PMID- 26446648
OWN - NLM
STAT- MEDLINE
DCOM- 20160726
LR  - 20181202
IS  - 1976-2437 (Electronic)
IS  - 0513-5796 (Print)
IS  - 0513-5796 (Linking)
VI  - 56
IP  - 6
DP  - 2015 Nov
TI  - The Effect of Bortezomib on Antibody-Mediated Rejection after Kidney 
      Transplantation.
PG  - 1638-42
LID - 10.3349/ymj.2015.56.6.1638 [doi]
AB  - PURPOSE: Recently, bortezomib has been used to treat antibody-mediated rejection 
      (AMR) refractory to conventional treatment such as plasmapheresis, intravenous 
      immunoglobulin, and rituximab. The authors aimed to describe their experiences 
      when bortezomib was used to treat refractory AMR. MATERIALS AND METHODS: Eleven 
      refractory AMR episodes treated with bortezomib were included in this study. The 
      patients received one or two cycles of bortezomib (1.3 mg/m(2)) on days 1, 4, 8, 
      and 11. RESULTS: Bortezomib effectively reduced antibodies against various 
      targets, including human leukocyte antigen (HLA) class I and II, ABO blood group 
      antigen, and angiotensin II type 1 receptor. Antibodies were depleted or reduced 
      significantly in eight AMR episodes. Overall, there was a significant improvement 
      in the mean estimated glomerular filtration rate (eGFR) at 3 months after therapy 
      (36.91+/-22.15 mL/min/1.73 m(2)) versus eGFR at time of AMR diagnosis (17.00+/-9.25 
      mL/min/1.73 m(2); p=0.007). All six early-onset AMR episodes (within 6 months 
      post-transplantation) showed full recovery of allograft function. Additionally, 
      three of the five late-onset AMR episodes (>6 months post-transplantation) showed 
      improved allograft function. CONCLUSION: Anti-humoral treatment based on 
      bortezomib might be an effective strategy against refractory AMR caused by 
      various types of antibodies. Notably, this treatment could be more effective in 
      early-onset AMR than in late-onset AMR.
FAU - Lee, Juhan
AU  - Lee J
AD  - The Research Institute for Transplantation, Yonsei University College of 
      Medicine, Seoul, Korea.
AD  - Department of Surgery, Yonsei University College of Medicine, Seoul, Korea.
FAU - Kim, Beom Seok
AU  - Kim BS
AD  - The Research Institute for Transplantation, Yonsei University College of 
      Medicine, Seoul, Korea.
AD  - Department of Internal Medicine (Nephrology), Yonsei University College of 
      Medicine, Seoul, Korea.
FAU - Park, Yongjung
AU  - Park Y
AD  - Department of Laboratory Medicine, Yonsei University College of Medicine, Seoul, 
      Korea.
FAU - Lee, Jae Geun
AU  - Lee JG
AD  - The Research Institute for Transplantation, Yonsei University College of 
      Medicine, Seoul, Korea.
AD  - Department of Surgery, Yonsei University College of Medicine, Seoul, Korea.
FAU - Lim, Beom Jin
AU  - Lim BJ
AD  - Department of Pathology, Yonsei University College of Medicine, Seoul, Korea.
FAU - Jeong, Hyeon Joo
AU  - Jeong HJ
AD  - Department of Pathology, Yonsei University College of Medicine, Seoul, Korea.
FAU - Kim, Yu Seun
AU  - Kim YS
AD  - The Research Institute for Transplantation, Yonsei University College of 
      Medicine, Seoul, Korea.
AD  - Department of Surgery, Yonsei University College of Medicine, Seoul, Korea.
FAU - Huh, Kyu Ha
AU  - Huh KH
AD  - The Research Institute for Transplantation, Yonsei University College of 
      Medicine, Seoul, Korea.
AD  - Department of Surgery, Yonsei University College of Medicine, Seoul, Korea. 
      khhuh@yuhs.ac.
LA  - eng
PT  - Journal Article
PT  - Research Support, Non-U.S. Gov't
PL  - Korea (South)
TA  - Yonsei Med J
JT  - Yonsei medical journal
JID - 0414003
RN  - 0 (Antibodies, Monoclonal)
RN  - 0 (Antineoplastic Agents)
RN  - 0 (Boronic Acids)
RN  - 0 (Immunoglobulins, Intravenous)
RN  - 0 (Immunologic Factors)
RN  - 0 (Isoantibodies)
RN  - 0 (Pyrazines)
RN  - 69G8BD63PP (Bortezomib)
SB  - IM
MH  - Adolescent
MH  - Adult
MH  - Antibodies, Monoclonal/therapeutic use
MH  - Antineoplastic Agents/*therapeutic use
MH  - Boronic Acids/therapeutic use
MH  - Bortezomib/*therapeutic use
MH  - Female
MH  - Graft Rejection/*drug therapy/*prevention & control
MH  - Humans
MH  - Immunoglobulins, Intravenous/therapeutic use
MH  - Immunologic Factors/therapeutic use
MH  - Isoantibodies
MH  - Kidney Failure, Chronic/*surgery
MH  - *Kidney Transplantation
MH  - Male
MH  - Middle Aged
MH  - Plasmapheresis
MH  - Pyrazines/administration & dosage
MH  - Transplantation, Homologous
PMC - PMC4630054
OTO - NOTNLM
OT  - Angiotensin II type 1 receptor antibodies
OT  - HLA antibodies
OT  - antibody-mediated rejection
OT  - bortezomib
OT  - kidney transplantation
COIS- The authors have no financial conflicts of interest.
EDAT- 2015/10/09 06:00
MHDA- 2016/07/28 06:00
PMCR- 2015/11/01
CRDT- 2015/10/09 06:00
PHST- 2015/03/04 00:00 [received]
PHST- 2015/04/13 00:00 [revised]
PHST- 2015/05/28 00:00 [accepted]
PHST- 2015/10/09 06:00 [entrez]
PHST- 2015/10/09 06:00 [pubmed]
PHST- 2016/07/28 06:00 [medline]
PHST- 2015/11/01 00:00 [pmc-release]
AID - 2015111638 [pii]
AID - 10.3349/ymj.2015.56.6.1638 [doi]
PST - ppublish
SO  - Yonsei Med J. 2015 Nov;56(6):1638-42. doi: 10.3349/ymj.2015.56.6.1638.