The presence of human-leukocyte antigen （HLA）-antibodies and blood group incompatibility remain a large barrier to kidney transplantation leading to increased morbidity and mortality on the transplant waiting list. ...The presence of human-leukocyte antigen （HLA）-antibodies and blood group incompatibility remain a large barrier to kidney transplantation leading to increased morbidity and mortality on the transplant waiting list. Over the last decade a number of new approaches were developed to overcome these barriers. Intravenous immunoglobulin （IVIG） remains the backbone of HLA desensitization therapy and has been shown in a prospective, randomized, placebo controlled trial to improve transplantation rates. Excellent outcomes with the addition of rituximab （anti-B cell） to IVIG based desensitization have been achieved. There is limited experience with bortezomib （anti-plasma cell） and eculizumab （complement inhibition） for desensitization. However, these agents may be good adjuncts for patients who are broadly sensitized with strong, complement-fxing HLA antibodies. Excellent short and long-term outcomes have been achieved in ABO incompatible transplantation with the combination of antibody removal, B cell depletion, and pre-transplant immunosuppression. Kidney paired donation has emerged as a reasonable alternative for programs who cannot provide desensitization or in conjunction with desensitization. Future therapies directed toward cytokines that alter B cell proliferation are under investigation.展开更多
Our understanding of immune responses to SARS-CoV-2 and variants of concern(VOCs)has been primarily acquired through analysis of Spike-specific IgG responses.However,a more comprehensive understanding of the breadth a...Our understanding of immune responses to SARS-CoV-2 and variants of concern(VOCs)has been primarily acquired through analysis of Spike-specific IgG responses.However,a more comprehensive understanding of the breadth and longevity of immune responses after infection and vaccination requires analysis of cellular immunity.Herein,we report on T cell immunity in infected and vaccinated individuals,identifying CD4+/CD8+T cell cytokine responses to SARS-CoV-2 and variant peptides(Alpha,B.1.1.7 and Delta,B.1.617.2).展开更多
文摘The presence of human-leukocyte antigen （HLA）-antibodies and blood group incompatibility remain a large barrier to kidney transplantation leading to increased morbidity and mortality on the transplant waiting list. Over the last decade a number of new approaches were developed to overcome these barriers. Intravenous immunoglobulin （IVIG） remains the backbone of HLA desensitization therapy and has been shown in a prospective, randomized, placebo controlled trial to improve transplantation rates. Excellent outcomes with the addition of rituximab （anti-B cell） to IVIG based desensitization have been achieved. There is limited experience with bortezomib （anti-plasma cell） and eculizumab （complement inhibition） for desensitization. However, these agents may be good adjuncts for patients who are broadly sensitized with strong, complement-fxing HLA antibodies. Excellent short and long-term outcomes have been achieved in ABO incompatible transplantation with the combination of antibody removal, B cell depletion, and pre-transplant immunosuppression. Kidney paired donation has emerged as a reasonable alternative for programs who cannot provide desensitization or in conjunction with desensitization. Future therapies directed toward cytokines that alter B cell proliferation are under investigation.
文摘Our understanding of immune responses to SARS-CoV-2 and variants of concern(VOCs)has been primarily acquired through analysis of Spike-specific IgG responses.However,a more comprehensive understanding of the breadth and longevity of immune responses after infection and vaccination requires analysis of cellular immunity.Herein,we report on T cell immunity in infected and vaccinated individuals,identifying CD4+/CD8+T cell cytokine responses to SARS-CoV-2 and variant peptides(Alpha,B.1.1.7 and Delta,B.1.617.2).
