• MeSH
• lidé MeSH
• odběr tkání a orgánů * MeSH
• rejekce štěpu imunologie   klasifikace   terapie   MeSH
• transplantace jater MeSH
• transplantace ledvin MeSH
• transplantace * klasifikace   MeSH
• Check Tag
• lidé MeSH
• Publikační typ
• přehledy MeSH

The project is focused on the study of innate immune mechanisms in kidney transplantation. The parameters of human monocytes activation will be studied in early post-transplant period and in treatment complications (delayed graft function/rejection/infection). Soluble forms of myeloid antigens (sCD14, sCD163, S100A8/S100A9) will be monitored in kidney transplant patients as potential biomarkers of monocyte/macrophage activation, in the case of complications, proportions of monocytes subpopulations CD14+CD16+ and CD14+CD163+ in peripheral blood will be also evaluated. Using an co-culture model, the effect of macrophages on renal epithelial activation (gene induction and release of cytokines, expression of activation membrane markers) and reparative ability (renewal of mechanicaly damaged monolayer) will be studied. Furthermore, mRNA markers of monocyte activation in a co-culture with autologous v.s. allogenic v.s. xenogenic cells will be tested to asses potential allo (xeno-) reactivity of innate immune cells.

Projekt je zaměřen na studium mechanismů přirozené imunity u transplantací ledvin. Studovány budou parametry aktivace lidských monocytů v časném potransplantačním období a při komplikacích léčby (oddálená funkce štěpu/rejekce/infekce). U pacientů po transplantaci ledviny budou monitorovány solubilní formy myeloidních antigenů (sCD14, sCD163, S1008/S10014) jako potenciální biomarkery aktivace monocytů a makrofágů, v průběhu komplikací léčby bude vyšetřováno také zastoupení monocytárních subpopulací CD14+CD16+ a CD14+CD163+ v periferní krvi. Na tkáňovém modelu bude sledován vliv ko-kultivovaných makrofágů na aktivaci (indukce genů a sekrece prozánětlivých cytokinů, exprese aktivačních membránových znaků) renálních epiteliálních buněk a na jejich reparační schopnosti (rychlost obnovy mechanicky porušené konfluentní vrstvy). Dále budou porovnávány na úrovni mRNA známky aktivace monocytů při kokultivaci s autologními vs. allogenními v.s. xenogenními buňkami za účelem posoudit možnost jejich případné allo- či xeno-reaktivity.

• MeSH
• biologické markery MeSH
• epitelové buňky imunologie   MeSH
• lidé MeSH
• makrofágy imunologie   MeSH
• monocyty imunologie   MeSH
• přirozená imunita MeSH
• rejekce štěpu imunologie   MeSH
• transplantace ledvin MeSH
• Check Tag
• lidé MeSH

• Konspekt
• Patologie. Klinická medicína
• NLK Obory
• transplantologie
• alergologie a imunologie
• NLK Publikační typ
• závěrečné zprávy o řešení grantu AZV MZ ČR

Molecular assessment of renal allografts has already been suggested in antibody-mediated rejection (ABMR), but little is known about the gene transcript patterns in particular renal compartments. We used laser capture microdissection coupled with quantitative RT-PCR to distinguish the transcript patterns in the glomeruli and tubulointerstitium of kidney allografts in sensitized retransplant recipients at high risk of ABMR. The expressions of 13 genes were quantified in biopsies with acute active ABMR, chronic active ABMR, acute tubular necrosis (ATN), and normal findings. The transcripts were either compartment specific (TGFB1 in the glomeruli and HAVCR1 and IGHG1 in the tubulointerstitium), ABMR specific (GNLY), or follow-up specific (CXCL10 and CX3CR1). The transcriptional profiles of early acute ABMR shared similarities with ATN. The transcripts of CXCL10 and TGFB1 increased in the glomeruli in both acute ABMR and chronic active ABMR. Chronic active ABMR was associated with the upregulation of most genes (SH2D1B, CX3CR1, IGHG1, MS4A1, C5, CD46, and TGFB1) in the tubulointerstitium. In this study, we show distinct gene expression patterns in specific renal compartments reflecting cellular infiltration observed by conventional histology. In comparison with active ABMR, chronic active ABMR is associated with increased transcripts of tubulointerstitial origin.

• MeSH
• biopsie MeSH
• chronická nemoc MeSH
• dospělí MeSH
• glomerulus imunologie   metabolismus   patologie   MeSH
• HLA antigeny imunologie   MeSH
• isoprotilátky imunologie   MeSH
• kvantitativní polymerázová řetězová reakce MeSH
• laserová záchytná mikrodisekce MeSH
• ledviny imunologie   metabolismus   patologie   MeSH
• lidé středního věku MeSH
• lidé MeSH
• polymerázová řetězová reakce s reverzní transkripcí MeSH
• rejekce štěpu genetika   imunologie   metabolismus   patologie   MeSH
• senioři MeSH
• stanovení celkové genové exprese MeSH
• studie případů a kontrol MeSH
• transkriptom * MeSH
• transplantace ledvin škodlivé účinky   MeSH
• výsledek terapie MeSH
• Check Tag
• dospělí MeSH
• lidé středního věku MeSH
• lidé MeSH
• mužské pohlaví MeSH
• senioři MeSH
• ženské pohlaví MeSH
• Publikační typ
• časopisecké články MeSH
• práce podpořená grantem MeSH
• srovnávací studie MeSH

BACKGROUNDRejection is the primary barrier to broader implementation of vascularized composite allografts (VCAs), including face and limb transplants. The immunologic pathways activated in face transplant rejection have not been fully characterized.METHODSUsing skin biopsies prospectively collected over 9 years from 7 face transplant patients, we studied rejection by gene expression profiling, histology, immunostaining, and T cell receptor sequencing.RESULTSGrade 1 rejection did not differ significantly from nonrejection, suggesting that it does not represent a pathologic state. In grade 2, there was a balanced upregulation of both proinflammatory T cell activation pathways and antiinflammatory checkpoint and immunomodulatory pathways, with a net result of no tissue injury. In grade 3, IFN-γ-driven inflammation, antigen-presenting cell activation, and infiltration of the skin by proliferative T cells bearing markers of antigen-specific activation and cytotoxicity tipped the balance toward tissue injury. Rejection of VCAs and solid organ transplants had both distinct and common features. VCA rejection was uniquely associated with upregulation of immunoregulatory genes, including SOCS1; induction of lipid antigen-presenting CD1 proteins; and infiltration by T cells predicted to recognize CD1b and CD1c.CONCLUSIONOur findings suggest that the distinct features of VCA rejection reflect the unique immunobiology of skin and that enhancing cutaneous immunoregulatory networks may be a useful strategy in combatting rejection.Trial registrationClinicalTrials.gov NCT01281267.FUNDINGAssistant Secretary of Defense and Health Affairs, through Reconstructive Transplant Research (W81XWH-17-1-0278, W81XWH-16-1-0647, W81XWH-16-1-0689, W81XWH-18-1-0784, W81XWH-1-810798); American Society of Transplantation's Transplantation and Immunology Research Network Fellowship Research Grant; Plastic Surgery Foundation Fellowship from the American Society of Plastic Surgeons; Novo Nordisk Foundation (NNF15OC0014092); Lundbeck Foundation; Aage Bangs Foundation; A.P. Moller Foundation for the Advancement of Medical Science; NIH UL1 RR025758.

• MeSH
• kůže imunologie   patologie   MeSH
• lidé MeSH
• lipidy imunologie   MeSH
• následné studie MeSH
• prezentace antigenu * MeSH
• prospektivní studie MeSH
• receptory antigenů T-buněk * genetika   imunologie   MeSH
• rejekce štěpu genetika   imunologie   patologie   MeSH
• stanovení celkové genové exprese * MeSH
• T-lymfocyty imunologie   MeSH
• transplantace obličeje * MeSH
• Check Tag
• lidé MeSH
• mužské pohlaví MeSH
• ženské pohlaví MeSH
• Publikační typ
• časopisecké články MeSH
• klinické zkoušky MeSH
• multicentrická studie MeSH
• práce podpořená grantem MeSH
• Research Support, N.I.H., Extramural MeSH
• Research Support, U.S. Gov't, Non-P.H.S. MeSH

Kidney allograft transplantation improved the prognosis and quality of life of patients with end-stage renal diseases but the occurrence of acute rejection represents a limitation of the final outcome. Noninvasive biomarkers are needed as well as further advancements in the understanding of immune mechanisms of reaction to the allograft. Our study of 138 patients focused on one-year monitoring of serum concentrations of 12 chemokines regulating the recruitment of different immune cells into transplanted allograft and on in vitro regulation of the same chemokines release by interactions of renal proximal epithelial cells with monocyte/macrophage cell line stimulated with TNF alpha. In a group of 44 patients with acute rejection, higher serum pretransplant levels of CXCL1, CXCL5, CXCL6, CCL2, CCL21, and particularly CXCL10 and CX3CL1(both p < 0.001) were found suggesting their higher proinflammatory status as compared to subjects with the uncomplicated outcome. In samples collected at the day of biopsy positive for acute rejection, chemokines CXCL9 and CXCL11 attracting preferentially Th1 lymphocytes were found to be upregulated. In our in vitro model with TNF alpha induction, renal proximal epithelial cells seemed to be a more potent source of chemokines attracting neutrophils as compared to monocyte/macrophage cell line but the coculture of these cells potentiated release of neutrophilic chemokines CXCL5 and CXCL6. Similar augmentation of chemokine production was found also in the case of CCL2. On the other hand, adding of monocytes/macrophages to a culture of renal epithelial cells suppressed the release of CXCL10 and CXCL11 attracting T lymphocytes. We assume from our data that in kidney allograft transplantation, chemokines attracting neutrophils, T lymphocytes, and monocytes are induced simultaneously and measurement some of them in combination might be used as biomarkers of acute rejection. Mutual cell-cell interactions of immune cells with renal parenchyma seem to be important for fine regulation of chemokine release.

• MeSH
• alografty MeSH
• chemokin CCL2 krev   MeSH
• chemokin CCL21 krev   MeSH
• chemokin CX3CL1 krev   MeSH
• chemokin CXCL1 krev   MeSH
• chemokin CXCL10 krev   MeSH
• chemokin CXCL11 krev   MeSH
• chemokin CXCL5 krev   MeSH
• chemokin CXCL6 krev   MeSH
• chemokin CXCL9 krev   MeSH
• chemokiny krev   MeSH
• kvalita života MeSH
• lidé MeSH
• rejekce štěpu krev   imunologie   MeSH
• Th1 buňky metabolismus   MeSH
• transplantace ledvin škodlivé účinky   MeSH
• Check Tag
• lidé MeSH
• Publikační typ
• časopisecké články MeSH

PURPOSE OF REVIEW: In this review, we discuss achievements in immunosuppression in kidney transplant recipients published at last 18 months. RECENT FINDINGS: Results of recent trials with everolimus in low-risk primary kidney transplant recipients suggest that lowTAC/EVR combination is noninferior and CMV and BKV viral infections are less frequent to standTAC/MPA. Iscalimab monoclonal antibody, which prevents CD40 to CD154 binding, has just recently entered phase II clinical studies in kidney transplantation. Eculizumab, anti-C5 monoclonal antobody was recently shown to improve outcomes in DSA+ living-donor kidney transplant recipients requiring pretransplant desensitization because of crossmatch positivity. Proximal complement C1 inhibition in patients with antibody-mediated rejection was studied in several phase I trials. SUMMARY: Recent knowledge creates a path towards future immunosuppression success in sensitized recipients and in those in high risk of viral infections or CNI nephrotoxicity.

• MeSH
• everolimus terapeutické užití   MeSH
• humanizované monoklonální protilátky terapeutické užití   MeSH
• imunosupresiva terapeutické užití   MeSH
• imunosupresivní léčba metody   MeSH
• lidé MeSH
• monoklonální protilátky terapeutické užití   MeSH
• příjemce transplantátu statistika a číselné údaje   MeSH
• randomizované kontrolované studie jako téma MeSH
• rejekce štěpu imunologie   prevence a kontrola   MeSH
• transplantace ledvin metody   MeSH
• Check Tag
• lidé MeSH
• Publikační typ
• časopisecké články MeSH
• práce podpořená grantem MeSH
• přehledy MeSH

BACKGROUND: High prevalence of arterial hypertension is known in pediatric renal transplant patients, but how blood pressure (BP) distribution and control differ between age groups and whether sex and age interact and potentially impact BP after transplantation have not been investigated. METHODS: This retrospective analysis included 336 pediatric renal transplant recipients (62% males) from the Cooperative European Pediatric Renal Transplant Initiative Registry (CERTAIN) with complete BP measurement at discharge and 1, 2 and 3 years post-transplant. RESULTS: At discharge and 3 years post-transplant, arterial hypertension was highly prevalent (84% and 77%); antihypertensive drugs were used in 73% and 68% of the patients. 27% suffered from uncontrolled and 9% from untreated hypertension at 3 years post-transplant. Children transplanted at age < 5 years showed sustained high systolic BP z-score and received consistently less antihypertensive treatment over time. Younger age, shorter time since transplantation, male sex, higher body mass index (BMI), high cyclosporine A (CSA) trough levels, and a primary renal disease other than congenital anomalies of the kidney and urinary tract (CAKUT) were significantly associated with higher systolic BP z-score. Sex-stratified analysis revealed a significant association between high CSA and higher systolic BP in older girls that likely had started puberty already. An association between BP and estimated glomerular filtration rate was not detected. CONCLUSIONS: BP control during the first 3 years was poor in this large European cohort. The description of age- and sex-specific risk profiles identified certain recipient groups that may benefit from more frequent BP monitoring (i.e. young children) or different choices of immunosuppression (i.e. older girls).

• MeSH
• časové faktory MeSH
• cyklosporin aplikace a dávkování   škodlivé účinky   farmakokinetika   MeSH
• dítě MeSH
• hypertenze diagnóza   epidemiologie   etiologie   MeSH
• imunosupresiva aplikace a dávkování   škodlivé účinky   farmakokinetika   MeSH
• lidé MeSH
• longitudinální studie MeSH
• měření krevního tlaku statistika a číselné údaje   MeSH
• mladiství MeSH
• následné studie MeSH
• předškolní dítě MeSH
• prevalence MeSH
• příjemce transplantátu statistika a číselné údaje   MeSH
• registrace statistika a číselné údaje   MeSH
• rejekce štěpu imunologie   prevence a kontrola   MeSH
• retrospektivní studie MeSH
• sexuální faktory MeSH
• takrolimus aplikace a dávkování   škodlivé účinky   farmakokinetika   MeSH
• transplantace ledvin škodlivé účinky   MeSH
• věkové faktory MeSH
• Check Tag
• dítě MeSH
• lidé MeSH
• mladiství MeSH
• mužské pohlaví MeSH
• předškolní dítě MeSH
• ženské pohlaví MeSH
• Publikační typ
• časopisecké články MeSH
• práce podpořená grantem MeSH
• Geografické názvy
• Evropa MeSH

BACKGROUND: We previously developed molecular assessment systems for lung transplant transbronchial biopsies (TBBs) with high surfactant and bronchial mucosal biopsies, identifying T-cell‒mediated rejection (TCMR) on the basis of the expression of rejection-associated transcripts, but the relationship of rejection to graft loss is unknown. This study aimed to develop molecular assessments for TBBs and mucosal biopsies and to establish the impact of molecular TCMR on graft survival. METHODS: We used microarrays and machine learning to assign TCMR scores to an expanded cohort of 457 TBBs (367 high surfactant plus 90 low surfactant) and 314 mucosal biopsies. We tested the score agreement between TBB-TBB, mucosal-mucosal, and TBB-mucosal biopsy pairs in the same patient. We also assessed the association of molecular TCMR scores with graft loss (death or retransplantation) and compared it with the prognostic associations for histology and donor-specific antibodies. RESULTS: The molecular TCMR scores assigned in all the TBBs performed similarly to those in high-surfactant TBBs, indicating that variation in alveolation in TBBs does not prevent the detection of TCMR. Mucosal biopsy pieces showed less piece-to-piece variation than TBBs. TCMR scores in TBBs agreed with those in mucosal biopsies. In both TBBs and mucosal biopsies, molecular TCMR was associated with graft loss, whereas histologic rejection and donor-specific antibodies were not. CONCLUSIONS: Molecular TCMR can be detected in TBBs regardless of surfactant and in mucosal biopsies, which show less variability in the sampled tissue than TBBs. On the basis of these findings, molecular TCMR appears to be an important predictor of the risk of future graft failure. TRIAL REGISTRATION: ClinicalTrials.gov NCT02812290.

• MeSH
• biopsie metody   MeSH
• bronchy MeSH
• buněčná imunita * MeSH
• lidé MeSH
• plíce imunologie   patologie   MeSH
• přežívání štěpu MeSH
• prognóza MeSH
• prospektivní studie MeSH
• rejekce štěpu diagnóza   imunologie   metabolismus   MeSH
• respirační sliznice imunologie   patologie   MeSH
• rizikové faktory MeSH
• strojové učení MeSH
• T-lymfocyty imunologie   MeSH
• transplantace plic škodlivé účinky   MeSH
• Check Tag
• lidé MeSH
• mužské pohlaví MeSH
• ženské pohlaví MeSH
• Publikační typ
• časopisecké články MeSH
• multicentrická studie MeSH
• práce podpořená grantem MeSH

OBJECTIVES AND DESIGN: At the present time there are two waiting list for patients with vascular prosthetic infection indicated for arterial transplantation in the Czech Republic. The inclusion of each patient for cold-stored or cryopreserved arterial transplantation is the preference of indicating surgeon. In this experimental work we studied the immunogenicity of rat aortal allografts treated by our new clinical cryopreservation/slow thawing protocol. MATERIAL AND METHODS: Brown-Norway (BN) (N = 6, 203-217 g) or Lewis (LEW) (N = 6, 248-254 g) abdominal aortal grafts treated in accordance with our new clinical cryopreservation/slow thawing protocol were orthotopically transplanted to Lewis recipients (N = 12, 191-245 g). Aortal wall histology and infiltration by recipient immune cells, as well as donor specific anti MHC class I and II antibodies in recipient serum were studied in both isografts and allografts on day 30 postransplant. Core data of cryopreserved allografts were compared to our previous data of cold-stored aortal allografts treated in accordance with our clinical cold-storage protocol. RESULTS: Cryopreserved allografts showed regular morphology of aortal wall with clear differentiation of all three basic anatomical layers on day 30 postransplant. Intimal layer showed no hyperplasia, luminal surface was covered by endothelial cells. No statistical difference was observed in tunica media thickness between isografts and allografts. The medial layer showed no necrosis, shrinkage or immunoglobuline G deposition in any experimental group. The adventitial infiltration by immune cells was significantly higher (P<0.05) in allografts. Cryopreserved allografts showed significant lower activation of both cell- and antibody mediated immunity compared to historical data of cold-stored allografts. CONCLUSION: Aortal wall histology of rat allografts treated by our new standardized clinical cryopreservation/slow thawing protocol was comparable to that of the cryopreserved isografts on day 30 posttranspant. The immunogenicity of cryopreserved aortal allografts was significantly lower compared to that of cold-stored aortal allografts.

• MeSH
• alografty fyziologie   MeSH
• aorta transplantace   MeSH
• arterie transplantace   MeSH
• homologní transplantace metody   MeSH
• kryoprezervace metody   normy   MeSH
• krysa rodu rattus MeSH
• modely u zvířat MeSH
• potkani inbrední BN MeSH
• potkani inbrední LEW MeSH
• rejekce štěpu imunologie   MeSH
• zvířata MeSH
• Check Tag
• krysa rodu rattus MeSH
• mužské pohlaví MeSH
• zvířata MeSH
• Publikační typ
• časopisecké články MeSH
• Geografické názvy
• Česká republika MeSH

BACKGROUND: We compared, through the European Liver Transplant Registry, long-term liver transplantation outcomes with prolonged-release tacrolimus (PR-T) versus immediate-release tacrolimus (IR-T)-based immunosuppression. This retrospective analysis comprises up to 8-year data collected between 2008 and 2016, in an extension of our previously published study. METHODS: Patients with <1 month follow-up were excluded; patients were propensity score matched for baseline characteristics. Efficacy measures included: univariate/multivariate analyses of risk factors influencing graft/patient survival up to 8 years posttransplantation, and graft/patient survival up to 4 years with PR-T versus IR-T. Overall, 13 088 patients were included from 44 European centers; propensity score-matched analyses comprised 3006 patients (PR-T: n = 1002; IR-T: n = 2004). RESULTS: In multivariate analyses, IR-T-based immunosuppression was associated with reduced graft survival (risk ratio, 1.49; P = 0.0038) and patient survival (risk ratio, 1.40; P = 0.0215). There was improvement with PR-T versus IR-T in graft survival (83% versus 77% at 4 y, respectively; P = 0.005) and patient survival (85% versus 80%; P = 0.017). Patients converted from IR-T to PR-T after 1 month had a higher graft survival rate than patients receiving IR-T at last follow-up (P < 0.001), or started and maintained on PR-T (P = 0.019). One graft loss in 4 years was avoided for every 14.3 patients treated with PR-T versus IR-T. CONCLUSIONS: PR-T-based immunosuppression might improve long-term outcomes in liver transplant recipients than IR-T-based immunosuppression.

• MeSH
• časové faktory MeSH
• hodnocení rizik MeSH
• imunosupresiva aplikace a dávkování   škodlivé účinky   MeSH
• inhibitory kalcineurinu aplikace a dávkování   škodlivé účinky   MeSH
• léky s prodlouženým účinkem MeSH
• lidé středního věku MeSH
• lidé MeSH
• přežívání štěpu účinky léků   MeSH
• příprava léků MeSH
• registrace MeSH
• rejekce štěpu imunologie   mortalita   prevence a kontrola   MeSH
• retrospektivní studie MeSH
• rizikové faktory MeSH
• senioři MeSH
• takrolimus aplikace a dávkování   škodlivé účinky   MeSH
• transplantace jater * škodlivé účinky   mortalita   MeSH
• výsledek terapie MeSH
• Check Tag
• lidé středního věku MeSH
• lidé MeSH
• mužské pohlaví MeSH
• senioři MeSH
• ženské pohlaví MeSH
• Publikační typ
• časopisecké články MeSH
• multicentrická studie MeSH
• práce podpořená grantem MeSH
• srovnávací studie MeSH
• Geografické názvy
• Evropa MeSH