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3. Efficacy and Safety of Ravulizumab in IgA Nephropathy: A Phase 2 Randomized Double-Blind Placebo-Controlled Trial

Author

Lafayette, Richard, Tumlin, James, Fenoglio, Roberta, Kaufeld, Jessica, Pérez Valdivia, Miguel Angel, Wu, Mai-Szu, Susan Huang, Shih-Han, Alamartine, Eric, Kim, Sung Gyun, Yee, Min, Kateifides, Andreas, Rice, Kara, Garlo, Katherine, Barratt, Jonathan, Ranganathan, Dwarakanathan, Wolley, Martin, Tan, Sven-Jean, Chow, Kevin, Tin Law, Mandy Man, Nichols, Kathleen, See, Emily Jan, Steinberg, Adam Glenn, Tiong, Mark, Susan Huang, Shih-Han, Jain, Arsh, Laurin, Louis-Phillipe, Lafrance, Jean-Phillipe, Lamarche, Caroline, Philibert, David, Agharazii, Mohsen, Mac-Way, Fabrice, Alamartine, Eric, Maillard, Nicolas, Mariat, Christophe, Masson, Ingrid, Boffa, Jean-Jacques, Cez, Alexandre, Esteve, Emmanuel, Marchal, Armance, Chauveau, Dominique, Belliere, Julie, Monrozeis, Pauline Bernadet, Colliou, Eloise, Faguer, Stanislas, Huart, Antoine, Ribes, David, Garrouste, Cyril, Heng, Anne-Elisabeth, Mayet, Valentin, Philipponnet, Carole, Moulin, Bruno, Parvez, Laura Braun, Vargas, Gabriela Gautier, Perrin, Peggy, Ohlmann, Sophie, Olagne, Jerome, Haller, Herman, Schmidt-Ott, Kai, Bahlmann-Kroll, Elisabeth, Kaufeld, Jessica, Reinhardt, Martin, Gaeckler, Anja, Dolff, Sebastian, Wilde, Benjamin, Schreiber, Adrian, Koch, Nadine, Seelow, Evelyn, Alberici, Federico, Affatato, Stefania, Mainardi, Allesandro, Mescia, Federica, Scolari, Francesco, Tedesco, Martina, Venturini, Margherita, Cirami, Calogero Lino, Antognoli, Giulia, Caroti, Leonardo, Gualtiero, Gabriele, Moscato, Marcos, Trivioli, Giorgio, La Manna, Gaetano, Baraldi, Olga, Campus, Anita, Stefanini, Carlo, Vischini, Gisella, Roccatello, Dario, Fenoglio, Roberta, Lalloni, Stefania, Sciascia, Savino, Nowicki, Michal, Holub, Tomasz, Kieszek, Błażej, Makówka, Agnieszka, Masajtis, Anna, Piechota, Piotr, Tylski, Maciej, Han, Seung Hyeok, Lee, Sang-Won, Lim, Beon Jin, Pyo, Jung Yoon, Kim, Sung Gyun, An, Jung Nam, Chung, Byung Ha, Kim, Jwa-Kyung, Lee, Hyung Seok, Seo, Young Il, Song, Young Rim, Lee, Hajeong, Park, Sehoon, Han, Seung Seok, Kim, Dong Ki, Kim, Yong Chul, Ryu, Hyunjin, Agraz, Irene, Bolufer, Monica, Hernandez, Josefina Cortés, Gabaldon, Maria Alejandra, Soler, Maria José, Arroyo, David, Carbayo, Javier, Diezhandino, Marian Goicoechea, Perez de Jose, Ana, Guzman, Ursula Verdalles, Moreno, Eduardo Verde, García, Olga Gracia, Albines Fiestas, Zoila Stany, Aladren Gonzalvo, Daniel Joaquin, Gonzalez, Andrea Bernal, Lou Arnal, Luis Miguel, Villarroya, Cristina Medrano, Lopez, Paula Mora, Moncasi, Eduardo Parra, Martin Conde, Maria Luisa, Gonzalez, Jorge, Jatem, Elias, Estor, Aida Moroba, Medrano, Alfons Segarra, Moreno, Antolina Rodriguez, Sanchez de la Nieta, Dolores, Garcia, Clara, Velo, Mercedes, Rocha Castilla, Jose Luis, Bermejo, Sheila, Mendoza, Manuel Lopez, Pérez Valdivia, Miguel Angel, Rojas, Remedios Toledo, Hidalgo, Pilar, Sanchez, Teresa Vazquez, Uriol Rivera, Miguel Giovanni, Fuentes, Mario Lado, Chiu, Yi-Wen, Chang, Jer-Ming, Chen, Hung-Chun, Hsiao, Mei-Ju, Hung, Chi-Chih, Hwang, Shang-Jih, Kuo, Mei Chuan, Kuo, Hung-Tien, Lim, Lee-Moay, Lee, Jia-Jung, Lai, Ping Chin, Chang, David Ray, Chang, Yun-Lun, Chen, I-Ru, Hsieh, Ming-Han, Huang, Chiu-Ching, Kuo, Huey-Liang, Wang, I-Kuan, Wu, Mai-Szu, Chen, Yu-Wei, Chiu, I-Jen, Hsu, Yung-Ho, Hung, Lie-Yee, Laio, Chia-Te, Lin, Gua-Hong, Lin, Yuh-Feng, Wu, Mei-Yi, Zheng, Cai-Mei, Lightstone, Elizabeth, Cairns, Tommy, Mcadoo, Stephen, Medjeral-Thomas, Nicholas, Pickering, Matthew, Robson, Michael, Sinha, Smeeta, Chukwu, Chukwuma, Storrar, Joshua, Ahmed, Sadiq, Cornea, Virgilius, Nadim, Amina, Sims, Tyler, Awad, Ahmed, Aldahan, Mohammed, Clark, Laurie, Lustig, Ryan, Niles, John, Jeyabalan, Anushya, Zonozi, Reza, Tumlin, James, and Paxton, William

Published
2024
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6. Rare Single Nucleotide and Copy Number Variants and the Etiology of Congenital Obstructive Uropathy: Implications for Genetic Diagnosis

Author

Ahram, Dina F., Lim, Tze Y., Ke, Juntao, Jin, Gina, Verbitsky, Miguel, Bodria, Monica, Kil, Byum Hee, Chatterjee, Debanjana, Piva, Stacy E., Marasa, Maddalena, Zhang, Jun Y., Cocchi, Enrico, Caridi, Gianluca, Gucev, Zoran, Lozanovski, Vladimir J., Pisani, Isabella, Izzi, Claudia, Savoldi, Gianfranco, Gnutti, Barbara, Capone, Valentina P., Morello, William, Guarino, Stefano, Esposito, Pasquale, Lambert, Sarah, Radhakrishnan, Jai, Appel, Gerald B., Uy, Natalie S., Rao, Maya K., Canetta, Pietro A., Bomback, Andrew S., Nestor, Jordan G., Hays, Thomas, Cohen, David J., Finale, Carolina, Wijk, Joanna A.E. van, La Scola, Claudio, Baraldi, Olga, Tondolo, Francesco, Di Renzo, Dacia, Jamry-Dziurla, Anna, Pezzutto, Alessandro, Manca, Valeria, Mitrotti, Adele, Santoro, Domenico, Conti, Giovanni, Martino, Marida, Giordano, Mario, Gesualdo, Loreto, Zibar, Lada, Masnata, Giuseppe, Bonomini, Mario, Alberti, Daniele, La Manna, Gaetano, Caliskan, Yasar, Ranghino, Andrea, Marzuillo, Pierluigi, Kiryluk, Krzysztof, Krzemień, Grażyna, Miklaszewska, Monika, Lin, Fangming, Montini, Giovanni, Scolari, Francesco, Fiaccadori, Enrico, Arapović, Adela, Saraga, Marijan, McKiernan, James, Alam, Shumyle, Zaniew, Marcin, Szczepańska, Maria, Szmigielska, Agnieszka, Sikora, Przemysław, Drożdż, Dorota, Mizerska-Wasiak, Malgorzata, Mane, Shrikant, Lifton, Richard P., Tasic, Velibor, Latos-Bielenska, Anna, Gharavi, Ali G., Ghiggeri, Gian Marco, Materna-Kiryluk, Anna, Westland, Rik, and Sanna-Cherchi, Simone

Published
2023
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15. Safety and Efficacy of Vedolizumab in Kidney Transplant Recipients With Crohn’s Disease

Author

Busutti, Marco, primary, Baraldi, Olga, additional, Porcu, Clara Valentina, additional, Samele, Gianluca, additional, Campus, Anita, additional, Grandinetti, Valeria, additional, Bini, Claudia, additional, Provenzano, Michele, additional, Dussias, Nikolas, additional, Rizzello, Fernando, additional, Gionchetti, Paolo, additional, La Manna, Gaetano, additional, and Comai, Giorgia, additional

Published
2023
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19. Treatment of Acute Antibody-Mediated Rejection

Author

Comai, Giorgia, primary, Ravaioli, Matteo, additional, Baraldi, Olga, additional, Cuna, Vania, additional, Gasperoni, Lorenzo, additional, D''Arcangelo, Giovanni Liviano, additional, Cappuccilli, Maria, additional, Pinna, Antonio D., additional, Ronco, Claudio, additional, and La Manna, Gaetano, additional

Published
2017
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21. Early Light Chains Removal and Albumin Levels with a Double Filter-Based Extracorporeal Treatment for Acute Myeloma Kidney

Author

Donati, Gabriele, primary, Zappulo, Fulvia, additional, Maietti, Elisa, additional, Scrivo, Anna, additional, Gasperoni, Lorenzo, additional, Zamagni, Elena, additional, Tacchetti, Paola, additional, Pantani, Lucia, additional, Baraldi, Olga, additional, Comai, Giorgia, additional, Cappuccilli, Maria, additional, Cavo, Michele, additional, and La Manna, Gaetano, additional

Published
2022
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22. The Relationship between Timing of Pretransplant Kidney Biopsy, Graft Loss, and Survival in Kidney Transplantation:An Italian Cohort Study

Author

Odaldi, Federica, Serenari, Matteo, Comai, Giorgia, La Manna, Gaetano, Bova, Raffaele, Frascaroli, Giacomo, Malvi, Deborah, Maroni, Lorenzo, Vasuri, Francesco, Germinario, Giuliana, Baraldi, Olga, Capelli, Irene, Cuna, Vania, Sangiorgi, Gabriela, D'Errico, Antonietta, Del Gaudio, Massimo, Bertuzzo, Valentina Rosa, Zanfi, Chiara, Sessa, Maurizio, Ravaioli, Matteo, Odaldi, Federica, Serenari, Matteo, Comai, Giorgia, La Manna, Gaetano, Bova, Raffaele, Frascaroli, Giacomo, Malvi, Deborah, Maroni, Lorenzo, Vasuri, Francesco, Germinario, Giuliana, Baraldi, Olga, Capelli, Irene, Cuna, Vania, Sangiorgi, Gabriela, D'Errico, Antonietta, Del Gaudio, Massimo, Bertuzzo, Valentina Rosa, Zanfi, Chiara, Sessa, Maurizio, and Ravaioli, Matteo

Abstract

Introduction: Kidney biopsy is performed to assess if an extended criteria graft can be used for transplantation. It may be performed before or after cross-clamping during organ procurement. This study aims to evaluate whether the timing of biopsy may modify cold ischemia times (CIT) and/or graft outcomes. Methods: Kidney transplants performed in our center from January 2007 to December 2017 were analyzed. Grafts with preimplantation kidney biopsy were included. Biopsies were performed during surgical back table (ex situ kidney biopsy [ESKB]) until 2012 and since then before the aortic cross-clamping (in situ kidney biopsy [ISKB]). To overcome biases owing to different distributions, a propensity score model was developed. The study population consists in 322 patients, 115 ESKB, and 207 ISKB. Results: CIT was significantly lower for ISKB (730 min ISKB vs. 840 min ESKB, p value = 0.001). In both crude (OR 0.27; 95% confidence interval, 95% CI 0.12-0.60; p value = 0.002) and adjusted analyses (OR 0.37; 95% CI 0.14-0.94; p value = 0.039), ISKB was associated with a reduced odd of graft loss when compared to ESKB. Discussion/Conclusion: Performing preimplantation kidney biopsy during the recovery, prior to the aortic cross-clamping, may be a strategy to reduce CIT and improve transplant outcomes.

Published
2022

23. The Relationship between Timing of Pretransplant Kidney Biopsy, Graft Loss, and Survival in Kidney Transplantation: An Italian Cohort Study

Author

Odaldi, Federica, primary, Serenari, Matteo, additional, Comai, Giorgia, additional, La Manna, Gaetano, additional, Bova, Raffaele, additional, Frascaroli, Giacomo, additional, Malvi, Deborah, additional, Maroni, Lorenzo, additional, Vasuri, Francesco, additional, Germinario, Giuliana, additional, Baraldi, Olga, additional, Capelli, Irene, additional, Cuna, Vania, additional, Sangiorgi, Gabriela, additional, D’Errico, Antonietta, additional, Del Gaudio, Massimo, additional, Bertuzzo, Valentina Rosa, additional, Zanfi, Chiara, additional, Sessa, Maurizio, additional, and Ravaioli, Matteo, additional

Published
2021
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24. The Relationship Between Timing of Pre-Transplant Kidney Biopsy, Graft Loss, and Survival in Kidney Transplantation: An Italian Cohort Study.

Author

Odaldi, Federica, primary, Serenari, Matteo, additional, Comai, Giorgia, additional, Manna, Gaetano La, additional, Bova, Raffaele, additional, Frascaroli, Giacomo, additional, Malvi, Deborah, additional, Maroni, Lorenzo, additional, Vasuri, Francesco, additional, Germinario, Giuliana, additional, Baraldi, Olga, additional, Capelli, Irene, additional, Cuna, Vania, additional, Sangiorgi, Gabriela, additional, D'Errico, Antonietta, additional, Gaudio, Massimo Del, additional, Bertuzzo, Valentina, additional, Zanfi, Chiara, additional, Sessa, Maurizio, additional, and Ravaioli, Matteo, additional

Published
2020
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27. The Relationship between Timing of Pretransplant Kidney Biopsy, Graft Loss, and Survival in Kidney Transplantation: An Italian Cohort Study.

Author

Odaldi, Federica, Serenari, Matteo, Comai, Giorgia, La Manna, Gaetano, Bova, Raffaele, Frascaroli, Giacomo, Malvi, Deborah, Maroni, Lorenzo, Vasuri, Francesco, Germinario, Giuliana, Baraldi, Olga, Capelli, Irene, Cuna, Vania, Sangiorgi, Gabriela, D'Errico, Antonietta, Del Gaudio, Massimo, Bertuzzo, Valentina Rosa, Zanfi, Chiara, Sessa, Maurizio, and Ravaioli, Matteo

Published
2022
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29. [Membranous glomerulonephritis (MGN), ongoing studies]

Author

La Manna, Gaetano, Baraldi, Olga, Cunia, Vania, Corradetti, Valeria, Aiello, Valeria, BUSUTTI, MARCO, Gasperoni, Lorenzo, Spazzoli, Alessandra, Comai, Giorgia, La Manna, Gaetano, Baraldi, Olga, Cunia, Vania, Corradetti, Valeria, Aiello, Valeria, Busutti, Marco, Gasperoni, Lorenzo, Spazzoli, Alessandra, and Comai, Giorgia

Subjects
Adult, Clinical Trials as Topic, Nephrotic Syndrome, Membranous Glomerulonephritis, membranous nephropathy, Rituximab, ECULIZUMAB, Podocytes, Receptors, Phospholipase A2, Calcineurin Inhibitors, Antibodies, Monoclonal, Antibodies, Monoclonal, Humanized, Autoantigens, Glomerulonephritis, Membranous, Bortezomib, Observational Studies as Topic, Adrenocorticotropic Hormone, Humans, Multicenter Studies as Topic, Rituximab, Complement Activation, Cyclophosphamide, Immunosorbent Techniques, Autoantibodies, Randomized Controlled Trials as Topic
Abstract

La glomerulonefrite membranosa rappresenta il 20% dei casi di sindrome nefrosica dell’adulto, con una incidenza annuale di 1/100.000 pazienti/anno. Negli ultimi 10 anni è stato identificato nel podocita il vero responsabile del processo patologico. In risposta a possibili triggers ambientali in pazienti geneticamente predisposti, il podocita espone epitopi antigenici (recettore della fosfolipasi A2, trombospondina tipo 1) che diventano bersaglio di autoanticorpi in grado di attivare il complemento e determinare danno della membrana basale glomerulare. Rimane incerto il meccanismo effettivamente patogenetico in queste complesse interazioni. Da queste acquisizioni sono derivati nuovi trattamenti focalizzati sui meccanismi specifici di blocco delle vie di attivazione della malattia con l’ipotesi di superamento dei farmaci convenzionali ad attività meno specifica. ll rituximab (Rtx), anticorpo monoclonale diretto contro il CD20 espresso dai linfociti B, è utilizzato in numerosi trials con lo scopo di bloccare la produzione di anticorpi. Il presupposto degli studi in corso deriva dal GEMRITUX trial, in cui Rtx si è dimostrato in grado di indurre remissione della sindrome nefrosica in circa il 65% dei pazienti senza un maggior rischio di eventi avversi; resta da definire lo schema terapeutico e posologico più efficace. Altri trials evidenziano nuovi orientamenti della ricerca su meccanismi di blocco specifico (belimumab) ed aspecifico (ACTH) e più occasionali segnalazioni prendono in considerazione nuove possibili opzioni terapeutiche quali l’ofatumumab, il bortezomib e l’eculizumab. Queste novità in campo patogenetico e terapeutico hanno determinato un impulso alla ricerca sui processi patologici implicati nella genesi delle nefropatie glomerulari ed avviato nuove prospettive di trattamento. The membranous nephropathy (MN) is the major cause of nephrotic syndrome in in the adult, account for 20% of cases with annual incidence is 1 in 100.000. In the past 10 years, the role of podocytes has been identified; environmental triggers in genetically predisposed patients can activate podocytes to exhibit antigenic epitopes (receptor of phospholipase A2, thrombospondin type 1) that become targets of specific autoantibodies with subsequent complement activation. The discovery of this mechanisms has opened new horizons in the therapy of MN and novel drugs are available with more specific mechanism of action. Rituximab, a monoclonal antibody directed against CD20 expressed by lymphocytes B, has been used in several trials and appears able to induce remission of nephrotic syndrome in 60% of patients (GEMRITUX trial) with similar risk profile. Nowadays it remains to define the most effective therapeutic pattern. In MN, the concept of targeting disease control, has permit novel therapies with specific blocking mechanisms (belimumab) and non-specific (ACTH) and new therapeutic options, such as ofatumumab, bortezomib and eculizumab, that have allowed to recognize pathological processes involved in the glomerular diseases.

Published
2017

31. Trapianto renale nelle malattie da errori congeniti del metabolismo = Kidney Transplantation and inborn errors of metabolism

Author

CAPELLI, IRENE, BATTAGLINO, GIUSEPPE, BARALDI, OLGA, RAVAIOLI, MATTEO, CUNA, VANIA, MORETTI, ILARIA, ANGELETTI, ANDREA, MENCARELLI, FRANCESCA, PASINI, ANDREA, MONTINI, GIOVANNI, PINNA, ANTONIO DANIELE, LA MANNA, GAETANO, Capelli, Irene, Battaglino, Giuseppe, Baraldi, Olga, Ravaioli, Matteo, Cuna, Vania, Moretti, Ilaria, Angeletti, Andrea, Mencarelli, Francesca, Pasini, Andrea, Montini, Giovanni, Pinna, Antonio Daniele, La Manna, Gaetano, Capelli, I, Battaglino, G, Baraldi, O, Ravaioli, M, Cuna, V, Moretti, I, Angeletti, A, Mencarelli, F, Pasini, A, Montini, G, Pinna, Ad, and La Manna, G.

Subjects
ereditary nephropaty, inborn errors of metabolism, kidney, kidney transplantation, primary hyperossaluria
Abstract

Le nefropatie ereditarie comprendono circa 150 differenti disordini e hanno una prevalenza di circa 60-80 casi per 100.000 in Europa ed in USA. Circa il 10% degli adulti e quasi tutti i pazienti pediatrici che arrivano alla dialisi hanno una nefropatia ereditaria, la quinta causa più comune di insufficienza renale terminale dopo il diabete, l'ipertensione, le glomerulonefriti e le pielonefriti. Tali condizioni comprendono sia disordini strutturali che funzionali, tra le quali sono annoverate le malattie derivanti da errori congeniti del metabolismo (inborn errors of metabolism - IEM). Alcuni errori congeniti del metabolismo si manifestano con un danno primitivamente renale e per via dei progressi nel campo della terapia sostitutiva della funzione renale, i pazienti con nefropatia ereditaria raramente muoiono al progredire della malattia, vivendo per molti anni. Tuttavia questi pazienti presentano una scarsa qualità di vita. Il trapianto renale offre una valida opzione terapeutica per quegli errori congeniti del metabolismo con espressione renale primitiva causata da una disfunzione della proteina mutata, come nella cistinuria. In questo caso l'indicazione al trapianto renale rende possibile il superamento dello specifico difetto enzimatico. Tuttavia tale indicazione rimane valida anche nelle forme in cui il difetto genetico è espresso a livello sistemico e il coinvolgimento renale è solo una delle manifestazioni cliniche della malattia, come nella malattia di Anderson-Fabry, nella cistinosi, nell'amiloidosi familiare, nell'iperossaluria primitiva. In queste condizioni il trapianto renale viene combinato con quello epatico (iperossaluria primitiva) o cardiaco (amiloidosi familiare) migliorando la qualità e l'aspettativa di vita dei pazienti Inherited kidney diseases constitute at least 150 different disorders and they have an overall prevalence of about 6080 cases per 100 000 in Europe and in USA. At least 10% of adults and nearly all children who progress to renal-replacement therapy have an inherited kidney disease, representing the fifth most common cause of end-stage renal disease after diabetes, hypertension, glomerulonephritis, and pyelonephritis. These conditions include both structural and functional disorders, among which are counted diseases resulting from inborn errors of metabolism (IEM). Some inborn errors of metabolism primarily affect kidney and because of progress in renal replacement therapy, patients with inherited kidney disorders rarely die when their disease progresses and can live for many years. However, these patients often have compromised health with a poor quality of life. Renal transplantation offers a viable treatment option for those inborn errors of metabolism characterized by primary renal damage caused by dysfunction of a mutated protein, as in cystinuria. In this case, the indication to renal transplantation makes it possible to overcome the specific enzyme defect. However this option remains valid even when the genetic defect is expressed systemically and renal involvement is just one of the clinical manifestations of the disease, as in Anderson-Fabry disease, cystinosis, hereditary amyloidosis and primary hyperoxaluria. In these conditions, renal transplantation is combined with the liver (primary hyperoxaluria) or cardiac transplant (familial amyloidosis) improving the quality and life expectancy of patients.

Published
2015

33. Preliminary experience of sequential use of normothermic and hypothermic oxygenated perfusion for donation after circulatory death kidney with warm ischemia time over the conventional criteria - a retrospective and observational study

Author

Ravaioli, Matteo, primary, De Pace, Vanessa, additional, Comai, Giorgia, additional, Capelli, Irene, additional, Baraldi, Olga, additional, D'Errico, Antonietta, additional, Bertuzzo, Valentina Rosa, additional, Del Gaudio, Massimo, additional, Zanfi, Chiara, additional, D'Arcangelo, Giovanni Liviano, additional, Cuna, Vania, additional, Siniscalchi, Antonio, additional, Sangiorgi, Gabriela, additional, and La Manna, Gaetano, additional

Published
2018
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36. An in vitro model of renal inflammation after ischemic oxidative stress injury: nephroprotective effects of a hyaluronan ester with butyric acid on mesangial cells

Author

Baraldi,Olga, Bianchi,Francesca, Menghi,Viola, Angeletti,Andrea, Croci Chiocchini,Anna Laura, Cappuccilli,Maria, Aiello,Valeria, Comai,Giorgia, La Manna,Gaetano, Baraldi,Olga, Bianchi,Francesca, Menghi,Viola, Angeletti,Andrea, Croci Chiocchini,Anna Laura, Cappuccilli,Maria, Aiello,Valeria, Comai,Giorgia, and La Manna,Gaetano

Abstract

Olga Baraldi,1 Francesca Bianchi,2,3 Viola Menghi,1 Andrea Angeletti,1 Anna Laura Croci Chiocchini,1 Maria Cappuccilli,1 Valeria Aiello,1 Giorgia Comai,1 Gaetano La Manna1 1Department of Experimental, Diagnostic and Specialty Medicine, Nephrology, Dialysis and Renal Transplant Unit, Sant’Orsola-Malpighi Hospital, University of Bologna, Bologna, 2Stem Wave Institute for Tissue Healing, Gruppo Villa Maria Care & Research – Ettore Sansavini Health Science Foundation, Lugo, Ravenna, 3National Institute of Biostructures and Biosystems at the Department of Experimental, Diagnostic and Specialty Medicine, Sant’Orsola-Malpighi Hospital, University of Bologna, Bologna, Italy Background: Acute kidney injury, known as a major trigger for organ fibrosis and independent predictor of chronic kidney disease, is characterized by mesangial cell proliferation, inflammation and unbalance between biosynthesis and degradation of extracellular matrix. Therapeutic approaches targeting the inhibition of mesangial cell proliferation and matrix expansion may represent a promising opportunity for the treatment of kidney injury. An ester of hyaluronic acid and butyric acid (HB) has shown vasculogenic and regenerative properties in renal ischemic-damaged tissues, resulting in enhanced function recovery and minor degree of inflammation in vivo. This study evaluated the effect of HB treatment in mesangial cell cultures exposed to H2O2-induced oxidative stress.Materials and methods: Lactate dehydrogenase release and caspase-3 activation were measured using mesangial cells prepared from rat kidneys to assess necrosis and apoptosis. Akt and p38 phosphorylation was analyzed to identify the possible mechanism underlying cell response to HB treatment. The relative expressions of matrix metallopeptidase 9 (MPP-9) and collagen type 1 alpha genes were also analyzed by quantitative real-time polymerase chain reaction. Cell proliferation rate and viability were measured

Published
2017

37. Identification of expanded T-cell clones by spectratyping in nonfunctioning kidney transplants

Author

Cappuccilli,Maria, Donati,Gabriele, Comai,Giorgia, Baraldi,Olga, Conte,Diletta, Capelli,Irene, Aiello,Valeria, Pession,Andrea, La Manna,Gaetano, Cappuccilli,Maria, Donati,Gabriele, Comai,Giorgia, Baraldi,Olga, Conte,Diletta, Capelli,Irene, Aiello,Valeria, Pession,Andrea, and La Manna,Gaetano

Abstract

Maria Cappuccilli,1 Gabriele Donati,1 Giorgia Comai,1 Olga Baraldi,1 Diletta Conte,1 Irene Capelli,1 Valeria Aiello,1 Andrea Pession,2 Gaetano La Manna1 1Department of Experimental Diagnostic and Specialty Medicine (DIMES), Nephrology, Dialysis, and Renal Transplant Unit, 2Molecular Laboratory of Pediatrics, Hematology–Oncology Unit, St Orsola Hospital, University of Bologna, Bologna, Italy Background: The aim of this study was the application of complementarity-determining region-3 spectratyping analysis to determine T-cell-repertoire complexity and to detect T-cell-clone expansion, as a measure of immune response in nonfunctioning kidney transplants (group hemodialysis-transplant [HD-Tx]), nontransplanted dialysis patients (group hemodialysis [HD]), and normal subjects as controls (group C).Patients and methods: Analysis of T-cell receptor (TCR) diversity by spectratyping was applied to peripheral blood samples collected from 21 subjects: eight in group HD-Tx, seven in group HD, and six in group C.Results: Considering the extent of the skew in TCR variable region repertoires as a measure of clonal T cells, we found that the number of altered spectra showed a progressive increase from normal subjects to dialysis patients and to nonfunctioning kidney transplants, respectively. Healthy subjects had the lowest number of altered spectra, and patients with nonfunctioning kidney transplants the highest. Differences were significant for group HD-Tx vs group C (P=0.017) and group HD vs group C (P=0.015), but not between nonfunctioning kidney-transplant recipients and dialysis patients (group HD-Tx vs group HD).Conclusion: Although dialysis appears to be a weaker trigger for clonal expansion of T cells, our data suggest that the utilization of complementarity-determining region-3 spectratyping analysis of the TCR repertoire might be useful to monitor specific immunoactivation in patients before and after kidney transplantation. Keywords: dialysis, nonfunctioning k

Published
2017

38. Urinary neutrophil gelatinase-associated lipocalin is a biomarker of delayed graft function after kidney transplantation

Author

Capelli,Irene, Baraldi,Olga, Comai,Giorgia, Sala,Elisa, Cappuccilli,Maria, Donadei,Chiara, Cuna,Vania, Angelini,Maria, Donati,Gabriele, La Manna,Gaetano, Capelli,Irene, Baraldi,Olga, Comai,Giorgia, Sala,Elisa, Cappuccilli,Maria, Donadei,Chiara, Cuna,Vania, Angelini,Maria, Donati,Gabriele, and La Manna,Gaetano

Abstract

Irene Capelli, Olga Baraldi, Giorgia Comai, Elisa Sala, Maria Cappuccilli, Chiara Donadei, Vania Cuna, Maria Laura Angelini, Gabriele Donati, Gaetano La Manna Department of Experimental Diagnostic and Specialty Medicine (DIMES), Nephrology, Dialysis and Renal Transplant Unit, St Orsola Hospital, University of Bologna, Bologna, Italy Background: Acute kidney injury occurring after kidney transplantation frequently leads to delayed graft function with detrimental long-term effects on graft survival. Neutrophil gelatinase-associated lipocalin (NGAL) has been validated as a biomarker for posttransplant acute kidney injury. This observational study aimed to assess the effectiveness of urinary NGAL as a predictive marker of delayed graft function.Materials and methods: Forty-three consecutive patients who received renal transplant were included in the study. Urine samples were collected before transplant (if available) and at days 1, 3, 7, 14, and 30 after transplant, and urinary NGAL levels were quantified by enzyme-linked immunosorbent assay.Results: Urinary NGAL progressively decreased after transplant in patients with both delayed and immediate graft function. However, urinary NGAL concentration remained significantly higher in the presence of delayed graft function in the first 14 days after transplant. The area under the receiver operating characteristic curve showed that the ability of urinary NGAL to predict delayed graft function was accurate at 1st and 3rd days after transplant.Conclusion: The relative decrease of urinary NGAL concentration rather than its absolute value may be relevant to predict delayed graft function after renal transplant. In particular, urinary NGAL area under the curve for 3 days seems to be a more valuable parameter of decision making in the early posttransplant period. Keywords: area under the curve, delayed graft function, immediate graft function, kidney t

Published
2017

39. Ganciclovir-Resistant Cytomegalovirus Infection in a Kidney Transplant Recipient Successfully Treated with Foscarnet and Everolimus

Author

Menghi, Viola, Comai, Giorgia, Baraldi, Olga, Liviano D’Arcangelo, Giovanni, Lazzarotto, Tiziana, and La Manna, Gaetano

Subjects
surgical procedures, operative, Article Subject, virus diseases
Abstract

Cytomegalovirus (CMV) infection remains a major cause of morbidity, graft failure, and death in kidney transplant recipients. We describe a case of a 53-year-old CMV-seronegative man who underwent renal transplant from a CMV-positive donor and who developed ganciclovir- (GCV-) resistant CMV infection. Foscarnet was started while immunosuppressive therapy was modified with the introduction of everolimus minimizing tacrolimus dosage. Only two weeks after the start of this treatment regimen was the patient’s viral load negative. At two-year follow-up the patient has no clinical or laboratory signs of CMV infection and a good and stable renal function or graft survival. In our case, administration of an mTOR inhibitor combined with foscarnet led to rapid and persistent viral clearance without compromising short- and medium-term graft function. This combination therapy supports the need for the kidney transplant community to individualize a target therapy for each type of GCV-resistant CMV infection.

Published
2016
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