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15. EVOLUZIONE DELL'IMMUNOSOPPRESSIONE NEL TRAPIANTO CLINICO DI RENE:ESPERIENZA SU 700 CASI

Author

Alfani, D., Bruzzone, Paolo, BACHETONI ROSSI VACCARI, Alessandra, Berloco, Pasquale Bartolomeo, Caricato, M., Casciaro, Giovanni Enrico, Cinti, Paola, Iappelli, Massimo, Marciani, A., Poli, Luca, Pretagostini, Renzo, Renna Molajoni, E., Rossi, Massimo, Trovati, A., and Cortesin, R.

Subjects
immunosoppressione, trapianto di rene
Published
1991

30. IMMUNOSUPPRESSIVE THERAPY IN HIGH RISK PATIENTS

Author

Cortesini, Raffaello, Marinucci, G, RENNA MOLAJONI, E, Cinti, P, Capua, A, Berloco, Pasquale Bartolomeo, Famulari, A, Pretagostini, Renzo, Rossi, Massimo, and Alfani, Dario

Subjects
immunosuppressive therapy, high risk patients
Published
1986

31. INFLUENCE OF TOTAL LYMPHOID IRRADIATION PLUS CYCLOSPORINE ON KIDNEY GRAFT OUTCOME IN HIGH-RISK PATIENTS

Author

Cortesini, R., Berloco, Pasquale Bartolomeo, Famulari, A., Trovati, A., Iappelli, M., Renna Molajoni, E., BACHETONI ROSSI VACCARI, Alessandra, Pretagostini, Renzo, Marinucci, G., Capua, A., Rossi, Massimo, and Alfani, D.

Subjects
Adult, Graft Rejection, Immunosuppression Therapy, Clinical Trials as Topic, Lymphoid Tissue, Mercaptopurine, Histocompatibility Testing, Graft Survival, kidney grafts, tli, Antibodies, Monoclonal, Cyclosporins, Combined Modality Therapy, Kidney Transplantation, Risk Factors, Azathioprine, Humans, Transplantation, Homologous, Female, Whole-Body Irradiation
Published
1987

35. LA PREPARAZIONE DEL RICEVENTE AL TRAPIANTO RENALE CLINICO

Author

Alfani, D, RENNA MOLAJONI, E, BACHETONI ROSSI VACCARI, Alessandra, Berloco, Pasquale Bartolomeo, Famulari, A, Passalacqua, S, Trovati, A, Monari, C, Rossi, Massimo, Marciani, A, and Cortesini, Raffaello

Published
1982

41. Monitoring of NK-1 and NK-15 subsets and natural killer activity in kidney transplant recipients receiving cyclosporine

Author

Renna Molajoni E, Barnaba V, Bachetoni A, Massimo Levrero, Cinti P, Rossi M, Alfani D, and Cortesini R

Subjects
Adult, Killer Cells, Natural, Adolescent, Humans, Cyclosporins, Middle Aged, Kidney Transplantation
Abstract

NK-1, NK-15 subsets and natural killer (NK) activity were studied in 13 patients, before undergoing renal transplantation and in the post-transplant period. Pretransplant there was a significant reduction of NK activity with a defect in Vmax capacity in all patients. NK-1+ and NK-15+ cell number was normal or slightly increased in all subjects. Post-transplant evaluation under cyclosporine immunosuppression showed a quantitative reduction in NK cells while no changes in NK activity and killing activity have been seen. We conclude that in spite of a numerical decrease, NK activity was not affected by cyclosporine treatment.

42. Tailoring of immunosuppression in renal and liver allograft recipients displaying donor specific T-suppressor cells.

Author

Cortesini R, Renna-Molajoni E, Cinti P, Pretagostini R, Ho E, Rossi P, and Suciu-Foca Cortesini N

Subjects
Antigen-Presenting Cells physiology, Female, Humans, Male, Monitoring, Immunologic, Transplantation, Homologous, Immunosuppression Therapy, Kidney Transplantation immunology, Liver Transplantation immunology, T-Lymphocytes, Regulatory immunology
Abstract

Although transplantation tolerance cannot be yet reliably achieved in humans, there is evidence that active immunosuppression contributes to the maintenance of quiescence. However, the mechanism that underlies quiescence and the precise identity of regulatory cells are not completely understood. We have demonstrated that allograft recipients who remain rejection-free display allospecific T-suppressor cells (Ts). Ts express the CD8(+) CD28(-) phenotype, recognize major histocompatibility complex (MHC) class I antigens, and suppress the up-regulation of costimulatory molecules induced by CD40 ligation of donor antigen presenting cells. The presence of Ts is inversely correlated with T cell alloreactivity to donor MHC peptides, alloantibody production, and rejection. Monitoring of Ts has been successfully used in our studies for tailoring immunosuppression in kidney and liver allograft recipients.

Published
2002
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43. Suppression of allorecognition by use of synthetic peptides.

Author

Colovai AI, Renna-Molajoni E, Cocciolo PL, Tugulea S, Liu Z, Harris PE, Suciu-Foca N, and Cortesini R

Subjects
Amino Acid Sequence, Antigen-Presenting Cells drug effects, Antigen-Presenting Cells radiation effects, Cells, Cultured, Clone Cells, HLA-DR Antigens chemistry, HLA-DR Serological Subtypes, Humans, Peptide Fragments chemistry, Recombinant Proteins chemistry, Recombinant Proteins immunology, Structure-Activity Relationship, T-Lymphocytes drug effects, Antigen-Presenting Cells immunology, HLA-DR Antigens immunology, Lymphocyte Activation, Peptide Fragments pharmacology, T-Lymphocytes immunology
Published
1996

44. OKT3 prophylaxis in kidney transplant recipients: drug monitoring by flow cytometry.

Author

Cinti P, Cocciolo P, Evangelista B, Orlandini AM, Bruzzone P, Renna Molajoni E, and Cortesini R

Subjects
Antigens, CD blood, CD3 Complex blood, Drug Monitoring methods, Flow Cytometry methods, Graft Rejection immunology, Humans, Immunosuppression Therapy methods, Immunosuppressive Agents blood, Muromonab-CD3 blood, T-Lymphocyte Subsets immunology, Graft Rejection prevention & control, Immunosuppressive Agents therapeutic use, Kidney Transplantation immunology, Muromonab-CD3 therapeutic use
Published
1996

45. The clinical relevance of pretransplant recipient immunoresponsiveness in renal transplantation: impact on rejection.

Author

Renna Molajoni E, Cinti P, Evangelista B, Poli L, Cocciolo P, Berloco P, and Cortesini R

Subjects
Azathioprine therapeutic use, Cyclosporine therapeutic use, Drug Therapy, Combination, Graft Rejection drug therapy, Humans, Lymphocyte Activation, Lymphocyte Culture Test, Mixed, Methylprednisolone therapeutic use, Phytohemagglutinins, Predictive Value of Tests, Risk Factors, Tissue Donors, Graft Rejection epidemiology, Immunosuppressive Agents therapeutic use, Kidney Transplantation immunology, Lymphocytes immunology
Published
1996

46. Comparative flow cytometric analysis of peripheral blood, graft infiltrating and urinary sediment cells during kidney allograft rejection.

Author

Ciniti P, Evangelista B, Speziale A, Ingenito L, Orlandini AM, Baiano V, Renna Molajoni E, and Cortesini R

Subjects
Antigens, CD analysis, Azathioprine therapeutic use, Biopsy, Needle, Cyclosporine therapeutic use, Female, Flow Cytometry methods, Graft Rejection blood, Graft Rejection urine, Humans, Kidney Transplantation pathology, Kidney Transplantation physiology, Male, Methylprednisolone therapeutic use, T-Lymphocytes pathology, Transplantation, Homologous, Graft Rejection immunology, Kidney Transplantation immunology, T-Lymphocytes immunology
Published
1995

47. Immunological analysis of kidney allograft infiltrates during rejection: presence of cells coexpressing CD4 and CD8 antigens.

Author

Trovati A, Cinti P, Tamburro ML, Lattanzi R, Baiano V, Orlandini AM, Renna Molajoni E, and Cortesini R

Subjects
Azathioprine therapeutic use, Biopsy, Needle, CD3 Complex analysis, CD4 Antigens analysis, CD4-Positive T-Lymphocytes pathology, CD8 Antigens analysis, CD8-Positive T-Lymphocytes pathology, Cyclosporine therapeutic use, Flow Cytometry, Graft Rejection pathology, HLA-DR Antigens analysis, Humans, Lymphocyte Activation, Methylprednisolone therapeutic use, Phytohemagglutinins, Transplantation, Homologous, CD4-Positive T-Lymphocytes immunology, CD8-Positive T-Lymphocytes immunology, Graft Rejection immunology, Kidney Transplantation immunology, Kidney Transplantation pathology
Published
1995

48. Serum HLA class I soluble antigens: a marker of acute rejection following liver transplantation.

Author

Renna Molajoni E, Puppo F, Brenci S, Scudeletti M, Cinti P, Alfani D, Indiveri F, and Cortesini R

Subjects
Adult, Biomarkers blood, Female, Graft Rejection pathology, Graft Rejection therapy, Humans, Liver Transplantation pathology, Male, Middle Aged, Time Factors, Graft Rejection diagnosis, Histocompatibility Antigens Class I blood, Liver Transplantation immunology
Published
1995

49. Monitoring of donor sensitization in kidney transplant recipients by flow cytometric crossmatch.

Author

Cinti P, Bachetoni A, Baiano V, Pretagostini R, Poli L, Berloco P, Renna Molajoni E, and Cortesini R

Subjects
Azathioprine therapeutic use, Cyclosporine therapeutic use, Flow Cytometry methods, Humans, Immunosorbent Techniques, Immunosuppression Therapy methods, Kidney Transplantation physiology, Methylprednisolone therapeutic use, Muromonab-CD3 therapeutic use, Steroids therapeutic use, Tissue Donors, Graft Rejection therapy, Histocompatibility Testing, Kidney Transplantation immunology
Published
1993

50. Immunological studies of renal allograft recipients treated with total lymphoid irradiation.

Author

Bachetoni A, Cinti P, Sallusto F, Poli L, Pretagostini R, Alfani D, Renna Molajoni E, and Cortesini R

Subjects
Antilymphocyte Serum analysis, Cyclosporine therapeutic use, Follow-Up Studies, Graft Survival radiation effects, Humans, Lymphocyte Activation, Pilot Projects, Receptors, Interleukin-2 analysis, Risk Factors, T-Lymphocyte Subsets immunology, T-Lymphocyte Subsets radiation effects, Uremia immunology, Uremia surgery, Kidney Transplantation immunology, Lymphocyte Depletion methods, Whole-Body Irradiation
Abstract

It is well known that highly sensitized patients and/or high responders, even under CsA therapy, constitute a risk category for transplantation. Based on this evidence, in 1982, our group initiates a pilot study using total lymphoid irradiation (TLI) as a pre-transplant modulator of patient's immuno-response. TLI has been employed in 30 uremic, non diabetic, patients. During this experience the first protocol, characterized by pre-transplant TLI greater than 2,000 rads (13 pts.) and post-transplant conventional therapy, was abandoned because of the severe TLI side effects. In the second protocol TLI dose never exceeded 2,000 rads and CsA was given, at initial dose of 7-12 mg/Kg/day according to CsA blood through levels. The immunological monitoring was performed during TLI treatment and in the postoperative clinical course by cell markers profile determination and functional assays. The data obtained have demonstrated that TLI treatment causes a prolonged depression in CD4 positive cells, a predominant recovery of T suppressor population, a pronounced impairment of T functions and a development of specific unresponsiveness to donor antigens. Furthermore the TLI plus CsA protocol, showing an additive effect which steadily decreases patient immunoreactivity, a lack of side effects and a stable long term graft function seems to be a more useful method for transplantation in high-risk or in strongly immunoreactive patients.

Published
1991

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