Effectiveness of complement inhibitors against refractory antibody-mediated rejection of lung transplantation: Two clinical cases

IF 1.6 4区医学 Q4 IMMUNOLOGY

Transplant immunology Pub Date : 2025-01-03 DOI:10.1016/j.trim.2025.102174

Hadrien Mallet , Laurent Razat , Quentin Perrier , Amandine Briault , Christel Saint Raymond , Loic Falque , Lionel Rostaing , Bruno Degano , Pierrick Bedouch

{"title":"Effectiveness of complement inhibitors against refractory antibody-mediated rejection of lung transplantation: Two clinical cases","authors":"Hadrien Mallet , Laurent Razat , Quentin Perrier , Amandine Briault , Christel Saint Raymond , Loic Falque , Lionel Rostaing , Bruno Degano , Pierrick Bedouch","doi":"10.1016/j.trim.2025.102174","DOIUrl":null,"url":null,"abstract":"<div><div>Antibody-mediated rejection (AMR) has been recognized as a significant cause of acute and chronic lung allograft dysfunction after lung transplantation. Some treatments, eculizumab, an anti-complement (C)5 component monoclonal antibody (Mab), seem to have a promising effect in the management of some patients with AMR. We present two patients with acute AMR after lung transplantation who received the anti-C5 Mab therapy. In both cases, we identified the presence of C4d deposition in the peritubular capillaries on trans-alveolar biopsies, which suggested activation of complement in AMR. Prior to eculizumab therapy, both patients had also received immunoadsorption, courses of intravenous immunoglobulins (IVIG) and rituximab. For the first patient, we have shown that eculizumab can serve as an effective bridge to re-transplantation. For the second patient, we observed the absence of clinical and biological efficacy, and without a clear therapeutic efficacy the therapy with eculizumab had been discontinued after two months.</div></div>","PeriodicalId":23304,"journal":{"name":"Transplant immunology","volume":"89 ","pages":"Article 102174"},"PeriodicalIF":1.6000,"publicationDate":"2025-01-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"Transplant immunology","FirstCategoryId":"3","ListUrlMain":"https://www.sciencedirect.com/science/article/pii/S0966327425000024","RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q4","JCRName":"IMMUNOLOGY","Score":null,"Total":0}

引用次数: 0

Abstract

Antibody-mediated rejection (AMR) has been recognized as a significant cause of acute and chronic lung allograft dysfunction after lung transplantation. Some treatments, eculizumab, an anti-complement (C)5 component monoclonal antibody (Mab), seem to have a promising effect in the management of some patients with AMR. We present two patients with acute AMR after lung transplantation who received the anti-C5 Mab therapy. In both cases, we identified the presence of C4d deposition in the peritubular capillaries on trans-alveolar biopsies, which suggested activation of complement in AMR. Prior to eculizumab therapy, both patients had also received immunoadsorption, courses of intravenous immunoglobulins (IVIG) and rituximab. For the first patient, we have shown that eculizumab can serve as an effective bridge to re-transplantation. For the second patient, we observed the absence of clinical and biological efficacy, and without a clear therapeutic efficacy the therapy with eculizumab had been discontinued after two months.

查看原文本刊更多论文

补体抑制剂对抗难治性抗体介导的肺移植排斥反应的有效性：两个临床病例。

抗体介导的排斥反应（AMR）已被认为是肺移植后急性和慢性同种异体肺功能障碍的重要原因。一些治疗方法，如eculizumab，一种抗补体(C)5组分单克隆抗体（Mab），似乎对一些AMR患者的治疗有很好的效果。我们报告了两例接受抗c5单抗治疗的肺移植后急性AMR患者。在这两种情况下，我们在经肺泡活检中发现小管周围毛细血管中存在C4d沉积，这表明AMR中补体的激活。在eculizumab治疗之前，两名患者也接受了免疫吸附，静脉注射免疫球蛋白（IVIG）和利妥昔单抗疗程。对于第一位患者，我们已经证明eculizumab可以作为再次移植的有效桥梁。对于第二例患者，我们观察到缺乏临床和生物学疗效，并且由于没有明确的治疗效果，两个月后停用了eculizumab治疗。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

求助全文

约1分钟内获得全文求助全文

来源期刊

Transplant immunology 医学-免疫学

CiteScore

2.10

自引率

13.30%

发文量

198

审稿时长

48 days

期刊介绍： Transplant Immunology will publish up-to-date information on all aspects of the broad field it encompasses. The journal will be directed at (basic) scientists, tissue typers, transplant physicians and surgeons, and research and data on all immunological aspects of organ-, tissue- and (haematopoietic) stem cell transplantation are of potential interest to the readers of Transplant Immunology. Original papers, Review articles and Hypotheses will be considered for publication and submitted manuscripts will be rapidly peer-reviewed and published. They will be judged on the basis of scientific merit, originality, timeliness and quality.