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2.
Transplant Proc ; 50(10): 4067-4070, 2018 Dec.
Artículo en Inglés | MEDLINE | ID: mdl-30577317

RESUMEN

Elevated panel-reactive antibody (PRA) levels serve as a significant risk factor for allograft survival and episodes of rejection after heart transplantation (HTX). Patients with high PRA levels tend to show expressions of donor-specific human leukocyte antigen antibodies (DSA), which can cause catastrophic hyperacute rejection after HTX. Therefore, such highly sensitized patients are required to undergo strategic perioperative desensitization therapy. We describe a successful HTX after desensitization in a patient with extremely high PRA levels and pretransplant DSA positivity.


Asunto(s)
Desensibilización Inmunológica/métodos , Antígenos HLA/inmunología , Trasplante de Corazón/métodos , Adulto , Anticuerpos , Femenino , Rechazo de Injerto/inmunología , Supervivencia de Injerto/inmunología , Humanos , Trasplante Homólogo
3.
Transplant Proc ; 50(9): 2839-2841, 2018 Nov.
Artículo en Inglés | MEDLINE | ID: mdl-30401408

RESUMEN

Pigs have recently become very popular for use not only in xenotransplantation field, but in regeneration studies as well, sometimes with pigs being used as the scaffold. We have already presented our findings related to the pig immune system against human cells, including the complement systems, natural antibodies (NAs), and NK cells. In this study, we investigated the pig innate immunological reaction against human cells further. Our investigations included issues such as the production of NAs in newborns, day 0 and day 1, and sow colostrum. The alternative pathway for pig complement reacted with human cells, and pig NK cells and macrophages directly injured human aortic endothelial cells. Pig serum clearly contains the natural antibodies IgG and IgM to human peripheral blood mononuclear cells (PBMCs). Pig plasma from day 1 newborns contained almost the same levels of these natural antibodies to human PBMCs as those of sow plasma. On the other hand, pig plasma from day 0 newborns did not contain IgG and IgM to human PBMCs. In addition, sow colostrum clearly contained both IgG and IgM to human PBMCs. As expected, the pig innate immunity system reacted to human cells, including natural antibodies. However, the NAs of pigs, both IgM and IgG, against human cells do not exist in pig serum at day 0, but at day 1 and in mother's milk, indicating that NAs in newborns did not come from the placenta but from sow colostrum.


Asunto(s)
Calostro/inmunología , Inmunidad Innata/inmunología , Porcinos/inmunología , Inmunología del Trasplante/inmunología , Trasplante Heterólogo , Animales , Animales Recién Nacidos , Femenino , Humanos , Inmunoglobulina G/sangre , Inmunoglobulina G/inmunología , Inmunoglobulina M/sangre , Inmunoglobulina M/inmunología , Leucocitos Mononucleares/inmunología , Embarazo
4.
Transplant Proc ; 48(4): 1279-81, 2016 May.
Artículo en Inglés | MEDLINE | ID: mdl-27320603

RESUMEN

BACKGROUND: The purpose of this study was to produce molecules that can precisely regulate the complement and coagulation system and to assess the expression of such molecules in transgenic animals. METHODS: The CTDM gene, which is composed of the delta-1-99 amino acid (aa) C1-INH, EGF domain 4-6 of thrombomoduline (TM), short consensus repeat (SCR) 2-4 of DAF(CD55), and SCR 2-4 of MCP(CD46) was established. The codon usage for expression in mammals was adopted. The cDNA of CTDM was subcloned into the pCPI site (the human insulin promoter and a cytomegalovirus enhancer). pCPI-CTDM was transfected into pig endothelial cells (PEC). The expression of the molecule was clearly assessed by means of flow cytometry. RESULTS: BD3F1 female mice were induced to superovulate and were then crossed with BD3F1 males. Micro-injection and embryo transfer were performed by standard methods, thus generating transgenic mice that express CTDM. The mice carried the CTDM plasmid, as verified by PCR. Tissue expression levels in transgenic mouse lines generated with the constructs were follows: pancreas, 1.0; brain, 5.4; thymus, 0.3; heart, 0.2; lung, 1.2; liver, 0.1; kidney, 0.1; intestine, 0.4; and spleen, 1.6. A naive control mouse was also analyzed in the exact manner as for the transgenic mice. CONCLUSIONS: A synthetic CTDM gene with codon usage optimized to the mammalian system represents a critical factor in the development of transgenic animals.


Asunto(s)
Coagulación Sanguínea/genética , Proteínas del Sistema Complemento/genética , Genes Sintéticos/genética , Animales , Antígenos CD55/genética , Clonación Molecular , ADN Complementario/genética , Células Endoteliales/metabolismo , Femenino , Citometría de Flujo , Proteínas de Homeodominio/genética , Humanos , Masculino , Proteína Cofactora de Membrana/genética , Ratones , Ratones Transgénicos , Regiones Promotoras Genéticas , Porcinos , Trombomodulina/genética , Transfección/métodos , Trasplante Heterólogo
5.
Transplant Proc ; 48(4): 1282-4, 2016 May.
Artículo en Inglés | MEDLINE | ID: mdl-27320604

RESUMEN

BACKGROUND: On the basis of a comparison of the hemolytic complement titer in pigs with that in humans, the complement system of pigs was investigated. The response of innate immunity, such as the natural antibodies, against humans was also examined. METHODS: Hemolytic complement activity of pig serum was measured with the use of a microtitration technique. CH50 was determined according to the method of Mayer. ACH50 was assayed according to the methods of Platts-Milles and Ishizaka. Hemolytic activities of C1, C4, C2, C3, C5, C8, and C9 were estimated through the use of intermediate cells and reagents, as described previously. In addition, the pig natural anti-human antibody was studied with the use of human peripheral blood mononuclear cells (PBMCs). Human PBMCs were stained with 5% pig serum, followed by staining with fluorescein isothiocyanate-labeled goat anti-pig IgG and IgM. The resulting stained cells were quantified by use of a FACScalibur system. The alternative pathway of pig complement was also measured with the use of human erythrocytes and normal pooled pig serum with or without Mg(++)EGTA. RESULTS: Both the CH50 and ACH50 titers were lower than those of humans. Concerning the components, except for C3, each component, that is, C1, C4, C2, C5, C8, and C9, was also lower than that of humans, based on measured values for human complement components. Pig serum clearly contains natural antibodies, IgG and IgM, to human PBMCs. The alternative pathway of pig complement reacted with human erythrocytes. CONCLUSIONS: As a whole, pig innate immunity, the complement system and natural antibody, recognizes the surfaces of human cells.


Asunto(s)
Proteínas del Sistema Complemento/inmunología , Hemólisis/inmunología , Inmunidad Innata/inmunología , Animales , Anticuerpos Antiidiotipos/metabolismo , Activación de Complemento/inmunología , Ensayo de Actividad Hemolítica de Complemento , Proteínas del Sistema Complemento/metabolismo , Eritrocitos/inmunología , Fibronectinas/metabolismo , Humanos , Leucocitos Mononucleares/inmunología , Proteínas Recombinantes/metabolismo , Sus scrofa , Porcinos
6.
Transplant Proc ; 48(4): 1285-7, 2016 May.
Artículo en Inglés | MEDLINE | ID: mdl-27320605

RESUMEN

The inhibitory function of HLA-G1, a class Ib molecule, on monocyte/macrophage-mediated cytotoxicity was examined. The expression of inhibitory receptors that interact with HLA-G, immunoglobulin-like transcript 2 (ILT2), ILT4, and KIR2DL4 (CD158d) on in vitro-generated macrophages obtained from peripheral blood mononuclear cells and the phorbol 12-myristate 13-acetate (PMA)-activated THP-1 cells were examined by flow cytometry. cDNAs of HLA-G1, HLA-G3, HLA-E, and human ß2-microglobulin were prepared, transfected into pig endothelial cells (PECs), and macrophage- and the THP-1 cell-mediated PEC cytolysis was then assessed. In vitro-generated macrophages expressed not only ILT2 and ILT4 but CD158d as well. The transgenic HLA-G1 on PEC indicated a significant suppression in macrophage-mediated cytotoxicity, which was equivalent to that of transgenic HLA-E. HLA-G1 was clearly expressed on the cell surface of PEC, whereas the levels of HLA-G3 were much lower and remained in the intracellular space. On the other hand, the PMA-activated THP-1 cell was less expressed these inhibitory molecules than in vitro-generated macrophages. Therefore, the HLA-G1 on PECs showed a significant but relatively smaller suppression to THP-1 cell-mediated cytotoxicity compared to in vitro-generated macrophages. These results indicate that by generating HLA-G1, but not HLA-G3, transgenic pigs can protect porcine grafts from monocyte/macrophage-mediated cytotoxicity.


Asunto(s)
Antígenos HLA-G/fisiología , Leucocitos Mononucleares/inmunología , Macrófagos/inmunología , Animales , Animales Modificados Genéticamente , Antígenos CD/metabolismo , Citocinas/metabolismo , Citotoxicidad Inmunológica/fisiología , Células Endoteliales/inmunología , Endotelio/inmunología , Citometría de Flujo , Antígenos HLA-G/metabolismo , Humanos , Células Asesinas Naturales/inmunología , Receptor Leucocitario Tipo Inmunoglobulina B1 , Glicoproteínas de Membrana/metabolismo , Receptores Inmunológicos/metabolismo , Receptores KIR2DL4/metabolismo , Porcinos , Transfección/métodos
7.
Transplant Proc ; 48(4): 1302-3, 2016 May.
Artículo en Inglés | MEDLINE | ID: mdl-27320609

RESUMEN

The pig pancreas is considered to be one of the most suitable sources of islets for clinical xenotransplantation. However, after producing α1-3galactosyltransferase knockout pigs, most of the organs of these pigs showed less antigenicity to the human body. Wild-type adult pig islets (APIs) that originally produced negligible levels of α-Gal, different from neonatal porcine islet-like cell clusters, showed a clear antigenicity to human serum. Concerning the so-called non-Gal epitopes, many studies related to glycoproteins and glycolipids are ongoing in efforts to identify them. However, our knowledge of non-Gal glycoantigens remains incomplete. In our previous study, N-glycans were isolated from APIs, and the structures of 28 of the N-glycans were detected. In this study, to identify additional structures, further analyses were performed by liquid chromatography-mass spectrometry (LC-MS). N-glycans were isolated from APIs by the method described by O'Neil et al with minor modifications and LC-MS-based structural analyses were then performed. The detected N-glycan peaks in the LC-MS spectra were selected using the FLexAnalysis software program and the structures of the glycans were predicted using the GlyocoMod Tool. The API preparation contained 11 peaks and 16 structures were then nominated as containing N-linked sugars. Among them, 5 sulfated glycans were estimated, confirming the existence of sulfate structures in N-glycans in API. In addition, these data may supplement several N-glycan structures that contain two deoxyhexose units, such as fucose, to our previous report. The data herein will be helpful for future studies of antigenicity associated with API.


Asunto(s)
Islotes Pancreáticos/química , Polisacáridos/metabolismo , Animales , Epítopos/metabolismo , Glicoproteínas/metabolismo , Humanos , Espectrometría de Masas , Sus scrofa , Porcinos , Trasplante Heterólogo
8.
Transplant Proc ; 48(4): 1320-2, 2016 May.
Artículo en Inglés | MEDLINE | ID: mdl-27320613

RESUMEN

BACKGROUND: We attempted to knock out the expression of Hanganutziu-Deicher (H-D) antigens through the use of a CRISPR (clustered regulatory interspaced short palindromic repeat)/Cas9 system for pig cytidine monophospho-N-acetylneuraminic acid hydroxylase (CMAH). METHODS: Plasmids expressing hCas9 and sgRNA for pCMAH were prepared by ligating oligos into the BbsI site of pX330. The N-terminal and C-terminal EGFP coding regions overlapping 482 bp were PCR-amplified and placed under a ubiquitous CAG promoter. The approximately 400-bp genomic fragments containing the sgRNA target sequence of pCMAH were placed into the multi-cloning sites flanked by the EGFP fragments. The pCAG-EGxxFP-target was mixed with pX330 with/without the sgRNA sequences and then introduced into HEK293T cells. RESULTS: Four oligos and primers, gSO1, gSO3, gSO4, and gSO8, were nominated from 8 candidates. Among them, gSO1 showed the best efficiency. Pig endothelial cells (PECs) from an α-Gal knockout pig were then used to examine the changes in the expression of the H-D antigen by the knockout of the CMAH genome by the pX330-gS01. CONCLUSIONS: Changes in the expression of the H-D antigen in the PECs with the CRISPR (gS01) were clear in comparison with those in the parental cells, on the basis of FACS analysis data. The expression of the H-D antigen can be knocked out by use of the CRISPR system for pCMAH, thus confirming that this system is a very convenient system for producing knockout pigs.


Asunto(s)
Repeticiones Palindrómicas Cortas Agrupadas y Regularmente Espaciadas/genética , Oxigenasas de Función Mixta/deficiencia , Animales , Antígenos Heterófilos/metabolismo , Secuencia de Bases , Células Endoteliales/inmunología , Técnicas de Inactivación de Genes , Células HEK293 , Humanos , Oxigenasas de Función Mixta/genética , Ácido N-Acetilneuramínico/metabolismo , Sistemas de Lectura Abierta/genética , Reacción en Cadena de la Polimerasa , ARN Mensajero/metabolismo , Sus scrofa , Porcinos
9.
Transplant Proc ; 48(4): 1323-5, 2016 May.
Artículo en Inglés | MEDLINE | ID: mdl-27320614

RESUMEN

BACKGROUND: In our previous study, we reported on the development of substituting S147C for HLA-E as a useful gene tool for xenotransplantation. In this study we exchanged the codon of HLA-Ev (147), checked its function, and established a line of transgenic mice. METHODS: A new construct, a codon exchanging human HLA-Ev (147) + IRES + human beta 2-microgloblin, was established. The construct was subcloned into pCXN2 (the chick beta-actin promoter and cytomegalovirus enhancer) vector. Natural killer cell- and macrophage-mediated cytotoxicities were performed using the established the pig endothelial cell (PEC) line with the new gene. Transgenic mice with it were next produced using a micro-injection method. RESULTS: The expression of the molecule on PECs was confirmed by the transfection of the plasmid. The established molecules on PECs functioned well in regulating natural killer cell-mediated cytotoxicity and macrophage-mediated cytotoxicity. We have also successfully generated several lines of transgenic mice with this plasmid. The expression of HLA-Ev (147) in each mouse organ was confirmed by assessing the mRNA. The chick beta-actin promoter and cytomegalovirus enhancer resulted in a relatively broad expression of the gene in each organ, and a strong expression in the cases of the heart and lung. CONCLUSION: A synthetic HLA-Ev (147) gene with a codon usage optimized to a mammalian system represents a critical factor in the development of transgenic animals for xenotransplantation.


Asunto(s)
Animales Modificados Genéticamente/genética , Codón/genética , Antígenos de Histocompatibilidad Clase I/metabolismo , Actinas/genética , Animales , Animales Modificados Genéticamente/inmunología , Línea Celular , Citomegalovirus , Células Endoteliales/metabolismo , Elementos de Facilitación Genéticos/genética , Genes Sintéticos , Humanos , Células Asesinas Naturales/fisiología , Macrófagos/fisiología , Ratones , Regiones Promotoras Genéticas/genética , Porcinos , Transfección , Trasplante Heterólogo , Antígenos HLA-E
10.
Transplant Proc ; 47(7): 2274-7, 2015 Sep.
Artículo en Inglés | MEDLINE | ID: mdl-26361698

RESUMEN

We report the case of a 58-year-old man referred to our hospital for liver tumor treatment. The patient had a history of neurosurgery for a meningeal hemangiopericytoma 16 years previously. Pre-operative imaging revealed a hypervascular tumor extending from Couinaud segment 4 to segment 8 of the liver, measuring 95 mm in diameter, indicating an atypical hepatocellular carcinoma. Because right trisectionectomy of the liver was considered to be high risk, living-donor liver transplantation (LDLT) was indicated. After transcatheter arterial embolization, LDLT was performed with the use of a left-lobe liver graft from the patient's son. Post-operative histological findings of the liver tumor were identical to those for meningeal hemangiopericytoma, therefore the patient was diagnosed with meningeal hemangiopericytoma that had metastasized to the liver. After LDLT, the patient had a healthy, active life for 2 years; then, a subcutaneous relapse was discovered in the left chest. The patient did not undergo any systemic chemotherapy in response to the relapse. After thoracic and orthopedic surgeries and radiotherapy for multiple metastases, the patient died 5 years and 5 months after LDLT. LDLT could be an effective treatment for localized metastatic hemangiopericytoma in the liver, but it should be indicated only for carefully selected patients.


Asunto(s)
Hemangiopericitoma/cirugía , Neoplasias Hepáticas/cirugía , Trasplante de Hígado/métodos , Donadores Vivos , Neoplasias Meníngeas/patología , Angiografía , Hemangiopericitoma/diagnóstico , Hemangiopericitoma/secundario , Humanos , Neoplasias Hepáticas/diagnóstico , Neoplasias Hepáticas/secundario , Masculino , Neoplasias Meníngeas/cirugía , Persona de Mediana Edad , Tomografía Computarizada por Rayos X
11.
Oncogene ; 34(8): 1035-43, 2015 Feb 19.
Artículo en Inglés | MEDLINE | ID: mdl-24632614

RESUMEN

Numerous studies support a role of phosphatase and tensin homolog deleted from chromosome 10 (Pten) as a tumor suppressor gene that controls epithelial cell homeostasis to prevent tumor formation. Mouse vaginal epithelium cyclically exhibits cell proliferation and differentiation in response to estrogen and provides a unique model for analyzing homeostasis of stratified squamous epithelia. We analyzed vaginal epithelium-specific Pten conditional knockout (CKO) mice to provide new insights into Pten/phosphoinositide-3-kinase (PI3K)/Akt function. The vaginal epithelium of ovariectomized (OVX) mice (control) was composed of 1-2 layers of cuboidal cells, whereas OVX CKO mice exhibited epithelial hyperplasia in the suprabasal cells with increased cell mass and mucin production. This is possibly due to misactivation of mammalian target of rapamycin and mitogen-activated protein kinase. Intriguingly, estrogen administration to OVX Pten CKO mice induced stratification and keratinized differentiation in the vaginal epithelium, as in estrogen-treated controls. We found that Pten is exclusively expressed in the suprabasal cells in the absence of estrogens, whereas estrogen administration induced Pten expression in the basal cells. This suggests that Pten acts to prevent excessive cell proliferation as in the case of other squamous tissues. Thus, Pten exhibits a dual role on the control of vaginal homeostasis, depending on whether estrogens are present or absent. Our results provide new insights into how Pten functions in tissue homeostasis.


Asunto(s)
Células Epiteliales/efectos de los fármacos , Células Epiteliales/fisiología , Estradiol/farmacología , Fosfohidrolasa PTEN/genética , Vagina/efectos de los fármacos , Animales , Diferenciación Celular/efectos de los fármacos , Diferenciación Celular/genética , Femenino , Regulación de la Expresión Génica/efectos de los fármacos , Homeostasis/efectos de los fármacos , Homeostasis/genética , Masculino , Ratones , Ratones Endogámicos C57BL , Ratones Noqueados , Mucinas/metabolismo , Ovariectomía , Fosfohidrolasa PTEN/metabolismo , Vagina/citología , Vagina/fisiología
12.
Hernia ; 19(5): 841-3, 2015 Oct.
Artículo en Inglés | MEDLINE | ID: mdl-24218077

RESUMEN

An 81-year-old emaciated woman was admitted to our hospital with a one-year history of recurrent bilateral inguinal swellings. Palpable lumps were observed not only in bilateral groin areas, but also on the right iliac fossa (RIF) of her abdomen. During a planned transabdominal preperitoneal laparoscopic herniorrhaphy, a previously unreported form of ventral hernia was observed at a position lateral and cranial to the right internal inguinal ring, which probably corresponded to the palpable lump on the RIF. The hernia orifice was 2 cm in diameter, and a vascular structure ran through the orifice. The contents of the hernia consisted of fatty tissue arising from the retroperitoneal tissue. Routine exploration revealed orifices of the following hernias: left indirect, right direct, bilateral femoral, bilateral obturator, and right Spigelian hernia. Her postoperative course was uneventful and a mass on the right lower quadrant disappeared after operation.


Asunto(s)
Emaciación/complicaciones , Hernia Ventral/patología , Hernia Ventral/cirugía , Herniorrafia , Laparoscopía , Anciano de 80 o más Años , Femenino , Hernia Ventral/complicaciones , Humanos
13.
Transplant Proc ; 46(4): 1254-5, 2014 May.
Artículo en Inglés | MEDLINE | ID: mdl-24815174

RESUMEN

BACKGROUND: Myeloid-derived suppressor cells (MDSCs) were initially found to contribute to immunosuppression in tumor patients and have recently been recognized as a subset of innate immune cells that are capable of regulating adaptive immunity. A variety of innate immune stimuli, such as lipopolysaccharide, act as a double-edged sword, inducing both the maturation of dendritic cells and the expansion of MDSCs. METHODS: We isolated MDSCs from peripheral blood mononuclear cells (PBMCs) and examined the suppressive effect of MDSCs against xenocytotoxicity mediated by YT cells, a natural killer-like cell line, with the use of the lactate dehydrogenase assay method. RESULTS: Although primed MDSCs induced no significant suppression in YT cell-mediated cytotoxicity, activated MDSCs significantly suppressed the xenogenic cytotoxicity. CONCLUSIONS: These findings indicate that MDSCs have a great deal of potential as a therapeutic strategy for dealing with xenograft rejection. Further investigations of the underlying mechanisms will facilitate the development of this therapeutic strategy.


Asunto(s)
Citotoxicidad Inmunológica , Células Endoteliales/inmunología , Células Asesinas Naturales/inmunología , Monocitos/inmunología , Inmunidad Adaptativa , Animales , Biomarcadores/metabolismo , Línea Celular , Técnicas de Cocultivo , Humanos , Inmunidad Innata , Células Asesinas Naturales/metabolismo , Células Asesinas Naturales/patología , L-Lactato Deshidrogenasa/metabolismo , Lipopolisacáridos/farmacología , Monocitos/efectos de los fármacos , Poli I-C/farmacología , Porcinos , Trasplante Heterólogo
14.
Transplant Proc ; 46(4): 1256-8, 2014 May.
Artículo en Inglés | MEDLINE | ID: mdl-24815175

RESUMEN

Macrophages play an important role in xenogenic rejection and therefore may represent a major obstacle in clinical application of xenograft. CD33-related sialic acid-binding immunoglobulin-like lectins (Siglecs) belong to the immunoglobulin superfamily and contain a cytoplasmic immunoreceptor tyrosine-based inhibitory motif (ITIM) that is able to inhibit cytokine production. Because human macrophages express various CD33-related Siglecs, we hypothesized that overexpression of α-2,6-sialyltransferase (2,6-ST) in swine endothelial cells (SECs) might prevent the cytotoxicity mediated by macrophages. To confirm our hypothesis, the cytotoxicity of macrophages against 2,6-ST-overexpressing SECs was determined with the use of in vitro-generated macrophages as an effector and naïve or 2,6-ST-overexpressing SECs as a target. The 2,6-ST-overexpressing SECs were established by transfection with the genes for 2,6-ST. Transfection of 2,6-ST led to significant reduction in cytotoxicity compared with naïve SECs. These findings indicate that the sialylated ligands against CD33-related Siglecs may provide an effective therapeutic strategy to inhibit macrophage-mediated xenograft rejection in xenotransplantation.


Asunto(s)
Células Endoteliales/inmunología , Activación de Macrófagos , Macrófagos/inmunología , Sialiltransferasas/inmunología , Animales , Línea Celular , Técnicas de Cocultivo , Células Endoteliales/enzimología , Inducción Enzimática , Rechazo de Injerto/inmunología , Rechazo de Injerto/prevención & control , Humanos , Ligandos , Macrófagos/metabolismo , Lectinas Similares a la Inmunoglobulina de Unión a Ácido Siálico/inmunología , Lectinas Similares a la Inmunoglobulina de Unión a Ácido Siálico/metabolismo , Sialiltransferasas/biosíntesis , Sialiltransferasas/genética , Porcinos , Transfección , Trasplante Heterólogo , beta-D-Galactósido alfa 2-6-Sialiltransferasa
15.
Transplant Proc ; 46(3): 721-5, 2014 Apr.
Artículo en Inglés | MEDLINE | ID: mdl-24767333

RESUMEN

INTRODUCTION: Donor shortages occasionally necessitate the use of hepatic allografts from hepatitis B core antibody-positive (HBcAb+) donors, with an attendant risk of post-transplantation hepatitis B virus (HBV) infection. The aim of the present study was to develop and evaluate a protocol of active immunization for prevention of post-transplantation de novo HBV infection in patients receiving liver grafts from HBcAb+ donors. PATIENTS AND METHODS: Ten patients who had received HBcAb+ liver grafts at Shinshu University Hospital between October 1996 and December 2012 were enrolled. All the recipients were negative for HBV serological tests, and HBV-DNA. Hepatitis B immunoglobulin (HBIG) was given routinely in the peritransplantation and post-transplantation periods, without antiviral drugs. Subcutaneous vaccination with recombinant HBV was given at a dosage of 20 µg in adults and 5 µg in children concomitant with HBIG until acquisition of active immunization. The timing to start HBV vaccination was dependent on the condition of the patient. RESULTS: The median follow-up period after liver transplantation was 140 months, and the median period after transplantation until the start of vaccination was 7.0 months. Nine patients (90%) acquired active immunity after a median number of 4 (range, 2-13) vaccinations (hepatitis B surface antibody >300 mIU/mL for 1 year, or >100 mIU/mL thereafter), and did not require HBIG administration thereafter. None had any side effects of HBV vaccination or developed hepatitis B infection during the study period. Four fast responders who achieved antibody high titers by active immunization within 9 months received pretransplantation vaccinations, whereas 5 slow responders did not. CONCLUSIONS: Our vaccination protocol provides a new effective strategy for prevention of de novo hepatitis B infection after liver transplantation in recipients with HBcAb+ liver grafts. Pretransplantation HBV vaccination was helpful for the post-transplantation vaccine response.


Asunto(s)
Anticuerpos contra la Hepatitis B/inmunología , Antígenos del Núcleo de la Hepatitis B/inmunología , Vacunas contra Hepatitis B/administración & dosificación , Trasplante de Hígado , Adolescente , Adulto , Niño , Preescolar , Femenino , Hepatitis B/prevención & control , Humanos , Inmunosupresores/administración & dosificación , Lactante , Masculino , Persona de Mediana Edad , Adulto Joven
16.
Transplant Proc ; 46(3): 794-6, 2014 Apr.
Artículo en Inglés | MEDLINE | ID: mdl-24767351

RESUMEN

INTRODUCTION: Once-daily extended-release tacrolimus (Tac-OD) is expected to reduce non-adherence in recipients after liver transplantation (LT). The aim of this study was to determine the optimal initial dose of orally administered Tac-OD after intravenous tacrolimus (Tac-IV) therapy after LT. PATIENTS AND METHODS: This prospective study included 10 adult recipients who had undergone LT at our institute. The recipients were prescribed tacrolimus by continuous intravenous administration with a steroid as initial immunosuppression therapy. Tacrolimus was converted from intravenous administration to once-daily oral intake when gastrointestinal function returned. We evaluated tacrolimus concentrations in blood 9 times a day and area under the blood concentration-time curve (AUC) during conversion. The optimal initial dose of Tac-OD was determined based on simple regression analysis between the oral dose of Tac-OD and the total dose of Tac-IV during a 24-hour period. RESULTS: The AUC before and after conversion showed no differences. We found that the optimal initial dose of Tac-OD was 8 times the dose of Tac-IV. There was a relationship between the AUC and the trough level. No recipients experienced acute rejection or adverse effects such as renal failure, neurotoxicity, or cardiac failure during conversion. CONCLUSIONS: We successfully converted continuous Tac-IV to oral intake of Tac-OD by adjusting the dose using trough levels without acute rejection or adverse effects. The AUC of Tac-OD correlated with the trough level. The optimal initial dose ratio of Tac-OD after Tac-IV was 8:1.


Asunto(s)
Inmunosupresores/administración & dosificación , Trasplante de Hígado , Tacrolimus/administración & dosificación , Administración Oral , Área Bajo la Curva , Preparaciones de Acción Retardada , Humanos , Estudios Prospectivos
17.
Cell Death Differ ; 21(6): 990-7, 2014 Jun.
Artículo en Inglés | MEDLINE | ID: mdl-24632946

RESUMEN

The cloaca is temporally formed and eventually divided by the urorectal septum (URS) during urogenital and anorectal organ development. Although congenital malformations, such as anorectal malformations (ARMs), are frequently observed during this process, the underlying pathogenic mechanisms remain unclear. ß-Catenin is a critical component of canonical Wnt signaling and is essential for the regulation of cell differentiation and morphogenesis during embryogenesis. The expression of ß-catenin is observed in endodermal epithelia, including URS epithelia. We modulated the ß-catenin gene conditionally in endodermal epithelia by utilizing tamoxifen-inducible Cre driver line (Shh(CreERT2)). Both ß-catenin loss- and gain-of-function (LOF and GOF) mutants displayed abnormal clefts in the perineal region and hypoplastic elongation of the URS. The mutants also displayed reduced cell proliferation in the URS mesenchyme. In addition, the ß-catenin GOF mutants displayed reduced apoptosis and subsequently increased apoptosis in the URS epithelium. This instability possibly resulted in reduced expression levels of differentiation markers, such as keratin 1 and filaggrin, in the perineal epithelia. The expression of bone morphogenetic protein (Bmp) genes, such as Bmp4 and Bmp7, was also ectopically induced in the epithelia of the URS in the ß-catenin GOF mutants. The expression of the Msx2 gene and phosphorylated-Smad1/5/8, possible readouts of Bmp signaling, was also increased in the mutants. Moreover, we introduced an additional mutation for a Bmp receptor gene: BmprIA. The Shh(CreERT2/+); ß-catenin(flox(ex3)/+); BmprIA(flox/-) mutants displayed partial restoration of URS elongation compared with the ß-catenin GOF mutants. These results indicate that some ARM phenotypes in the ß-catenin GOF mutants were caused by abnormal Bmp signaling. The current analysis revealed the close relation of endodermal ß-catenin signaling to the ARM phenotypes. These results are considered to shed light on the pathogenic mechanisms of human ARMs.


Asunto(s)
Ano Imperforado/genética , Cloaca/metabolismo , Endodermo/metabolismo , beta Catenina/genética , Animales , Malformaciones Anorrectales , Ano Imperforado/patología , Cloaca/crecimiento & desarrollo , Cloaca/patología , Endodermo/crecimiento & desarrollo , Proteínas Filagrina , Regulación Neoplásica de la Expresión Génica/genética , Proteínas de Homeodominio , Humanos , Ratones , Vía de Señalización Wnt/genética , beta Catenina/metabolismo
18.
Br J Surg ; 101(2): 79-88, 2014 Jan.
Artículo en Inglés | MEDLINE | ID: mdl-24375300

RESUMEN

BACKGROUND: The International Union Against Cancer (UICC) staging system for perihilar cholangiocarcinoma changed in 2009. The aim of this study was to validate and optimize the UICC system for these tumours. METHODS: This retrospective study was conducted in eight Japanese hospitals between 2001 and 2010. Perihilar cholangiocarcinoma was defined as a cholangiocarcinoma that involves the hilar bile duct, independent of the presence or absence of a liver mass component. The stratification ability of the UICC tumour node metastasis (TNM) system was compared with that of a modified system. RESULTS: Of 1352 patients, 35.9, 44.8 and 12.6 per cent had Bismuth type IV tumours, nodal metastasis (N1) and distant metastasis (M1) respectively. T4 tumours (43.2 per cent) and stage IVA (T4 Nany M0; 36.3 per cent) disease were most common. Survival was not significantly different between patients with T3 versus T4 tumours (P = 0.284). Survival for patients with stage IVA disease was comparable to that for patients with stage IIIB tumours (T1-3 N1 M0) (P = 0.426). Vascular invasion, pancreatic invasion, positive margin, N1 and M1 status were identified as independent predictors of survival. When Bismuth type IV tumours were removed from the T4 determinants and N1 tumours grouped together, the modified grouping had a higher linear trend χ2 and likelihood ratio χ2 compared with the original system (245.6 versus 170.3 respectively and 255.8 versus 209.3 respectively). CONCLUSION: The present data suggest that minimal modification with removal of Bismuth type IV tumours from the T4 determinants and bundling of N1 disease may enhance the prognostic ability of the UICC system. However, this requires validation on an independent data set.


Asunto(s)
Neoplasias de los Conductos Biliares/patología , Conductos Biliares Intrahepáticos/patología , Colangiocarcinoma/patología , Estadificación de Neoplasias/métodos , Adulto , Anciano , Anciano de 80 o más Años , Neoplasias de los Conductos Biliares/mortalidad , Colangiocarcinoma/mortalidad , Colangiocarcinoma/secundario , Femenino , Humanos , Japón/epidemiología , Metástasis Linfática , Masculino , Persona de Mediana Edad , Invasividad Neoplásica , Metástasis de la Neoplasia , Estadificación de Neoplasias/normas , Pronóstico , Estudios Retrospectivos
19.
Oncogene ; 32(29): 3477-82, 2013 Jul 18.
Artículo en Inglés | MEDLINE | ID: mdl-22945641

RESUMEN

The Wnt/ß-catenin signaling is essential for various organogenesis and is often implicated during tumorigenesis. Dysregulated ß-catenin signaling is associated with the formation of endometrial adenocarcinomas (EACs), which is considered as the common form of endometrial cancer in women. In the current study, we investigate the downstream target of Wnt/ß-catenin signaling in the uterine epithelia and the mechanism leading to the formation of endometrial hyperplasia. We report that conditional ablation and activation of ß-catenin in the uterine epithelia lead to aberrant epithelial structures and endometrial hyperplasia formation, respectively. We demonstrate that ß-catenin regulates Foxa2 with its candidate upstream region for the uterine epithelia. Furthermore, knockdown of Foxa2 leads to defects in cell cycle regulation, suggesting a possible function of Foxa2 in the control of cell proliferation. We also observe that ß-catenin and Foxa2 expression levels are augmented in the human specimens of complex atypical endometrial hyperplasia, which is considered to have a greater risk of progression to EACs. Thus, our study indicates that ß-catenin regulates Foxa2 expression, and this interaction is possibly essential to control cell cycle progression during endometrial hyperplasia formation. Altogether, the augmented expression levels of ß-catenin and Foxa2 are essential features during the formation of endometrial hyperplasia.


Asunto(s)
Hiperplasia Endometrial/metabolismo , Factor Nuclear 3-beta del Hepatocito/biosíntesis , Transducción de Señal/fisiología , beta Catenina/metabolismo , Animales , Femenino , Regulación de la Expresión Génica , Técnicas de Silenciamiento del Gen , Humanos , Inmunohistoquímica , Ratones , Análisis de Secuencia por Matrices de Oligonucleótidos
20.
Transplant Proc ; 44(4): 1134-5, 2012 May.
Artículo en Inglés | MEDLINE | ID: mdl-22564645

RESUMEN

BACKGROUND: The pig pancreas is considered to be the most suitable source of islets for clinical xenotransplantation. Two types of islet transplantation are: adult pig islets and neonatal porcine islet-like cell clusters (NPCC). However, besides a-Gal expression, differences in glycosylation and xenoantigenicity between both types were not clear so fat to date. In this study, we performed lectin microarray analyses of NPCCs cultured for 1, 5, or 9 days. METHODS: We studied differences in gycoantigens among several kinds of wild-type NPCCs isolated from 1- to 3-day-old neonatal wild-type pigs (Large White/Landrace × Duroc) and cultured for 1, 5 and 9 days in Ham's 10 in the presence of nicotinamide, using a previously published technique. After sonication and centrifugation, supernatant proteins from each islet were labeled with Cy3, applied to a lectin array and scanned with an SC-Profiler for evaluation using an Array Pro Analyzer. RESULTS: The overall signals of NPCC at days 5 and 9, showed almost the same values to most lectins, whereas those on day 1 showed differences, suggesting that the NPCC on day 1 contain immature cells that gradually turn to mature NPCCs in culture.


Asunto(s)
Antígenos , Glicoproteínas/metabolismo , Islotes Pancreáticos/metabolismo , Lectinas/metabolismo , Análisis por Matrices de Proteínas , Amino Azúcares/metabolismo , Animales , Animales Recién Nacidos , Fluorescencia , Fucosa/metabolismo , Glicoproteínas/inmunología , Glicosilación , Islotes Pancreáticos/citología , Islotes Pancreáticos/inmunología , Manosa/metabolismo , Porcinos , Factores de Tiempo
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