Ghasem Solgi; Gholamreza Pourmand; Abdorasool Mehrsai; Mohsen Tahei-mahmoudi; Mohammad Hossein Nicknam; Mohammad Ebrahimi Rad; Ali Seraji; Amirabbas Asadpoor; Bita Ansaripor; Behrouz Nikbin; Aliakbar Amirzargar
Volume 7, Issue 1 , March 2010, , Pages 18-29
Abstract
Background: Anti-HLA-antibodies are known to affect the allograft survival in transplant recipient patients. Objective: The aim of this study was to evaluate the association between anti-HLA antibodies and kidney allograft outcomes, particularly in recipients with concur-rent donor bone marrow cell infusion ...
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Background: Anti-HLA-antibodies are known to affect the allograft survival in transplant recipient patients. Objective: The aim of this study was to evaluate the association between anti-HLA antibodies and kidney allograft outcomes, particularly in recipients with concur-rent donor bone marrow cell infusion (DBMI). Methods: Between June 2006 and May 2007, forty living unrelated donor kidney transplants consisting of 20 recipients with DBMI and 20 without infusion entered into the study and were monitored prospectively for one year. Pre- and post-transplant (days 14, 30, and 90) sera were screened for the presence of anti-HLA class-I and II antibodies, and subsequently positive sera retested with ELISA spe-cific panel for antibody specification. Results: Of 40 patients, 9 (22.5%) experienced acute rejection episodes (ARE) (6/20 cases in non-infused versus 3/20 in DBMI patients). The prevalence of anti-HLA antibodies before and after transplantation were higher in patients with ARE compared to non-rejecting ones (88.8% vs. 38.7%, p=0.01 and 66.6% vs. 25.8%, p=0.04, respectively). A total of 10% (4/40) of patients developed donor specific anti-HLA antibodies (DSA) and in this regard 2 patients from the control group experienced ARE. All 3 rejecting patients in DBMI group were negative for DSA and positive for non-DSA. The lower titer of post-transplant anti-HLA antibodies were shown in DBMI patients compared to pre-transplantation titer. Additionally, the average serum creatinine levels during one year follow up and even in those patients with ARE were lower compared to controls. Con-clusion: Our findings reveal an association between pre- and post-transplant anti-HLA an-tibodies, and ARE and also early allograft dysfunction. It suggests that lower incidence of ARE, undetectable DSA, lower titer of antibodies concomitant with a decrease in serum creatinine level, better allograft function and lower percentages of PRA in DBMI patients, could be the probable manifestations of partial hypo-responsiveness against allografts.
Mandana Mohyeddin Bonab; Sepideh Yazdanbakhsh; Jamshid Lotfi; Kamran Alimoghaddom; Fatemeh Talebian; Farnaz Hooshmand; Ardeshir Ghavamzadeh; Behrouz Nikbin
Volume 4, Issue 1 , March 2007, , Pages 50-57
Abstract
Background: Mesenchymal stem cells (MSCs) with their potential to differentiate into mesodermal and non-mesodermal lineages have several immunomodulatory characteris-tics. These properties make them promising tools in cell and gene therapy. Objective: To evaluate the potential therapeutic applications ...
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Background: Mesenchymal stem cells (MSCs) with their potential to differentiate into mesodermal and non-mesodermal lineages have several immunomodulatory characteris-tics. These properties make them promising tools in cell and gene therapy. Objective: To evaluate the potential therapeutic applications of autologous MSC in improving clinical manifestations of MS patients. Methods: Ten patients were included in this pi-lot study. All had progressive disease that had not responded to disease modifying agents including Mitoxantrone. Their Expanded Disability Status Scale (EDSS) score ranged from 3.5 to 6. Patients were injected intrathecally with culture expanded MSCs. They were followed with monthly neurological assessment and a MRI scan at the end of the first year. Results: During 13 to 26 months of follow up (mean: 19 months), the EDSS of one patient improved from 5 to 2.5 score. Four patients showed no change in EDSS. Five patients’ EDSS increased from 0.5 to 2.5. In the functional system assess-ment, six patients showed some degree of improvement in their sensory, pyramidal, and cerebellar functions. One showed no difference in clinical assessment and three deterio-rated. The result of MRI assessment after 12 months was as following: seven patients with no difference, two showed an extra plaque, and one patient showed decrease in the number of plaques. Conclusion: This preliminary report emphasizes on the feasibility of autologous MSC for treatment of MS patients. However, in order to draw a definitive conclusion a larger sample size is required.
