July 4, 2011

Early and Late Acute Antibody-Mediated Rejection Differ Immunologically and in Response to Proteasome Inhibition


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Antibody-mediated rejection (AbMR) requires the production of donor specific antibody (DSA) by recipient plasma cells and can present at early or late times post-transplant. Bortezomib is a proteasome inhibitor (PI) approved by the FDA for treatment of multiple myeloma that is increasingly being used off-label for the treatment of AbMR. This study, from one of the most experienced centers with this PI, shows that early and late AbMR respond differently to PI therapy. Early AbMR benefitted most from PI therapy showing better and quicker reduction in DSA levels, improved resolution of AbMR histology as well as graft function. Conclusions from this study will help to guide future AbMR interventions using PI and other therapies targeting plasma cells.

Renal Transplantation

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