Repurposed drug may be first targeted treatment for serious kidney disease
(Massachusetts General Hospital) A team led by Massachusetts General Hospital researchers is reporting that treatment with abatacept appeared to halt the course of focal segmental glomerulosclerosis in five patients, preventing four from losing transplanted kidneys and achieving disease remission in the fifth.
To the Editor: Vitiligo remains a major challenge in dermatology because there is no definitive cure.1 The autoimmune nature of vitiligo has been described,2 and the involvement of T cells in pathogenesis of vitiligo has also been shown in previous reports.3 While the therapeutic potential of immunosuppressants has often been raised, their role has not been well examined.
To the Editor: Invasive melanoma incidence is over 2-fold increased among organ transplant recipients (OTRs) compared to the general population; OTRs also have a 3-fold increased risk for disease-specific mortality compared with the general population.1 Recent advances in the treatment of metastatic melanoma, including targeted therapies (BRAF and MEK inhibitors) and checkpoint inhibitors (anti –cytotoxic T-lymphocyte–associated protein [CTLA] 4 and anti–programmed cell death [PD] 1) have revolutionized melanoma treatment and had a major impact on progression-free and overall survival for the general population.
What is it like to be a donor family, a recipient or to be on the waiting list for a transplant?
My coauthors and I appreciate the interest in our study and the comments of Drs Adhyapak and Parachuri. We agree that our study focused on a previously underinvestigated patient cohort, namely those who in addition to having severe left ventricular dysfunction met criteria for advanced surgical therapies such as tra nsplant or ventricular assist device implantation. In contrast to many studies that simply used a left ventricular ejection fraction value less than 20% as an inclusion criterion, our study excluded those patients who had transient “hibernating” myocardium and those with stable cardiomyopathie...
In a recent article,1 conventional coronary artery bypass grafting surgery was associated with excellent results, like transplantation and/or left ventricular assist device implantation, although coronary artery bypass grafting surgery was only offered to a highly selected group of patients who demonstrated left ventricle myocardial viability and appropriate coronary target vessels for coronary bypass. Moreover, the patients were evaluated by a team of physicians with a large amount of experience in the treatment of patients with end-stage heart failure.
Adhyapak and Parachuri have rightly focused on the most remarkable conclusion of the recent article by Kawajiri and colleagues1—that advanced heart failure is not a contraindication to conventional cardiac surgery. This conclusion gives credence to the natural instincts of many cardiologists and surgeons to address ex isting pathology before considering replacement or assist strategies. Nevertheless, routinely incorporating an expected 12% (n = 16) in-hospital mortality into one's practice carries substantial reputational risks that may offset the benefits of taking on these types of cases—particular...
Despite several interventions, both pharmacologic- and device-based, for the treatment of advanced heart failure following ischemic heart disease, the incidence is increasing in large proportions, mainly targeting a patient's productive years. Several novel molecular- and device-based therapies have been developed that show promising short-term results with no long-term benefits.1 Although most randomized controlled trials yield results that are disappointing or difficult to interpret, the seemingly neutral findings of these trials promote the need for further trials.
Max Olivares has a rare heart and lung condition, which requires a complex transplant operation.
A new study examines the association of post-dialysis weight changes with all-cause mortality in hemodialysis patients.Nephrology Dialysis Transplantation
In this study, we examined whether astrocytic function could be utilized to overcome the current limitations of cell-based therapies in a murine model of Parkinson’s disease (PD) that is characterized by dopamine (DA) neuron degeneration in the midbrain. We show here that cografting astrocytes, especially those derived from the midbrain, remarkably enhanced NPC-based cell therapeutic outcomes along with robust DA neuron engraftment in PD rats for at least 6 months after transplantation. We further show that engineering of donor astrocytes with Nurr1 and Foxa2, transcription factors that were recently reported to pola...