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托珠单抗单药治疗对高敏肾移植受者抗人白细胞抗原同种抗体的边际影响

Marginal Impact of Tocilizumab Monotherapy on Anti-HLA Alloantibodies in Highly Sensitized Kidney Transplant Candidates.

作者信息

Daligault Mélanie, Bardy Béatrice, Noble Johan, Bourdin Anne, Masson Dominique, Naciri Bennani Hamza, Bugnazet Mathilde, Malvezzi Paolo, Rostaing Lionel, Jouve Thomas

机构信息

Nephrology, Hemodialysis, Apheresis and Kidney Transplantation Department, Grenoble University Hospital, Grenoble, France.

HLA Laboratory, Etablissement Français du Sang, La Tronche, France.

出版信息

Transplant Direct. 2021 Apr 22;7(5):e690. doi: 10.1097/TXD.0000000000001139. eCollection 2021 May.

DOI:10.1097/TXD.0000000000001139
PMID:33912657
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC8078280/
Abstract

BACKGROUND

Highly HLA-sensitized kidney transplant candidates are difficult to desensitize, which reduces their chances of receiving a transplant.

METHODS

We administered tocilizumab as a monotherapy (8 mg/kg once a mo) to 14 highly sensitized kidney transplant candidates. Highest mean fluorescence intensities of anti-HLA antibodies obtained before and after tocilizumab administration were compared from raw and diluted sera.

RESULTS

The administration of tocilizumab significantly reduced dominant anti-HLA antibody sensitization. However, this decrease in mean fluorescence intensities was minor compared with the initial values.

CONCLUSIONS

Tocilizumab as a monotherapy was not sufficient to allow highly sensitized kidney-transplant candidates to undergo transplantation and, therefore, was not an effective desensitization method.

摘要

背景

高度HLA致敏的肾移植候选者难以脱敏,这降低了他们接受移植的机会。

方法

我们对14名高度致敏的肾移植候选者采用托珠单抗单药治疗(每月一次,8mg/kg)。比较托珠单抗给药前后从原始血清和稀释血清中获得的抗HLA抗体的最高平均荧光强度。

结果

托珠单抗的给药显著降低了主要抗HLA抗体致敏。然而,与初始值相比,平均荧光强度的降低幅度较小。

结论

托珠单抗单药治疗不足以使高度致敏的肾移植候选者接受移植,因此不是一种有效的脱敏方法。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/0bd7/8078280/fd2c89e05b3a/txd-7-e690-g002.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/0bd7/8078280/4563a2ff70ca/txd-7-e690-g001.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/0bd7/8078280/fd2c89e05b3a/txd-7-e690-g002.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/0bd7/8078280/4563a2ff70ca/txd-7-e690-g001.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/0bd7/8078280/fd2c89e05b3a/txd-7-e690-g002.jpg

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Int Immunopharmacol. 2020 Aug;85:106649. doi: 10.1016/j.intimp.2020.106649. Epub 2020 Jun 5.
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Early effects of first-line treatment with anti-interleukin-6 receptor antibody tocilizumab for chronic active antibody-mediated rejection in kidney transplantation.一线治疗抗白细胞介素 6 受体抗体托珠单抗治疗肾移植后慢性活动性抗体介导排斥反应的早期效果。
Clin Transplant. 2020 Aug;34(8):e13908. doi: 10.1111/ctr.13908. Epub 2020 Jun 16.
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以白细胞介素-6为靶点实现肾脏保护。
Front Immunol. 2024 Dec 11;15:1502299. doi: 10.3389/fimmu.2024.1502299. eCollection 2024.
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