Proteasome inhibition by bortezomib: Effect on HLA-antibody levels and specificity in sensitized patients awaiting renal allograft transplantation

► Directly targets terminally differentiated, antibody-producing plasma cells. ► Effectively reduces HLA-antibody levels in antibody-mediated rejection. ► Does not alter preformed HLA-antibody levels and specificity in sensitized patients. ► Does not impair protective immunity. ► Requires activated plasma cells to induce apoptosis and alter antibody production.