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Objective To investigate the treatment on de novo donor specific antibody (dnDSA) mediated acute rejection after lung transplantation. Methods Clinical data of 1 recipient with antibody-mediated rejection (AMR) early after lung transplantation was retrospectively analyzed. The process of diagnosis and treatment were assessed. Results The recipient underwent right lung transplantation due to systemic sclerosis-associated end-stage interstitial lung disease. Preoperatively, classⅠ panel reactive antibody (PRA) was positive (11%). No pretreatment was given before transplantation. Antithymocyte globulin induction therapy was delivered on the day of transplantation and postoperatively. The recipient was properly recovered early after transplantation. Chest tightness and shortness of breath occurred at postoperative 13 d, which were progressively worsened and rapidly progressed into type Ⅰ respiratory failure. Class Ⅰ PRA was increased to 58%, and dnDSA was observed at the loci of A24: 02. The mean fluorescence intensity (MFI) was 2 110. According to the guidelines of International Society for Heart and Lung Transplantation, the recipient was diagnosed as possible AMR. After comprehensive treatment including plasmapheresis, protein A immunoadsorption, glucocorticoid pulse, rituximab and immunoglobulin intravenous drip, the PRA and DSA levels were gradually decreased, and the MFI of DSA was 0 at postoperative 20 d. Clinical condition of the recipient was gradually improved. The dyspnea was healed, shortness of breath was eased, respiratory failure was treated, and pulmonary effusion was gradually absorbed. At postoperative 45 d, the recipient was discharged after full recovery. During 1-year follow-up, the recipient was physically stable and obtained normal quality of life. Class Ⅰ PRA was 5%, and class Ⅱ PRA was negative. No DSA was noted. Conclusions Based on traditional drug therapy, supplement of protein A immunoadsorption therapy may effectively eliminate DSA from the circulating blood of the recipient and mitigate the damage of target organs. Ideal short- and long-term prognosis may be achieved. Traditional drug therapy combined with immunoadsorption may yield ideal efficacy in treating AMR after lung transplantation. [ABSTRACT FROM AUTHOR]

Objective: To analyze the effect of endoscopic gland resection on serum immunoglobulin, TNF-α and IL-10 levels in patients with early breast cancer, so as to evaluate its advantages. Methods: 75 patients undergoing breast cancer surgery were selected and divided into 2 groups according to their choice of surgical methods: group A (laparoscopic surgery, 59 cases) and group B (open breast subcutaneous gland resection, 41 cases) . The operation time, postoperative extubation time, and hospital stay were counted. One month after the operation, the peripheral blood of the patient was collected, and the serum was collected by centrifugation. The immunoturbidimetric method was used to detect the serum immune function-related indicators of Ig M and Ig G. The human enzyme-linked immunosorbent assay (ELISA) kit was used to detect the serum levels of TNF-α and IL-10, and the number of postoperative complications such as subcutaneous hemorrhage, subcutaneous effusion, and nipple and areola necrosis in the two groups of patients was counted; one year after the operation, the number of cases of recurrence and lymph node metastasis in the two groups were counted. Results: The operation time of patients in group A was significantly longer than that in group B, while their extubation time and hospital stay were significantly shorter than those in group B (P<0.05) . The incidence of complications in group A (5.00%) was significantly higher than that in group B (25.71%) (P<0.05) . 1 day before surgery, there was no significant difference in serum immune index Ig M and Ig G levels and inflammation response index TNF-α and IL-10 levels between the two groups of patients (P>0.05) ; From 3 days after operation to 1 m after operation, the serum immune index Ig M and Ig G levels and the anti-inflammatory factor IL-10 levels of group A patients were significantly higher than those of group B, and the level of pro-inflammatory factor TNF-α was significantly lower than that of group B (P<0.05) . The breast cancer recurrence rate (3.3%) of group A patients within 1 year after operation was not statistically different from that of group B (10.0%) (P>0.05) . Conclusion: Endoscopic gland resection for the treatment of early breast cancer has the advantages of extubation time, short postoperative hospital stay, and low complication rate. The reason may be related to the lesser effect of the operation on the patient’s serum immunoglobulin Ig M and Ig G, inflammatory factors TNF-α and IL-10 levels, and faster postoperative recovery. [ABSTRACT FROM AUTHOR]

In order to further standardize the clinical technical operation of blood purification related to organ transplantation, experts in the fields of organ transplantation and nephrology organized by Branch of Organ Transplantation of Chinese Medical Association have formulated this specification from the perspectives of technical operation specifications of vascular access, hemodialysis, peritoneal dialysis, hemofiltration, plasma exchange and immunoadsorption. [ABSTRACT FROM AUTHOR]

Objective: To obtain A/B blood group antigen by immunomagnetic separation technique and explore whether the puri­fied antigens could be as an ABO blood group antibodies adsorbent to remove anti-A/B in serum. Methods: Magnetic beads coated with antibody were mixed with the pretreated saliva containing blood group materials to purity A/B antigen. The antigenicity and purity were confirmed by enzyme-linked immunosorbent assay and agglutination inhibition assay. The antibody adsorption effect of acquired anti­gens were evaluated by using unpurified antigens and purified antigens coated beads to adsorb antibodies in the serums which containing A/B antibodies, and using purified antigens coated beads to adsorb antibodies in the serums which from O-type pregnant woman. Results: The absorption value of wells adding purified antigen and the corresponding antibody were significantly high than the control wells (A antigen and anti-A 0.85± 0.12 vs. 0.27± 0.03, P<0.01; B antigen and anti-B 0.86± 0.09 vs. 0.24± 0.06, P<0.05), while the difference be­tween test well and control was not statistical significance when purified antigen reacted with other type antibodies. In the erythrocyte ag­glutination inhibition experiment, the antigen we purified could inhibit the reaction between the corresponding antibody and erythrocytes completely, but had no effect on the reaction of other type antibodies and erythrocytes. Then when we did serum antibody adsorption test, we found that purified antigen had higher adsorption efficiency than unpurified antigen (97.00 % vs. 88.00 %, P<0.001). In serum anti­body adsorption test of clinical samples, the adsorption efficiency of purified A antigens against anti-A IgG/IgM were 96.88 %, 98.44 % respectively, purified B antigen against anti-B IgM/IgG were 96.88 %, 98.44 % respectively. Conclusion: The purified antigens could specifically bind to anti-A or anti-B to adsorb blood group antibodies in serum with good effect, which were expected to be used as sub­stitutes for the synthetic A/B antigen. [ABSTRACT FROM AUTHOR]

Objective: To evaluated the efficacy of additional immunoadsorption therapy (2 times) besides infliximab (IFX) ondisease remission in patients with severe rheumatoid arthritis (RA). Methods: 90 patients with serve RA were included in this study.There were 43 patients in the control group who were treated with IFX 3 mg/kg+ methotrexate (MTX) therapy, and other 47 patients were experimental group, who were previous given 2 times additional immunoadsorption therapy before IFX 3 mg/kg+ MTX therapy.IFX 3 mg/kg was infused at weeks 0, 2, 6, 14, 22 and 30.Age, sex ration, mean disease duration and core index of disease activity in two treatment groups were collected at weeks 0, 2, 6 and 30 weeks to compare the efficacy and safety of combined immunosorbent therapy in the treatment of severe RA. Results: The baseline age, sex ration and core indexes of disease activity were comparable between the two treatment groups ( P >0.05). After treatment, the core indexes of disease activity of all patients decreased significantly compared with their baseline levels ( P <0.05) and the difference of sustainable maintenance to 30 weeks ( P <0.05). After 2 and 6 weeks of treatment, patients' ACR20 remission rates of the experimental group were 46.81% and 68.08%, significantly higher than the control group; after 30 weeks of treatment, patients' ACR20 remission rates of the experimental group was more than 90%, while the number was 79.07% in the control group.At the same time DAS28-ESR clinical remission and low disease activity also reached 72.34% in the experimental group, higher than the control group( P <0.05). Conclusion: Additional immunoadsorption therapy can rapid relive the disease activity of serve RA patients, and the remission rate of 30W was significantly higher than only IFX treatment.