کد مقاله | کد نشریه | سال انتشار | مقاله انگلیسی | نسخه تمام متن |
---|---|---|---|---|
2998823 | 1180261 | 2013 | 6 صفحه PDF | دانلود رایگان |
عنوان انگلیسی مقاله ISI
Antineutrophil Cytoplasmic Antibody-Associated Renal Vasculitis Treated With Autologous Mesenchymal Stromal Cells: Evaluation of the Contribution of Immune-Mediated Mechanisms
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کلمات کلیدی
AAVphytohemagglutinTNFCYCBVASTregRTXANCAMSCPHACTLPBMCnatural killer - (سلول های) کشنده طبیعیPANCA - BENCHAntineutrophil cytoplasmic antibody - آنتی تیتوپلاسم آنتی تروپیلیلBirmingham Vasculitis Activity Score - امتیاز فعالیت بیرمنگام واسکولیتinterleukin - اینترلوکینRituximab - ریتوکسیمابRegulatory T cell - سلول T تنظیم کنندهMesenchymal stromal cell - سلول استروما MesenchymalPeripheral blood mononuclear cell - سلول تک هسته ای خون محیطیCyclophosphamide - سیکلوفسفامید tumor necrosis factor - فاکتور نکروز تومورcytotoxic T lymphocyte - لنفوسیت T سیتوتوکسیکANCA-associated vasculitis - واسکولیت مرتبط با ANCA
موضوعات مرتبط
علوم پزشکی و سلامت
پزشکی و دندانپزشکی
کاردیولوژی و پزشکی قلب و عروق
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چکیده انگلیسی
We report the first case of renal antineutrophil cytoplasmic antibody (ANCA)-associated vasculitis treated with autologous mesenchymal stromal cells (MSCs). A 73-year-old man was admitted to the hospital for malaise, weight loss, and oliguria. His serum creatinine level was 2.7 mg/dL but it rapidly increased to 7.8 mg/dL; urinalysis showed proteinuria and hematuria, and the ANCA to myeloperoxidase with a perinuclear pattern (pANCA) titer was high (132 IU/mL). Renal biopsy showed necrotizing crescentic glomerulonephritis. Standard immunosuppressive therapy (cyclophosphamide and corticosteroids) was ineffective. Rituximab therapy was started, but it was discontinued after the third dose to minimize the risk of systemic spread of a severe oral Candida infection and to prevent superinfections that were facilitated by leukopenia. The patient received autologous MSCs, 1.5 à 106 cells/kg body weight, intravenously. After 7 days, his serum creatinine level decreased to 2.2 mg/dL, pANCA titer decreased to 75 IU/mL, and urinalysis findings normalized. Eight months later, he received a second MSC infusion because his serum creatinine level increased. In 1 week, his creatinine level decreased to 1.9 mg/dL and his pANCA titer decreased to 14 IU/mL. Immunosuppressive therapy was subsequently withdrawn. At the last follow-up visit, 12 months after the second MSC infusion, the patient remained in clinical remission without any therapy. Infusion of MSCs induced expansion of the T-lymphocyte subset expressing a regulatory T-cell phenotype (CD4+CD25+Foxp3+) and a notable reduction in interferon-γ, interleukin 6, and tumor necrosis factor serum levels.
ناشر
Database: Elsevier - ScienceDirect (ساینس دایرکت)
Journal: Mayo Clinic Proceedings - Volume 88, Issue 10, October 2013, Pages 1174-1179
Journal: Mayo Clinic Proceedings - Volume 88, Issue 10, October 2013, Pages 1174-1179
نویسندگان
Marilena MD, PhD, Rita PhD, Maria Antonietta PhD, Valeria MD, Antonia PhD, Carmelo MD, PhD, Pasquale MD, PhD, Francesca MD, Antonio MD, PhD, Teresa MD,