The effect of low and ultra-low dosages Thymoglobulin on peripheral T, B and NK cells in kidney transplant recipients

Kho, Marcia M. L.; Bouvy, Anne P.; Cadogan, Monique; Kraaijeveld, Rens; Baan, Carla C.; Weimar, Willem

doi:10.1016/j.trim.2012.02.003

Cited by 74 publications

(78 citation statements)

References 32 publications

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“…We observed a sustained low peripheral T- and B-cell count at 6 and 12 months which were similar in both groups. Also Kho et al found a sustained low T- and B-cell count in kidney transplant patients after an induction treatment with a total dose of 6mg/kg/BW of Thymo after one year [9]. They observed dose dependent T-cell recovery as patients with lower doses had T-cell recovery after one year.…”

Section: Discussionmentioning

confidence: 99%

A Comparison of Two Types of Rabbit Antithymocyte Globulin Induction Therapy in Immunological High-Risk Kidney Recipients: A Prospective Randomized Control Study

et al. 2016

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BackgroundInduction treatment with rabbit polyclonal antithymocyte globulins (ATGs) is frequent used in kidney transplant recipients with donorspecific HLA antibodies and shows acceptable outcomes. The two commonly used ATGs, Thymoglobulin and ATG-F have slightly different antigen profile and antibody concentrations. The two compounds have never been directly compared in a prospective trial in immunological high-risk recipients. Therefore we performed a prospective randomized controlled study comparing the two compounds in immunological high-risk kidney recipients in terms of safety and efficacy.MethodsImmunological high-risk kidney recipients, defined as the presence of HLA DSA but negative CDC-B and T-cell crossmatches were randomized 1:1 to receive ATG-F or Thymoglobulin. Maintenance immunosuppressive therapy consisted of tacrolimus, mycophenolate mofetil and steroids.ResultsThe per-protocol analysis included 35 patients. There was no immediate infusion reaction observed with both compounds. No PTLD or malignancy occurred during the follow-up in both groups. The incidence of viral and bacterial infections was similar in both groups (p = 0.62). The cumulative incidence of clinical and subclinical antibody mediated allograft rejection as well as T-cell mediated allograft rejection during the first year between ATG-F and Thymoglobulin was similar (35% versus 19%; p = 0.30 and 11% versus 18%; 0.54 respectively). The two-year graft function was similar with a median eGFR of 56 ml/min/1.73m2 (range 21–128) (ATG-F-group) and 51 ml/min/1.73m2 (range 22–132) (Thymo-group) (p = 0.69).ConclusionWe found no significant differences between the compared study drugs for induction treatment in immunological high-risk patients regarding safety and efficacy during follow-up with good allograft function at 2 years after transplantation.

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Section: Discussionmentioning

confidence: 99%

A Comparison of Two Types of Rabbit Antithymocyte Globulin Induction Therapy in Immunological High-Risk Kidney Recipients: A Prospective Randomized Control Study

et al. 2016

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“…In one study, RT outcome did not differ between groups who received different doses (1.5, 3, and 6.0 mg/kg) of thymoglobulin. 17 Hence, we used 1.5 mg/kg (single low dose) thymoglobulin in our study with an acceptable outcome. The favorable outcome with this regimen is very encouraging and cost effective also.…”

Section: Discussionmentioning

confidence: 99%

“…The Multi Organ Harvesting Aid Network (MOHAN) Foundation has improved the deceased organ donation in India. 3,4,8,9,17 The MOHAN Foundation (Non-Governmental Organization based in Tamil Nadu and Andhra Pradesh) has facilitated 400 of the 1300 deceased organ transplants performed in the country over the last 14 years. This private-public partnership promoting DD transplantation has effectively eliminated commercialization in transplantation in the state of Tamil Nadu with a population of 72 million which is a model for other regions of South Asia and developing countries.…”

Section: Discussionmentioning

confidence: 99%

“…A previous study by this group from a single-center experience showed a patient survival of 79.58%, 76.7%, and 74.8% and death censored graft survival was 92.4%, 87.9%, and 87.9% at 1, 2, and 3 years, respectively. 17 Currently, the state of Tamil Nadu has DD rate of 1.2 PMP per year. Although this is low compared with international standards, it is nearly 10 times that of the rate for India as a whole.…”

Section: Discussionmentioning

confidence: 99%

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Outcome of renal transplantation from deceased donors: experience from developing country

et al. 2014

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Background: In India, there are a large number of end-stage renal disease (ESRD) patients waiting for renal transplantation (RT). Organ retrieval from brain dead deceased donor (DD) is getting increased attention as the waiting list for organ recipients far exceeds the organ donor pool. In our country, despite a large population, the number of brain dead donors undergoing organ donation is very less. DDRT is the possible solution to bridge the disparity between organ supply and demand. In India, the potential for DDRT is huge due to the high number of fatal road traffic accidents and this pool is yet to be tapped. Patients and methods: We report DDRT outcome in 294 patients (age: 36.5 ± 14.1 years; male:female, 200:94) between 2005 and 2012. All patients received single-dose rabbit-anti-thymocyte globulin for induction and steroids, calcineurin inhibitor, and mycophenolate mofetil/azathioprine for maintenance immunosuppression. Results: Our retrospective study in 294 DDRT shows a fairly successful outcome. Over a mean follow-up of 3.93 years, patient and graft survival rates were 81.7% and 92.6%, respectively, with a median serum creatinine of 1.5 mg/dL. 20.7% had biopsy-proven acute rejection. Conclusion: Given the widespread organ shortage, DDRT has a potential to expand the donor pool and shorten the waiting list for RT, encouraging the use of this approach even in low-income countries. Aggressive donor management, increasing public awareness about the concept of organ donation, good communication between clinician and the family members, and a well-trained team of transplant coordinators can help in improving the number of organ donations.

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“…Significant effectiveness has been reported in supportive therapy and pain relief in cancer patients [Rajendran, 2004;Sunila et al, 2009;Radice et al, 2014]. In addition, a reduction of symptoms and an improved quality of life have been observed in patients with psoriasis or vitiligo [Witt et al, 2009;Roberti et al, 2014;Barygina et al, 2015] or in immune system imbalances [Kho et al, 2012].…”

Section: Discussionmentioning

confidence: 99%

Stimulation of the Nonneuronal Cholinergic System by Highly Diluted Acetylcholine in Keratinocytes

Uberti¹,

Bardelli²,

Morsanuto³

et al. 2016

Cells Tissues Organs

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The physiological effects of acetylcholine on keratinocytes depend on the presence of nicotinic and muscarinic receptors. The role of nonneuronal acetylcholine in keratinocytes could have important clinical implications for patients with various skin disorders such as nonhealing wounds. In order to evaluate the efficacy of highly diluted acetylcholine solutions obtained by sequential kinetic activation, we aimed to investigate the effects of these solutions on normal human keratinocytes. Two different concentrations (10 fg/mL and 1 pg/mL) and formulations (kinetically activated and nonkinetically activated) of acetylcholine were used to verify keratinocyte viability, proliferation, and migration and the intracellular pathways involved using MTT, crystal violet, wound healing, and Western blot compared to 147 ng/mL acetylcholine. The activated formulations (1 pg/mL and 10 fg/mL) revealed a significant capacity to increase migration, cell viability, and cell proliferation compared to 147 ng/mL acetylcholine, and these effects were more evident after a single administration. Sequential kinetic activation resulted in a statistically significant decrease in reactive oxygen species production accompanied by an increase in mitochondrial membrane potential and a decrease in oxygen consumption compared to 147 ng/mL acetylcholine. The M1 muscarinic receptor was involved in these effects. Finally, the involvement of ERK/mitogen-activated protein kinases (MAPK) and KI67 confirmed the effectiveness of the single treatment on cell proliferation. The intracellular pathways of calcium were investigated as well. Our results indicate for the first time that highly diluted and kinetically activated acetylcholine seems to play an active role in an in vitro model of wound healing. Moreover, the administration of acetylcholine within the physiological range may not only be effective but is also likely to be safe.

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The effect of low and ultra-low dosages Thymoglobulin on peripheral T, B and NK cells in kidney transplant recipients

Cited by 74 publications

References 32 publications

A Comparison of Two Types of Rabbit Antithymocyte Globulin Induction Therapy in Immunological High-Risk Kidney Recipients: A Prospective Randomized Control Study

A Comparison of Two Types of Rabbit Antithymocyte Globulin Induction Therapy in Immunological High-Risk Kidney Recipients: A Prospective Randomized Control Study

Outcome of renal transplantation from deceased donors: experience from developing country

Stimulation of the Nonneuronal Cholinergic System by Highly Diluted Acetylcholine in Keratinocytes

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