title: Effect of Immunosuppressive Drugs on Humoral Allosensitization after Kidney Transplant.
abstract: The negative effect of donor-specific antibodies on the success of solid transplant is now clearly established. However, the lack of effective treatment to prevent the development of antibody-mediated lesions deepens the need for clinicians to focus on primary prevention of de novo humoral allosensitization. Among the factors associated with the risk of developing de novo donor-specific antibodies, therapeutic immunosuppression is the most obvious parameter in which improvement is possible. Beyond compliance and the overall depth of immunosuppression, it is likely that the nature of the drugs is also crucial. Here, we provide an overview of the molecular effect of the various immunosuppressive drugs on B cell biology. Clinical data related to the effect of these drugs on de novo humoral allosensitization are also examined, providing a platform from which clinicians can optimize immunosuppression for prevention of de novo donor-specific antibody generation at the individual level.
authors.affiliation: Service de Transplantation, Néphrologie et Immunologie Clinique, Hôpital Edouard Herriot, Hospices Civils de Lyon, INSERM UMR1111, Université de Lyon, Lyon, France; and olivier.thaunat@chu-lyon.fr philippe.grimbert@hmn.aphp.fr.
authors.forename: Olivier
authors.initials: O
authors.lastname: Thaunat
authors.affiliation: Service de Transplantation, Néphrologie et Immunologie Clinique, Hôpital Edouard Herriot, Hospices Civils de Lyon, INSERM UMR1111, Université de Lyon, Lyon, France; and.
authors.forename: Alice
authors.initials: A
authors.lastname: Koenig
authors.affiliation: Service de Néphrologie et Transplantation, Hôpital Henri Mondor, Centre de référence maladie rare Syndrome Néphrotique Idiopathique, Institut Francilien de recherche en Néphrologie et Transplantation, INSERM U955, Université Paris Est Créteil, Assistance Publique-Hôpitaux de Paris, Creteil, France.
authors.forename: Claire
authors.initials: C
authors.lastname: Leibler
authors.affiliation: Service de Néphrologie et Transplantation, Hôpital Henri Mondor, Centre de référence maladie rare Syndrome Néphrotique Idiopathique, Institut Francilien de recherche en Néphrologie et Transplantation, INSERM U955, Université Paris Est Créteil, Assistance Publique-Hôpitaux de Paris, Creteil, France olivier.thaunat@chu-lyon.fr philippe.grimbert@hmn.aphp.fr.
authors.forename: Philippe
authors.initials: P
authors.lastname: Grimbert
mesh_terms: D000069594:Abatacept / Q000494:pharmacology / Q000627:therapeutic use; D000305:Adrenal Cortex Hormones / Q000494:pharmacology / Q000627:therapeutic use; D001402:B-Lymphocytes / Q000187:drug effects / Q000276:immunology; D065095:Calcineurin Inhibitors / Q000494:pharmacology / Q000627:therapeutic use; D006801:Humans; D056724:Immunity, Humoral / Q000187:drug effects*; D007166:Immunosuppressive Agents / Q000494:pharmacology* / Q000627:therapeutic use; D007519:Isoantigens / Q000187:drug effects* / Q000276:immunology; D016030:Kidney Transplantation; D012307:Risk Factors; D058570:TOR Serine-Threonine Kinases / Q000037:antagonists & inhibitors; D014019:Tissue Donors; D014181:Transplantation Immunology
chemical_list: D000305:Adrenal Cortex Hormones; D065095:Calcineurin Inhibitors; D007166:Immunosuppressive Agents; D007519:Isoantigens; D000069594:Abatacept; C546842:MTOR protein, human; D058570:TOR Serine-Threonine Kinases
keywords: immunology; immunosuppression; renal transplantation