首页 > 最新文献

Transplant immunology最新文献

英文 中文
Association between interleukin 6, C-reactive protein, and kidney transplantation outcomes: A systematic review and meta-analysis 白细胞介素6、c反应蛋白与肾移植结果之间的关系:一项系统综述和荟萃分析。
IF 1.4 4区 医学 Q4 IMMUNOLOGY Pub Date : 2025-10-04 DOI: 10.1016/j.trim.2025.102308
Lasin Ozbek , Berk Mizrak , Zeynep Y. Yilmaz , Mustafa Guldan , Derya G. Fidan , Sama Mahmoud Abdel-Rahman , Mehmet Kanbay

Background

Kidney transplant recipients experience heightened systemic inflammation, and biomarkers such as interleukin-6 (IL-6), C-reactive protein (CRP), and high-sensitivity CRP (hsCRP) have been proposed as prognostic indicators.

Objective

This meta-analysis evaluates the associations between IL-6, CRP, and hsCRP levels and all-cause mortality, cardiovascular events, and graft dysfunction in kidney transplant recipients.

Methods

A comprehensive search of PubMed, Web of Science, Scopus, Ovid MEDLINE, and the Cochrane Library until October 11, 2024, identified eligible studies reporting associations between IL-6, CRP, or hsCRP and clinical outcomes in adult kidney transplant recipients.

Results

The systematic review included 40 studies, with 18 meeting criteria for meta-analysis. Elevated IL-6 was associated with a higher risk of graft dysfunction (HR 1.53, 95 % CI 1.28–1.83; I2 = 0 %) and all-cause mortality (HR 1.66, 95 % CI 1.05–2.61; I2 = 97.2 %), but not cardiovascular events. CRP was associated with all-cause mortality (HR 2.07, 95 % CI 1.59–2.70; I2 = 0 %) and cardiovascular events (HR 6.89, 95 % CI 2.52–18.85; I2 = 0 %), but not cardiovascular mortality or graft dysfunction. Elevated hsCRP was associated with all-cause mortality (HR 1.29, 95 % CI 1.15–1.44; I2 = 61 %), but not with cardiovascular events or graft dysfunction.

Conclusions

Among kidney transplant recipients, elevated levels of IL-6, CRP, and hsCRP were significantly associated with increased all-cause mortality, though the association of IL-6 with all-cause mortality showed substantial heterogeneity and should be interpreted with caution. IL-6 also emerged as a predictor of graft dysfunction, while CRP demonstrated a strong association with cardiovascular events. These findings highlight the potential role of inflammatory biomarkers, particularly IL-6 and CRP, in post-transplant risk stratification; however, further studies are needed to establish causality and clarify their clinical utility.
背景:肾移植受者会经历更高的全身性炎症,生物标志物如白细胞介素-6 (IL-6)、c反应蛋白(CRP)和高敏CRP (hsCRP)已被提出作为预后指标。目的:本荟萃分析评估IL-6、CRP和hsCRP水平与肾移植受者全因死亡率、心血管事件和移植物功能障碍之间的关系。方法:全面检索PubMed、Web of Science、Scopus、Ovid MEDLINE和Cochrane图书馆,直到2024年10月11日,确定了IL-6、CRP或hsCRP与成人肾移植受者临床结果相关的符合条件的研究。结果:系统评价纳入40项研究,其中18项符合meta分析标准。IL-6升高与移植物功能障碍的高风险(HR 1.53, 95 % CI 1.28-1.83; I2 = 0 %)和全因死亡率(HR 1.66, 95 % CI 1.05-2.61; I2 = 97.2 %)相关,但与心血管事件无关。CRP与全因死亡率(HR 2.07, 95 % CI 1.59-2.70; I2 = 0 %)和心血管事件(HR 6.89, 95 % CI 2.52-18.85; I2 = 0 %)相关,但与心血管死亡率或移植物功能障碍无关。hsCRP升高与全因死亡率相关(HR 1.29, 95 % CI 1.15-1.44; I2 = 61 %),但与心血管事件或移植物功能障碍无关。结论:在肾移植受者中,IL-6、CRP和hsCRP水平的升高与全因死亡率的增加显著相关,尽管IL-6与全因死亡率的关系显示出很大的异质性,应谨慎解释。IL-6也可作为移植物功能障碍的预测因子,而CRP则与心血管事件密切相关。这些发现强调了炎症生物标志物,特别是IL-6和CRP在移植后风险分层中的潜在作用;然而,需要进一步的研究来确定因果关系并阐明其临床应用。
{"title":"Association between interleukin 6, C-reactive protein, and kidney transplantation outcomes: A systematic review and meta-analysis","authors":"Lasin Ozbek ,&nbsp;Berk Mizrak ,&nbsp;Zeynep Y. Yilmaz ,&nbsp;Mustafa Guldan ,&nbsp;Derya G. Fidan ,&nbsp;Sama Mahmoud Abdel-Rahman ,&nbsp;Mehmet Kanbay","doi":"10.1016/j.trim.2025.102308","DOIUrl":"10.1016/j.trim.2025.102308","url":null,"abstract":"<div><h3>Background</h3><div>Kidney transplant recipients experience heightened systemic inflammation, and biomarkers such as interleukin-6 (IL-6), C-reactive protein (CRP), and high-sensitivity CRP (hsCRP) have been proposed as prognostic indicators.</div></div><div><h3>Objective</h3><div>This meta-analysis evaluates the associations between IL-6, CRP, and hsCRP levels and all-cause mortality, cardiovascular events, and graft dysfunction in kidney transplant recipients.</div></div><div><h3>Methods</h3><div>A comprehensive search of PubMed, Web of Science, Scopus, Ovid MEDLINE, and the Cochrane Library until October 11, 2024, identified eligible studies reporting associations between IL-6, CRP, or hsCRP and clinical outcomes in adult kidney transplant recipients.</div></div><div><h3>Results</h3><div>The systematic review included 40 studies, with 18 meeting criteria for meta-analysis. Elevated IL-6 was associated with a higher risk of graft dysfunction (HR 1.53, 95 % CI 1.28–1.83; I<sup>2</sup> = 0 %) and all-cause mortality (HR 1.66, 95 % CI 1.05–2.61; I<sup>2</sup> = 97.2 %), but not cardiovascular events. CRP was associated with all-cause mortality (HR 2.07, 95 % CI 1.59–2.70; I<sup>2</sup> = 0 %) and cardiovascular events (HR 6.89, 95 % CI 2.52–18.85; I<sup>2</sup> = 0 %), but not cardiovascular mortality or graft dysfunction. Elevated hsCRP was associated with all-cause mortality (HR 1.29, 95 % CI 1.15–1.44; I<sup>2</sup> = 61 %), but not with cardiovascular events or graft dysfunction.</div></div><div><h3>Conclusions</h3><div>Among kidney transplant recipients, elevated levels of IL-6, CRP, and hsCRP were significantly associated with increased all-cause mortality, though the association of IL-6 with all-cause mortality showed substantial heterogeneity and should be interpreted with caution. IL-6 also emerged as a predictor of graft dysfunction, while CRP demonstrated a strong association with cardiovascular events. These findings highlight the potential role of inflammatory biomarkers, particularly IL-6 and CRP, in post-transplant risk stratification; however, further studies are needed to establish causality and clarify their clinical utility.</div></div>","PeriodicalId":23304,"journal":{"name":"Transplant immunology","volume":"93 ","pages":"Article 102308"},"PeriodicalIF":1.4,"publicationDate":"2025-10-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145239938","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Macrophage activation via the NTPDase1-adenosine pathway and associated injury in acute antibody-mediated rejection 急性抗体介导的排斥反应中巨噬细胞通过ntpdase1 -腺苷途径激活和相关损伤
IF 1.4 4区 医学 Q4 IMMUNOLOGY Pub Date : 2025-10-04 DOI: 10.1016/j.trim.2025.102302
Pu Yan , Yong Zhang , Zhongbao Zhou , Yongjin Huang , Peng Xue , Xiaoyan Wang

Background

Nucleoside triphosphate diphosphohydrolase 1 (NTPDase1) is a calcium- and magnesium-dependent nucleoside triphosphate diphosphohydrolase. NTPDase1, expressed in mature immune cells to hydrolyze ATP and ADP into adenosine. The NTPDase1and its function in an adenosine pathway plays an important role in suppressing inflammation, immune responses, cell proliferation, and other processes. We investigated the effects and mechanisms of macrophage activation through the NTPDase1-adenosine pathway and the resulting damage from acute antibody-mediated rejection (AMR).

Methods

We established an acute AMR skin-graft model by transplanting MHC-mismatched B10.A ear skin onto BALB/c nude mice and inducing rejection with 100 μg anti-H-2Kk IgG. Mice were grouped as wild-type, NTPDase1-knockout, and NTPDase1-overexpression, with isotype-IgG controls. Outcomes were compared across groups, and statistical analyses were performed using SPSS 16.0.

Results

After the onset of acute AMR, higher NTPDase1 expression in B cells and grafted skin was associated with lower concentration of extracellular ADP, a reduced proportion of CD68+ macrophages, and milder pathological injury in nude mice, and each parameter showing a negative correlation. At 30 min after AMR onset, CD68 + TNF-α + M1 macrophages predominated, whereas CD68 + CD163+ M2 macrophage numbers did not change significantly. Over time, M1 macrophages progressively decreased, and M2 macrophages became increasingly prominent. By day 7 after AMR onset, compared with controls, CD163+ M2 macrophages and the expression of TGF-β1, vimentin, and α-SMA were significantly increased, whereas the epithelial marker E-cadherin was significantly decreased.

Conclusion

NTPDase1 constrains acute AMR by limiting extracellular ADP, curbing macrophage expansion, and reducing graft injury. Transgenic overexpression sustained expression, moderated M1-to-M2 dynamics, and attenuated C4d and fibrotic markers, whereas knockout intensified purinergic signaling, inflammation, and fibrosis. Findings position NTPDase1 as a protective regulator and therapeutic target in AMR.
背景:核苷三磷酸二磷酸水解酶1 (NTPDase1)是一种钙镁依赖性核苷三磷酸二磷酸水解酶。NTPDase1,在成熟免疫细胞中表达,将ATP和ADP水解成腺苷。ntpdase1及其在腺苷途径中的功能在抑制炎症、免疫反应、细胞增殖等过程中发挥重要作用。我们研究了通过ntpdase1 -腺苷途径激活巨噬细胞的作用和机制,以及急性抗体介导的排斥反应(AMR)造成的损伤。方法:通过移植mhc错配的B10建立急性AMR皮肤移植模型。BALB/c裸鼠耳皮,100 μg抗h - 2kk IgG诱导排斥反应。将小鼠分为野生型、ntpdase1敲除型和ntpdase1过表达型,并以同型igg为对照。各组结果比较,采用SPSS 16.0进行统计学分析。结果:急性AMR发生后,裸鼠B细胞和移植皮肤NTPDase1表达升高与细胞外ADP浓度降低、CD68+巨噬细胞比例降低、病理损伤减轻相关,且各参数呈负相关。在AMR发生30 min后,CD68 + TNF-α + M1巨噬细胞数量占主导地位,而CD68 + CD163+ M2巨噬细胞数量无显著变化。随着时间的推移,M1巨噬细胞逐渐减少,M2巨噬细胞日益突出。AMR发生后第7天,与对照组相比,CD163+ M2巨噬细胞及TGF-β1、vimentin、α-SMA的表达显著升高,上皮标志物E-cadherin的表达显著降低。结论:ntpdese1通过限制细胞外ADP、抑制巨噬细胞扩张、减轻移植物损伤来抑制急性AMR。转基因过表达持续表达,减缓m1到m2的动态,减弱C4d和纤维化标志物,而敲除嘌呤能信号,炎症和纤维化。研究结果表明,NTPDase1是AMR的保护调节因子和治疗靶点。
{"title":"Macrophage activation via the NTPDase1-adenosine pathway and associated injury in acute antibody-mediated rejection","authors":"Pu Yan ,&nbsp;Yong Zhang ,&nbsp;Zhongbao Zhou ,&nbsp;Yongjin Huang ,&nbsp;Peng Xue ,&nbsp;Xiaoyan Wang","doi":"10.1016/j.trim.2025.102302","DOIUrl":"10.1016/j.trim.2025.102302","url":null,"abstract":"<div><h3>Background</h3><div>Nucleoside triphosphate diphosphohydrolase 1 (NTPDase1) is a calcium- and magnesium-dependent nucleoside triphosphate diphosphohydrolase. NTPDase1, expressed in mature immune cells to hydrolyze ATP and ADP into adenosine. The NTPDase1and its function in an adenosine pathway plays an important role in suppressing inflammation, immune responses, cell proliferation, and other processes. We investigated the effects and mechanisms of macrophage activation through the NTPDase1-adenosine pathway and the resulting damage from acute antibody-mediated rejection (AMR).</div></div><div><h3>Methods</h3><div>We established an acute AMR skin-graft model by transplanting MHC-mismatched B10.A ear skin onto BALB/c nude mice and inducing rejection with 100 μg anti-H-2Kk IgG. Mice were grouped as wild-type, NTPDase1-knockout, and NTPDase1-overexpression, with isotype-IgG controls. Outcomes were compared across groups, and statistical analyses were performed using SPSS 16.0.</div></div><div><h3>Results</h3><div>After the onset of acute AMR, higher NTPDase1 expression in B cells and grafted skin was associated with lower concentration of extracellular ADP, a reduced proportion of CD68+ macrophages, and milder pathological injury in nude mice, and each parameter showing a negative correlation. At 30 min after AMR onset, CD68 + TNF-α + M1 macrophages predominated, whereas CD68 + CD163+ M2 macrophage numbers did not change significantly. Over time, M1 macrophages progressively decreased, and M2 macrophages became increasingly prominent. By day 7 after AMR onset, compared with controls, CD163+ M2 macrophages and the expression of TGF-β1, vimentin, and α-SMA were significantly increased, whereas the epithelial marker E-cadherin was significantly decreased.</div></div><div><h3>Conclusion</h3><div>NTPDase1 constrains acute AMR by limiting extracellular ADP, curbing macrophage expansion, and reducing graft injury. Transgenic overexpression sustained expression, moderated M1-to-M2 dynamics, and attenuated C4d and fibrotic markers, whereas knockout intensified purinergic signaling, inflammation, and fibrosis. Findings position NTPDase1 as a protective regulator and therapeutic target in AMR.</div></div>","PeriodicalId":23304,"journal":{"name":"Transplant immunology","volume":"93 ","pages":"Article 102302"},"PeriodicalIF":1.4,"publicationDate":"2025-10-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145239659","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Effects of intravenous immunoglobulin (IVIG) treatment on BK viremia and BK virus-associated nephropathy (BKVN) in kidney transplant patients: A systematic review 静脉注射免疫球蛋白(IVIG)治疗肾移植患者BK病毒血症和BK病毒相关肾病(BKVN)的影响:一项系统综述
IF 1.4 4区 医学 Q4 IMMUNOLOGY Pub Date : 2025-09-18 DOI: 10.1016/j.trim.2025.102288
Maryam Hassanian , Mojgan Mortazavi , Firouzeh Moeinzadeh

Background

There are limited approved therapeutic options for BK viremia management in kidney transplant patients. We performed the present study to investigate the effect of Intravenous immunoglobulin (IVIG) treatment on BK viremia and BK virus-associated nephropathy (BKVN) in kidney transplant patients.

Methods

A systematic search was performed in Web of Science, Embase, PubMed, and Scopus for studies that investigated the effect of IVIG therapy on BK viremia and BKVN in kidney transplant patients. Observational studies and case series were considered eligible for inclusion in this study. Data extraction was performed by two independent investigators by a standard checklist.

Findings

Our results indicated that IVIG treatment in patients with BKVN was effective in BK viremia treatment and nephropathy. In addition, preemptive IVIG significantly decreased the risk of BK viremia and BKVN in high-risk patients. However, it does not seem that IVIG treatment has a beneficial impact on allograft function. Because no significant improvement in serum levels of creatinine has been reported in previous studies. In addition, the presence of interstitial fibrosis or tubular atrophy was reported in studies with histopathological examinations of renal biopsies following IVIG treatment.

Conclusion

IVIG therapy combined with immunosuppression reduction may be beneficial in treating BK viremia and BKVN, but its impact on graft function and survival remains uncertain. Further studies are needed to clarify its role in kidney transplant outcomes.
背景:肾移植患者BK病毒血症的治疗方案有限。本研究旨在探讨静脉注射免疫球蛋白(IVIG)治疗肾移植患者BK病毒血症和BK病毒相关肾病(BKVN)的效果。方法:系统检索Web of Science、Embase、PubMed和Scopus中有关IVIG治疗肾移植患者BK病毒血症和BKVN的研究。观察性研究和病例系列被认为符合纳入本研究的条件。数据提取由两名独立调查员按照标准检查表进行。结果:我们的研究结果表明,IVIG治疗BKVN患者对BK病毒血症治疗和肾病有效。此外,预防性IVIG可显著降低高危患者发生BK病毒血症和BKVN的风险。然而,IVIG治疗似乎并没有对同种异体移植物功能产生有益的影响。因为在以前的研究中没有报道血清肌酐水平有显著改善。此外,在IVIG治疗后肾活检的组织病理学检查中报告了间质纤维化或小管萎缩的存在。结论:IVIG联合免疫抑制减少治疗BK病毒血症和BKVN可能有益,但对移植物功能和存活的影响尚不确定。需要进一步的研究来阐明其在肾移植结果中的作用。
{"title":"Effects of intravenous immunoglobulin (IVIG) treatment on BK viremia and BK virus-associated nephropathy (BKVN) in kidney transplant patients: A systematic review","authors":"Maryam Hassanian ,&nbsp;Mojgan Mortazavi ,&nbsp;Firouzeh Moeinzadeh","doi":"10.1016/j.trim.2025.102288","DOIUrl":"10.1016/j.trim.2025.102288","url":null,"abstract":"<div><h3>Background</h3><div>There are limited approved therapeutic options for BK viremia management in kidney transplant patients. We performed the present study to investigate the effect of Intravenous immunoglobulin (IVIG) treatment on BK viremia and BK virus-associated nephropathy (BKVN) in kidney transplant patients.</div></div><div><h3>Methods</h3><div>A systematic search was performed in Web of Science, Embase, PubMed, and Scopus for studies that investigated the effect of IVIG therapy on BK viremia and BKVN in kidney transplant patients. Observational studies and case series were considered eligible for inclusion in this study. Data extraction was performed by two independent investigators by a standard checklist.</div></div><div><h3>Findings</h3><div>Our results indicated that IVIG treatment in patients with BKVN was effective in BK viremia treatment and nephropathy. In addition, preemptive IVIG significantly decreased the risk of BK viremia and BKVN in high-risk patients. However, it does not seem that IVIG treatment has a beneficial impact on allograft function. Because no significant improvement in serum levels of creatinine has been reported in previous studies. In addition, the presence of interstitial fibrosis or tubular atrophy was reported in studies with histopathological examinations of renal biopsies following IVIG treatment.</div></div><div><h3>Conclusion</h3><div>IVIG therapy combined with immunosuppression reduction may be beneficial in treating BK viremia and BKVN, but its impact on graft function and survival remains uncertain. Further studies are needed to clarify its role in kidney transplant outcomes.</div></div>","PeriodicalId":23304,"journal":{"name":"Transplant immunology","volume":"93 ","pages":"Article 102288"},"PeriodicalIF":1.4,"publicationDate":"2025-09-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145102939","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Oral cyclosporine a nanosuspension for improved immunosuppressive efficacy: In vivo cytokine profiling in rats 口服环孢素纳米混悬液改善免疫抑制效果:大鼠体内细胞因子谱。
IF 1.4 4区 医学 Q4 IMMUNOLOGY Pub Date : 2025-09-17 DOI: 10.1016/j.trim.2025.102301
Çağman Tan , Sıla Gülbağ Pınar , Nevin Çelebi

Background

Cyclosporine A (CycA) is a cornerstone immunosuppressant in transplantation, but its poor solubility and variable bioavailability limit therapeutic efficacy. Nanosuspension technology offers an innovative formulation strategy to enhance oral absorption and potentially improve immunomodulatory effects.

Methods

Wistar rats (n = 4/group) received oral CycA as coarse powder, physical mixture, commercial product, or nanosuspension. Serum cytokines and chemokines (IL-4, IL-5, IL-10, IL-13, IL-17 A, Eotaxin, GRO-α, IP-10, MCP-1, MCP-3, MIP-1α, MIP-2, Rantes) were quantified on days 7, 14, and 21. Data were expressed as mean ± SD. Statistical analysis was performed using Mann–Whitney U test with Benjamini–Hochberg correction for multiple comparisons.

Results

At day 21, IL-10 levels were significantly higher in the nanosuspension group compared to control and coarse powder (adjusted p = 0.041), confirming nanosuspension-mediated IL-10 upregulation. IL-13 was also elevated in nanosuspension and commercial product groups versus control (p_adj = 0.048). IL-4 was significantly reduced in the nanosuspension group at both day 7 (p_adj = 0.042) and day 21 (p_adj = 0.049). IL-5 levels increased in the nanosuspension group at day 21 compared to control and coarse powder (p_adj = 0.037). No statistically significant differences were detected for IL-17 A or chemokines, although descriptive trends suggested altered profiles in the nanosuspension group.

Conclusion

CycA nanosuspension selectively modulates cytokine networks by elevating IL-10, fine-tuning Th2 cytokines (IL-4, IL-5, IL-13), and trending toward chemokine regulation. These findings highlight nanosuspension technology as a promising strategy to enhance CycA's immunosuppressive efficacy, with potential implications for transplantation.
背景:环孢素A (Cyclosporine A, CycA)是移植中的基础免疫抑制剂,但其溶解度差和生物利用度多变限制了其治疗效果。纳米悬浮液技术提供了一种创新的配方策略,以增强口服吸收,并有可能改善免疫调节作用。方法:Wistar大鼠(n = 4只/组)口服CycA粗粉、物理混合物、商品产品和纳米混悬液。血清细胞因子和趋化因子(IL-4、IL-5、IL-10、IL-13、IL-17 A、Eotaxin、GRO-α、IP-10、MCP-1、MCP-3、MIP-1α、MIP-2、Rantes)在第7、14和21天进行定量。数据以平均值 ± SD表示。统计学分析采用Mann-Whitney U检验,多组比较采用Benjamini-Hochberg校正。结果:在第21天,与对照组和粗粉相比,纳米悬液组IL-10水平显著升高(调整p = 0.041),证实纳米悬液介导IL-10上调。与对照组相比,纳米混悬液和商业产品组IL-13也升高(p_adj = 0.048)。纳米悬浮液组IL-4在第7天(p_adj = 0.042)和第21天(p_adj = 0.049)均显著降低。与对照组和粗粉相比,纳米混悬液组IL-5水平在第21天升高(p_adj = 0.037)。IL-17 A或趋化因子未检测到统计学上的显著差异,尽管描述性趋势表明纳米悬浮液组的特征发生了改变。结论:CycA纳米悬浮液通过上调IL-10、微调Th2细胞因子(IL-4、IL-5、IL-13)、趋化因子调控等方式选择性调节细胞因子网络。这些发现突出了纳米悬液技术作为一种有前途的策略来增强CycA的免疫抑制效果,对移植有潜在的影响。
{"title":"Oral cyclosporine a nanosuspension for improved immunosuppressive efficacy: In vivo cytokine profiling in rats","authors":"Çağman Tan ,&nbsp;Sıla Gülbağ Pınar ,&nbsp;Nevin Çelebi","doi":"10.1016/j.trim.2025.102301","DOIUrl":"10.1016/j.trim.2025.102301","url":null,"abstract":"<div><h3>Background</h3><div>Cyclosporine A (CycA) is a cornerstone immunosuppressant in transplantation, but its poor solubility and variable bioavailability limit therapeutic efficacy. Nanosuspension technology offers an innovative formulation strategy to enhance oral absorption and potentially improve immunomodulatory effects.</div></div><div><h3>Methods</h3><div>Wistar rats (<em>n</em> = 4/group) received oral CycA as coarse powder, physical mixture, commercial product, or nanosuspension. Serum cytokines and chemokines (IL-4, IL-5, IL-10, IL-13, IL-17 A, Eotaxin, GRO-α, IP-10, MCP-1, MCP-3, MIP-1α, MIP-2, Rantes) were quantified on days 7, 14, and 21. Data were expressed as mean ± SD. Statistical analysis was performed using Mann–Whitney <em>U</em> test with Benjamini–Hochberg correction for multiple comparisons.</div></div><div><h3>Results</h3><div>At day 21, IL-10 levels were significantly higher in the nanosuspension group compared to control and coarse powder (adjusted <em>p</em> = 0.041), confirming nanosuspension-mediated IL-10 upregulation. IL-13 was also elevated in nanosuspension and commercial product groups versus control (p_adj = 0.048). IL-4 was significantly reduced in the nanosuspension group at both day 7 (p_adj = 0.042) and day 21 (p_adj = 0.049). IL-5 levels increased in the nanosuspension group at day 21 compared to control and coarse powder (p_adj = 0.037). No statistically significant differences were detected for IL-17 A or chemokines, although descriptive trends suggested altered profiles in the nanosuspension group.</div></div><div><h3>Conclusion</h3><div>CycA nanosuspension selectively modulates cytokine networks by elevating IL-10, fine-tuning Th2 cytokines (IL-4, IL-5, IL-13), and trending toward chemokine regulation. These findings highlight nanosuspension technology as a promising strategy to enhance CycA's immunosuppressive efficacy, with potential implications for transplantation.</div></div>","PeriodicalId":23304,"journal":{"name":"Transplant immunology","volume":"93 ","pages":"Article 102301"},"PeriodicalIF":1.4,"publicationDate":"2025-09-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145092460","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Recurrent sarcoidosis in a transplanted kidney: A case report and literature review 移植肾复发性结节病1例报告并文献复习。
IF 1.4 4区 医学 Q4 IMMUNOLOGY Pub Date : 2025-09-16 DOI: 10.1016/j.trim.2025.102300
Abd Assalam Qannus , H. Tahsin Özpolat , Dory Salazar , Erica Bracamonte , Bekir Tanriover , Venkatesh Ariyamathu
Sarcoidosis is a multisystem inflammatory disorder that primarily affects the lungs. However, extra-pulmonary involvement, including the kidneys and heart, is also observed. Kidney involvement may manifest as hypercalcemia or as acute or chronic kidney injury, which could progress to end-stage kidney disease. Patients with sarcoidosis have been reported to successfully undergo kidney transplants, although some have experienced recurrence of sarcoidosis after the transplant, affecting both the kidneys and other organs. Here, we present a case of a patient who underwent a kidney transplant followed by the recurrence of sarcoidosis, which manifested as hypercalcemia five months after the transplant.
结节病是一种多系统炎症性疾病,主要影响肺部。然而,肺外受累,包括肾脏和心脏,也被观察到。肾脏受累可表现为高钙血症或急性或慢性肾损伤,可发展为终末期肾脏疾病。有报道称,结节病患者成功地接受了肾移植,尽管有些患者在移植后结节病复发,影响肾脏和其他器官。在此,我们报告一例接受肾移植后结节病复发的患者,移植后5个月表现为高钙血症。
{"title":"Recurrent sarcoidosis in a transplanted kidney: A case report and literature review","authors":"Abd Assalam Qannus ,&nbsp;H. Tahsin Özpolat ,&nbsp;Dory Salazar ,&nbsp;Erica Bracamonte ,&nbsp;Bekir Tanriover ,&nbsp;Venkatesh Ariyamathu","doi":"10.1016/j.trim.2025.102300","DOIUrl":"10.1016/j.trim.2025.102300","url":null,"abstract":"<div><div>Sarcoidosis is a multisystem inflammatory disorder that primarily affects the lungs. However, extra-pulmonary involvement, including the kidneys and heart, is also observed. Kidney involvement may manifest as hypercalcemia or as acute or chronic kidney injury, which could progress to end-stage kidney disease. Patients with sarcoidosis have been reported to successfully undergo kidney transplants, although some have experienced recurrence of sarcoidosis after the transplant, affecting both the kidneys and other organs. Here, we present a case of a patient who underwent a kidney transplant followed by the recurrence of sarcoidosis, which manifested as hypercalcemia five months after the transplant.</div></div>","PeriodicalId":23304,"journal":{"name":"Transplant immunology","volume":"93 ","pages":"Article 102300"},"PeriodicalIF":1.4,"publicationDate":"2025-09-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145087666","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
De novo donor specific antibody (dnDSA) development with tacrolimus versus Belatacept based regimens in kidney transplant recipients 在肾移植受者中,他克莫司与基于Belatacept的方案的新供者特异性抗体(dnDSA)的发展。
IF 1.4 4区 医学 Q4 IMMUNOLOGY Pub Date : 2025-09-15 DOI: 10.1016/j.trim.2025.102297
Cayla Kass , Goni Katz-Greenberg , Jason Bodner , Scott Sanoff , Alice Parish , Alaattin Erkanli , Jennifer Byrns

Purpose

Belatacept has been associated with less de novo specific antibody (dnDSA) development, but few publications have compared the incidence of dnDSA development between tacrolimus and belatacept-based immunosuppression regimens. The purpose of this study was to investigate the differences in dnDSA development and clinical outcomes between these two maintenance regimens in kidney transplant.

Methods

This was a retrospective, single center, cohort study of patients transplanted between 2013 and 2019 who received a de novo belatacept or tacrolimus-based immunosuppression regimen. The primary outcome was the incidence of dnDSA development (MFI ≥ 1000) at 36 months. Secondary outcomes included renal function, biopsy proven rejection (BPAR), and patient/graft survival.

Results

Ninety patients met inclusion criteria. The primary outcome occurred in 4 (8.9 %) belatacept patients and 6 (13.3 %) tacrolimus patients, with an overall median time to dnDSA of 300 days (p = 0.51). Class II dnDSA development occurred in 3 (6.7 %) belatacept patients and 6 (13.3 %) tacrolimus patients. Belatacept patients had a lower, but not significantly different, rate of developing BPAR (4.4 % vs 13.3 %, p = 0.13) and had superior renal function at 36 months (median 66 ml/min vs 53 ml/min, p < 0.01). Overall, there was excellent patient/graft survival at 36 months post-transplant.

Conclusion

De novo belatacept use did not result in a statistically significant difference in the development of dnDSAs but did show a numerically lower class II dnDSA and BPAR development. Overall, belatacept was associated with improved renal function as compared to tacrolimus-based regimens.
目的:Belatacept与较少的新发特异性抗体(dnDSA)发生相关,但很少有文献比较他克莫司和基于Belatacept的免疫抑制方案之间dnDSA发生的发生率。本研究的目的是调查两种维持方案在肾移植中dnDSA发展和临床结果的差异。方法:这是一项回顾性、单中心、队列研究,研究对象是2013年至2019年间接受贝拉他普或他克莫司免疫抑制方案的移植患者。主要终点是36 个月时dnDSA发生的发生率(MFI ≥ 1000)。次要结局包括肾功能、活检证实的排斥反应(BPAR)和患者/移植物存活。结果:90例患者符合纳入标准。主要结局发生在4例(8.9 %)belatacept患者和6例(13.3 %)他克莫司患者中,到达dnDSA的总中位时间为300 天(p = 0.51)。II类dnDSA发生在3例(6.7 %)belataccept患者和6例(13.3 %)他克莫司患者中。Belatacept患者发生BPAR的比率较低,但没有显著差异(4.4 % vs 13.3 %,p = 0.13),并且在36 个月时具有较好的肾功能(中位值66 ml/min vs 53 ml/min, p )。结论:重新使用Belatacept并没有导致dnDSA发展的统计学差异,但确实显示了较低的II级dnDSA和BPAR发展。总的来说,与以他克莫司为基础的方案相比,贝拉他普与肾功能改善有关。
{"title":"De novo donor specific antibody (dnDSA) development with tacrolimus versus Belatacept based regimens in kidney transplant recipients","authors":"Cayla Kass ,&nbsp;Goni Katz-Greenberg ,&nbsp;Jason Bodner ,&nbsp;Scott Sanoff ,&nbsp;Alice Parish ,&nbsp;Alaattin Erkanli ,&nbsp;Jennifer Byrns","doi":"10.1016/j.trim.2025.102297","DOIUrl":"10.1016/j.trim.2025.102297","url":null,"abstract":"<div><h3>Purpose</h3><div>Belatacept has been associated with less de novo specific antibody (dnDSA) development, but few publications have compared the incidence of dnDSA development between tacrolimus and belatacept-based immunosuppression regimens. The purpose of this study was to investigate the differences in dnDSA development and clinical outcomes between these two maintenance regimens in kidney transplant.</div></div><div><h3>Methods</h3><div>This was a retrospective, single center, cohort study of patients transplanted between 2013 and 2019 who received a de novo belatacept or tacrolimus-based immunosuppression regimen. The primary outcome was the incidence of dnDSA development (MFI ≥ 1000) at 36 months. Secondary outcomes included renal function, biopsy proven rejection (BPAR), and patient/graft survival.</div></div><div><h3>Results</h3><div>Ninety patients met inclusion criteria. The primary outcome occurred in 4 (8.9 %) belatacept patients and 6 (13.3 %) tacrolimus patients, with an overall median time to dnDSA of 300 days (<em>p</em> = 0.51). Class II dnDSA development occurred in 3 (6.7 %) belatacept patients and 6 (13.3 %) tacrolimus patients. Belatacept patients had a lower, but not significantly different, rate of developing BPAR (4.4 % vs 13.3 %, <em>p</em> = 0.13) and had superior renal function at 36 months (median 66 ml/min vs 53 ml/min, <em>p</em> &lt; 0.01). Overall, there was excellent patient/graft survival at 36 months post-transplant.</div></div><div><h3>Conclusion</h3><div>De novo belatacept use did not result in a statistically significant difference in the development of dnDSAs but did show a numerically lower class II dnDSA and BPAR development. Overall, belatacept was associated with improved renal function as compared to tacrolimus-based regimens.</div></div>","PeriodicalId":23304,"journal":{"name":"Transplant immunology","volume":"93 ","pages":"Article 102297"},"PeriodicalIF":1.4,"publicationDate":"2025-09-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145081726","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Assessing the influence of isolation techniques on NK cell transcriptomic profiles 评估分离技术对NK细胞转录组谱的影响。
IF 1.4 4区 医学 Q4 IMMUNOLOGY Pub Date : 2025-09-14 DOI: 10.1016/j.trim.2025.102298
Rana ElNouty , Ahmed Moustafa , Maha Mostafa , Amged Ouf , Khaled Abou-Aisha , Mona Rady
Natural Killer (NK) cells are vital components of the innate immune system, playing a crucial role in defending the body against tumors and virally infected cells. While various methods exist for their isolation, the profound impact of these techniques on NK cell biology remains poorly characterized.This study presents a comprehensive analysis of the transcriptomic profiles of NK cells isolated using different positive selection methods; anti-CD56, anti-CD7 (with two distinct lineage depletion protocols), and a combination of anti-CD16 and anti-CD56 antibodies, compared to negative selection using immunomagnetic beads. Our integrated analysis of RNA-Seq datasets revealed that the isolation method is a dominant source of transcriptomic variation, accounting for 68.6 % of the total dataset variance, with technical factors being inextricably confounded with this biological signal. We identified extensive method-specific transcriptional signatures, with minimal overlap (<0.1 %) in differentially expressed genes (DEGs) across techniques. Functional enrichment analysis demonstrated that these signatures correspond to starkly different functional states: anti-CD16/anti-CD56 selection enriched for a highly activated, cytotoxically competent NK cell population with upregulated pathways in cytotoxicity and immune surveillance, while one anti-CD7-based method captured NK cells in a suppressed state, showing significant downregulation of lymphocyte activation and cytotoxicity pathways. Marker expression analysis further revealed extreme inter-study heterogeneity, with fold-changes in key cytotoxic genes exceeding 70,000-fold between methods. These findings highlight that the choice of isolation technique is not neutral but fundamentally determines the transcriptional and functional identity of the studied NK cell population. Our results highlight the critical importance of methodological standardization in NK cell research and provide essential guidance for selecting isolation strategies tailored to specific research or therapeutic applications.
自然杀伤细胞(NK)是先天免疫系统的重要组成部分,在保护身体免受肿瘤和病毒感染细胞的侵害方面起着至关重要的作用。虽然存在各种方法来分离NK细胞,但这些技术对NK细胞生物学的深远影响仍然缺乏表征。本研究对使用不同阳性选择方法分离的NK细胞的转录组学特征进行了全面分析;与使用免疫磁珠的阴性选择相比,抗cd56,抗cd7(有两种不同的谱系耗尽方案),以及抗cd16和抗cd56抗体的组合。我们对RNA-Seq数据集的综合分析表明,分离方法是转录组变异的主要来源,占总数据集变异的68.6% %,技术因素与这种生物信号不可避免地混淆在一起。我们发现了广泛的方法特异性转录特征,重叠最小(
{"title":"Assessing the influence of isolation techniques on NK cell transcriptomic profiles","authors":"Rana ElNouty ,&nbsp;Ahmed Moustafa ,&nbsp;Maha Mostafa ,&nbsp;Amged Ouf ,&nbsp;Khaled Abou-Aisha ,&nbsp;Mona Rady","doi":"10.1016/j.trim.2025.102298","DOIUrl":"10.1016/j.trim.2025.102298","url":null,"abstract":"<div><div>Natural Killer (NK) cells are vital components of the innate immune system, playing a crucial role in defending the body against tumors and virally infected cells. While various methods exist for their isolation, the profound impact of these techniques on NK cell biology remains poorly characterized.This study presents a comprehensive analysis of the transcriptomic profiles of NK cells isolated using different positive selection methods; anti-CD56, anti-CD7 (with two distinct lineage depletion protocols), and a combination of anti-CD16 and anti-CD56 antibodies, compared to negative selection using immunomagnetic beads. Our integrated analysis of RNA-Seq datasets revealed that the isolation method is a dominant source of transcriptomic variation, accounting for 68.6 % of the total dataset variance, with technical factors being inextricably confounded with this biological signal. We identified extensive method-specific transcriptional signatures, with minimal overlap (&lt;0.1 %) in differentially expressed genes (DEGs) across techniques. Functional enrichment analysis demonstrated that these signatures correspond to starkly different functional states: anti-CD16/anti-CD56 selection enriched for a highly activated, cytotoxically competent NK cell population with upregulated pathways in cytotoxicity and immune surveillance, while one anti-CD7-based method captured NK cells in a suppressed state, showing significant downregulation of lymphocyte activation and cytotoxicity pathways. Marker expression analysis further revealed extreme inter-study heterogeneity, with fold-changes in key cytotoxic genes exceeding 70,000-fold between methods. These findings highlight that the choice of isolation technique is not neutral but fundamentally determines the transcriptional and functional identity of the studied NK cell population. Our results highlight the critical importance of methodological standardization in NK cell research and provide essential guidance for selecting isolation strategies tailored to specific research or therapeutic applications.</div></div>","PeriodicalId":23304,"journal":{"name":"Transplant immunology","volume":"93 ","pages":"Article 102298"},"PeriodicalIF":1.4,"publicationDate":"2025-09-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145076088","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Case report: Recipient-derived, late-onset post-transplant lymphoproliferative disorder involving a transplanted liver 病例报告:受者来源,移植后迟发性淋巴细胞增生性疾病累及移植肝脏。
IF 1.4 4区 医学 Q4 IMMUNOLOGY Pub Date : 2025-09-12 DOI: 10.1016/j.trim.2025.102299
Dongmei Zou , Qiang Ma , Dandan Wang , Dongdong Lin , Hong Zhao , Wanling Sun

Introduction

Post-transplant lymphoproliferative disorders (PTLD) are severe complications of transplantation associated with poor outcomes. Compared to early-onset PTLDs, late-onset PTLDs are much less associated with allograft localization. Herein, we report a case of Epstein-Barr virus (EBV)-negative lymphoma involving a graft 7 years after liver transplantation.

Case presentation

A 45-year-old man presented with hepatomegaly 7 years after liver transplantation. Liver puncture biopsy revealed B-cell lymphoma with a high proliferation index and a germinal center B-cell-like subtype. Tissue and other donor information were unavailable. Next-generation sequencing was performed on the tumor and recipient tissues, and the single nucleotide polymorphism (SNP) sites were identical, thereby confirming the recipient origin. The patient received a reduction in immunosuppression and six cycles of rituximab, reduced doses of cyclophosphamide, doxorubicin, vincristine, and prednisone, and achieved complete remission after the fourth cycle of treatment. The patient remained in good condition for 7 months after the last chemotherapy dose.

Conclusion

This rare case report describes a late-onset EBV-negative recipient-derived PTLD involving a transplanted liver. SNP analysis is a useful method for determining tumor origin in situations where donor tissue is unavailable.
移植后淋巴细胞增生性疾病(PTLD)是移植术后的严重并发症,预后较差。与早发性PTLDs相比,晚发性PTLDs与同种异体移植物定位的相关性要小得多。在此,我们报告一例eb病毒(EBV)阴性淋巴瘤,涉及肝移植7 年后的移植物。病例介绍:45岁男性,肝移植后7 年出现肝肿大。肝脏穿刺活检显示高增殖指数的b细胞淋巴瘤和生发中心b细胞样亚型。无法获得组织和其他捐赠者的信息。对肿瘤和受体组织进行新一代测序,单核苷酸多态性(SNP)位点相同,从而确认受体来源。患者接受了免疫抑制的减少和6个周期的利妥昔单抗,减少了环磷酰胺、阿霉素、长春新碱和强的松的剂量,并在第4个周期的治疗后完全缓解。在最后一次化疗后,患者保持良好状态7 个月。结论:这个罕见的病例报告描述了一个迟发性ebv阴性受体与PTLD累及肝脏移植。在供体组织不可用的情况下,SNP分析是确定肿瘤起源的有用方法。
{"title":"Case report: Recipient-derived, late-onset post-transplant lymphoproliferative disorder involving a transplanted liver","authors":"Dongmei Zou ,&nbsp;Qiang Ma ,&nbsp;Dandan Wang ,&nbsp;Dongdong Lin ,&nbsp;Hong Zhao ,&nbsp;Wanling Sun","doi":"10.1016/j.trim.2025.102299","DOIUrl":"10.1016/j.trim.2025.102299","url":null,"abstract":"<div><h3>Introduction</h3><div>Post-transplant lymphoproliferative disorders (PTLD) are severe complications of transplantation associated with poor outcomes. Compared to early-onset PTLDs, late-onset PTLDs are much less associated with allograft localization. Herein, we report a case of Epstein-Barr virus (EBV)-negative lymphoma involving a graft 7 years after liver transplantation.</div></div><div><h3>Case presentation</h3><div>A 45-year-old man presented with hepatomegaly 7 years after liver transplantation. Liver puncture biopsy revealed B-cell lymphoma with a high proliferation index and a germinal center B-cell-like subtype. Tissue and other donor information were unavailable. Next-generation sequencing was performed on the tumor and recipient tissues, and the single nucleotide polymorphism (SNP) sites were identical, thereby confirming the recipient origin. The patient received a reduction in immunosuppression and six cycles of rituximab, reduced doses of cyclophosphamide, doxorubicin, vincristine, and prednisone, and achieved complete remission after the fourth cycle of treatment. The patient remained in good condition for 7 months after the last chemotherapy dose.</div></div><div><h3>Conclusion</h3><div>This rare case report describes a late-onset EBV-negative recipient-derived PTLD involving a transplanted liver. SNP analysis is a useful method for determining tumor origin in situations where donor tissue is unavailable.</div></div>","PeriodicalId":23304,"journal":{"name":"Transplant immunology","volume":"93 ","pages":"Article 102299"},"PeriodicalIF":1.4,"publicationDate":"2025-09-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145065259","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Racial and ethnic disparities in kidney transplantation 肾移植中的种族差异。
IF 1.4 4区 医学 Q4 IMMUNOLOGY Pub Date : 2025-09-10 DOI: 10.1016/j.trim.2025.102289
Macrae Kozody , Roberta Buccilli , Giovanni Faddoul , Jorge Ortiz
Social determinants of health, bias and genetic predisposition contribute to racial inequities in chronic kidney disease (CKD) and kidney transplant (KTX) allocation. Recognizing and addressing these complex factors leads to improvement in outcomes. This narrative review aims to discuss the current state of racial disparities surrounding KTX and identify where future efforts should be concentrated. The discussion focuses on data from the past 10 years (2015–2025). Overall mortality and graft loss is lowest in Hispanics and Asians and highest in Native Americans, perhaps due to the unique protective or detrimental social factors in these populations. Blacks have equal to better mortality than Whites, but worse graft survival. In an effort to identify paucities in the current literature, KTX outcomes by specific CKD etiologies are reviewed, including: diabetic nephropathy, focal segmental glomerulosclerosis, membranous nephropathy, lupus nephritis, vasculitis and polycystic kidney disease. Graft survival and mortality patterns for disease specific kidney transplant generally mirrors that of all cause KTX, but available data is limited. In recent years, racial disparities in CKD and transplant have improved, but still persist, representing the need for continued investigation and improvement. Future work should focus on continued identification and implementation of successful mitigation strategies and investigation where current literature is insufficient, such as diabetic nephropathy.
健康、偏见和遗传易感性的社会决定因素导致慢性肾脏疾病(CKD)和肾脏移植(KTX)分配中的种族不平等。认识和处理这些复杂的因素会导致结果的改善。这篇叙述性评论旨在讨论围绕KTX的种族差异的现状,并确定未来的努力应该集中在哪里。讨论的重点是过去10年 年(2015-2025)的数据。西班牙裔和亚洲人的总体死亡率和移植物损失最低,而美洲原住民最高,这可能是由于这些人群中独特的保护性或有害的社会因素。黑人的死亡率比白人高,但存活率却比白人差。为了找出目前文献中的不足之处,我们回顾了特定CKD病因的KTX结果,包括:糖尿病肾病、局灶节段性肾小球硬化、膜性肾病、狼疮性肾炎、血管炎和多囊肾病。特定疾病肾移植的移植物存活和死亡率模式通常反映了全因KTX,但可用的数据有限。近年来,CKD和移植中的种族差异有所改善,但仍然存在,这表明需要继续调查和改进。未来的工作应侧重于继续确定和实施成功的缓解策略,并调查目前文献不足的领域,如糖尿病肾病。
{"title":"Racial and ethnic disparities in kidney transplantation","authors":"Macrae Kozody ,&nbsp;Roberta Buccilli ,&nbsp;Giovanni Faddoul ,&nbsp;Jorge Ortiz","doi":"10.1016/j.trim.2025.102289","DOIUrl":"10.1016/j.trim.2025.102289","url":null,"abstract":"<div><div>Social determinants of health, bias and genetic predisposition contribute to racial inequities in chronic kidney disease (CKD) and kidney transplant (KTX) allocation. Recognizing and addressing these complex factors leads to improvement in outcomes. This narrative review aims to discuss the current state of racial disparities surrounding KTX and identify where future efforts should be concentrated. The discussion focuses on data from the past 10 years (2015–2025). Overall mortality and graft loss is lowest in Hispanics and Asians and highest in Native Americans, perhaps due to the unique protective or detrimental social factors in these populations. Blacks have equal to better mortality than Whites, but worse graft survival. In an effort to identify paucities in the current literature, KTX outcomes by specific CKD etiologies are reviewed, including: diabetic nephropathy, focal segmental glomerulosclerosis, membranous nephropathy, lupus nephritis, vasculitis and polycystic kidney disease. Graft survival and mortality patterns for disease specific kidney transplant generally mirrors that of all cause KTX, but available data is limited. In recent years, racial disparities in CKD and transplant have improved, but still persist, representing the need for continued investigation and improvement. Future work should focus on continued identification and implementation of successful mitigation strategies and investigation where current literature is insufficient, such as diabetic nephropathy.</div></div>","PeriodicalId":23304,"journal":{"name":"Transplant immunology","volume":"93 ","pages":"Article 102289"},"PeriodicalIF":1.4,"publicationDate":"2025-09-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145055869","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
PD-1 inhibitor use for skin malignancies in patients with solid organ and bone marrow transplants: Graft rejection, treatment responses, and survival PD-1抑制剂用于实体器官和骨髓移植患者的皮肤恶性肿瘤:移植排斥反应,治疗反应和生存
IF 1.4 4区 医学 Q4 IMMUNOLOGY Pub Date : 2025-09-10 DOI: 10.1016/j.trim.2025.102287
Lily M. Parker , Kate E. Beekman , Meredith E. Thomley , Rahul Mhaskar , Kenneth Tsai , Lilia M. Correa-Selm

Importance

Solid organ transplant recipients face a markedly increased risk of aggressive skin cancers. Programmed cell death protein-1 (PD-1) inhibitors have significantly improved outcomes for advanced melanoma, squamous cell carcinoma (SCC), and Merkel cell carcinoma (MCC), but their use in transplant patients is limited by the risk of graft rejection. Data in this population remain scarce.

Objective

To evaluate rates of graft rejection, treatment responses, and survival among transplant recipients treated with PD-1 inhibitors for advanced skin malignancies.

Methods

We identified 16 solid organ transplants patients (14 kidney, 2 liver) and 5 allogeneic bone marrow transplant patients. Skin cancer types included 14 squamous cell carcinomas, 2 melanomas, and 5 Merkel cell carcinomas.

Results

Among 16 solid organ transplant recipients (14 kidney, 2 liver), 4 developed graft rejection. Three occurred prior to PD-1 initiation, leaving only one rejection attributable to therapy. Median survival following PD-1 initiation was longer in patients with rejection (8.3 months) compared with those who died of cancer progression (3.0 months). No bone marrow transplant recipients experienced rejection.

Conclusions and relevance

In our data (the largest reported cohort to date), most transplant recipients tolerated PD-1 inhibitors without graft rejection. Although rejection remains a serious risk, these findings suggest that PD-1 immunotherapy may be considered as a salvage option for carefully selected patients with advanced skin cancer.
实体器官移植受者患侵袭性皮肤癌的风险明显增加。程序性细胞死亡蛋白-1 (PD-1)抑制剂可以显著改善晚期黑色素瘤、鳞状细胞癌(SCC)和默克尔细胞癌(MCC)的预后,但它们在移植患者中的应用受到移植物排斥反应风险的限制。这一人群的数据仍然很少。目的评价PD-1抑制剂治疗晚期皮肤恶性肿瘤患者的移植排斥反应率、治疗反应和生存率。方法对16例实体器官移植患者(肾14例,肝2例)和5例异体骨髓移植患者进行分析。皮肤癌类型包括14种鳞状细胞癌、2种黑色素瘤和5种默克尔细胞癌。结果16例实体器官移植受者(肾14例,肝2例)中,4例发生排斥反应。其中三例发生在PD-1启动之前,仅留下一例可归因于治疗的排斥反应。PD-1启动后的中位生存期(8.3个月)比死于癌症进展的患者(3.0个月)更长。骨髓移植受者没有出现排斥反应。结论和相关性在我们的数据中(迄今为止报道的最大队列),大多数移植受者耐受PD-1抑制剂而无移植排斥反应。尽管排斥反应仍然存在严重的风险,但这些发现表明,PD-1免疫疗法可能被认为是精心挑选的晚期皮肤癌患者的救助性选择。
{"title":"PD-1 inhibitor use for skin malignancies in patients with solid organ and bone marrow transplants: Graft rejection, treatment responses, and survival","authors":"Lily M. Parker ,&nbsp;Kate E. Beekman ,&nbsp;Meredith E. Thomley ,&nbsp;Rahul Mhaskar ,&nbsp;Kenneth Tsai ,&nbsp;Lilia M. Correa-Selm","doi":"10.1016/j.trim.2025.102287","DOIUrl":"10.1016/j.trim.2025.102287","url":null,"abstract":"<div><h3>Importance</h3><div>Solid organ transplant recipients face a markedly increased risk of aggressive skin cancers. Programmed cell death protein-1 (PD-1) inhibitors have significantly improved outcomes for advanced melanoma, squamous cell carcinoma (SCC), and Merkel cell carcinoma (MCC), but their use in transplant patients is limited by the risk of graft rejection. Data in this population remain scarce.</div></div><div><h3>Objective</h3><div>To evaluate rates of graft rejection, treatment responses, and survival among transplant recipients treated with PD-1 inhibitors for advanced skin malignancies.</div></div><div><h3>Methods</h3><div>We identified 16 solid organ transplants patients (14 kidney, 2 liver) and 5 allogeneic bone marrow transplant patients. Skin cancer types included 14 squamous cell carcinomas, 2 melanomas, and 5 Merkel cell carcinomas.</div></div><div><h3>Results</h3><div>Among 16 solid organ transplant recipients (14 kidney, 2 liver), 4 developed graft rejection. Three occurred prior to PD-1 initiation, leaving only one rejection attributable to therapy. Median survival following PD-1 initiation was longer in patients with rejection (8.3 months) compared with those who died of cancer progression (3.0 months). No bone marrow transplant recipients experienced rejection.</div></div><div><h3>Conclusions and relevance</h3><div>In our data (the largest reported cohort to date), most transplant recipients tolerated PD-1 inhibitors without graft rejection. Although rejection remains a serious risk, these findings suggest that PD-1 immunotherapy may be considered as a salvage option for carefully selected patients with advanced skin cancer.</div></div>","PeriodicalId":23304,"journal":{"name":"Transplant immunology","volume":"93 ","pages":"Article 102287"},"PeriodicalIF":1.4,"publicationDate":"2025-09-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145047117","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
期刊
Transplant immunology
全部 Acc. Chem. Res. ACS Applied Bio Materials ACS Appl. Electron. Mater. ACS Appl. Energy Mater. ACS Appl. Mater. Interfaces ACS Appl. Nano Mater. ACS Appl. Polym. Mater. ACS BIOMATER-SCI ENG ACS Catal. ACS Cent. Sci. ACS Chem. Biol. ACS Chemical Health & Safety ACS Chem. Neurosci. ACS Comb. Sci. ACS Earth Space Chem. ACS Energy Lett. ACS Infect. Dis. ACS Macro Lett. ACS Mater. Lett. ACS Med. Chem. Lett. ACS Nano ACS Omega ACS Photonics ACS Sens. ACS Sustainable Chem. Eng. ACS Synth. Biol. Anal. Chem. BIOCHEMISTRY-US Bioconjugate Chem. BIOMACROMOLECULES Chem. Res. Toxicol. Chem. Rev. Chem. Mater. CRYST GROWTH DES ENERG FUEL Environ. Sci. Technol. Environ. Sci. Technol. Lett. Eur. J. Inorg. Chem. IND ENG CHEM RES Inorg. Chem. J. Agric. Food. Chem. J. Chem. Eng. Data J. Chem. Educ. J. Chem. Inf. Model. J. Chem. Theory Comput. J. Med. Chem. J. Nat. Prod. J PROTEOME RES J. Am. Chem. Soc. LANGMUIR MACROMOLECULES Mol. Pharmaceutics Nano Lett. Org. Lett. ORG PROCESS RES DEV ORGANOMETALLICS J. Org. Chem. J. Phys. Chem. J. Phys. Chem. A J. Phys. Chem. B J. Phys. Chem. C J. Phys. Chem. Lett. Analyst Anal. Methods Biomater. Sci. Catal. Sci. Technol. Chem. Commun. Chem. Soc. Rev. CHEM EDUC RES PRACT CRYSTENGCOMM Dalton Trans. Energy Environ. Sci. ENVIRON SCI-NANO ENVIRON SCI-PROC IMP ENVIRON SCI-WAT RES Faraday Discuss. Food Funct. Green Chem. Inorg. Chem. Front. Integr. Biol. J. Anal. At. Spectrom. J. Mater. Chem. A J. Mater. Chem. B J. Mater. Chem. C Lab Chip Mater. Chem. Front. Mater. Horiz. MEDCHEMCOMM Metallomics Mol. Biosyst. Mol. Syst. Des. Eng. Nanoscale Nanoscale Horiz. Nat. Prod. Rep. New J. Chem. Org. Biomol. Chem. Org. Chem. Front. PHOTOCH PHOTOBIO SCI PCCP Polym. Chem.
×
引用
GB/T 7714-2015
复制
MLA
复制
APA
复制
导出至
BibTeX EndNote RefMan NoteFirst NoteExpress
×
0
微信
客服QQ
Book学术公众号 扫码关注我们
反馈
×
意见反馈
请填写您的意见或建议
请填写您的手机或邮箱
×
提示
您的信息不完整,为了账户安全,请先补充。
现在去补充
×
提示
您因"违规操作"
具体请查看互助需知
我知道了
×
提示
现在去查看 取消
×
提示
确定
Book学术官方微信
Book学术文献互助
Book学术文献互助群
群 号:604180095
Book学术
文献互助 智能选刊 最新文献 互助须知 联系我们:info@booksci.cn
Book学术提供免费学术资源搜索服务,方便国内外学者检索中英文文献。致力于提供最便捷和优质的服务体验。
Copyright © 2023 Book学术 All rights reserved.
ghs 京公网安备 11010802042870号 京ICP备2023020795号-1