Bortezomib as the Sole Post-Renal Transplantation Desensitization Agent Does Not Decrease Donor-Specific Anti-HLA Antibodies

被引：99

作者：

Sberro-Soussan, R. ^{[1
,2
]}

Zuber, J. ^{[1
,2
]}

Suberbielle-Boissel, C. ^{[3
]}

Candon, S. ^{[1
,4
]}

Martinez, F. ^{[2
]}

Snanoudj, R. ^{[2
]}

Rabant, M. ^{[1
,2
]}

Pallet, N. ^{[1
,2
]}

Nochy, D. ^{[5
]}

Anglicheau, D. ^{[1
,2
]}

Leruez, M. ^{[1
,6
]}

Loupy, A. ^{[1
,2
]}

Thervet, E. ^{[1
,2
]}

Hermine, O. ^{[1
,7
]}

Legendre, C. ^{[1
,2
]}

机构：

[1] Univ Paris 05, Paris, France

[2] Hop Necker Enfants Malad, AP HP, Serv Transplantat Renale, Paris, France

[3] Hop St Louis, AP HP, Lab Histocompatibil, Paris, France

[4] Hop Necker Enfants Malad, AP HP, Immunol Lab, Paris, France

[5] Hop Europeen Georges Pompidou, AP HP, Lab Anatomopathol, Paris, France

[6] Hop Necker Enfants Malad, AP HP, Virol Lab, Paris, France

[7] Hop Necker Enfants Malad, AP HP, Serv Hematol Clin Adulte, Paris, France

来源：

AMERICAN JOURNAL OF TRANSPLANTATION | 2010年 / 10卷 / 03期

关键词：

Bortezomib; desensitize; donor-specific antibodies; DSA; kidney transplantation; HIGH-DOSE DEXAMETHASONE; CROSS-MATCH; INTRAVENOUS IMMUNOGLOBULIN; MEDIATED REJECTION; PLASMA-CELLS; INHIBITOR; DISEASE;

D O I：

10.1111/j.1600-6143.2009.02968.x

中图分类号：

R61 [外科手术学];

学科分类号：

摘要：

Persistence of donor-specific anti-HLA antibodies (DSA) associated with antibody-mediated graft injuries following kidney transplantation predicts evolution toward chronic humoral rejection and reduced graft survival. Targeting plasma cells, the main antibody-producing cells, with the proteasome inhibitor bortezomib may be a promising desensitization strategy. We evaluated the in vivo efficacy of one cycle of bortezomib (1.3 mg/m2 x 4 doses), used as the sole desensitization therapy, in four renal transplant recipients experiencing subacute antibody-mediated rejection with persisting DSA (> 2000 [Mean Fluorescence Intensity] MFI). Bortezomib treatment did not significantly decrease DSA MFI within the 150-day posttreatment period in any patient. In addition, antivirus (HBV, VZV and HSV) antibody levels remained stable following treatment suggesting a lack of efficacy on long-lived plasma cells. In conclusion, one cycle of bortezomib alone does not decrease DSA levels in sensitized kidney transplant recipients in the time period studied. These results underscore the need to evaluate this new desensitization agent properly in prospective, randomized and well-controlled studies.

引用

页码：681 / 686

页数：6

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