The addition of sirolimus to cyclosporine and steroids inhibits the anti-equine antibody response in renal transplant recipients treated with antithymocyte globulin

Mark D. Pescovitz, Benita K. Book, Sharon Henson, Stephen B. Leapman, Martin L. Milgrom, Jess Kimball, Douglas Norman, Ronald S. Filo

Research output: Contribution to journalArticle

16 Citations (Scopus)

Abstract

Polyclonal antibodies, such as equine antithymocyte globulin (ATGAM®), are known to induce antibody formation. This study evaluated the in vivo effect of sirolimus on antibody formation associated with the use of equine antithymocyte globulin in renal transplant recipients. Recipients of either a living-related donor or cadaveric renal allograft received azathioprine (AZA) (n = 15), mycophenolate mofetil (MMF) (n = 12), or sirolimus (n = 15) in addition to baseline immunosuppression with corticosteroids, cyclosporine, and equine antithymocyte globulin. Immediately before transplantation and weekly for at least 1 month, sequential serum specimens were tested for the presence of human antiequine antibody using an enzyme-linked immunosorbent assay (ELISA). Anti-equine antibody formation was significantly different among the three treatment groups. Fewer patients receiving MMF (17%, p=0.007 vs. AZA) and sirolimus (13%, p =0.003 vs. AZA) developed anti-equine antibody compared with AZA (66%). There was no significant difference (p=0.81) in the sensitization to equine antithymocyte globulin when comparing the patients receiving MMF or sirolimus. In the sensitized patients, high anti-equine antibody titers (>1:500) were more common in those receiving AZA (n = 3) than MMF (n = 0) or sirolimus (n = 1). Compared to AZA, sirolimus, when given in combination with cyclosporine A, significantly reduced anti-equine antibody formation to a degree similar to MMF.

Original languageEnglish (US)
Pages (from-to)497-500
Number of pages4
JournalAmerican Journal of Transplantation
Volume3
Issue number4
DOIs
StatePublished - Apr 2003
Externally publishedYes

Fingerprint

Antilymphocyte Serum
Sirolimus
Cyclosporine
Horses
Antibody Formation
Anti-Idiotypic Antibodies
Mycophenolic Acid
Azathioprine
Steroids
Kidney
Transplant Recipients
Antibodies
Living Donors
Immunosuppression
Allografts
Adrenal Cortex Hormones
Transplantation
Enzyme-Linked Immunosorbent Assay
Serum

Keywords

  • Antibody
  • Human kidney
  • Sirolimus

ASJC Scopus subject areas

  • Immunology

Cite this

The addition of sirolimus to cyclosporine and steroids inhibits the anti-equine antibody response in renal transplant recipients treated with antithymocyte globulin. / Pescovitz, Mark D.; Book, Benita K.; Henson, Sharon; Leapman, Stephen B.; Milgrom, Martin L.; Kimball, Jess; Norman, Douglas; Filo, Ronald S.

In: American Journal of Transplantation, Vol. 3, No. 4, 04.2003, p. 497-500.

Research output: Contribution to journalArticle

Pescovitz, Mark D. ; Book, Benita K. ; Henson, Sharon ; Leapman, Stephen B. ; Milgrom, Martin L. ; Kimball, Jess ; Norman, Douglas ; Filo, Ronald S. / The addition of sirolimus to cyclosporine and steroids inhibits the anti-equine antibody response in renal transplant recipients treated with antithymocyte globulin. In: American Journal of Transplantation. 2003 ; Vol. 3, No. 4. pp. 497-500.
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AU - Kimball, Jess

AU - Norman, Douglas

AU - Filo, Ronald S.

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AB - Polyclonal antibodies, such as equine antithymocyte globulin (ATGAM®), are known to induce antibody formation. This study evaluated the in vivo effect of sirolimus on antibody formation associated with the use of equine antithymocyte globulin in renal transplant recipients. Recipients of either a living-related donor or cadaveric renal allograft received azathioprine (AZA) (n = 15), mycophenolate mofetil (MMF) (n = 12), or sirolimus (n = 15) in addition to baseline immunosuppression with corticosteroids, cyclosporine, and equine antithymocyte globulin. Immediately before transplantation and weekly for at least 1 month, sequential serum specimens were tested for the presence of human antiequine antibody using an enzyme-linked immunosorbent assay (ELISA). Anti-equine antibody formation was significantly different among the three treatment groups. Fewer patients receiving MMF (17%, p=0.007 vs. AZA) and sirolimus (13%, p =0.003 vs. AZA) developed anti-equine antibody compared with AZA (66%). There was no significant difference (p=0.81) in the sensitization to equine antithymocyte globulin when comparing the patients receiving MMF or sirolimus. In the sensitized patients, high anti-equine antibody titers (>1:500) were more common in those receiving AZA (n = 3) than MMF (n = 0) or sirolimus (n = 1). Compared to AZA, sirolimus, when given in combination with cyclosporine A, significantly reduced anti-equine antibody formation to a degree similar to MMF.

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