Additive Effectiveness of Everolimus Plus Tamoxifen Therapy in Treatment of Encapsulating Peritoneal Sclerosis

Huddam, Bülent; Azak, Alper; Koçak, Gülay; Başaran, Murat; Voyvoda, Nuray; Duranay, Murat

doi:10.3109/0886022x.2011.647338

Cited by 19 publications

(19 citation statements)

References 16 publications

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“…Two previous case report suggested favorable use of everolimus for PD patients who developed EPS . However, Temple et al published a report as a letter where a renal transplant patient developed EPS despite the use of sirolimus, i.e., its use did not prevent the subsequent development of EPS …”

Section: Discussionmentioning

confidence: 99%

A combination of corticosteroid, sirolimus, and intradialytic parenteral nutrition in encapsulating peritoneal sclerosis: Case report and literature review

Brabo

Reis

Barretti

et al. 2016

Hemodialysis International

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Encapsulating peritoneal sclerosis (EPS) is a rare complication of peritoneal dialysis that carries a high morbidity and mortality. Although its pathogenesis is still not clear, the "two hit theory" suggests that long term deterioration of the peritoneum combined with intraperitoneal inflammation is needed in the pathogenesis of EPS. To date, there is no proven effective therapy with an absence of randomized controlled trials. Individual case reports and small case series have reported on the use of tamoxifen and corticosteroids for medical management of EPS. Here, we present the first case of EPS treated successfully with a combination of sirolimus, low dose corticosteroid and intradialytic parenteral nutrition. A critical review of the relevant literature on this subject is also presented to determine the best approach.

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Section: Discussionmentioning

confidence: 99%

A combination of corticosteroid, sirolimus, and intradialytic parenteral nutrition in encapsulating peritoneal sclerosis: Case report and literature review

Brabo

Reis

Barretti

et al. 2016

Hemodialysis International

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“…mTOR inhibitors are well-known for having antiproliferative effects and have recently been used as medical treatment for ESP after transplantation [9]. The synergistic effects of mTOR inhibitor and tamoxifen have also been reported [10]. However, the optimal dose and duration have not been determined.…”

Section: Discussionmentioning

confidence: 99%

Encapsulating peritoneal sclerosis in liver transplant recipients: a report of 2 cases

et al. 2017

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Encapsulating peritoneal sclerosis (EPS) is a rare cause of intestinal obstruction by a thick fibrous membrane wrapping around the small intestine. It is a possible complication after liver transplantation (LT) that can be fatal. This report describes 2 cases of EPS after LT that were successfully treated with surgery, corticosteroids, tamoxifen, and mammalian target of rapamycin inhibitor. After treatment in both cases, the patients were able to start oral feeding and have been symptom free for more than 1 year. These cases suggests that for the management of EPS, surgical treatment is mandatory when the patients present with symptoms of intestinal obstruction or if there are findings suggestive of decreased mural perfusion. Surgery should be accompanied with medical treatment to prevent the relapse of EPS.

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“…Unfortunately, effective therapy for peritoneal fibrosis in clinic is scarce [40]. Some cases reported that mTOR inhibitors, with their antifibrotic properties, may be useful in the treatment of encapsulating peritoneal sclerosis (EPS), the most severe form of peritoneal fibrosis [ 41,42]. Recently, the limited studies have shown the effect of rapamycin in preventing the development of peritoneal fibrosis in experimental rat models [22,25].…”

Section: Discussionmentioning

confidence: 99%

Rapamycin inhibits epithelial‐to‐mesenchymal transition of peritoneal mesothelium cells through regulation of Rho GTPases

Xiang

Xie

et al. 2016

The FEBS Journal

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Epithelial–mesenchymal transition (EMT) of peritoneal mesothelial cells (PMCs) is a key process of peritoneal fibrosis. Rapamycin has been previously shown to inhibit EMT of PMCs and prevent peritoneal fibrosis. In this study, we investigated the undefined molecular mechanisms by which rapamycin inhibits EMT of PMCs. To define the protective effect of rapamycin, we initially used a rat PD model which was daily infused with 20 mL of 4.25% high glucose (HG) dialysis solution for 6 weeks to induce fibrosis. The HG rats showed decreased ultrafiltration volume and obvious fibroproliferative response, with markedly increased peritoneal thickness and higher expression of α‐smooth muscle actin (α‐SMA) and transforming growth factor‐β1. Rapamycin significantly ameliorated those pathological changes. Next, we treated rat PMCs with HG to induce EMT and/or rapamycin for indicated time. Rapamycin significantly inhibited HG‐induced EMT, which manifests as increased expression of α‐SMA, fibronectin, and collagen I, decreased expression of E‐cadherin, and increased mobility. HG increased the phosphorylation of PI3K, Akt, and mTOR. Importantly, rapamycin inhibits the RhoA, Rac1, and Cdc42 activated by HG. Moreover, rapamycin repaired the pattern of F‐actin distribution induced by HG, reducing the formation of stress fiber, focal adhesion, lamellipodia, and filopodia. Thus, rapamycin shows an obvious protective effect on HG‐induced EMT, by inhibiting the activation of Rho GTPases (RhoA, Rac1, and Cdc42).

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Additive Effectiveness of Everolimus Plus Tamoxifen Therapy in Treatment of Encapsulating Peritoneal Sclerosis

Cited by 19 publications

References 16 publications

A combination of corticosteroid, sirolimus, and intradialytic parenteral nutrition in encapsulating peritoneal sclerosis: Case report and literature review

A combination of corticosteroid, sirolimus, and intradialytic parenteral nutrition in encapsulating peritoneal sclerosis: Case report and literature review

Encapsulating peritoneal sclerosis in liver transplant recipients: a report of 2 cases

Rapamycin inhibits epithelial‐to‐mesenchymal transition of peritoneal mesothelium cells through regulation of Rho GTPases

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