Immune checkpoint inhibitors (CPIs), monoclonal antibodies that target inhibitory receptors expressed on T cells, represent an emerging class of immunotherapy used in treating solid organ and hematologic malignancies. We describe the clinical and histologic features of 13 patients with CPI-induced acute kidney injury (AKI) who underwent kidney biopsy. Median time from initiation of a CPI to AKI was 91 (range, 21 to 245) days. Pyuria was present in 8 patients, and the median urine protein to creatinine ratio was 0.48 (range, 0.12 to 0.98) g/g. An extra-renal immune-related adverse event occurred prior to the onset of AKI in 7 patients. Median peak serum creatinine was 4.5 (interquartile range, 3.6-7.3) mg/dl with 4 patients requiring hemodialysis. The prevalent pathologic lesion was acute tubulointerstitial nephritis in 12 patients, with 3 having granulomatous features, and one thrombotic microangiopathy. Among the 12 patients with acute tubulointerstitial nephritis, 10 received treatment with glucocorticoids, resulting in complete or partial improvement in renal function in 2 and 7 patients, respectively. However, the two patients with acute tubulointerstitial nephritis not given glucocorticoids had no improvement in renal function. Thus, CPI-induced AKI is a new entity that presents with clinical and histologic features similar to other causes of drug-induced acute tubulointerstitial nephritis, though with a longer latency period. Glucocorticoids appear to be a potentially effective treatment strategy. Hence, AKI due to CPIs may be caused by a unique mechanism of action linked to reprogramming of the immune system, leading to loss of tolerance.

No abstract

Two consecutive rotational transitions of the long cyanopolyyne HC 11 N, J = 39 → 38 and 38 → 37, have been detected in the cold dust cloud TMC-1 at the frequencies expected from recent laboratory measurements by Travers et al. (1996), and at about the expected intensities. The astronomical lines have a mean radial velocity of 5.8(1) km s −1 , in good agreement with the shorter cyanopolyynes HC 7 N and HC 9 N observed in this very sharp-line source [5.82(5) and 5.83(5) km s −1 , respectively]. The column density of HC 11 N is calculated to be 2.8 × 10 11 cm −2 . The abundance of the cyanopolyynes decreases smoothly with length to HC 11 N, the decrement from one to the next being about 6 for the longer carbon chains.

Context. Molecular oxygen, O 2 , has been expected historically to be an abundant component of the chemical species in molecular clouds and, as such, an important coolant of the dense interstellar medium. However, a number of attempts from both ground and from space have failed to detect O 2 emission. Aims. The work described here uses heterodyne spectroscopy from space to search for molecular oxygen in the interstellar medium. Methods. The Odin satellite carries a 1.1 m sub-millimeter dish and a dedicated 119 GHz receiver for the ground state line of O 2 . Starting in 2002, the star forming molecular cloud core ρ Oph A was observed with Odin for 34 days during several observing runs. Results. We detect a spectral line at v LSR = +3.5 km s −1 with ∆v FWHM = 1.5 km s −1 , parameters which are also common to other species associated with ρ Oph A. This feature is identified as the O 2 (N J = 1 1 −1 0 ) transition at 118 750.343 MHz. Conclusions. The abundance of molecular oxygen, relative to H 2 , is 5 × 10 −8 averaged over the Odin beam. This abundance is consistently lower than previously reported upper limits.

The G11.11Ϫ0.12 infrared-dark cloud has a filamentary appearance, both in absorption against the diffuse 8 mm Galactic background and in emission from cold dust at 850 mm. A detailed comparison of the dust properties at these two wavelengths reveals that standard models for the diffuse interstellar dust in the Galaxy are not consistent with the observations. The ratio of absorption coefficients within the cloud is , which is well below k /k ≤ 1010 8 850