Elimination of post-transplant donor-specific HLA antibodies with bortezomib.
We show the ability of bortezomib to remove donor-specific HLA antibody from kidney allograft patients, the drug acting as a proteasome inhibitor, providing targeted therapy against antibody-producing plasma cells. Ten out of thirteen patients (77%) experienced primary DSA reversal, and in the remaining three patients the MFI of their primary DSA was dramatically reduced. Bortezomib is a viable therapy to treat donor-specific HLA antibody in allograft recipients. The potential for long-term benefits--and complications--are still unknown. Prospective trials are being conducted at the University of Cincinnati, Cincinnati, OH; at the Mayo Clinic, Rochester, MN; and at IKDRC-ITS, Ahmedabad, India.
Idica
A
A
One Lambda Inc., Canoga Park, CA, USA.
Kaneku
H
H
Everly
M J
MJ
Trivedi
H L
HL
Feroz
A
A
Vanikar
A V
AV
Shankar
V
V
Trivedi
V B
VB
Modi
P R
PR
Khemchandani
S I
SI
Dave
S D
SD
Terasaki
P I
PI
D000328:Adult; D000906:Antibodies / Q000097:blood*; D001897:Boronic Acids / Q000627:therapeutic use*; D000069286:Bortezomib; D006084:Graft Rejection / Q000276:immunology / Q000517:prevention & control*; D006680:HLA Antigens / Q000276:immunology*; D006801:Humans; D007166:Immunosuppressive Agents / Q000627:therapeutic use*; D016030:Kidney Transplantation / Q000276:immunology*; D019520:Living Donors; D008297:Male; D008875:Middle Aged; D010950:Plasma Cells / Q000187:drug effects* / Q000201:enzymology / Q000276:immunology; D010956:Plasmapheresis; D011480:Protease Inhibitors / Q000627:therapeutic use*; D061988:Proteasome Inhibitors; D011719:Pyrazines / Q000627:therapeutic use*; D013997:Time Factors; D014184:Transplantation, Homologous; D016896:Treatment Outcome; D055815:Young Adult
D000906:Antibodies; D001897:Boronic Acids; D006680:HLA Antigens; D007166:Immunosuppressive Agents; D011480:Protease Inhibitors; D061988:Proteasome Inhibitors; D011719:Pyrazines; D000069286:Bortezomib