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J Dantal

Publications and source records attributed to J Dantal.

65 records · Page 4Linked to original sources
PubMed1991

Effect of anti-LFA1 (CD11a) monoclonal antibodies in acute rejection in human kidney transplantation.

A murine IgG1 monoclonal antibody, 25-3 (Immunotech, France), directed against the alpha chain (CD11a) of the human LFA1 molecule was used in the treatment of 7 histologically documented first acute rejection in first kidney transplantations under cyclosporine. Four patients (group I) received 20 mg/day for 2 days and 10 mg/day for 8 days of 25-3 MoAb. One developed Quincke's edema after the first injection of 25-3 and was immediately withdrawn from the study. In 2 patients, whose serum creatinine continued to increase, 25-3 MoAb was replaced by steroids, followed by ALG after 3 and 4 days of treatment, respectively. In the last case, rejection was reversed by 25-3 MoAb alone. As the clinical response of rejection to 25-3 was poor, another group of 3 patients (group II) was treated with 25-3 at a dose of 40 mg/day for 2 days, 20 mg/day for 2 days, and 10 mg/day for 6 days, but 25-3 was still unsuccessful in reversing acute rejection, and rescue treatment was initiated between days 5 and 8 in all cases. MoAb tolerance was excellent in 3 patients. With the exception of the one case of Quincke's edema, only minor side effects were noted in the last 3 recipients. 25-3 MoAb serum trough levels peaked between 1.5-3.5 micrograms/ml at day 3 in group I and between 2-9 micrograms/L at day 2 in group II. Surprisingly, only one patient, in group I, exhibited a borderline IgG immune response against 25-3. These findings suggest that the 25-3 anti-CD11a MoAb is ineffective in controlling the course of acute rejection in kidney transplantation. However as already reported for another anti-LFA1 or with an anti-CD4 MoAb in mouse, 25-3 would be the first example in humans of a MoAb that does not elicit a strong immune response against its own determinants. This property might have important applications if 25-3 can prevent rejection in a prophylactic protocol or block the immune response against other MoAbs.

Adult↗
PubMed1991

Recurrent nephrotic syndrome following renal transplantation in patients with focal glomerulosclerosis. A one-center study of plasma exchange effects.

Forty seven renal allografts performed over a period of 12 years in 43 recipients with chronic renal failure due to biopsy-proved focal glomerulosclerosis (FGS, 5.34% from 888 cadaveric renal transplantations) were reviewed. Recurrence of the disease was suspected in 14 grafts (29.8%) on the basis of immediate proteinuria, but recurrence of FGS lesions was demonstrated in only 7 patients. The remaining 7 patients had minimal-change nephropathy or mesangial hyperplasia. The duration of renal disease before transplantation was a clear predictive risk factor of FGS recurrence, and mesangial hyperplasia in the native kidneys was associated with 50% risk of FGS recurrence. Some reports have suggested that plasma exchange may be beneficial in the treatment of FGS recurrence. Our experience, in 9 patients, indicates that plasma exchange initiated early in the course of recurrent proteinuria leads to transient but significant disappearance (2 cases) or decrease (5 cases) of proteinuria, with a return to pre-plasma exchange levels within 2 weeks after the end of treatment. In 2 cases, there was no beneficial effect on proteinuria. Plasma exchange efficacy was correlated with proteinuria levels relative to disease severity. Although plasma exchange does not seem to improve the outcome of FGS recurrence, it demonstrates the possible presence of circulating factor(s) and argues for the characterization of humoral mediator(s).

Complement C1q↗
PubMed1988

[Circulating anticoagulants and pregnancy: a risky combination].

In the last ten years the relationship between the presence of lupus type anticoagulants in the blood and some obstetrical complications, in particular spontaneous abortions, repeated fetal deaths in utero and intra-uterine growth retardation, has been well documented. A study of the literature shows that there were only twenty live-born children out of 280 pregnancies in 71 women who had the lupus type anticoagulant factor. The presence of the factor in high levels in a pregnant woman was seen to be of poor prognostic significance for the obstetric outcome. Biologically the lupus type circulating anticoagulant should be suspected when there is a five to six seconds prolongation of clotting time and it is highly suspicious if the time is prolonged by more than seven seconds. Its presence should equally be suspected by testing for the activated partial thromboplastin time (APTT). It has been shown that early treatment directed to lessen the activity of the lupus type factor (the use of corticoid-immunosuppressors) and forestalling as far as possible placental insufficiency (by giving heparin, aspirin and dipyridamole) could help, thus enabling some women to have live children who would not otherwise be able to do so.

Autoantibodies↗