Immunologic aspects of small bowel transplantation

Adams, David H.

doi:10.1016/s0041-1345(98)00724-6

Cited by 12 publications

(5 citation statements)

References 13 publications

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“…In this regard, the successful induction of donor-specific immune tolerance remains a major challenge in organ transplantation. However, the lymphoid-rich small intestinal allograft might differ from such lymphoid-poor organs as the heart and kidney, making tolerance induction a particularly troublesome approach specific to this organ [12][13][14] . An approach to modify donor-derived DC in order to induce an immunological hyporesponsive state in the recipient has been attractive as a potential strategy in transplantation as it would theoretically let the possibility of donor-specific tolerance come true [15,16] .…”

Section: Discussionmentioning

confidence: 99%

Interleukin-10 modified dendritic cells induce allo-hyporesponsiveness and prolong small intestine allograft survival

Zhu

Wei²,

Liu³

et al. 2003

WJG

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AIM:To investigate whether IL-10-transduced dendritic cells (DCs) could induce tolerogenicity and prolong allograft survival in rat intestinal transplantation. METHODS:Spleen-derived DCs were prepared and genetically modified by hIL-10 gene. The level of IL-10 expression was quantitated by ELISA. DC function was assessed by MTT in mixed leukocyte reaction. Allogeneic T-cell apoptosis was examined by flow cytometric analysis. Seven days before heterotopic intestinal transplantation, 2×10 6 donor-derived IL-10-DC were injected intravenously, then transplantation was performed between SD donor and Wistar recipient. RESULTS:Compared with untransduced DC, IL-10-DC could suppress allogeneic mixed leukocyte reaction (MLR). The inhibitory effect was the most striking with the stimulator/ effector (S/E) ratio of 1:10. The inhibition rate was 33.25 %, 41.19 % (P<0.01) and 22.92 % with the S/E ratio of 1:1, 1:10 and 1:50 respectively. At 48 hours and 72 hours by flow cytometry counting, apoptotic T cells responded to IL-10-DC in MLR were 13.8 % and 30

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Section: Discussionmentioning

confidence: 99%

Interleukin-10 modified dendritic cells induce allo-hyporesponsiveness and prolong small intestine allograft survival

Zhu

Wei²,

Liu³

et al. 2003

WJG

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“…More recently Sindhi et al have shown that using pre-transplantation donor blood levels of allospecifi c CD154 + T-cytotoxic memory (TcM) cells by fl ow cytometry may provide a guide to the need for immunosuppression posttransplant and hence predict incidence of ACR. Other authors have purported a role for Toll-like receptors in ACR and still others have implicated a role for the NOD2 gene in ACR similar to a mechanism seen in infl ammatory bowel disease (Adams 1998 ;Cicalese et al 1996 ;de Pinho-Apezzato et al 2011 ;Fishbein et al 2008 ;Krams et al 2010 ). They calculated the immunoreactivity ratio for CD154+ TcM cells and found that those with a ratio greater than 1.23 showed increased histological incidence of ACR and also needed increased immunosuppression.…”

Section: Hsv and Vzv Infectionmentioning

confidence: 99%

“…While the role of the MHC (major histocompatibility complex) antigens has been known for a long time and routinely used for cross matching, more recently peripheral lymphocyte subset measurements have shown that rejection-prone children demonstrate higher pretransplant counts of total lymphocytes, T-cytotoxic, and NK cells prior to transplant (Adams 1998 ;Guo et al 2001 ). While the role of the MHC (major histocompatibility complex) antigens has been known for a long time and routinely used for cross matching, more recently peripheral lymphocyte subset measurements have shown that rejection-prone children demonstrate higher pretransplant counts of total lymphocytes, T-cytotoxic, and NK cells prior to transplant (Adams 1998 ;Guo et al 2001 ).…”

Section: Recent Advances and Future Directions Of Research In Sbtmentioning

confidence: 99%

Pathology of Pediatric Gastrointestinal and Liver Disease

2014

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“…Transplantation of the intestine continues to be associated with high rates of mortality and considerable morbidity. The increased propensity of the bowel to develop acute cellular rejection [103] necessitates heavier immunosuppression than that required with other solid organ transplants. Consequently multiple serious infections occur more frequently.…”

Section: Immunosuppression and Cancermentioning

confidence: 99%

Immunologic Aspects of Transplant Management: Pharmacotherapy and Rejection

Power

Rosenbloom

2000

J Intensive Care Med

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The intensivist caring for the critically ill transplant patient must be knowledgeable in the management of immunosuppression or have expert help. Critical illness often has a major impact on the absorption and metabolism of immunosuppressive drugs, increasing or decreasing net immunosuppression. Too little immunosuppression brings the risk of graft loss, while too much increases the morbidity and mortality of serious infection. Optimum management often requires the skillful manipulation of dosage and/or routes of drug delivery. In many cases of life‐threatening infection, immunosuppression must be discontinued altogether and restarted prior to significant graft injury. The cost of miscalculation is very high. Loss of a renal, pancreas, or small bowel transplant is tragic, while loss of a heart, lung, or liver is usually fatal. Unfortunately the management of immunosuppression is becoming more complex. As the field of transplantation matures, new immunosuppressants are being introduced. Also, more experience and growing numbers of clinical trials are making the required knowledge base ever larger. Each type of transplant has its own set of evolving immunosuppression strategies. This review presents the basic mechanisms of the most widely used drugs and the dangers of immunosuppression. The drugs are then discussed in the context of liver, small bowel, kidney, pancreas, heart, and lung transplantation. Finally, a brief section on the practical pharmacokinetics of the drugs is presented.

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Immunologic aspects of small bowel transplantation

Cited by 12 publications

References 13 publications

Interleukin-10 modified dendritic cells induce allo-hyporesponsiveness and prolong small intestine allograft survival

Interleukin-10 modified dendritic cells induce allo-hyporesponsiveness and prolong small intestine allograft survival

Pathology of Pediatric Gastrointestinal and Liver Disease

Immunologic Aspects of Transplant Management: Pharmacotherapy and Rejection

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