americana, Americana; Department of Genetics, Evolution and Bioagents, Institute of Biology, University of Campinas, Campinas; Department of Biochemistry and Microbiology, Institute of Biosciences, Universidade Estadual Paulista, Rio Claro, São Paulo, Brazil
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Godoy-Carrillo MC, Meneses-Saco A, Torrealva CV, Pastor AC. Nefropatía por poliomavirus en un paciente inmunosuprimido por trasplante renal secundario a la enfermedad de arteritis de Takayasu. INFECTIO 2016. [DOI: 10.1016/j.infect.2015.10.009] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022] Open
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Fayyad-Kazan H, Faour WH, Badran B, Lagneaux L, Najar M. The immunomodulatory properties of human bone marrow-derived mesenchymal stromal cells are defined according to multiple immunobiological criteria. Inflamm Res 2016; 65:501-10. [PMID: 26956767 DOI: 10.1007/s00011-016-0933-2] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/28/2015] [Revised: 01/19/2016] [Accepted: 02/22/2016] [Indexed: 12/13/2022] Open
Abstract
OBJECTIVE Human bone marrow-derived mesenchymal stromal cells (hBM-MSCs) are well known to modulate T cells. However, the molecular mechanisms that mark hBM-MSCs immunomodulation of T cells are not fully resolved. MATERIALS AND METHODS hBM-MSCs harvested from sternum or iliac crest of five healthy donors and characterized in accordance with the International Society of Cellular Therapy (ISCT) guidelines are co-cultured with T cells. Additionally, modulatory effects of MSCs on T-cell viability, proliferation, cytokine profile, co-stimulatory pathway, activation and immunomodulation are also determined. RESULTS hBM-MSCs significantly reduced the expression of T-cell activation marker CD38 as well as co-stimulatory markers CD134 and CD154, whilst that of CD27 remained unchanged. BrdU, CFSE and Ki67 proliferation assays showed that hBM-MSCs reduced T-cell proliferation. Moreover, viability of T cells remained unchanged when co-cultured with hBM-MSCs. Finally, T cells when co-cultured with hBM-MSCs showed increased secretion of IL-10 and IL-11. CONCLUSION Collectively, hBM-MSCs are able to modulate the main steps involved in T-cell response toward a tolerogenic state. Thus, establishing immunobiological criteria defining the immunosuppressive effect of hBM-MSCs is of importance to reach efficient immunotherapeutic intervention.
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Affiliation(s)
- Hussein Fayyad-Kazan
- Laboratory of Cancer Biology and Molecular Immunology, Faculty of Sciences I, Lebanese University, Hadath, Lebanon
| | - Wissam H Faour
- School of Medicine, Lebanese American University, P.O. Box 36, Byblos, Lebanon
| | - Bassam Badran
- Laboratory of Cancer Biology and Molecular Immunology, Faculty of Sciences I, Lebanese University, Hadath, Lebanon.
| | - Laurence Lagneaux
- Laboratory of Clinical Cell Therapy, Jules Bordet Institute, Université Libre de Bruxelles (ULB), Campus Erasme, Bâtiment de Transfusion (Level +1), Route de Lennik n° 808, 1070, Brussels, Belgium
| | - Mehdi Najar
- Laboratory of Clinical Cell Therapy, Jules Bordet Institute, Université Libre de Bruxelles (ULB), Campus Erasme, Bâtiment de Transfusion (Level +1), Route de Lennik n° 808, 1070, Brussels, Belgium
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Cheungpasitporn W, Thongprayoon C, Edmonds PJ, Bruminhent J, Tangdhanakanond K. The effectiveness and safety of rituximab as induction therapy in ABO-compatible non-sensitized renal transplantation: a systematic review and meta-analysis of randomized controlled trials. Ren Fail 2015; 37:1522-6. [PMID: 26337918 DOI: 10.3109/0886022x.2015.1077310] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND The objective of this systematic review and meta-analysis was to evaluate the effectiveness and safety of rituximab as induction therapy in ABO-compatible, non-sensitized renal transplantation. METHODS A literature search for randomized controlled trials (RCTs) was performed from inception through February 2015. Studies that reported relative risks or hazard ratios comparing the risks of biopsy-proven acute rejection (BPAR), graft loss, leukopenia, infection or mortality in ABO-compatible, non-sensitized renal transplant recipients who received rituximab as induction therapy versus controls were included. Pooled risk ratios (RRs) and 95% confidence intervals (CIs) were calculated using a random-effect, generic inverse variance method. RESULTS Four RCTs with 480 patients were included in the meta-analysis. Pooled RR of BPAR in recipients with rituximab induction was 0.90 (95% CI 0.50-1.60). Compared to placebo, the risk of BPAR in rituximab group was 0.76 (95% CI 0.51-1.14, I(2) = 0). The risk of leukopenia was increased in rituximab group with the pooled RR of 8.22 (95% CI 2.08-32.47). There were no statistical differences in the risks of infection, graft loss and mortality at 3-6 months after transplantation with pool RRs of 1.02 (95% CI 0.85-1.21), 0.55 (95% CI 0.21-1.48) and 0.58 (95% CI 0.17-1.99), respectively. CONCLUSION This meta-analysis demonstrated insignificant reduced risks of BPAR, graft loss or mortality among in ABO-compatible, non-sensitized renal transplant recipients with rituximab induction. Although rituximab induction significantly increases risk of leukopenia, it appears to be safe with no significant risk of infection.
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Affiliation(s)
| | - Charat Thongprayoon
- a Division of Nephrology and Hypertension , Mayo Clinic , Rochester , MN , USA
| | | | - Jackrapong Bruminhent
- c Department of Medicine , Faculty of Medicine Ramathibodi Hospital, Mahidol University , Bangkok , Thailand , and
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