title: Elimination of post-transplant donor-specific HLA antibodies with bortezomib.
abstract: 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.
authors.affiliation: One Lambda Inc., Canoga Park, CA, USA.
authors.forename: A
authors.initials: A
authors.lastname: Idica
authors.forename: H
authors.initials: H
authors.lastname: Kaneku
authors.forename: M J
authors.initials: MJ
authors.lastname: Everly
authors.forename: H L
authors.initials: HL
authors.lastname: Trivedi
authors.forename: A
authors.initials: A
authors.lastname: Feroz
authors.forename: A V
authors.initials: AV
authors.lastname: Vanikar
authors.forename: V
authors.initials: V
authors.lastname: Shankar
authors.forename: V B
authors.initials: VB
authors.lastname: Trivedi
authors.forename: P R
authors.initials: PR
authors.lastname: Modi
authors.forename: S I
authors.initials: SI
authors.lastname: Khemchandani
authors.forename: S D
authors.initials: SD
authors.lastname: Dave
authors.forename: P I
authors.initials: PI
authors.lastname: Terasaki
mesh_terms: 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
chemical_list: D000906:Antibodies; D001897:Boronic Acids; D006680:HLA Antigens; D007166:Immunosuppressive Agents; D011480:Protease Inhibitors; D061988:Proteasome Inhibitors; D011719:Pyrazines; D000069286:Bortezomib