Dataset Information

Immunoglobulin G-Degrading Enzyme of Streptococcus pyogenes (IdeS), Desensitization, and the Kidney Allocation System: Complementary Approaches to Increase Transplantation in Highly HLA Sensitized Patients.

ABSTRACT:

SUBMITTER: Huang E

PROVIDER: S-EPMC5969484 | biostudies-literature | 2018 May

REPOSITORIES: biostudies-literature

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Immunoglobulin G-Degrading Enzyme of <i>Streptococcus pyogenes</i> (IdeS), Desensitization, and the Kidney Allocation System: Complementary Approaches to Increase Transplantation in Highly HLA Sensitized Patients.

Huang Edmund E Jordan Stanley C SC

Clinical journal of the American Society of Nephrology : CJASN 20180309 5

PMID: 29523676

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Project description:Background: We aimed to investigate the effects of intravenous immune globulin (IVIG) and rituximab desensitization treatment on kidney transplant rate and blood gene expression profiles by microrarrays. Methods: We enrolled patients with PRA levels >50% and on the deceased-donor waiting list for >5 years. Patients received IVIG (2.0 g/kg) on day 0 and 30; and rituximab (375 mg/m2) on day 15. The antibodies with mean fluorescence intensity (MFI) values > 5,000 were reported to UNET as unacceptable antigens. The gene expression profiles of blood samples collected in PAXGene tube were studied by Affymetrix HuGene 1.0 ST expression arrays. Results: 40 of the 415 patients (10%) on the waiting list were eligible for desensitization treatment and 11 completed the treatment. While 15 of the remaining 29 patients (52%) received a transplant without therapy, only 2 of the 11 desensitized patients (18%) received transplant during a median follow-up of 217 days. While there were no statistically significant difference in demographics, desensitized patients had higher cPRA values (97% vs. 77%, p=0.0005) and more number of unacceptable antigens (39 vs. 10, p=0.0001). There was no significant change in the mean number of unacceptable antigens (39 ± 22 versus 39 ± 23) or reduction in the mean MFI values (11,333 ± 3,133 vs 11,289 ± 3,386). Analysis of genes chosen as significantly differentially expressed revealed downregulation of genes involved in B cells and immune system (CD79a, B and T lymphocyte associated transcript, B cell scaffold protein, CD22, CXCR5, fas apoptotic inhibitory protein). Gene set enrichment analysis using Pathogenesis Based Transcripts created by Edmonton Group demonstrated significant downregulation of B cell associated (p=0.04) and immunoglobulin transcripts (p=0.03). Conclusion: Although, desensitization with IVIG and rituximab decreases the expression of B cell and immunoglobulin associated transcripts, it was not successful in increasing kidney transplant rate or in decreasing the number of unacceptable antigens.

Dataset Information

Immunoglobulin G-Degrading Enzyme of Streptococcus pyogenes (IdeS), Desensitization, and the Kidney Allocation System: Complementary Approaches to Increase Transplantation in Highly HLA Sensitized Patients.

Publications

Immunoglobulin G-Degrading Enzyme of <i>Streptococcus pyogenes</i> (IdeS), Desensitization, and the Kidney Allocation System: Complementary Approaches to Increase Transplantation in Highly HLA Sensitized Patients.

Similar Datasets

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