Document Detail


Antineutrophil cytoplasmic antibody-associated renal vasculitis treated with autologous mesenchymal stromal cells: evaluation of the contribution of immune-mediated mechanisms.
MedLine Citation:
PMID:  24079687     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
We report the first case of renal antineutrophil cytoplasmic antibody (ANCA)-associated vasculitis treated with autologous mesenchymal stromal cells (MSCs). A 73-year-old man was admitted to the hospital for malaise, weight loss, and oliguria. His serum creatinine level was 2.7 mg/dL but it rapidly increased to 7.8 mg/dL; urinalysis showed proteinuria and hematuria, and the ANCA to myeloperoxidase with a perinuclear pattern (pANCA) titer was high (132 IU/mL). Renal biopsy showed necrotizing crescentic glomerulonephritis. Standard immunosuppressive therapy (cyclophosphamide and corticosteroids) was ineffective. Rituximab therapy was started, but it was discontinued after the third dose to minimize the risk of systemic spread of a severe oral Candida infection and to prevent superinfections that were facilitated by leukopenia. The patient received autologous MSCs, 1.5 × 10(6) cells/kg body weight, intravenously. After 7 days, his serum creatinine level decreased to 2.2 mg/dL, pANCA titer decreased to 75 IU/mL, and urinalysis findings normalized. Eight months later, he received a second MSC infusion because his serum creatinine level increased. In 1 week, his creatinine level decreased to 1.9 mg/dL and his pANCA titer decreased to 14 IU/mL. Immunosuppressive therapy was subsequently withdrawn. At the last follow-up visit, 12 months after the second MSC infusion, the patient remained in clinical remission without any therapy. Infusion of MSCs induced expansion of the T-lymphocyte subset expressing a regulatory T-cell phenotype (CD4(+)CD25(+)Foxp3(+)) and a notable reduction in interferon-γ, interleukin 6, and tumor necrosis factor serum levels.
Authors:
Marilena Gregorini; Rita Maccario; Maria Antonietta Avanzini; Valeria Corradetti; Antonia Moretta; Carmelo Libetta; Pasquale Esposito; Francesca Bosio; Antonio Dal Canton; Teresa Rampino
Related Documents :
2342997 - Histopathological changes in the skin and subcutaneous tissues of mouse legs after trea...
24527947 - A new intravenous immunoglobulin (bivigam(®)) for primary humoral immunodeficiency.
17631507 - Pharmacokinetics of dalbavancin in plasma and skin blister fluid.
11174087 - Moisturisers for psoriatic skin--do gross morphological differences matter?
25181837 - Influence of bile acid derivates on morphine analgesic effect in mice.
3696837 - Pharmacokinetic profile of cefixime in man.
Publication Detail:
Type:  Case Reports; Journal Article    
Journal Detail:
Title:  Mayo Clinic proceedings     Volume:  88     ISSN:  1942-5546     ISO Abbreviation:  Mayo Clin. Proc.     Publication Date:  2013 Oct 
Date Detail:
Created Date:  2013-10-01     Completed Date:  2013-12-11     Revised Date:  2013-12-13    
Medline Journal Info:
Nlm Unique ID:  0405543     Medline TA:  Mayo Clin Proc     Country:  England    
Other Details:
Languages:  eng     Pagination:  1174-9     Citation Subset:  AIM; IM    
Copyright Information:
Copyright © 2013 Mayo Foundation for Medical Education and Research. Published by Elsevier Inc. All rights reserved.
Export Citation:
APA/MLA Format     Download EndNote     Download BibTex
MeSH Terms
Descriptor/Qualifier:
Aged
Anti-Neutrophil Cytoplasmic Antibody-Associated Vasculitis / surgery*
Humans
Male
Mesenchymal Stem Cell Transplantation / methods*
Transplantation, Autologous

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


Previous Document:  Electrical storm in the brain and in the heart: epilepsy and Brugada syndrome.
Next Document:  The emergence of maternal health as a political priority in Madhya Pradesh, India: a qualitative stu...