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Transplantation

IdeS to desensitize organ allograft recipients

Nature Reviews Nephrology volume 13, pages 666–668 (2017)Cite this article

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HLA sensitization greatly increases the risk of transplant rejection and failure. An IgG endopeptidase derived from Streptococcus pyogenes (IdeS) may be an attractive new therapy for desensitization. Recent data indicate that IdeS effectively depletes anti-HLA IgG, creating a therapeutic window for successful renal transplantation in sensitized recipients.

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Figure 1: IdeS is a promising new strategy for desensitization of transplant candidates with donor-specific anti-HLA antibodies.

References

  1. Loupy, A., Hill, G. S. & Jordan, S. C. The impact of donor-specific anti-HLA antibodies on late kidney allograft failure. Nat. Rev. Nephrol. 8, 348–357 (2012).

    Article  CAS  PubMed  Google Scholar 

  2. Winstedt, L. et al. Complete removal of extracellular IgG antibodies in a randomized dose-escalation phase I study with the bacterial enzyme IdeS — a novel therapeutic opportunity. PLoS One 10, e0132011 (2015).

    Article  PubMed  PubMed Central  Google Scholar 

  3. Jordan, S. C. et al. IgG endopeptidase in highly sensitized patients undergoing transplantation. N. Engl. J. Med. 377, 442–453 (2017).

    Article  CAS  PubMed  Google Scholar 

  4. Orandi, B. J. et al. Quantifying the risk of incompatible kidney transplantation: a multicenter study. Am. J. Transplant. 14, 1573–1580 (2014).

    Article  CAS  PubMed  Google Scholar 

  5. Manook, M. et al. Post-listing survival for highly sensitised patients on the UK kidney transplant waiting list: a matched cohort analysis. Lancet 389, 727–734 (2017).

    Article  PubMed  Google Scholar 

  6. Stegall, M. D. et al. Terminal complement inhibition decreases antibody-mediated rejection in sensitized renal transplant recipients. Am. J. Transplant. 11, 2405–2413 (2011).

    Article  CAS  Google Scholar 

  7. Vo, A. A. et al. A phase I/II trial of the interleukin-6 receptor-specific humanized monoclonal (tocilizumab) + intravenous immunoglobulin in difficult to desensitize patients. Transplantation 99, 2356–2363 (2015).

    Article  CAS  PubMed  Google Scholar 

  8. Jarnum, S., Bockermann, R., Runstrom, A., Winstedt, L. & Kjellman, C. The bacterial enzyme IdeS cleaves the IgG-type of B cell receptor (BCR), abolishes BCR-mediated cell signaling, and inhibits memory B cell activation. J. Immunol. 195, 5592–5601 (2015).

    Article  PubMed  PubMed Central  Google Scholar 

  9. Woodle, E. S. et al. Prospective iterative trial of proteasome inhibitor-based desensitization. Am. J. Transplant. 15, 101–118 (2015).

    Article  CAS  PubMed  Google Scholar 

  10. Schwaiger, E. et al. Deceased donor kidney transplantation across donor-specific antibody barriers: predictors of antibody-mediated rejection. Nephrol. Dial. Transplant. 31, 1342–1351 (2016).

    Article  CAS  PubMed  Google Scholar 

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Authors and Affiliations

  1. Department of Medicine III, Medical University of Vienna, Währinger Gürtel 18–20, Vienna, A-1090, Austria

    Georg A. Böhmig

  2. Service de Néphrologie, Hémodialyse, Aphérèses et Transplantation, Centre Hospitalier Universitaire Grenoble-Alpes, Avenue du maquis du Grésivaudan, La Tronche, 38700, France

    Lionel Rostaing

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  1. Georg A. Böhmig
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Correspondence to Georg A. Böhmig.

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Competing interests

G.A.B. has received lecture fees from Fresenius and Miltenyi, who provide immunoadsorption devices for antibody depletion in transplantation. L.R. has received lecture fees from Fresenius and HaemaT, who provide apheresis technology for antibody elimination in transplantation.

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Böhmig, G., Rostaing, L. IdeS to desensitize organ allograft recipients. Nat Rev Nephrol 13, 666–668 (2017). https://doi.org/10.1038/nrneph.2017.128

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