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Saláková M, Ludvíková V, Hamšíková E, Kolářová M, Šroller V, Viklický O, Wohlfahrtová M. Pretransplantation seroreactivity in kidney donors and recipients as a predictive factor for posttransplant BKPyV-DNAemia. Front Immunol 2022; 13:929946. [PMID: 35967393 PMCID: PMC9364833 DOI: 10.3389/fimmu.2022.929946] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/27/2022] [Accepted: 06/24/2022] [Indexed: 11/17/2022] Open
Abstract
BK polyomavirus (BKPyV) often reactivates after kidney transplantation, causing BKPyV-associated nephropathy (BKPyVAN) in 1%–10% of cases with a potential detrimental effect on allograft survival. Kidney transplant recipients are regularly screened for BKPyV DNA in plasma. As this strategy may not always reduce the risk of BKPyVAN, other predictive markers are needed. To evaluate the role of pretransplant BKPyV-specific antibody, 210 kidney transplant recipients and 130 donors were screened for BKPyV DNA and BKPyV-specific antibodies. We found that the donor BKPyV immunoglobulin G (IgG) seroprevalence and antibody level were strongly associated with BKPyV-DNAemia and BKPyVAN, although multivariant analysis found the presence of anti-BKPyV-specific antibodies as a predictive factor only for BKPyV-DNAemia. The pretransplant recipient status had no effect on posttransplant BKPyV-DNAemia and BKVAN. BKPyV IgG levels remained stable in BKPyV-negative recipients during 1-year follow-up, while a considerable increase was observed in BKPyV-positive patients. The presence of anti-BKPyV-specific antibodies in kidney allograft donors is a good and reliable predictive marker for posttransplant BKPyV replication with relevance to risk stratification in transplant recipients.
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Affiliation(s)
- Martina Saláková
- Department of Genetics and Microbiology, Faculty of Science, Charles University, Prague, Czechia
- *Correspondence: Martina Saláková,
| | - Viera Ludvíková
- National Reference Laboratory for Papillomaviruses and Polyomaviruses, Institute of Hematology and Blood Transfusion, Prague, Czechia
| | - Eva Hamšíková
- National Reference Laboratory for Papillomaviruses and Polyomaviruses, Institute of Hematology and Blood Transfusion, Prague, Czechia
| | - Marie Kolářová
- Department of Nephrology, Transplant Centre, Institute for Clinical and Experimental Medicine, Prague, Czechia
| | - Vojtěch Šroller
- Department of Genetics and Microbiology, Faculty of Science, Charles University, Prague, Czechia
| | - Ondřej Viklický
- Department of Nephrology, Transplant Centre, Institute for Clinical and Experimental Medicine, Prague, Czechia
| | - Mariana Wohlfahrtová
- Department of Nephrology, Transplant Centre, Institute for Clinical and Experimental Medicine, Prague, Czechia
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Viklický O, Ryšavá R, Tesař V, Rychlík I, Prázný M, Češka R, Haluzík M. Expert opinion on the cooperation of diabetologists and internists with nephrologists in the care of patients with chronic kidney diseases. Vnitr Lek 2022; 68:426-431. [PMID: 36402566 DOI: 10.36290/vnl.2022.090] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/16/2023]
Abstract
Chronic kidney disease (CKD) affects 10% of the population of developed countries and significantly affects the population health. In addition to the well-known renoprotection tools slowing down the progression of CKD, SGLT2 inhibitors have been newly introduced into clinical practice based on the results of extensive studies, both in diabetics and non-diabetics. This expert opinion discusses the classification of CKD, current renoprotection options, and the recent role of SGLT2 inhibitors in the care of patients with CKD.
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Magicová M, Viklický O. Covid-19 in kidney transplant recipients. Vnitr Lek 2022; 68:444-448. [PMID: 36402569 DOI: 10.36290/vnl.2022.093] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/16/2023]
Abstract
Kidney transplant recipients are a very vulnerable population at risk of severe course and death from Covid-19. Several antiviral drugs are now available for the treatment of nonhospitalized individuals with mild to moderate Covid-19 and hospitalized patients with severe disease. The combination of monoclonal antibodies is also available to be used as pre-exposure prophylaxis in elderly patients. Previously used monoclonal antibodies for post-exposure prophylaxis are no longer effective because of the new mutations and are no longer recommended. Although the immune response to Covid-19 vaccines is impaired in kidney transplant recipients, the effectiveness of the Covid-19 vaccines was described even in this immunocompromised group. Therefore vaccination, together with anti-epidemic measures, remains the most important tool to prevent Covid-19.
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Novotná M, Kment M, Viklický O. Antibody-Mediated Rejection of Renal Allografts: Diagnostic Pitfalls and Challenges. Physiol Res 2021; 70:S551-S565. [DOI: 10.33549/physiolres.934801] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
Abstract
Antibody-mediated rejection (ABMR) is a major obstacle to the long-term success in kidney transplantation. Diagnosis of ABMR is determined according to the internationally recognized Banff criteria. However, a significant proportion of patients does not meet all the defined criteria, and the outcome of such cases remains poorly understood. The histology of ABMR frequently lacks sensitivity and specificity. More importantly, mixed forms of ABMR and T cell-mediated rejection as well as findings of nonspecific injury are common in clinical settings. Donor-specific anti-HLA antibodies (DSA) are detectable only in half of the ABMR cases by histology. Prognostic role of non-HLA antibodies against various endothelial proteins has been discussed. Antibody independent NK cell activation reflecting killer-cells’ inhibitory receptor incompatibility is suggested in microvascular inflammation in DSA negative patients. Molecular assessment of ABMR has been prioritized to overcome high interobserver variability and improve diagnostics in mixed forms of rejections and in DSA negative cases. Finally, donor-derived cell-free DNA detected in a recipient’s peripheral blood sample has been proposed as a noninvasive marker for diagnosis of graft rejection, and thus might serve as a liquid biopsy in the near future. Despite all achievements, diagnosing ABMR in kidney allografts remains to be a challenge in a significant number of cases.
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Novotný M, Kment M, Viklický O. Adipose tissue macrophages and atherogenesis – a synergy with cholesterolaemia. Physiol Res 2021. [DOI: 10.33549//physiolres.934801] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
Abstract
Antibody-mediated rejection (ABMR) is a major obstacle to the long-term success in kidney transplantation. Diagnosis of ABMR is determined according to the internationally recognized Banff criteria. However, a significant proportion of patients does not meet all the defined criteria, and the outcome of such cases remains poorly understood. The histology of ABMR frequently lacks sensitivity and specificity. More importantly, mixed forms of ABMR and T cell-mediated rejection as well as findings of nonspecific injury are common in clinical settings. Donor-specific anti-HLA antibodies (DSA) are detectable only in half of the ABMR cases by histology. Prognostic role of non-HLA antibodies against various endothelial proteins has been discussed. Antibody independent NK cell activation reflecting killer-cells’ inhibitory receptor incompatibility is suggested in microvascular inflammation in DSA negative patients. Molecular assessment of ABMR has been prioritized to overcome high interobserver variability and improve diagnostics in mixed forms of rejections and in DSA negative cases. Finally, donor-derived cell-free DNA detected in a recipient’s peripheral blood sample has been proposed as a noninvasive marker for diagnosis of graft rejection, and thus might serve as a liquid biopsy in the near future. Despite all achievements, diagnosing ABMR in kidney allografts remains to be a challenge in a significant number of cases.
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Affiliation(s)
| | | | - O Viklický
- Department of Nephrology, Institute for Clinical and Experimental Medicine, Prague, Czech Republic.
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Abstract
In the era of COVID-19 pandemic, organ transplantation programs were facing serious challenges. The lung transplantation donor pool was extremely limited and SARS-CoV-2 viral load assessment has become a crucial part of selecting an optimal organ donor. Since COVID-19 is a respiratory disease, the viral load is thought to be more important in lung transplantations as compared to other solid organ transplantations. We present two challenging cases of potential lung donors with a questionable COVID-19 status. Based on these cases, we suggest that the cycle threshold (Ct) value should always be requested from the laboratory and the decision whether to proceed with transplantation should be made upon complex evaluation of diverse criteria, including the nasopharyngeal swab and bronchoalveolar lavage PCR results, the Ct value, imaging findings and the medical history. However, as the presence of viral RNA does not ensure infectivity, it is still to be clarified which Ct values are associated with the viral viability. Anti-SARS-CoV-2 IgA antibodies may support the diagnosis and moreover, novel methods, such as quantifying SARS-CoV-2 nucleocapsid antigen in serum may provide important answers in organ transplantations and donor selections.
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Affiliation(s)
- R Novysedlak
- Third Department of Surgery, Prague Lung Transplant Program, First Faculty of Medicine, Charles University and University Hospital Motol, Prague, Czech Republic; Department of Immunology, Second Faculty of Medicine, Charles University and University Hospital Motol, Praha 5, Czech Republic.
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Švachová V, Krupičková L, Novotný M, Fialová M, Mezerová K, Čečrdlová E, Lánská V, Slavčev A, Viklický O, Viklický O, Stříž I. Changes in phenotypic patterns of blood monocytes after kidney transplantation and during acute rejection. Physiol Res 2021; 70:709-721. [PMID: 34505523 DOI: 10.33549/physiolres.934700] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
Abstract
Peripheral blood monocytes, which serve as precursors for tissue macrophages and dendritic cells (DC), play a key role in the immune response to kidney allograft, reparation processes and homeostasis regulation. In this prospective study, we used multicolor flow cytometry to monitor the phenotypic patterns of peripheral monocytes in subjects with uncomplicated outcomes and those with acute rejection. We found a reciprocal increase in the proportion of "classical monocytes" (CD14+CD16-) along with a decline in pro-inflammatory "intermediary" (CD14+CD16+) and "non-classical" (CD14lowCD16+) monocytes in subjects with normal outcomes. In subjects with acute rejection, we observed no reduction in "intermediary" monocytes and no increase in "classical" monocytes. Patients with uncomplicated outcomes exhibited downregulated HLA-DR in all three monocyte subpopulations. However, non-classical monocytes were unaffected in subjects with acute rejection. Expression of CD47 was downregulated after transplantation, while patients with antibody-mediated rejection and donor-specific antibodies showed higher pre-transplant values. In monocytes isolated at the time of biopsy, CD47 expression was higher in individuals with acute rejection compared to patients with normal outcomes one year post-transplant. Expression of CD209 (DC-SIGN) and the proportion of CD163+CD206+ subpopulations were upregulated during the first week after kidney transplantation. CD209 was also upregulated in samples taken on the day of biopsy confirming acute rejection. Our data demonstrate that kidney allograft transplantation is associated with phenotypic changes in peripheral blood monocytes during acute rejection.
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Affiliation(s)
- V Švachová
- Department of Clinical and Transplant Immunology, Institute for Clinical and Experimental Medicine, Prague 4, Czech Republic.
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Berchtold L, Letouzé E, Alexander MP, Canaud G, Logt AEVD, Hamilton P, Mousson C, Vuiblet V, Moyer AM, Guibert S, Mrázová P, Levi C, Dubois V, Cruzado JM, Torres A, Gandhi MJ, Yousfi N, Tesar V, Viklický O, Hourmant M, Moulin B, Rieu P, Choukroun G, Legendre C, Wetzels J, Brenchley P, Ballarín Castan JA, Debiec H, Ronco P. Corrigendum to Berchtold L, Letouzé E, Alexander MP, et al. HLA-D and PLA2R1 risk alleles associate with recurrent primary membranous nephropathy in kidney transplant recipients. Kidney Int. 2021;99:671-685. Kidney Int 2021; 100:243. [PMID: 34154713 DOI: 10.1016/j.kint.2021.05.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Affiliation(s)
- Lena Berchtold
- Sorbonne Université, Université Pierre et Marie Curie Paris 06, Paris, France; Institut National de la Santé et de la Recherche Médicale, Unité Mixte de Recherche S1155, Paris, France; Division of Nephrology, Department of Internal Medicine Specialties, University Hospital of Geneva, Geneva, Switzerland
| | - Eric Letouzé
- Centre de Recherche des Cordeliers, Sorbonne Université, INSERM, France; Functional Genomics of Solid Tumor, Labex Immuno- Oncology, Equipe Labellisée Ligue Contre le Cancer, Université Paris 13, Paris, France
| | | | - Guillaume Canaud
- Inserm U1151, Necker-Enfants Malades Hospital, Paris, France; University Paris Descartes, Sorbonne Paris Cité, Paris, France; Department of Adult Nephrology and Transplantation, Necker-Enfants Malades Hospital, Paris, France
| | - Anne-Els van de Logt
- Department of Nephrology, Radboud University Medical Center, Radboud Institute for Health Sciences, Nijmegen, The Netherlands
| | - Patrick Hamilton
- Division of Cardiovascular Sciences, School of Medical Sciences, Faculty of Biology, Medicine and Health, University of Manchester, Manchester, UK
| | - Christiane Mousson
- Department of Nephrology and Transplantation, University Hospital, Dijon, France
| | - Vincent Vuiblet
- BioSpec T Laboratory, EA 7506 URCA, Reims, France; Nephropathology Department of Biopathology Laboratory, Reims University Hospital, Reims, France; Division of Nephrology, Reims University Hospital, Reims, France
| | - Ann M Moyer
- Department of Laboratory Medicine and Pathology, Personalized Genomics Laboratory Mayo Clinic, Rochester, Minnesota, USA
| | | | - Petra Mrázová
- Transplant Laboratory, Institute for Clinical and Experimental Medicine, Prague, Czech Republic
| | - Charlène Levi
- Department of Transplantation, Nephrology, and Clinical Immunology, Edouard Herriot Hospital, Hospices Civils de Lyon, Lyon, France
| | - Valérie Dubois
- Laboratoire HLA, Etablissement Français du Sang Auvergne Rhone-Alpes, Lyon, France
| | - Josep Maria Cruzado
- Nephrology Department, Hospital Universitari Bellvitge, Bellvitge Research Institute (IDIBELL), Barcelona, Spain; RedInRen, RD16/0009/0031, University of Barcelona, L'Hospitalet de Llobregat, Barcelona, Spain
| | - Armando Torres
- Hospital Universitario de Canarias, Instituto de Tecnologías Biomédicas (ITB), Universidad de La Laguna, Tenerife, Spain
| | - Manish J Gandhi
- Division of Transfusion Medicine, Mayo Clinic, Rochester, Minnesota, USA
| | - Nadhir Yousfi
- Sorbonne Université, Université Pierre et Marie Curie Paris 06, Paris, France; Institut National de la Santé et de la Recherche Médicale, Unité Mixte de Recherche S1155, Paris, France
| | - Vladimir Tesar
- Department of Nephrology, First Faculty of Medicine, Charles University and General University Hospital, Prague, Czech Republic
| | - Ondřej Viklický
- Department of Nephrology, Transplant Center, Institute for Clinical and Experimental Medicine, Prague, Czech Republic
| | | | - Bruno Moulin
- Institut National de la Santé et de la Recherche Médicale, Unité Mixte de Recherche S 1109, Strasbourg University, Strasbourg, France; Fédération de Médecine Translationnelle de Strasbourg (FMTS), Strasbourg, France; Department of Nephrology, Strasbourg University Hospital, Strasbourg, France
| | - Philippe Rieu
- Division of Nephrology, Reims University Hospital, Reims, France; Université de Reims Champagne-Ardenne, CNRS UMR 7369 (Matrice Extracellulaire et Dynamique Cellulaire, MEDyC), Reims, France
| | | | - Christophe Legendre
- University Paris Descartes, Sorbonne Paris Cité, Paris, France; Department of Adult Nephrology and Transplantation, Necker-Enfants Malades Hospital, Paris, France
| | - Jack Wetzels
- Department of Nephrology, Radboud University Medical Center, Radboud Institute for Health Sciences, Nijmegen, The Netherlands
| | - Paul Brenchley
- Division of Cardiovascular Sciences, School of Medical Sciences, Faculty of Biology, Medicine and Health, University of Manchester, Manchester, UK
| | | | - Hanna Debiec
- Sorbonne Université, Université Pierre et Marie Curie Paris 06, Paris, France; Institut National de la Santé et de la Recherche Médicale, Unité Mixte de Recherche S1155, Paris, France
| | - Pierre Ronco
- Sorbonne Université, Université Pierre et Marie Curie Paris 06, Paris, France; Institut National de la Santé et de la Recherche Médicale, Unité Mixte de Recherche S1155, Paris, France; Department of Nephrology (Day Hospital), AP-HP, Tenon Hospital, Paris, France
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Berchtold L, Letouzé E, Alexander MP, Canaud G, Logt AEVD, Hamilton P, Mousson C, Vuiblet V, Moyer AM, Guibert S, Mrázová P, Levi C, Dubois V, Cruzado JM, Torres A, Gandhi MJ, Yousfi N, Tesar V, Viklický O, Hourmant M, Moulin B, Rieu P, Choukroun G, Legendre C, Wetzels J, Brenchley P, Ballarín Castan JA, Debiec H, Ronco P. HLA-D and PLA2R1 risk alleles associate with recurrent primary membranous nephropathy in kidney transplant recipients. Kidney Int 2021; 99:671-685. [DOI: 10.1016/j.kint.2020.08.007] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/27/2020] [Revised: 07/30/2020] [Accepted: 08/13/2020] [Indexed: 12/22/2022]
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Rychlik I, Jeřábková K, Dusilová Sulková S, Táborský P, Vojanec V, Ryšavá R, Viklický O, Tesař V. SAT-149 NATION-WIDE CZECH REGISTRY OF CKD 4-5 PREDIALYSIS PATIENTS (RIP) – 10 YEARS DATA SURVEY. Kidney Int Rep 2020. [DOI: 10.1016/j.ekir.2020.02.158] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022] Open
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Hejtmánková A, Roubalová K, Forejtová A, Žáčková Suchanová J, Forstová J, Viklický O, Španielová H. Prevalence of antibodies against BKPyV subtype I and IV in kidney transplant recipients and in the general Czech population. J Med Virol 2019; 91:856-864. [PMID: 30609063 DOI: 10.1002/jmv.25388] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/30/2018] [Accepted: 12/24/2018] [Indexed: 01/04/2023]
Abstract
Active infection with BK polyomavirus (BKPyV) may cause serious complications in transplantation settings. Recently, the level of BKPyV IgG seroreactivity in graft donors has been shown to predict viremia and BKPyV-associated nephropathy in kidney transplant (KTx) recipients. Pretransplantation testing of the donor and recipient BKPyV serostatus could, therefore, identify patients at high risk. For the development of serological immunoassays, antibody response to the predominant BKPyV subtypes (BKPyV-I and BKPyV-IV) was studied using virus-like particle (VLP)-based enzyme-linked immunosorbent assay (ELISA). VLPs made from the capsid protein, VP1, derived from BKPyV-I and BKPyV-IV subtypes were produced using a baculovirus expression system and used as antigens. The tests were used for IgG antibody determination in 50 KTx recipients and 111 healthy blood donors. While 87% of samples reacted with mixed BKPyV-I and BKPyV-IV antigens, only 49% of samples were reactive in both ELISA tests when using BKPyV-I or BKPyV-IV antigens separately. Twenty-seven percent of healthy blood donors and 26% of KTx recipients were reactive only with BKPyV-I, while 9% and 20% were reactive only with BKPyV-IV, respectively. To determine the specificities of the antigens, selected seropositive samples were retested after preadsorption with soluble BKPyV-I, BKPyV-IV, or JC polyomavirus antigens. The experiments confirmed that recombinant VP1 VLP-based ELISAs predominantly detected BKPyV type-specific antibodies. The results imply that anti-BKPyV antibody ELISA tests should contain a mixture of subtype-specific VLP-based antigens instead of antigen derived from the most prevalent BKPyV-I subtype. The tests can be used for serological surveys of BKPyV infection and improved KTx patient management.
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Affiliation(s)
- Alžběta Hejtmánková
- Department of Genetics and Microbiology, Faculty of Science, Charles University, Prague, Czech Republic
| | | | | | - Jiřina Žáčková Suchanová
- Department of Genetics and Microbiology, Faculty of Science, Charles University, Prague, Czech Republic
| | - Jitka Forstová
- Department of Genetics and Microbiology, Faculty of Science, Charles University, Prague, Czech Republic
| | - Ondřej Viklický
- Department of Nephrology, Institute for Clinical and Experimental Medicine, Prague, Czech Republic
| | - Hana Španielová
- Department of Genetics and Microbiology, Faculty of Science, Charles University, Prague, Czech Republic
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Živná M, Kidd K, Přistoupilová A, Barešová V, DeFelice M, Blumenstiel B, Harden M, Conlon P, Lavin P, Connaughton DM, Hartmannová H, Hodaňová K, Stránecký V, Vrbacká A, Vyleťal P, Živný J, Votruba M, Sovová J, Hůlková H, Robins V, Perry R, Wenzel A, Beck BB, Seeman T, Viklický O, Rajnochová-Bloudíčková S, Papagregoriou G, Deltas CC, Alper SL, Greka A, Bleyer AJ, Kmoch S. Noninvasive Immunohistochemical Diagnosis and Novel MUC1 Mutations Causing Autosomal Dominant Tubulointerstitial Kidney Disease. J Am Soc Nephrol 2018; 29:2418-2431. [PMID: 29967284 DOI: 10.1681/asn.2018020180] [Citation(s) in RCA: 30] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/16/2018] [Accepted: 06/08/2018] [Indexed: 11/03/2022] Open
Abstract
BACKGROUND Autosomal dominant tubulointerstitial kidney disease caused by mucin-1 gene (MUC1) mutations (ADTKD-MUC1) is characterized by progressive kidney failure. Genetic evaluation for ADTKD-MUC1 specifically tests for a cytosine duplication that creates a unique frameshift protein (MUC1fs). Our goal was to develop immunohistochemical methods to detect the MUC1fs created by the cytosine duplication and, possibly, by other similar frameshift mutations and to identify novel MUC1 mutations in individuals with positive immunohistochemical staining for the MUC1fs protein. METHODS We performed MUC1fs immunostaining on urinary cell smears and various tissues from ADTKD-MUC1-positive and -negative controls as well as in individuals from 37 ADTKD families that were negative for mutations in known ADTKD genes. We used novel analytic methods to identify MUC1 frameshift mutations. RESULTS After technique refinement, the sensitivity and specificity for MUC1fs immunostaining of urinary cell smears were 94.2% and 88.6%, respectively. Further genetic testing on 17 families with positive MUC1fs immunostaining revealed six families with five novel MUC1 frameshift mutations that all predict production of the identical MUC1fs protein. CONCLUSIONS We developed a noninvasive immunohistochemical method to detect MUC1fs that, after further validation, may be useful in the future for diagnostic testing. Production of the MUC1fs protein may be central to the pathogenesis of ADTKD-MUC1.
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Affiliation(s)
- Martina Živná
- Research Unit for Rare Diseases, Department of Pediatrics and Adolescent Medicine, First Faculty of Medicine
| | - Kendrah Kidd
- Section on Nephrology, Wake Forest School of Medicine, Winston-Salem, North Carolina
| | - Anna Přistoupilová
- Research Unit for Rare Diseases, Department of Pediatrics and Adolescent Medicine, First Faculty of Medicine
| | - Veronika Barešová
- Research Unit for Rare Diseases, Department of Pediatrics and Adolescent Medicine, First Faculty of Medicine
| | - Mathew DeFelice
- Broad Institute of Harvard and Massachusetts Institute of Technology, Cambridge, Massachusetts
| | - Brendan Blumenstiel
- Broad Institute of Harvard and Massachusetts Institute of Technology, Cambridge, Massachusetts
| | - Maegan Harden
- Broad Institute of Harvard and Massachusetts Institute of Technology, Cambridge, Massachusetts
| | - Peter Conlon
- Department of Nephrology, Beaumont Hospital, Dublin, Ireland.,Royal College of Surgeons, Dublin, Ireland
| | - Peter Lavin
- Trinity Health Kidney Centre, Tallaght Hospital, Dublin, Ireland
| | - Dervla M Connaughton
- Department of Nephrology, Beaumont Hospital, Dublin, Ireland.,Trinity Health Kidney Centre, Tallaght Hospital, Dublin, Ireland
| | - Hana Hartmannová
- Research Unit for Rare Diseases, Department of Pediatrics and Adolescent Medicine, First Faculty of Medicine
| | - Kateřina Hodaňová
- Research Unit for Rare Diseases, Department of Pediatrics and Adolescent Medicine, First Faculty of Medicine
| | - Viktor Stránecký
- Research Unit for Rare Diseases, Department of Pediatrics and Adolescent Medicine, First Faculty of Medicine
| | - Alena Vrbacká
- Research Unit for Rare Diseases, Department of Pediatrics and Adolescent Medicine, First Faculty of Medicine
| | - Petr Vyleťal
- Research Unit for Rare Diseases, Department of Pediatrics and Adolescent Medicine, First Faculty of Medicine
| | - Jan Živný
- Institute of Pathophysiology, First Faculty of Medicine
| | - Miroslav Votruba
- Research Unit for Rare Diseases, Department of Pediatrics and Adolescent Medicine, First Faculty of Medicine
| | - Jana Sovová
- Research Unit for Rare Diseases, Department of Pediatrics and Adolescent Medicine, First Faculty of Medicine
| | - Helena Hůlková
- Research Unit for Rare Diseases, Department of Pediatrics and Adolescent Medicine, First Faculty of Medicine.,Institute of Pathology, First Faculty of Medicine, and
| | - Victoria Robins
- Section on Nephrology, Wake Forest School of Medicine, Winston-Salem, North Carolina
| | - Rebecca Perry
- Section on Nephrology, Wake Forest School of Medicine, Winston-Salem, North Carolina
| | - Andrea Wenzel
- Center for Molecular Medicine Cologne, University of Cologne, Cologne, Germany.,Institute of Human Genetics, University Hospital of Cologne, Cologne, Germany
| | - Bodo B Beck
- Center for Molecular Medicine Cologne, University of Cologne, Cologne, Germany.,Institute of Human Genetics, University Hospital of Cologne, Cologne, Germany
| | - Tomáš Seeman
- Department of Paediatrics, Second Faculty of Medicine, Charles University, Prague, Czech Republic
| | - Ondřej Viklický
- Nephrology Department, Institute for Clinical and Experimental Medicine, Prague, Czech Republic
| | | | - Gregory Papagregoriou
- Molecular Medicine Research Center, Department of Biological Sciences, University of Cyprus, Nicosia, Cyprus
| | - Constantinos C Deltas
- Molecular Medicine Research Center, Department of Biological Sciences, University of Cyprus, Nicosia, Cyprus
| | - Seth L Alper
- Division of Nephrology and Vascular Biology Research Center, Beth Israel Deaconess Medical Center, Boston, Massachusetts
| | - Anna Greka
- Broad Institute of Harvard and Massachusetts Institute of Technology, Cambridge, Massachusetts.,Department of Medicine, Brigham and Women's Hospital, Boston, Massachusetts; and.,Department of Medicine, Harvard Medical School, Boston, Massachusetts
| | - Anthony J Bleyer
- Research Unit for Rare Diseases, Department of Pediatrics and Adolescent Medicine, First Faculty of Medicine, .,Section on Nephrology, Wake Forest School of Medicine, Winston-Salem, North Carolina
| | - Stanislav Kmoch
- Research Unit for Rare Diseases, Department of Pediatrics and Adolescent Medicine, First Faculty of Medicine.,Section on Nephrology, Wake Forest School of Medicine, Winston-Salem, North Carolina
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Rajnochová Bloudíčková S, Macháčková K, Viklický O. SP721IS POSSIBLE TO OBJECTIVELY PREDICT THE RENAL TRANSPLANT OUTCOME IN ELDERLY PATIENT?- SINGLE CENTER EXPERIENCE. Nephrol Dial Transplant 2018. [DOI: 10.1093/ndt/gfy104.sp721] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Affiliation(s)
- Silvie Rajnochová Bloudíčková
- Department of Nephrology Transplant Center, Institute for Clinical and Experimental Medicine, Prague 4, Czech Republic
| | - Karolína Macháčková
- Department of Nephrology Transplant Center, Institute for Clinical and Experimental Medicine, Prague 4, Czech Republic
| | - Ondřej Viklický
- Department of Nephrology Transplant Center, Institute for Clinical and Experimental Medicine, Prague 4, Czech Republic
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14
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Tycová I, Hrubá P, Maixnerová D, Girmanová E, Mrázová P, Straňavová L, Zachoval R, Merta M, Slatinská J, Kollár M, Honsová E, Tesař V, Viklický O. Molecular profiling in IgA nephropathy and focal and segmental glomerulosclerosis. Physiol Res 2017; 67:93-105. [PMID: 29137483 DOI: 10.33549/physiolres.933670] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/09/2023] Open
Abstract
The aim of the study was to characterize by molecular profiling two glomerular diseases: IgA nephropathy (IgAN) and focal segmental glomerulosclerosis (FSGS) and to identify potential molecular markers of IgAN and FSGS progression. The expressions of 90 immune-related genes were compared in biopsies of patients with IgAN (n=33), FSGS (n=17) and in controls (n=11) using RT-qPCR. To identify markers of disease progression, gene expression was compared between progressors and non-progressors in 1 year follow-up. The results were verified on validation cohort of patients with IgAN (n=8) and in controls (n=6) using laser-capture microdissection, that enables to analyze gene expression separately for glomeruli and interstitium. In comparison to controls, patients with both IgAN and FSGS, had lower expression of BAX (apoptotic molecule BCL2-associated protein) and HMOX-1 (heme oxygenase 1) and higher expression of SELP (selectin P). Furthermore, in IgAN higher expression of PTPRC (protein-tyrosine phosphatase, receptor-type C) and in FSGS higher expression of BCL2L1 (regulator of apoptosis BCL2-like 1) and IL18 compared to control was observed. Validation of differentially expressed genes between IgAN and controls on another cohort using laser-capture microdissection confirmed higher expression of PTPRC in glomeruli of patients with IgAN. The risk of progression in IgAN was associated with higher expression EDN1 (endothelin 1) (AUC=0.77) and FASLG (Fas ligand) (AUC=0.82) and lower expression of VEGF (vascular endothelial growth factor) (AUC=0.8) and in FSGS with lower expression of CCL19 (chemokine (C-C motif) ligand 19) (AUC=0.86). Higher expression of EDN1 and FASLG along with lower expression of VEGF in IgAN and lower expression of CCL19 in FSGS at the time of biopsy can help to identify patients at risk of future disease progression.
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Affiliation(s)
- I Tycová
- Transplant Laboratory, Institute for Clinical and Experimental Medicine, Prague, Czech Republic.
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15
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Ghisdal L, Baron C, Lebranchu Y, Viklický O, Konarikova A, Naesens M, Kuypers D, Dinic M, Alamartine E, Touchard G, Antoine T, Essig M, Rerolle JP, Merville P, Taupin JL, Le Meur Y, Grall‐Jezequel A, Glowacki F, Noël C, Legendre C, Anglicheau D, Broeders N, Coppieters W, Docampo E, Georges M, Ajarchouh Z, Massart A, Racapé J, Abramowicz D, Abramowicz M. Genome-Wide Association Study of Acute Renal Graft Rejection. Am J Transplant 2017; 17:201-209. [PMID: 27272414 PMCID: PMC5215306 DOI: 10.1111/ajt.13912] [Citation(s) in RCA: 37] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/18/2016] [Revised: 04/29/2016] [Accepted: 05/23/2016] [Indexed: 01/25/2023]
Abstract
Acute renal rejection is a major risk factor for chronic allograft dysfunction and long-term graft loss. We performed a genome-wide association study to detect loci associated with biopsy-proven acute T cell-mediated rejection occurring in the first year after renal transplantation. In a discovery cohort of 4127 European renal allograft recipients transplanted in eight European centers, we used a DNA pooling approach to compare 275 cases and 503 controls. In an independent replication cohort of 2765 patients transplanted in two European countries, we identified 313 cases and 531 controls, in whom we genotyped individually the most significant single nucleotide polymorphisms (SNPs) from the discovery cohort. In the discovery cohort, we found five candidate loci tagged by a number of contiguous SNPs (more than five) that was never reached in iterative in silico permutations of our experimental data. In the replication cohort, two loci remained significantly associated with acute rejection in both univariate and multivariate analysis. One locus encompasses PTPRO, coding for a receptor-type tyrosine kinase essential for B cell receptor signaling. The other locus involves ciliary gene CCDC67, in line with the emerging concept of a shared building design between the immune synapse and the primary cilium.
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Affiliation(s)
- L. Ghisdal
- Department of Nephrology, Dialysis, and TransplantationHôpital Erasme (Université Libre de Bruxelles)BrusselsBelgium,Present address: Department of NephrologyCentre Hospitalier EpiCURABaudourBelgium
| | - C. Baron
- Department of NephrologyCentre Hospitalier Régional Universitaire de ToursToursFrance
| | - Y. Lebranchu
- Department of NephrologyCentre Hospitalier Régional Universitaire de ToursToursFrance
| | - O. Viklický
- Department of NephrologyTransplant CentreInstitute for Clinical and Experimental MedicinePragueCzech Republic
| | - A. Konarikova
- Department of NephrologyTransplant CentreInstitute for Clinical and Experimental MedicinePragueCzech Republic
| | - M. Naesens
- Department of Microbiology and ImmunologyKU LeuvenUniversity of LeuvenLeuvenBelgium,Department of NephrologyUniversity Hospitals LeuvenLeuvenBelgium
| | - D. Kuypers
- Department of Microbiology and ImmunologyKU LeuvenUniversity of LeuvenLeuvenBelgium,Department of NephrologyUniversity Hospitals LeuvenLeuvenBelgium
| | - M. Dinic
- Department of NephrologyCentre Hospitalier Universitaire de Saint‐EtienneSaint‐EtienneFrance
| | - E. Alamartine
- Department of NephrologyCentre Hospitalier Universitaire de Saint‐EtienneSaint‐EtienneFrance
| | - G. Touchard
- Department of NephrologyCentre Hospitalier Universitaire de PoitiersPoitiersFrance
| | - T. Antoine
- Department of NephrologyCentre Hospitalier Universitaire de PoitiersPoitiersFrance
| | - M. Essig
- Department of Nephrology, Dialysis, TransplantationCentre Hospitalier Universitaire de Limoges and INSERM UMR 850 (Université de Limoges)LimogesFrance
| | - J. P. Rerolle
- Department of Nephrology, Dialysis, TransplantationCentre Hospitalier Universitaire de Limoges and INSERM UMR 850 (Université de Limoges)LimogesFrance
| | - P. Merville
- Department of NephrologyCentre Hospitalier Universitaire de BordeauxBordeauxFrance
| | - J. L. Taupin
- Department of Immunology and HistocompatibilityHôpital Saint‐LouisParisFrance
| | - Y. Le Meur
- Department of NephrologyCentre Hospitalier Universitaire la Cavale blancheBrestFrance
| | - A. Grall‐Jezequel
- Department of NephrologyCentre Hospitalier Universitaire la Cavale blancheBrestFrance
| | - F. Glowacki
- Department of NephrologyCentre Régional Hospitalier Universitaire de LilleLilleFrance
| | - C. Noël
- Department of NephrologyCentre Régional Hospitalier Universitaire de LilleLilleFrance
| | - C. Legendre
- Department of Renal TransplantationUniversité Paris Descartes and Hôpital NeckerAssistance Publique‐Hôpitaux de ParisParisFrance
| | - D. Anglicheau
- Department of Renal TransplantationUniversité Paris Descartes and Hôpital NeckerAssistance Publique‐Hôpitaux de ParisParisFrance
| | - N. Broeders
- Department of Nephrology, Dialysis, and TransplantationHôpital Erasme (Université Libre de Bruxelles)BrusselsBelgium
| | - W. Coppieters
- Unit of Animal GenomicsGroupe Interdisciplinaire de Génoprotéomique Appliquée‐Research (GIGA‐R)University of LiègeLiègeBelgium
| | - E. Docampo
- Unit of Animal GenomicsGroupe Interdisciplinaire de Génoprotéomique Appliquée‐Research (GIGA‐R)University of LiègeLiègeBelgium
| | - M. Georges
- Unit of Animal GenomicsGroupe Interdisciplinaire de Génoprotéomique Appliquée‐Research (GIGA‐R)University of LiègeLiègeBelgium
| | - Z. Ajarchouh
- Institute of Interdisciplinary Research in Molecular and Human biology (IRIBHM)Université Libre de BruxellesBrusselsBelgium
| | - A. Massart
- Department of Nephrology, Dialysis, and TransplantationHôpital Erasme (Université Libre de Bruxelles)BrusselsBelgium,Institute of Interdisciplinary Research in Molecular and Human biology (IRIBHM)Université Libre de BruxellesBrusselsBelgium
| | - J. Racapé
- Centre of EpidemiologyBiostatistic and Clinical ResearchSchool of Public Health (Université Libre de Bruxelles)BrusselsBelgium
| | - D. Abramowicz
- Department of Nephrology, Dialysis, and TransplantationHôpital Erasme (Université Libre de Bruxelles)BrusselsBelgium,Department of NephrologyAntwerp University HospitalAntwerpenBelgium
| | - M. Abramowicz
- Institute of Interdisciplinary Research in Molecular and Human biology (IRIBHM)Université Libre de BruxellesBrusselsBelgium,Medical Genetics DepartmentHôpital Erasme (Université Libre de Bruxelles)BrusselsBelgium
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16
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Rebollo‐Mesa I, Nova‐Lamperti E, Mobillo P, Runglall M, Christakoudi S, Norris S, Smallcombe N, Kamra Y, Hilton R, Bhandari S, Baker R, Berglund D, Carr S, Game D, Griffin S, Kalra PA, Lewis R, Mark PB, Marks S, Macphee I, McKane W, Mohaupt MG, Pararajasingam R, Kon SP, Serón D, Sinha MD, Tucker B, Viklický O, Lechler RI, Lord GM, Hernandez‐Fuentes MP. Biomarkers of Tolerance in Kidney Transplantation: Are We Predicting Tolerance or Response to Immunosuppressive Treatment? Am J Transplant 2016; 16:3443-3457. [PMID: 27328267 PMCID: PMC5132071 DOI: 10.1111/ajt.13932] [Citation(s) in RCA: 82] [Impact Index Per Article: 10.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/24/2016] [Revised: 05/12/2016] [Accepted: 06/08/2016] [Indexed: 01/25/2023]
Abstract
We and others have previously described signatures of tolerance in kidney transplantation showing the differential expression of B cell-related genes and the relative expansions of B cell subsets. However, in all of these studies, the index group-namely, the tolerant recipients-were not receiving immunosuppression (IS) treatment, unlike the rest of the comparator groups. We aimed to assess the confounding effect of these regimens and develop a novel IS-independent signature of tolerance. Analyzing gene expression in three independent kidney transplant patient cohorts (232 recipients and 14 tolerant patients), we have established that the expression of the previously reported signature was biased by IS regimens, which also influenced transitional B cells. We have defined and validated a new gene expression signature that is independent of drug effects and also differentiates tolerant patients from healthy controls (cross-validated area under the receiver operating characteristic curve [AUC] = 0.81). In a prospective cohort, we have demonstrated that the new signature remained stable before and after steroid withdrawal. In addition, we report on a validated and highly accurate gene expression signature that can be reliably used to identify patients suitable for IS reduction (approximately 12% of stable patients), irrespective of the IS drugs they are receiving. Only a similar approach will make the conduct of pilot clinical trials for IS minimization safe and hence allow critical improvements in kidney posttransplant management.
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Affiliation(s)
- I. Rebollo‐Mesa
- Medical Research Council Centre for TransplantationKing's College LondonLondonUnited Kingdom,BiostatisticsInstitute of Psychiatry, Psychology and NeuroscienceKing's College LondonLondonUnited Kingdom,UCB CelltechUCB Pharma S.A.SloughUnited Kingdom
| | - E. Nova‐Lamperti
- Medical Research Council Centre for TransplantationKing's College LondonLondonUnited Kingdom
| | - P. Mobillo
- Medical Research Council Centre for TransplantationKing's College LondonLondonUnited Kingdom
| | - M. Runglall
- National Institute for Health Research Biomedical Research CentreGuy's and St. Thomas’ National Health Service Foundation TrustKing's College LondonLondonUnited Kingdom
| | - S. Christakoudi
- Medical Research Council Centre for TransplantationKing's College LondonLondonUnited Kingdom,BiostatisticsInstitute of Psychiatry, Psychology and NeuroscienceKing's College LondonLondonUnited Kingdom
| | - S. Norris
- Medical Research Council Centre for TransplantationKing's College LondonLondonUnited Kingdom,University College LondonLondonUnited Kingdom
| | - N. Smallcombe
- Medical Research Council Centre for TransplantationKing's College LondonLondonUnited Kingdom
| | - Y. Kamra
- Medical Research Council Centre for TransplantationKing's College LondonLondonUnited Kingdom,Peter Gorer Department of ImmunobiologyKing's College LondonLondonUnited Kingdom
| | - R. Hilton
- Guy's and St. Thomas’ NHS Foundation TrustLondonUnited Kingdom
| | - Indices of Tolerance EU Consortium
- King's College LondonLondonUnited Kingdom,Oxford UniversityOxfordUnited Kingdom,Imperial College LondonLondonUnited Kingdom,Institute for Medical Immunology, Université Libre de BruxellesBruxellesBelgium,Miltenyi BiotecBergisch GladbachGermany,University of NantesNantesFrance,Charité, Universitaatsmedizin BerlinBerlinGermany
| | - S. Bhandari
- Hull and East Yorkshire Hospitals NHS TrustHullUnited Kingdom
| | - R. Baker
- St. James's University HospitalLeedsUnited Kingdom
| | | | - S. Carr
- Leicester General HospitalLeicesterUnited Kingdom
| | - D. Game
- Guy's and St. Thomas’ NHS Foundation TrustLondonUnited Kingdom
| | - S. Griffin
- Cardiff and Vale University Health BoardCardiffUnited Kingdom
| | | | - R. Lewis
- Queen Alexandra HospitalPortsmouthUnited Kingdom
| | - P. B. Mark
- University of GlasgowGlasgowUnited Kingdom
| | - S. Marks
- Great Ormond Street Hospital for Children NHS Foundation TrustLondonUnited Kingdom
| | - I. Macphee
- St. George's HospitalLondonUnited Kingdom
| | - W. McKane
- Northern General HospitalSheffieldUnited Kingdom
| | - M. G. Mohaupt
- INSELSPITALUniversitätsspital BernKlinik für Nephrologie/Hypertonie Abteilung für HypertonieBernSwitzerland
| | | | - S. P. Kon
- King's College Hospital NHS Foundation TrustLondonUnited Kingdom
| | - D. Serón
- Hospital Universitari Vall d'Hebr_onBarcelonaSpain
| | - M. D. Sinha
- Evelina London Children's HospitalLondonUnited Kingdom
| | - B. Tucker
- King's College Hospital NHS Foundation TrustLondonUnited Kingdom
| | - O. Viklický
- Transplantační laboratoř IKEMPragueCzech Republic
| | - R. I. Lechler
- Medical Research Council Centre for TransplantationKing's College LondonLondonUnited Kingdom,King's Health PartnersLondonUnited Kingdom
| | - G. M. Lord
- Medical Research Council Centre for TransplantationKing's College LondonLondonUnited Kingdom,National Institute for Health Research Biomedical Research CentreGuy's and St. Thomas’ National Health Service Foundation TrustKing's College LondonLondonUnited Kingdom,Guy's and St. Thomas’ NHS Foundation TrustLondonUnited Kingdom
| | - M. P. Hernandez‐Fuentes
- Medical Research Council Centre for TransplantationKing's College LondonLondonUnited Kingdom,National Institute for Health Research Biomedical Research CentreGuy's and St. Thomas’ National Health Service Foundation TrustKing's College LondonLondonUnited Kingdom
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17
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Týcová I, Sulková SD, Štěpánková J, Krejčík Z, Merkerová MD, Stránecký V, Hrubá P, Girmanová E, Černoch M, Lipár K, Marada T, Povýšil C, Viklický O. Molecular patterns of diffuse and nodular parathyroid hyperplasia in long-term hemodialysis. Am J Physiol Endocrinol Metab 2016; 311:E720-E729. [PMID: 27600827 DOI: 10.1152/ajpendo.00517.2015] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/16/2015] [Accepted: 08/21/2016] [Indexed: 01/08/2023]
Abstract
Secondary hyperparathyroidism is a well-known complication of end-stage renal disease (ESRD). Both nodular and diffuse parathyroid hyperplasia occur in ESRD patients. However, their distinct molecular mechanisms remain poorly understood. Parathyroid tissue obtained from ESRD patients who had undergone parathyroidectomy was used for Illumina transcriptome screening and subsequently for discriminatory gene analysis, pathway mapping, and gene annotation enrichment analysis. Results were further validated using quantitative RT-PCR on the independent larger cohort. Microarray screening proved homogeneity of gene transcripts in hemodialysis patients compared with the transplant cohort and primary hyperparathyroidism; therefore, further experiments were performed in hemodialysis patients only. Enrichment analysis conducted on 485 differentially expressed genes between nodular and diffuse parathyroid hyperplasia revealed highly significant differences in Gene Ontology terms and the Kyoto Encyclopedia of Genes and Genomes database in ribosome structure (P = 3.70 × 10-18). Next, quantitative RT-PCR validation of the top differently expressed genes from microarray analysis proved higher expression of RAN guanine nucleotide release factor (RANGRF; P < 0.001), calcyclin-binding protein (CACYBP; P < 0.05), and exocyst complex component 8 (EXOC8; P < 0.05) and lower expression of peptidylprolyl cis/trans-isomerase and NIMA-interacting 1 (PIN1; P < 0.01) mRNA in nodular hyperplasia. Multivariate analysis revealed higher RANGRF and lower PIN1 expression along with parathyroid weight to be associated with nodular hyperplasia. In conclusion, our study suggests the RANGRF transcript, which controls RNA metabolism, to be likely involved in pathways associated with the switch to nodular parathyroid growth. This transcript, along with PIN1 transcript, which influences parathyroid hormone secretion, may represent new therapeutical targets to cure secondary hyperparathyroidism.
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Affiliation(s)
- Irena Týcová
- Transplant Laboratory, Institute for Clinical and Experimental Medicine, Prague, Czech Republic
| | - Sylvie Dusilová Sulková
- Department of Nephrology, Institute for Clinical and Experimental Medicine, Prague, Czech Republic; Hemodialysis Centre, University Hospital, Hradec Králové, Czech Republic
| | - Jitka Štěpánková
- Department of Nephrology, Institute for Clinical and Experimental Medicine, Prague, Czech Republic
| | - Zdeněk Krejčík
- Institute of Hematology and Blood Transfusion, Prague, Czech Republic
| | | | - Viktor Stránecký
- Institute of Inherited Metabolic Disorders, Charles University and 1st School of Medicine and General University Hospital, Prague, Czech Republic
| | - Petra Hrubá
- Transplant Laboratory, Institute for Clinical and Experimental Medicine, Prague, Czech Republic
| | - Eva Girmanová
- Transplant Laboratory, Institute for Clinical and Experimental Medicine, Prague, Czech Republic
| | - Marek Černoch
- Transplant Laboratory, Institute for Clinical and Experimental Medicine, Prague, Czech Republic
| | - Květoslav Lipár
- Transplant Surgery Department, Institute for Clinical and Experimental Medicine, Prague, Czech Republic
| | - Tomáš Marada
- Transplant Surgery Department, Institute for Clinical and Experimental Medicine, Prague, Czech Republic
| | - Ctibor Povýšil
- Department of Pathology, Charles University and 1st School of Medicine and General University Hospital, Prague, Czech Republic; and
| | - Ondřej Viklický
- Transplant Laboratory, Institute for Clinical and Experimental Medicine, Prague, Czech Republic; Department of Nephrology, Institute for Clinical and Experimental Medicine, Prague, Czech Republic;
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18
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Krásová M, Sečníková Z, Göpfertová D, Hercogová J, Viklický O, Jůzlová K, Jiráková A, Šmerhovský Z. Immunosuppressive therapy in the posttransplant period and skin cancer. Dermatol Ther 2016; 29:433-436. [DOI: 10.1111/dth.12379] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/17/2023]
Affiliation(s)
- Martina Krásová
- Dermatology Department, 2nd Medical Faculty; Charles University in Prague and Bulovka Hospital
- Institute of Epidemiology, 2nd Medical Faculty; Charles University in Prague
| | - Zuzana Sečníková
- Dermatology Department, 2nd Medical Faculty; Charles University in Prague and Bulovka Hospital
- Institute of Epidemiology, 2nd Medical Faculty; Charles University in Prague
| | - Dana Göpfertová
- Institute of Epidemiology, 2nd Medical Faculty; Charles University in Prague
| | - Jana Hercogová
- Dermatology Department, 2nd Medical Faculty; Charles University in Prague and Bulovka Hospital
| | - Ondřej Viklický
- Nephrology Department; Institute of Clinical and Experimental Medicine; Prague Czech Republic
| | - Kateřina Jůzlová
- Dermatology Department, 2nd Medical Faculty; Charles University in Prague and Bulovka Hospital
| | - Anna Jiráková
- Dermatology Department, 2nd Medical Faculty; Charles University in Prague and Bulovka Hospital
| | - Zdeněk Šmerhovský
- Institute of Epidemiology, 2nd Medical Faculty; Charles University in Prague
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19
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Hošková L, Franekova J, Málek I, Kautzner J, Szárszoi O, Jabor A, Pinďák M, Viklický O, Melenovský V. Comparison of Cystatin C and NGAL in Early Diagnosis of Acute Kidney Injury After Heart Transplantation. Ann Transplant 2016; 21:329-245. [PMID: 27226081 DOI: 10.12659/aot.896700] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022] Open
Abstract
BACKGROUND Acute kidney injury (AKI) is a risk factor for adverse hospital outcomes in recipients of a heart transplantation (HTx). Timely recognition of AKI is crucial for the initiation of proper treatment. We hypothesized that serum or urine biomarkers can predict AKI. MATERIAL AND METHODS In this prospective study we evaluated 117 consecutive patients after HTx. AKI was defined as an increase of the serum creatinine level by ≥50% or a worsening of the renal function requiring renal replacement therapy during the first post-HTx week. We serially sampled serum cystatin C (S-cystatin C) as a marker of glomerular filtration and urinary neutrophil gelatinase-associated lipocalin (U-NGAL) as a marker of tubular damage. RESULTS A cohort of 30 patients (25.6%) fulfilled the criteria of AKI. S-cystatin C allowed the earliest separation between the AKI and non-AKI groups, with a significant difference present as soon as 3 h after surgery and it persisted on days 7, 10, and 30. The increase in S-cystatin C preceded the serum creatinine elevation by 4 days. In a multivariate analysis, S-cystatin C >1.6 mg/L at 3 h after HTx predicted AKI with OR 4.3 (95% CI: 1.6-11.5). U-NGAL was significantly higher at day 3 in the AKI group (p=0.003) and elevated S-cystatin C (≥2.54 mg/L on day 7) could predict 1-year mortality in these HTx recipients. CONCLUSIONS Our study showed that the measurement of S-cystatin C at 3 h after surgery may help to identify patients with high risk for renal complications. A persistent elevation of S-cystatin C also predicts 1-year mortality.
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Affiliation(s)
- Lenka Hošková
- Heart Centre, Institute for Clinical and Experimental Medicine, Prague, Czech Republic
| | - Janka Franekova
- Department of Laboratory Methods, Institute for Clinical and Experimental Medicine, Prague, Czech Republic
| | - Ivan Málek
- Heart Centre, Institute for Clinical and Experimental Medicine, Prague, Czech Republic
| | - Josef Kautzner
- Heart Centre, Institute for Clinical and Experimental Medicine, Prague, Czech Republic
| | - Ondřej Szárszoi
- Heart Centre, Institute for Clinical and Experimental Medicine, Prague, Czech Republic
| | - Antonín Jabor
- Department of Laboratory Methods, Institute for Clinical and Experimental Medicine, Prague, Czech Republic
| | - Marian Pinďák
- Heart Centre, Institute for Clinical and Experimental Medicine, Prague, Czech Republic
| | - Ondřej Viklický
- Department of Nephrology, Institute for Clinical and Experimental Medicine, Prague, Czech Republic
| | - Vojtěch Melenovský
- Heart Centre, Institute for Clinical and Experimental Medicine, Prague, Czech Republic
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20
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Viklický O. [Chronic dysfunction of a transplanted kidney: the problem still unresolved]. Vnitr Lek 2016; 62 Suppl 6:102-105. [PMID: 28124940] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/06/2023]
Abstract
Kidney transplantation represents the best treatment of end stage renal diseases in respect of patient survival and quality of life. Despite many advances in immunosuppression and surgical techniques, many kidney grafts are being lost in the long term, mainly due to chronic rejection and recurrence of glomerulonephritis. Calcineurin drug nephrotoxicity, which was overestimated in last decades, seems to have only minor impact on graft survival if any. Despite better understanding of mechanisms of kidney graft injuries, which are reflected by never-ending changes in histological classification systems, optimal treatment strategies are not available for majority of cases. Prospective randomized trials generated from transplant community are therefore warranted to solve many questions about the therapy.Key words: chronic rejection - kidney transplantation - nephrotoxicity - recurrence.
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21
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Kieslichová E, Pokorná E, Protuš M, Viklický O, Uchytilová E. Relationship between hyperchloremia in braindead donors and delayed graft function in the kidney allograft recipients. Intensive Care Med Exp 2015. [PMCID: PMC4796215 DOI: 10.1186/2197-425x-3-s1-a459] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022] Open
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22
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Džambová M, Sečníková Z, Jiráková A, Jůzlová K, Viklický O, Hošková L, Göpfertovà D, Hercogová J. Malignant melanoma in organ transplant recipients: incidence, outcomes, and management strategies: a review of literature. Dermatol Ther 2015; 29:64-8. [PMID: 26460720 DOI: 10.1111/dth.12276] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/01/2023]
Abstract
Malignant melanoma is considered to be an immunogenic tumor, which is expected to change its behaviour in the field of immunosuppression. Although the incidence of melanoma in organ transplant recipients is increased to a smaller degree than in non-melanoma skin cancer, its potential morbidity and mortality has to be considered in the posttransplant care. The aim of this review is to investigate the relationship between melanoma and immunosuppression and to discuss management strategies for different melanoma scenarios in pre-transplant as well as posttransplant period.
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Affiliation(s)
- Martina Džambová
- Department of Dermatology, 2nd Medical Faculty, Charles University in Prague and Bulovka Hospital, Prague, Czech Republic
| | - Zuzana Sečníková
- Department of Dermatology, 2nd Medical Faculty, Charles University in Prague and Bulovka Hospital, Prague, Czech Republic
| | - Anna Jiráková
- Department of Dermatology, 2nd Medical Faculty, Charles University in Prague and Bulovka Hospital, Prague, Czech Republic
| | - Kateřina Jůzlová
- Department of Dermatology, 2nd Medical Faculty, Charles University in Prague and Bulovka Hospital, Prague, Czech Republic
| | - Ondřej Viklický
- Department of Nephrology, Institute of Clinical and Experimental Medicine, Prague, Czech Republic
| | - Lenka Hošková
- Department of Cardiology, Institute of Clinical and Experimental Medicine, Prague, Czech Republic
| | - Dana Göpfertovà
- Department of Epidemiology, 2nd Medical Faculty, Charles University in Prague, Prague, Czech Republic
| | - Jana Hercogová
- Department of Dermatology, 2nd Medical Faculty, Charles University in Prague and Bulovka Hospital, Prague, Czech Republic
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Viklický O, Paříková A, Slatinská J, Hanzal V, Pagáčová L, Honsová E, Kieslichová E, Janoušek L, Froněk J. [AB0 incompatible kidney transplantation - first experiences]. Vnitr Lek 2015; 61:725-730. [PMID: 26375704] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/05/2023]
Abstract
Living donor AB0 incompatible kidney transplantation represents a new tool how to improve the access to transplantation. Majority of European protocols are based on desensitization with rituximab, triple drug immunosuppression, intravenous immunoglobulins and specific immunoads option (IA) which eliminates isohaemaglutinins. AB0i kidney transplant program was initiated in our centre in 2011 and 21 patients have received grafts from incompatible donors until recently. Highest accepted isohaemaglutinins titers before rituximab were 1 : 64 and corresponding pretransplant immunoadsorption procedures varied from 2 to 9. In 5 patients 1-2 IA procedures were performed also after transplantation. With the advent of paired exchange program the AB0i transplantation is offered to patients with unsuccessful matching run or with aim to improve HLA match between donor and recipient. The main complications were postoperative bleeding and urinary tract infections in patients at risk. Majority of protocol biopsies exhibited positivity of C4d staining. Neither graft loss nor patient death were noticed.
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Hubáček JA, Dlouhá D, Adámková V, Zlatohlavek L, Viklický O, Hrubá P, Češka R, Vrablík M. SLCO1B1 polymorphism is not associated with risk of statin-induced myalgia/myopathy in a Czech population. Med Sci Monit 2015; 21:1454-9. [PMID: 25992810 PMCID: PMC4450600 DOI: 10.12659/msm.893007] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/07/2023] Open
Abstract
Background Gene SLCO1B1, encoding solute organic anionic transport polypeptide OATP1B1, belongs to the group of candidates potentially influencing statin treatment safety. OATP1B1 regulates (not only) the hepatic uptake of statins. Its genetic variation was described as an important predictor of statin-associated myopathy in a cohort of patients treated with a maximum dose of simvastatin. However, the impact of SLCO1B1 gene polymorphism on this risk in patients treated with other statins or lower doses of simvastatin needs to be assessed. Therefore, we performed the present study. Material/Methods SLCO1B1 tagging rs4363657 polymorphism was analyzed in 2 groups of patients with dyslipidemia (treated with simvastatin or atorvastatin, 10 or 20 mg per day), subgroup with statin-induced myalgia (N=286), and subgroup (N=707) without myalgia/myopathy, and in 2301 population controls without lipid-lowering treatment. Results Frequency of the individual genotypes in patients with myalgia/myopathy (TT=62.3%, CT=34.5%, CC=2.8%) did not significantly differ (both P values over 0.19) from that in patients without muscle symptoms (TT=61.4%, CT=32.9%, CC=5.7%) or from the population controls (TT=63.9%, CT=32.5%, CC=3.6%). Null results were also obtained for the dominant and recessive models of the analysis. Conclusions In Czech patients treated with low statin doses, there is no association between SLCO1B1 gene polymorphism and risk of myalgia/myopathy.
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Affiliation(s)
- Jaroslav A Hubáček
- Department of Experimental Medicine, Institute for Clinical and Experimental Medicine, Prague, Czech Republic
| | - Dana Dlouhá
- Department of Experimental Medicine, Institute for Clinical and Experimental Medicine, Prague, Czech Republic
| | - Vera Adámková
- Department of Preventive Cardiology, Institute for Clinical and Experimental Medicine, Prague, Czech Republic
| | - Lukáš Zlatohlavek
- 3rd Department of Internal Medicine, 1st Faculty of Medicine, Charles University Prague, Prague, Czech Republic
| | - Ondřej Viklický
- Department of Nephrology, Transplant Center, Institute for Clinical and Experimental Medicine, Prague, Czech Republic
| | - Petra Hrubá
- Department of Nephrology, Transplant Center, Institute for Clinical and Experimental Medicine, Prague, Czech Republic
| | - Richard Češka
- 3rd Department of Internal Medicine, 1st Faculty of Medicine, Charles University Prague, Prague, Czech Republic
| | - Michal Vrablík
- 3rd Department of Internal Medicine, 1st Faculty of Medicine, Charles University Prague, Prague, Czech Republic
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Rajnochová Bloudíčková S, Slatinská J, Janoušek L, Adamec M, Kudla M, Marada T, Baláž P, Viklický O. SP846DONOR AGE - A KEY FACTOR OF LONG-TERM KIDNEY TRANSPLANTATION OUTCOMES IN THE ELDERLY RECIPIENT? Nephrol Dial Transplant 2015. [DOI: 10.1093/ndt/gfv202.72] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
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Siepert A, Brösel S, Vogt K, Ahrlich S, Schmitt-Knosalla I, Loddenkemper C, Kühl A, Baumgrass R, Gerstmayer B, Tomiuk S, Tiedge M, Viklický O, Brabcova I, Nizze H, Lehmann M, Volk HD, Sawitzki B. Mechanisms and rescue strategies of calcineurin inhibitor mediated tolerance abrogation induced by anti-CD4 mAb treatment. Am J Transplant 2013; 13:2308-21. [PMID: 23855618 DOI: 10.1111/ajt.12352] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/04/2012] [Revised: 05/26/2013] [Accepted: 05/29/2013] [Indexed: 01/25/2023]
Abstract
To ensure safety tolerance induction protocols are accompanied by conventional immunosuppressive drugs (IS). But IS such as calcineurin inhibitors (CNI), for example, cyclosporin A (CsA), can interfere with tolerance induction. We investigated the effect of an additional transient CsA treatment on anti-CD4mAb-induced tolerance induction upon rat kidney transplantation. Additional CsA treatment induced deteriorated graft function, resulting in chronic rejection characterized by glomerulosclerosis, interstitial fibrosis, tubular atrophy and vascular changes. Microarray analysis revealed enhanced intragraft expression of the B cell attracting chemokine CXCL13 early during CsA treatment. Increase in CXCL13 expression is accompanied by enhanced B cell infiltration with local and systemic IgG production and C3d deposition as early as 5 days upon CsA withdrawal. Adding different CNIs to cultures of primary mesangial cells isolated from glomeruli resulted in a concentration-dependent increase in CXCL13 transcription. CsA in synergy with TNF-α can enhance the B cell attracting and activating potential of mesangial cells. Transient B cell depletion or transfer of splenocytes from tolerant recipients 3 weeks after transplantation could rescue tolerance induction and did inhibit intragraft B cell accumulation, alloantibody production and ameliorate chronic rejection.
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Affiliation(s)
- A Siepert
- Institute of Medical Biochemistry and Molecular Biology, University of Rostock, Rostock, Germany
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Viklický O, Rajnochová-Bloudíčková S. [Recent possibilities of treatment of End Stage Renal Disease]. Vnitr Lek 2013; 59:747-751. [PMID: 24007235] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/02/2023]
Abstract
The End Stage Renal Disease (ESRD) represents a significant medical and economic problem. The success of longterm outcome of ESRD is dependent on the adequate nephrological care. The treatment of choice represents a kidney transplantation from a living donor or in those who haven't got such possibility, a deceased donor kidney transplantation. Recently, number of living donor kidney transplants has been increasing during last years in Europe and USA, mainly because of large awareness campaign and by using incompatible pairs. There were 361 (34.3 pmp) deceased donor and 71 (6.7 pmp) living donor kidney transplants performed while 4,050 patients benefit the life with functioning kidney graft in the Czech Republic in 2012. Hemodialysis therapy had undergone 5,772 (550 pmp) while peritoneal dialysis 489 (47 pmp) patients on December 31st, 2012.
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Affiliation(s)
- O Viklický
- Klinika nefrologie, Transplantacni centrum IKEM Praha.
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Peregrin JH, Hanzal V, Bürgelová M, Viklický O. Nephrostomy in Early Posttransplantation Period in Patients with Nonfunctional Graft and Nondilated Collecting System. Cardiovasc Intervent Radiol 2013; 37:458-62. [DOI: 10.1007/s00270-013-0666-3] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/13/2013] [Accepted: 05/17/2013] [Indexed: 10/26/2022]
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Pokorná E, Bachleda P, Dedochová J, Fixa P, Kuman M, Navrátil P, Nemec P, Reischig T, Samlík J, Seeman T, Sobotová D, Spatenka J, Trunecka P, Treska V, Viklický O, Zadrazil J. [An overview of the results of renal transplantation in the Czech Republic]. Vnitr Lek 2011; 57:645-649. [PMID: 21877600] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/31/2023]
Abstract
Renal (kidney) transplantation is now a routine and the most successful form of renal replacement therapy. There is a long tradition of renal transplantation in the Czech Republic, The first was performed as early as 1961 in Hradec Kralove, and the programme as such was launched in 1966 with the first successful transplantation at the Institute of Experimental Surgery (later Institute for Clinical and Experimental Medicine, Prague). At present, transplantations are being performed at 7 transplantation centres (IKEM Prague, Centre for Cardiovascular and Transplantation Surgery Brno, Faculty Hospitals Hradec Kralove, Plzen, Olomouc and Ostrava and Faculty Hospital Motol for children). From the programme launch until the end of 2010, 8,761 renal transplantations were performed, 364 in 2010 alone. One-year patient and cadaver renal allograft survival, transplanted in the CR between 2000 and 2009, is around 95% and 92%, respectively, and 5-year survival is 87% and 81%, respectively. As of 31st December 2009, a total of 3,771 patients lived with functional renal allograft in the Czech Republic and the proportion of patients with irreversible renal failure treated with transplantation has recently been around 40%.
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Affiliation(s)
- E Pokorná
- Centrum kardiovaskulární a transplantatcní chirurgie Brno.
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Viklický O. [Biological treatment following renal transplantation]. Vnitr Lek 2011; 57:650-653. [PMID: 21877601] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/31/2023]
Abstract
Renal transplantation represents a method of choice in irreversible renal failure. The outcome of renal transplantation is affected by acute or chronic rejection and long-term evaluation also suggest a role of adverse effects of immunosuppressive therapy, mainly the incidence of cardiovascular complications and tumours. Immunosuppressive therapy with biologic agents aims to reduce the incidence of acute rejections, prolong allograft survival and, consequently, patient survival. Apart from a reduction in acute rejection incidence, biological agents are used in a selected group of patients to eliminate the need for an adjunctive treatment with steroids and to reduce consequences of ischemic-reperfusion damage in older donors who suffer from a range ofco-morbidities. The most frequently used therapies include induction and anti-rejection therapy with a rabbit polyclonal anti-human thymocyte globulin (rATG) or an induction therapy with monoclonal anti-interleukin-2 receptor antibody (anti-IL2R), basiliximab. Considering the high immunosuppressive effect of rATG, adverse effects, mainly opportunistic infections and more frequent delayed tumourigenesis, have to be taken into account.
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Affiliation(s)
- O Viklický
- Klinika nefrologie, Transplantacní/centrum IKEM Praha.
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Vyhnanovská P, Dezortová M, Herynek V, Táborský P, Viklický O, Hájek M. In Vivo 31P MR Spectroscopy of Human Kidney Grafts Using the 2D-Chemical Shift Imaging Method. Transplant Proc 2011; 43:1570-5. [DOI: 10.1016/j.transproceed.2010.11.027] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/10/2010] [Revised: 10/22/2010] [Accepted: 11/03/2010] [Indexed: 11/29/2022]
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Bloudícková S, Rajnoch J, Lodererová A, Honsová E, Viklický O. Leflunomide derivate FK 778 in accelerated renal injury in transgenic rat. Folia Biol (Praha) 2010; 56:72-77. [PMID: 20492759] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/29/2023]
Abstract
Renal ischaemia/reperfusion (I/R) injury and hypertension represent major alloantigen-independent risk factors contributing to the development of chronic allograft nephropathy. In a model of accelerated major histocompatibility complex-independent renal injury, we evaluated the effect of leflunomide derivate - FK778 - on the progression of accelerated nephropathy. Thirty-six uninephrectomized hypertensive transgenic (m-REN-2)-27 rats received a clip on renal pedicle for 45 minutes. Animals were treated with FK778 3 mg/kg/day (I/R 3 mg, N = 12), 10 mg/kg/day (I/R 10 mg, N = 12) or placebo (N = 12) via gavage for 16 weeks. Eighteen animals were sham-operated and treated with FK778 3 mg/kg/day (sham 3 mg, N = 6), 10 mg/kg/day (sham 10 mg, N = 6) or were untreated (sham, N = 6). Proteinuria and blood pressure were evaluated throughout and the kidneys were harvested for morphological and immunohistochemical analysis at the end of the experiment. At week 16, rats with I/R injury and FK778 treatment had lower proteinuria compared with placebo-treated rats (I/R 3 mg: 48.42 +/- 26.16, I/R 10 mg 27.28 +/- 21.86 vs. Placebo: 70.13 +/- 50.19 mg/day, P < 0.05). The untreated sham group exhibited lower proteinuria compared with FK778-treated sham groups (Sham 3 mg: 24.23 +/- 10.89; Sham 10 mg: 17.37 +/- 4.13; Sham: 14.23 +/- 1.18) There was no difference in glomerulosclerosis and interstitial fibrosis among the treated groups. In the untreated animals the rate of interstitial fibrosis decline reached statistical significance (Placebo vs. Sham: 1.125 +/- 0.641 % vs. 0.250 +/- 0.500 %, P < 0.05). There was higher CD5+ leukocyte infiltration in the placebotreated group. FK778-treated rats displayed amelioration of some changes induced by the I/R injury. Our observation also suggests potential nephrotoxicity of FK778.
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Affiliation(s)
- S Bloudícková
- Department of Nephrology, Transplant Centre, Institute for Clinical and Experimental Medicine, Prague, Czech Republic.
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Abstract
BACKGROUND Fetuin-A is a major inhibitor of ectopic calcium phosphate precipitation and an acute phase reactant. Its deficiency, common in end-stage renal disease, has been suggested to be associated with cardiovascular complications. The aim of this study was to monitor fetuin-A levels in the early period after renal transplantation. METHODS 30 deceased donor kidney recipients treated with calcineurin inhibitor-based immunosuppression were followed prospectively for the first 3 months and the association of fetuin-A levels with clinical and laboratory parameters was evaluated. RESULTS Despite a correlation of fetuin-A levels with creatinine clearance (r = 0.348, p < 0.01) and estimated GFR (r = 0.331, p < 0.01), no significant increase in fetuin-A levels over the first 3 months was observed. Moreover, a significant decrease in serum fetuin-A levels was noted at 2 weeks (p < 0.001). Subsequently, fetuin-A levels increased (p < 0.001) reaching pretransplant values at month 3. CONCLUSIONS In this study there was no increase of fetuin-A levels during the first 3 months, but a decrease 2 weeks after transplantation was observed.
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Affiliation(s)
- M Urbanová
- Department of Nephrology, Transplant Center, Institute for Clinical and Experimental Medicine, Prague, Czech Republic
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Reiterová J, Miroslav M, Stekrová J, Kohoutová M, Tesar V, Kmentová D, Hubácek JA, Viklický O. The Influence of G‐Protein β3‐Subunit Gene and Endothelial Nitric Oxide Synthase Gene in Exon 7 Polymorphisms on Progression of Autosomal Dominant Polycystic Kidney Disease. Ren Fail 2009; 26:119-25. [PMID: 15287194 DOI: 10.1081/jdi-120038485] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022] Open
Abstract
BACKGROUND A significant phenotypical variability is observed in autosomal dominant polycystic kidney disease (ADPKD). The variability cannot be fully explained by the genetic heterogeneity of the disease. We examined the influence of G-protein beta3-subunit C825T polymorphism and endothelial nitric oxide synthase Glu298Asp polymorphism on the progression of ADPKD towards end stage renal failure (ESRF). METHODS 306 ADPKD patients (pts) were analyzed; 261 pts (136 males, 125 females) with ESRF, with subgroup of 73 pts (44 males, 29 females) with ESRF before 45 years (rapid progressors), 46 pts (20 males, 26 females) with ESRF later than in 63 years (slow progressors) and 45 ADPKD pts (17 males, 28 females) in mean age 51 years with serum creatinine under 110 micromol/L (slow progressors) and 100 genetically unrelated healthy Czech subjects. DNA samples from collected blood were genotyped for G-protein beta3-subunit C825T genotype in exon 10 and for endothelial nitric oxide synthase Glu298Asp genotype in exon 7. RESULTS The G-protein beta3-subunit C825T genotype exhibited no significant differences among the groups of slow progressors (6.6% (6/91) TT, 54.9% (50/91) CT, 38.8% (35/91) CC), rapid progressors (9.6% (7/73) TT, 46.6% (34/73) CT, 43.8% (32/73) CC), ADPKD group with ESRF between 40-63 years (9.2% (13/142) TT, 50% (71/142) CT, 40.8% (58/142) CC) and control group (12% TT, 44% CT, 44% CC). When comparing the ages of ESRF of all patients with ESRF, we did not find significant differences in the ages: males TT--51.7+/-8.8 years, CT--51.9+/-10.3 years, CC--49.7+/-10.2 years and females TT--56+/-9.9 years, CT--53.2+/-8.5 years, CC--53.9+/-8.7 years. The endothelial nitric oxide synthase Glu298Asp and Asp29Asp genotypes were significantly more frequent in rapid progressors (9.6% (7/73) Asp/Asp, 39.7% (29/73) Asp/Glu, 50.7% (37/73) Glu/Glu) and in ADPKD group with ESRF between 40-63 years (11.3% (16/142) Asp/Asp, 41.5% (59/142) Asp/Glu, 47.2% (67/142) Glu/Glu) in comparison with slow progressors (8.8% (8/91) Asp/Asp, 24.2% (22/91) Asp/Glu, 67.0% (61/91) Glu/Glu) and with control group (8% Asp/Asp, 32% Asp/Glu, 60% Glu/Glu) (Chi-square test, p<0.05). Comparing the ages of ESRF of all patients with ESRF, we did not find significant differences in the ages in males with Asp/Asp--54.9+/-10.4 years, Asp/Glu--50.2+/-9.4 years, Glu/Glu--51.0+/-10.4 years. We found out in homozygous Asp/Asp females significantly earlier onset of ESRF (49.2+/-5.6 years) in comparison with heterozygous females (53.3+/-7.2 years) and with Glu/Glu homozygous females (54.8+/-9.7 years) (t-test, p<0.05). CONCLUSION We excluded the significance of G-protein beta3-subunit C825T polymorphism on the progression of ADPKD. We established the negative prognostic value of the carriers of Asp variant of eNOS polymorphism. Finding of new modifiers could have in future clinical consequences for ADPKD patients.
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Affiliation(s)
- J Reiterová
- 1st Internal Department of Medicine, Charles University, Prague, Czech Republic
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Reiterová J, Obeidová H, Lenícek M, Stekrová J, Merta M, Maixnerová D, Vítek L, Viklický O, Tesar V. Influence of VEGF polymorphism on progression of autosomal dominant polycystic kidney disease. Kidney Blood Press Res 2008; 31:398-403. [PMID: 19060482 DOI: 10.1159/000180269] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/24/2008] [Accepted: 10/24/2008] [Indexed: 11/19/2022] Open
Abstract
BACKGROUND Significant phenotypical variability is observed in autosomal dominant polycystic kidney disease (ADPKD). Dysregulation of vascular endothelial growth factor (VEGF) expression in the kidney has been demonstrated in a wide range of renal diseases. The aim of the present study was to assess the influence of the -2578 C/A and the -1154 G/A polymorphisms in the regulatory region of the VEGF gene upon the progression of ADPKD toward end-stage renal disease (ESRD). METHODS The study was performed on 283 ADPKD patients (145 males, 138 females, mean age 51.7 +/- 10.3 years) who had reached ESRD. Patients were divided into three groups: (1) ESRD development later than in 63 years (slow progressors, n = 47), (2) ESRD development before 45 years (rapid progressors, n = 69), and (3) ESRD development between 45 and 63 years (intermediate progressors, n = 167). Genetically unrelated healthy Czech individuals were analyzed as a control group (n = 311, 153 males, 158 females, mean age 44.6 +/- 9.2 years). DNA samples were genotyped for the -2578 C/A and for the -1154 G/A polymorphisms of the VEGF gene promoter. The serum levels of VEGF were established in 111 healthy Czech individuals from the control group. RESULTS The VEGF -2578 C/A and -1154 G/A genotype distribution showed no differences among the groups of slow, rapid and intermediate progressors. The age of ESRD with regard to different genotypes was not significantly different in all ADPKD patients. However, the AA genotype of the -2578 C/A polymorphism was associated with a significantly higher age of ESRD than other genotypes in rapid progressors (42.7 vs. 40.5 years, p = 0.01). The CG haplotype was found significantly more frequent in ADPKD rapid progressors than in slow progressors (p = 0.047). Serum levels of VEGF did not significantly differ in the control group, according to different genotypes of both polymorphisms. CONCLUSION To conclude, AA genotype of the -2578 C/A polymorphism was related to better prognosis of the disease in a limited group of ADPKD patients. Classical genetic recessive and dominant model did not find significant influence of separate VEGF polymorphisms on the progression of ADPKD. Accordingly, CG haplotype was associated with earlier onset of ESRD in ADPKD patients.
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Affiliation(s)
- J Reiterová
- Department of Nephrology, 1st Faculty of Medicine, Charles University, Prague, Czech Republic.
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Matl I, Honsová E, Lodererová A, Lánská V, Viklický O. [Subclinical acute rejections in protocol biopsies at 3 months after kidney transplantation]. Vnitr Lek 2008; 54:1054-1058. [PMID: 19069678] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/27/2023]
Abstract
AIM The primary aim of the study was detection of subclinical acute rejection and borderline changes in protocol biopsies at 3 months after transplantation, and assessment of possible clinical and laboratory associations. METHODS Biopsy was carried out in 194 patients with stabilized graft function. Patients were treated with immunosuppressive regimen based on cyclosporine A (n = 34), tacrolimus (n = 152), or sirolimus/everolimus (n = 10). Samples were processed by standard paraffine technique, and stained according to laboratory protocol. All samples were tested by immunofluorescence or immunohistochemical procedures for C4d presence as a sign of humoral rejection. RESULTS Of 192 representative samples, subclinical acute rejection and borderline changes were found in 24 samples (12.5%). In patients with this finding, the mean serum creatinine was significantly higher (185.2 +/- 2.2 micromol/L), than in patients with normal finding (128.2 +/- 28.3 micromol/L) p < 0.001. Using the ROC curve analysis of serum creatinine, the cut-off point 170 micromol/L was found to discriminate normal findings from subclinical rejection and borderline changes. A significant correlation between acute rejections before protocol biopsy and subclinical acute rejections together with borderline changes in protocol biopsy was found. C4d positivity was found in 6 samples. Immunosuppressive therapy (cyclosporine versus tacrolimus) did not have any impact on subclinical acute rejections and borderline changes prevalence. CONCLUSIONS The main conclusion of this study is a finding, that acute rejection early after renal transplantation and serum creatinine > or = 170 micromol/l at three months after transplantation are risks for development of subclinical acute rejection, even of humoral type, or borderline changes.
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Affiliation(s)
- I Matl
- Klinika nefrologie IKEM, Praha.
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Novotná E, Viklický O. [BK viral infection after renal transplantation]. Vnitr Lek 2008; 54:835-841. [PMID: 18924344] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/26/2023]
Abstract
Viral infections have been a subject of great interest in patients after organ transplantations. Post-transplant immunosuppressive therapy is often associated with transfenction or reactivation of viruses. The human polyomavirus type I, also called BKvirus (BKV), causes polyomavirus-associated nephropathy (PVAN) in 1-10% of renal transplant recipients. Thanks to increased PVAN awareness and improved diagnostic techniques, the rate of graft loss has lowered, more consistently in centres with active screening and intervention programs. The risk factors for PVAN are not conclusively defined and likely involve complementing determinants of recipient, graft, and virus. Central element seems to be the failing balance between BKV replication and BKV-specific immune control, which can result from intense triple immunosuppression, HLA-mismatches, prior rejection and anti-rejection treatment, or BKV-seropositive donor/seronegative recipient pairs. PVAN diagnosis requires the evaluation of a renal biopsy showing polyomavirus cytopathic changes and confirming BKV through an ancillary technique such as immunohistochemistry. The success rate of the intervention is increased with earlier diagnosis. Therefore, it is recommended that all renal transplant recipients should be screened for BKV replication in urine and serum. The treatment of BKVN consists mainly of reduction in immunosuppressive therapy. Currently, in the clinical management of PVAN, no satisfactory antiviral treatment has been defined. Retransplantation after renal allograft loss to PVAN remains a treatment option for patients clearing polyomavirus replication.
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Affiliation(s)
- E Novotná
- Transplantacní laborator, Pracovistĕ experimentální medicíny IKEM Praha.
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Baláz P, Rokosný S, Adamec M, Viklický O, Pokorná E, Bürgelová M, Vítko S. [Dual kidney transplantation]. Rozhl Chir 2008; 87:50-54. [PMID: 18432078] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/26/2023]
Abstract
Despite the increasing demand for organs for transplantation, the number of cadaveric donors remains stable and waiting time for transplantation is gradually getting longer. In addition to the options of using kidneys from living donors and those of non heart-beating donors (NHBD), an alternative approach is transplantation of both kidneys from adult marginal donors who would otherwise be considered unsuitable for single-kidney donation. Dual kidney transplantation involves the use of both kidneys from a marginal donor for a single recipient without the recipient having to cope with the drawbacks of a limited number of functioning nephrons. Normally. these kidneys would be excluded from the transplantation program and remain unused. The submitted presentation provides information on donor and recipient selection criteria and describes the course of the first dual kidney transplantation in an adult recipient in the Czech Republic.
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Affiliation(s)
- P Baláz
- Klinika transplantacní chirurgie, Institut klinické a experimentální medicíny, Praha.
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Maixnerová D, Merta M, Reiterová J, Stekrová J, Rysavá R, Viklický O, Obeidová H, Tesar V. The influence of two megsin polymorphisms on the progression of IgA nephropathy. Folia Biol (Praha) 2008; 54:40-45. [PMID: 18498720] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/26/2023]
Abstract
The clinical course of chronic renal diseases and their progression to ESRD is highly variable. The strongest predictors of poor outcome of IgAN involve hypertension, severe proteinuria and elevated serum creatinine level. Different candidate gene polymorphisms have been advocated as possible modulators of the progression of IgAN. Megsin belongs to the serpin superfamily and was mapped to chromosome 18q21.3. Megsin plays a role in the regulation of a wide variety of processes in mesangial cells, such as matrix metabolism, cell proliferation, and apoptosis. Overexpression of Megsin might lead to mesangial dysfunction, and impair degradation of the mesangial matrix and disposal of immune complexes. The expression of Megsin is upregulated in a variety of glomerular diseases with mesangial injury in humans and in animal models. We investigated a possible association of two C2093T, C2180T polymorphisms of the megsin gene with the progression of IgAN towards ESRD, as well as the haplotype reconstruction of megsin gene polymorphisms and clinical manifestation of IgAN. We examined a group of 197 pts with histologically proven IGAN (84 pts with normal renal function, 113 pts with progressive renal insufficiency); as a control group we used 61 genetically unrelated healthy subjects. DNA samples from collected blood were genotyped for two singlenucleotide polymorphisms of megsin C2093T, C2180T by means of PCR with defined primers, electrophoresis on 2% agarose gel, UV light visualization and direct sequencing. The megsin genotype distribution showed no differences among the groups of IgAN with normal renal function, progressive renal insufficiency and the control group. According to haplotype analysis, the TT haplotype (defined as T-2093, T-2180 alleles) was substantially more frequent in pts with IgAN and normal renal function (Table 1, P = 0.025; Table 3, P = 0.062). Pts in the progressive group showed significantly higher levels of 24-h UP (3.53 +/- 2.80 vs 2.06 +/- 2.06, P = 0.042; Table 10), diastolic blood pressure (92.89 +/- 15.66 vs 84.93 +/- 10.43, P = 0.047; Table 10) and almost significantly systolic blood pressure (150.79 +/- 32.88 vs 135.21 +/- 14.88, P = 0.058; Table 10). We confirmed the negative prognostic influence of hypertension and proteinuria on the progression of IgAN in Czech pts. We found out that the TT haplotype (defined as T-2093, T-2180 alleles) could play a protective role in the progression of IgAN. In our Czech population, we excluded the negative influence of the 2093C-2180T haplotype, which was proposed by Chinese studies.
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Affiliation(s)
- D Maixnerová
- Charles University in Prague, First Faculty of Medicine, Department of Nephrology, Czech Republic.
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Slatinská J, Honsová E, Lyerová L, Slavcev A, Viklický O. [Acute humoral rejection of renal transplant]. Vnitr Lek 2007; 53:246-7, 249-52. [PMID: 17503638] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/15/2023]
Abstract
Acute humoral rejection (AHR) is a rare complication which often results in the loss of kidney graft. The objective of this retrospective monocentric study was to evaluate two different approaches to AHR. Documentation of 730 patients was analysed, who underwent renal transplantation between 2002 and 2005. From 2002 to 2003, patients with AHR were treated with 5 plasmaphereses (PF group, n = 13), and from 2004 to 2005 with a combination of 5 PF and intravenous immunoglobulins (PF + IVIG, 0.5 g/kg, n = 8). Data for the period of one year post-transplant was analysed. AHR occurred in 21 out of 730 patients (2.9%). Survival of grafts in the 6th month and in the 1st year was significantly higher for the PF + IVIG group than for the PF group only (p < 0.05). Patient survival was similar in both groups. The incidence of infectious complications was similar in both groups. There was a higher incidence of acute cellular rejections in the PF group (46.2 vs. 14.3%) in control rebiopsies (performed due to deteriorated graft function or in order to check the efficiency of the treatment). It can be concluded that acute humoral rejection of transplanted kidney is a rare complication which can be treated by the combination of plasmaphereses and intravenous immunoglobulins.
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Affiliation(s)
- J Slatinská
- Klinika nefrologie, Transplantacní centrum Institutu klinické a experimentální medicíny, Praha.
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Reiterová J, Merta M, Stekrová J, Maixnerová D, Obeidová H, Kebrdlová V, Viklický O, Tesar V. The influence of endothelin-A receptor gene polymorphism on the progression of autosomal dominant polycystic kidney disease and IgA nephropathy. Folia Biol (Praha) 2007; 53:134-7. [PMID: 17706018] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/16/2023]
Abstract
ADPKD is the most common hereditary renal disease. IGAN is a mesangial proliferative glomerulonephritis characterized by diffuse mesangial deposition of immunoglobulin A. ET-1 has been suggested to be a major disease-promoting factor in renal diseases. The vasoconstrictor effect of ET-1 is mediated by the ET-A receptor. We have investigated the influence of C/T polymorphism in exon 8 of the EDNRA gene. A total number of 193 patients (87 males, 106 females) with ADPKD entered into this study. Patients were divided into three groups: 1. 47 pts with ESRD later than in 63 years (slow progressors), 2. 49 pts with ESRD before 45 (rapid progressors) and 3. 97 pts with ESRD between 45-63 years. Moreover, we examined a group of 153 pts with histologically proven IGAN (116 males, 37 females). Pts were divided into two groups: 1. 79 pts with ERSD during 5 years of the study (IGAN rapid progressors) and 2. 74 patients with normal renal function (IGAN slow progressors). As a control group we used 100 genetically unrelated healthy subjects. The distribution of C/T polymorphism did not significantly differ between rapid and slow progressors of ADPKD and IGAN. The comparison of ESRD ages showed that CC females with ADPKD failed significantly later than CT heterozygotes: CC (57.4 +/- 8.1 years), CT (53.0 +/- 9.1 years) and TT (54.5 +/- 6.4years) (t-test, P = 0.018). To conclude, the CC genotype could be protective in ADPKD females. This genotype was described to be associated with lower pulse pressure.
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Affiliation(s)
- J Reiterová
- Department of Nephrology, Charles University in Prague, 1st Faculty of Medicine, Prague, Czech Republic.
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Maixnerová D, Merta M, Reiterová J, Stekrová J, Rysavá R, Obeidová H, Viklický O, Potmĕsil P, Tesar V. The influence of three endothelin-1 polymorphisms on the progression of IgA nephropathy. Folia Biol (Praha) 2007; 53:27-32. [PMID: 17328840] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/14/2023]
Abstract
The clinical course of chronic renal diseases and their progression to ESRF is highly variable. Different candidate gene polymorphisms have been advocated as possible modulators of ESRF progression. Moreover, ET-1 has been suggested as a major promoting factor in renal disease. However, limited data are available regarding an association of three ET-1 SNP K198N, T- 1370G and 3A/4A with the progression of IgAN to ESRF. We examined a group of 122 pts with histologically proved IgAN (91 pts with normal renal function, 31 pts with ESRF), as a control group we used 132 genetically unrelated healthy subjects. Patients' DNAs were genotyped for three ET-1 SNP: K198N, T-1370G and 3A/4A by means of PCR. The frequencies of different genotypes and ET-1 gene haplotypes were compared among control group, IgAN pts with normal renal function and IgAN pts with ESRF. The ET-1 genotype distribution showed no differences among the groups of IgAN with normal renal function (1. K198N - 63.74% KK, 32.97% KN, 3.3% NN; 2. TT - 68.13% TT, 28.57% TG, 3.3% GG; 3. 3A/4A - 42.22% 3A/3A, 50.0% 3A/4A, 7.69% 4A/4A ), IgAN with ESRF (1. K198N - 74.19% KK, 25.81% KN, 0% NN; 2. TT - 77.42% TT, 22.58% TG, 0% GG, 3. 3A/4A - 56.25% 3A/3A, 37.5% 3A/4A, 6.25% 4A/4A ) and the control group (1. K198N - 66.67% KK, 31.82% KN, 1.52% NN, 2. TT - 76.51% TT, 22.72% TG, 0.76% GG, 3. 3A/4A - 43.94% 3A/3A, 44.70% 3A/4A, 11.36% 4A/4A ). The analysis of haplotypes showed that the frequency of G-198, G-1370 and 4A allele combination was significantly higher in comparison with the control group (P=0.0056). We excluded the effect of K198N, T-1370G and 3A/4A polymorphisms of the ET-1 gene in single-gene analysis on the progression of IgAN to ESRF. A significant association of the GG4A haplotype with IgAN, demonstrated by haplotype reconstruction of the ET-1 gene, could suggest a role in the pathogenesis of IgAN.
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Affiliation(s)
- D Maixnerová
- Department of Nephrology, 1st Faculty of Medicine, Charles University, Prague, Czech Republic.
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Reiterová J, Merta M, Stekrová J, Tesar V, Kmentová D, Ríhová Z, Rysavá R, Viklický O. The influence of the endothelin-converting enzyme-1 gene polymorphism on the progression of autosomal dominant polycystic kidney disease. Ren Fail 2006; 28:21-4. [PMID: 16526315 DOI: 10.1080/08860220500461211] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022] Open
Abstract
UNLABELLED BACKGROUND; A significant phenotypical variability is observed in autosomal dominant polycystic kidney disease (ADPKD), the most common renal hereditary disease. Endothelin-1 (ET-1) has been suggested to be an important disease-promoting factor of the kidney. Endothelin-converting enzyme-1 (ECE-1) is the main protease responsible for ET-1 generation by cleavage of its functionally inactive precursor. We examined the influence of the ECE-1b C-338A polymorphism on the progression of ADPKD toward end-stage renal disease (ESRD). The A allele was suggested to be associated with higher plasma level of ET-1. METHODS 200 ADPKD patients (107 males, 93 females) who had reached ESRD were analyzed. Patients were divided into three groups: (1) 47 patients (23 males, 24 females) with ESRD later than in 63 yr (slow progressors); (2) 71 patients (38 males, 33 females) with ESRD before 45 yr (rapid progressors); and (3) 82 patients (46 males, 36 females) with ESRD between 45-63 yr. Moreover, we analyzed 160 genetically unrelated healthy Czech subjects as the control group (82 males, 78 females, mean age 51.4 +/- 8.2 yr). DNA samples from collected blood were genotyped for ECE-1b C-338A polymorphism using described polymerase chain reaction (PCR) followed by restriction enzyme digestion. We compared the frequencies of different genotypes between the groups of slow and rapid progressors and the ages of ESRD with regard to different genotypes. RESULTS The ECE-1b C-338A genotype distribution showed no differences among the groups of slow progressors, rapid progressors, ADPKD group with ESRD between 45-63 yr and control group. Comparing the ages of ESRD of all patients, we did not find significant differences in the ages with regard to different genotypes: CC (51.5 +/- 10.1 yr), AC (51.6 +/- 11.4 yr), AA (48.2 +/- 5.9 yr). There was a tendency to lower age of ESRD in AA homozygotes in comparison with other genotypes (t-test, p = 0.12). We found no influence of gender. CONCLUSION We excluded the effect of ECE-1b C-338A polymorphism on the progression of ADPKD. We could observe a mild tendency toward faster decline of renal function in AA homozygous individuals.
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Affiliation(s)
- J Reiterová
- Nephrology Department 1st Medical Faculty, Charles University, Prague, Czech Republic.
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Bloudícková S, Rajnoch J, Lodererová A, Honsová E, Viklický O. Mycophenolate Mofetil Ameliorates Accelerated Progressive Nephropathy in Rat. Kidney Blood Press Res 2006; 29:60-6. [PMID: 16645304 DOI: 10.1159/000092948] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/12/2005] [Accepted: 01/02/2006] [Indexed: 11/19/2022] Open
Abstract
BACKGROUND Renal ischemia and hypertension have been suggested to be involved in the progression of renal diseases. Recently, we developed a model of accelerated major histocompatibility complex-independent renal injury, where high-renin hypertension aggravates functional and morphological changes induced by ischemia/reperfusion (I/R). In this model, we evaluated the effect of immunosuppressant mycophenolate mofetil (MMF) to test its capability to slow the progression of accelerated nephropathy. METHODS 34 anesthetized uninephrectomized hypertensive transgenic (mREN2)27 rats (TGR) received a clamp on the renal pedicle for 45 min. Animals were treated with MMF 10 mg/kg/day (n = 10), 20 mg/kg/day (n = 10) or placebo (n = 10) orally via gavage for 12 weeks. Four animals were sham operated and not treated. Proteinuria and blood pressure were evaluated throughout the experiment. At the end of the experiment, kidney function was evaluated and kidneys harvested for morphological analysis and immunohistochemistry (CD4+, CD8+ lymphocytes and specific rat monocyte/macrophage marker ED-1+ cells). RESULTS At week 12, both MMF-treated groups had lower proteinuria as compared to the placebo group (MMF 10: 22.4 +/- 9.8, MMF 20: 20.9 +/- 5.6 vs. 126.7 +/- 35.8; p < 0.01; sham 28.1 +/- 1.4 mg/day) and reduced glomerulosclerosis (MMF 10: 11.4 +/- 7.8, MMF 20: 5.2 +/- 2.7 vs. 20.9 +/- 10.9; p < 0.05; sham 15.7 +/- 9.2%). There were no differences in systolic blood pressure among groups. MMF-treated rats had lower CD4+ (MMF 10: 61.2 +/- 46.4, MMF 20: 29.3 +/- 18.2 vs. 125.3 +/- 42.8; p < 0.01, sham 84.9 +/- 6.1 cells/field of view) and CD8+ (MMF 10: 13.7 +/- 10.2, MMF 20: 10.0 +/- 8.1 vs. 37.8 +/- 14.3; p < 0.01; sham: 31.8 +/- 7.6 cells/field of view) lymphocytes infiltration and ED-1 macrophages infiltration (MMF 10: 5.5 +/- 6.4, MMF 20: 2.5 +/- 2.8 vs. 16.7 +/- 4.1; p < 0.01; sham 12.2 +/- 4.6 cells/field of view) than placebo-treated rats. CONCLUSION Our results thus support the hypothesis about the key role of immune mechanisms in progression of chronic nephropathies.
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Affiliation(s)
- S Bloudícková
- Department of Nephrology, Transplant Center, Prague, Czech Republic
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Vavrinová H, Viklický O, Lácha J, Housa D, Hosková L, Teplan V. [Post-transplantation lymphoproliferation in patients with intensive immunosuppression]. Vnitr Lek 2006; 52:645-8. [PMID: 16871771] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/11/2023]
Abstract
Organ allograft recipients are at higher risk for malignancies development. This risk is known to be different in different types of tumours. Skin cancers and lymphoproliferative disorders have been described to be ones the most frequent (comprising 15-25% of all malignancies). Here, we present the case of expansive formation localized near the renal allograft in patient, whose native kidneys failed as a consequence of long-term cyclosporine A therapy after orthotopic heart transplantation. The maintenance immunosuppression consisted of combination of cyclosporine A, mycophenolate mofetil and steroids. The expansion offside of transplanted kidney was detected by routine ultrasound examination. After indifferent neurological symptoms, sepsis, and then multiorgan failure occured. Shortly after acute surgery patient died. Autopsy and histopathology showed lymphoproliferative disorder--mo- nomorphic type of posttransplant lymphoproliferative disorder (PTLD). Occurence of PTLD in organ transplantation is discussed.
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Affiliation(s)
- H Vavrinová
- Klinika nefrologie, Transplantcentrum, IKEM, Praha.
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Brabcová I, Kotsch K, Hribová P, Louzecká A, Bartosová K, Hyklová K, Lácha J, Volk HD, Viklický O. Intrarenal gene expression of proinflammatory chemokines and cytokines in chronic proteinuric glomerulopathies. Physiol Res 2006; 56:221-226. [PMID: 16555943 DOI: 10.33549/physiolres.930932] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
Abstract
Proteinuria has been recently shown to be an independent risk factor for the progression of chronic nephropathies, but the actual mechanisms by which urinary protein load damages renal tissue in humans remain unsolved. Using real-time RT-PCR method we evaluated intrarenal mRNA expression of various cytokines and chemokines in patients with biopsy-proven IgA nephropathy (IgAN, n=11), membranous nephropathy (MN, n=6) and focal and segmental glomerulosclerosis (FSGS, n=6) who exhibited proteinuria over 0.5 g/day. There was a significant positive correlation between the proteinuria extent and the intrarenal RANTES (regulated upon activation normal T cell expressed and secreted) mRNA expression in patients with IgAN, a similar trend was also observed in patients with MN and FSGS. There were no clear relationships between the proteinuria and intrarenal mRNA expression of tumor necrosis factor alpha, transforming growth factor beta1 and monocyte chemoattractant peptide-1. There were no differences in the pattern of cytokine mRNA expression between different glomerulopathies. In conclusion, our results support the hypothesis that lymphocytes, macrophages and their products provoke tissue injury in response to proteinuria independently of the nature of renal diseases in man.
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MESH Headings
- Adult
- Aged
- Chemokine CCL5/genetics
- Chemokines/analysis
- Chemokines/genetics
- Cytokines/analysis
- Cytokines/genetics
- Female
- Gene Expression
- Glomerulonephritis, IGA/etiology
- Glomerulonephritis, IGA/genetics
- Glomerulonephritis, IGA/metabolism
- Glomerulonephritis, Membranous/etiology
- Glomerulonephritis, Membranous/genetics
- Glomerulonephritis, Membranous/metabolism
- Glomerulosclerosis, Focal Segmental/etiology
- Glomerulosclerosis, Focal Segmental/genetics
- Glomerulosclerosis, Focal Segmental/metabolism
- Humans
- Kidney/chemistry
- Male
- Middle Aged
- Proteinuria/complications
- Proteinuria/genetics
- Proteinuria/metabolism
- RNA, Messenger/analysis
- Reverse Transcriptase Polymerase Chain Reaction
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Affiliation(s)
- I Brabcová
- Transplant Laboratory, Institute for Clinical and Experimental Medicine, Prague, Czech Republic
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Honsová E, Lodererová A, Viklický O, Boucek P. BK-virus nephropathy and simultaneous C4d positive staining in renal allografts. Cesk Patol 2005; 41:163-6. [PMID: 16382993] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/05/2023]
Abstract
The role of antibodies in rejection of transplanted kidneys was the subject of debate at the last two Banff meetings and in medical journals. Diffuse C4d positive staining of peritubular capillaries (PTCs) was recognized as a marker of antibody-mediated rejection and this morphological feature was included in the updated Banff schema. At the same time polyomavirus infection of the renal allografts has been reported more frequently and is emerging as an important cause of renal allograft dysfunction and graft loss. At the present time, BK-virus nephropathy (BKN) represents the most common viral disease affecting renal allografts. BKN was identified in 6 patients in 12 biopsies and 2 graft nephrectomy specimens of 1115 biopsies between September 2000 and December 2003. Definite virus identification was done by immunohistochemistry. The reason for graft nephrectomies was graft failure due to BKN in a recipient after kidney-pancreas transplantation with good function of his pancreas graft and the necessity of continuing immunosuppression. Detection of C4d deposits was performed by immunofluorescence or by immunohistochemistry. In graftectomy samples C4d detection was performed by immunohistochemistry and retrospectively in all cases of BKN. Focal C4d positive PTCs and BKN were found simultaneously in 9 of 12 needle biopsies and in both graft nephrectomy samples. Detection of C4d by immunohistochemistry disclosed focal C4d positive staining in kidney tissue but diffuse in the sites where BK-virus inclusions in tubular epithelial cells were found. The complement system is part of the host defense response and is crucial to our natural ability to ward off infection. In cases of BKN, virus likely gains access to the bloodstream through injured tubular walls and via PTCs. Vascular endothelium in the PTCs represents a potential target antigen for alloresponse, and simultaneously possibly represents an imprint of complement activation or complement production in the places with BK-virus infection.
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Affiliation(s)
- E Honsová
- Department of Pathology, Institute for Clinical and Experimental Medicine, Prague, Czech Republic.
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Abstract
Angiogenesis is a vessel development process that maintains the vascular supply for organ function. Regulation of angiogenesis is provided by positive factors, such as vascular endothelial or basic fibroblast growth factors, and negative factors, such as thrombospondin and macrophage-derived inflammatory cytokines. While the role of angiogenesis in the wound healing, embryogenesis, tumor growth and proliferative diseases is clear, in organ transplantation it is not yet well established. Herein we discuss the potential role of angiogenesis in chronic renal disease and in transplant settings.
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Affiliation(s)
- J Rajnoch
- Department of Nephrology, Transplant Center, Institute for Clinical and Experimental Medicine, 140 21 Prague, Czechia
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Viklický O, Matl I, Voska L, Böhmová R, Jaresová M, Lácha J, Lodererová A, Stríz I, Teplan V, Vítko S. TGF-beta1 expression and chronic allograft nephropathy in protocol kidney graft biopsy. Physiol Res 2004; 52:353-60. [PMID: 12790768] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/02/2023] Open
Abstract
Chronic allograft nephropathy (CAN) represents a frequent and irreversible cause of long-term renal graft loss. TGF-beta1 is a key profibrogenic cytokine associated with CAN pathogenesis. Because of clinical diagnostic inaccuracy, protocol biopsy has been suggested to be a beneficial method for early CAN detection. Protocol core biopsy was carried out in 67 consecutive cyclosporine-based immunosuppression-treated kidney transplant recipients with stable renal function 12 months after renal transplantation. Biopsy specimens were analyzed morphologically according to Banff-97' criteria and immunohistologically for TGF-beta1 staining. The data obtained were correlated with plasma TGF-beta1 levels and clinical data. CAN (grade I-III) was found in 51 patients (76 %). CAN grade I was found to be the most frequent one (44 %). A normal finding within the graft was made in only 12 patients (18 %). Clinically silent acute rejection Banff IA was present in 4 patients (6 %). In 8 patients (12 %) with CAN, borderline changes were present. We found a significant correlation between CAN grade and creatinine clearance, as measured by the Cockroft-Gault formula (p<0.01) as well as body mass index (p<0.01). There was a significant correlation between chronic vasculopathy (Banff cv) and creatinine clearance, and between the degree of TGF-beta1 staining and chronic vasculopathy (p<0.01). There were no relations between morphological findings and TGF-beta1 plasma levels, cyclosporine levels, plasma lipids, HLA-mismatches, panel reactive antibodies (PRA), proteinuria, and the donor's age. In conclusion, CAN is a frequent finding in protocol kidney graft biopsies 12 months after transplantation. TGF-beta1 tissue expression is linked with chronic vasculopathy.
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Affiliation(s)
- O Viklický
- Department of Nephrology, Transplant Center, Institute for Clinical and Experimental Medicine, Prague, Czech Republic.
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