Search PubMed⌕ Search

SEARCH · Search PubMed

Results for “Muromonab-CD3”

Search indexed PubMed citations on genomics, clinical trials, systematic reviews and public health. Explore titles, authors and supplied subject terms, then open the PubMed record.

Quote a phrase for an exact phrase match. Source license links do not imply unrestricted reuse.

At least 505 records · Page 28Linked to original sources
PubMedDate not supplied

Association of pretransplantation antiheart antibodies with clinical course after heart transplantation.

METHODS: Sera from 129 patients awaiting heart transplantation were assayed for the presence of IgM and IgG antiheart antibodies by means of sodium dodecyl sulphate-polyacrylamide gel electrophoresis and Western blotting. The patients' posttransplantation clinical course was assessed with regard to the amount of methylprednisolone, rabbit antithymocyte globulin, and OKT3 anti-T cell antibody, and the number of biopsy-confirmed rejection episodes. Before undergoing heart transplantation, approximately half the patients had weak IgM (45%) and weak IgG (48%) antiheart antibodies. However, 22.5% of the patients had strong IgM antiheart antibodies before transplantation, and they required more methylprednisolone than those who were negative and weak and approximately twice as much rabbit antithymocyte globulin as those who were negative, weak, or moderate. Six of the patients in this group required OKT3 therapy, and additionally they had a significantly greater number of rejection episodes than those patients who were negative (p = 0.006), or who had weak antiheart antibodies before transplantation (p = 0.001). RESULTS AND CONCLUSIONS: Analysis of the pattern of banding of strong IgM antiheart antibody sera showed antiheart antibodies most frequently against myocardial proteins of 35, 42, 50, 60, 70, 110, 120, 150, 180, and 200 kDa. Several of these proteins were characterized by two-dimensional polyacrylamide gel electrophoresis and Western blotting as tropomyosin (35 kDa), actin (42 kDa), heat shock protein 60 (60 kDa), and heat shock protein 70 (70 kDa). All strong antiheart antibody sera showed reactivity against a 200 kDa protein corresponding to myosin heavy chain.

Adult↗
PubMedDate not supplied

Efficacy of low-dose OKT3 as cytolytic induction therapy in heart transplantation.

BACKGROUND: The need for prophylactic cytolytic treatment in heart transplantation is a controversial issue. Its use, however, might prevent the onset of cellular rejection in the immediate postoperative period, facilitating patient management. It has recently been suggested that the administration of these products at low doses might have the same immunologic impact and would reduce secondary effects and the cost of treatment. METHODS: In a nonrandomized retrospective study, we assessed 45 consecutive patients who underwent orthotopic heart transplantation in 1992 and 1993. Six patients who died before receiving the complete OKT3 dose were excluded. Twenty-three patients were treated with 5mg/day doses of OKT3 for 7 consecutive days. Another 16 patients received 2.5 mg of OKT3 for 7 consecutive days. RESULTS: There were no significant differences between the two groups with respect to CD3 counts on days 2 (0.1% +/- 0.3% versus 0.04% +/- 0.25%; p > 0.05) and 6 (0.2% +/- 0.45% versus 0.1% +/- 0.3%; p > 0.05), number of rejection episodes (1.45% +/- 0.8% per year of follow-up versus 1.7% +/- 1.2%, p = 0.66), number of infectious complications (8 versus 3, p > 0.05), total methylprednisolone dose used to treat rejection crises (3900 +/- 2765 versus 3600 +/- 1963 mg; p = 0.71), adverse effects attributed to OKT3 (two versus none), or length of the postoperative hospital stay (36.8 +/- 19 versus 30.2 +/- 20.9 days). CONCLUSIONS: As cytolytic induction therapy in heart transplantation, a daily regimen of 2.5 mg of OKT3 for 7 days achieves the same clinical and immunologic effect as the conventional 5 mg/day dose. In addition, it results in a considerable reduction in the cost of treatment.

Azathioprine↗
PubMedDate not supplied

Reliability and usefulness of immunofluorescence in heart transplantation.

BACKGROUND AND METHODS: To study the reliability and usefulness of immunofluorescence on heart biopsy specimens for routine monitoring of heart transplant recipients for rejection, frozen sections of 72 consecutive endomyocardial biopsy specimens from 18 heart transplant recipients during the first 6 weeks after transplantation (and later) and from 11 control specimens from donor hearts and other nontransplantation patients were studied. Fifteen patients received OKT3 induction. The diagnosis of vascular (humoral) rejection pattern as defined by Hammond was based on the microvascular deposition of immunoglobulin and C3 or C1q. Echocardiographic data and right-sided heart catheterization were obtained simultaneously. RESULTS: The results showed that immunofluorescence was positive for a vascular rejection pattern in 60% (43 of 72) overall, in heart transplant recipients it was positive in 59% (36 of 61), and in control subjects it was positive in 63% (7 of 11). Most of the patients who had positive immunofluorescence had no hemodynamic compromise. Humoral rejection was not predicted by positive immunofluorescence in our study. We also found no correlation with either positive or negative immunofluorescence for the short-term or long-term outcome during the first 6 weeks after transplantation. CONCLUSION: The usefulness of routine immunofluorescence in all surveillance heart biopsies is questionable as determined by this study.

Adult↗
PubMed1995

Expanding indications for biotechnology agents.

Many biotechnology products currently on the market were initially approved for indications affecting only a small number of patients. However, pharmaceutical manufacturers have continued to study these agents for potential new therapeutic uses. The result is that several of these products are now approved for multiple uses involving large patient populations. In many cases, the biotechnology agents are being used in patients for whom no effective therapy was previously available.

Biotechnology↗
PubMed1994

Ion exchange resins for the purification of monoclonal antibodies from animal cell culture.

We have compared various ion exchangers for monoclonal antibody (MAb) purification using different starting materials such as ascitic fluid and cell culture supernatant. Twelve cation and anion exchange resins were tested so far. Purification of MAbs with regard to the starting material is described. In well-defined conditions of adsorption (20 mM MES buffer, pH 6.50), one purification step based on cation-exchange chromatography is generally sufficient to achieve at least 90% purity of the MAb, even when produced by animal cell culture. Cation-exchange supports exhibit higher capacity for MAbs compared to anion exchangers. Among the cation exchangers tested, we have selected the cross-linked matrix S Sepharose FF for its large specificity and capacity for MAbs. Considering these key parameters and also the good mechanical resistance of the S Sepharose FF, we describe how, by varying the flow rate, sample concentration, and size of the column, the productivity may be improved in a monoclonal antibody purification process. Finally, a general 'gram scale' purification protocol of MAbs produced by animal cell cultures is proposed. This protocol, based on economical adsorption conditions and three steps of elution (100 mM, 200 mM and 1 M NaCl), allows the recovery of highly purified MAbs.

Animals↗
PubMedDate not supplied

Intragraft monitoring of rejection after prophylactic treatment with monoclonal anti-interleukin-2 receptor antibody (BT563) in heart transplant recipients.

BACKGROUND: Anti-interleukin-2 receptor monoclonal antibodies have been used successfully in the prevention of rejection in cardiac allografts in several animal models. METHODS: In an open randomized study murine monoclonal CD3 antibody and BT563, a murine anti-interleukin-2 receptor monoclonal antibody, were given as rejection prophylaxis during the first week after heart transplantation. Cyclosporine therapy was initiated at the third postoperative day. RESULTS: In half the BT563-treated patients an early rejection was histologically shown at week 1, whereas heart transplant recipients treated with murine monoclonal CD3 antibody had a rejection incidence at week 1 of only 9%. During BT563 treatment CD25-positive cells (i.e., cells bearing the interleukin-2 receptor) were not detectable in peripheral blood. However, immunohistologic studies of endomyocardial biopsy specimens taken 1 week after transplantation showed the presence of CD25-positive cells within these specimens in 8 of 10 (80%) of patients with rejection. In patients without rejection CD25-positive cells were present in the biopsy specimens of only two of nine patients (22%). Reverse-transcriptase polymerase chain reaction studies on biopsy material showed the presence of messenger RNA for the interleukin-2 receptor in all and for interleukin-2 in three of five (60%) of biopsy specimens of rejecting grafts. CONCLUSIONS: Although CD25-positive cells were not detectable in peripheral blood during BT563 treatment, these cells were at the same time found to be present within 80% of the endomyocardial biopsy specimens from the rejecting grafts. By initiating cyclosporine treatment at day 0, the synergistic effect of combining cyclosporine and anti-interleukin-2 receptor monoclonal antibodies may result in a lower rejection incidence.

Animals↗
PubMedDate not supplied

Acute rejection: significance of elapsed time after transplantation.

In July 1990 the new standardized grading scheme for the International Society for Heart and Lung Transplantation was established. One of the purposes of "splitting" the grades was to learn the significance and outcome of the various grades proposed. Between January 1990 and November 1992, 263 grade 1A, 19 grade 1B, and 100 grade 2 "new" rejection episodes were identified at our institution. These episodes occurred in 86 adult recipients who underwent transplantation between January 1990 and August 1992 and 98 recipients who underwent transplantation before January 1990, in whom the episodes occurred more than 1 year from the date of transplantation. The outcome of the episode was determined on subsequent endomyocardial biopsy samples to be resolution or "progression" to a higher grade. The percentage of focal mild (grade 1A) rejection episodes progressing to a moderate (grade 3A) rejection in the first 6 months after transplantation was 24.4% (20 of 82) compared with a progression rate of 5.1% (3 of 59) and 2% (3 of 149) in episodes occurring beyond 6 months and 1 year after transplantation, respectively (p < 0.005). Of the focal moderate (grade 2) rejection episodes receiving no augmentation of immunosuppression, 35.7% (5 of 14) occurring within the initial 6 months and 7.3% (3 of 41) of all such episodes diagnosed beyond 1 year after transplantation progressed to a moderate rejection. A similar trend was seen in the focal moderate rejection episodes that received augmentation of immunosuppression: 26.3% (5 of 19) of episodes occurring within 6 months and 0 of 15 of all episodes occurring beyond 1 year after transplantation progressed to a moderate rejection.(ABSTRACT TRUNCATED AT 250 WORDS)

Acute Disease↗
PubMed1995

Severe or multiple rejection episodes are associated with early recurrence of hepatitis C after orthotopic liver transplantation.

Recurrent hepatitis C causes significant morbidity after liver transplantation. Because immunosuppression is associated with enhanced viral replication, we postulated that clinical recurrence of the disease may be associated with augmented immunosuppression for rejection. In 96 patients with hepatitis C who received liver transplants, we recorded the interval from transplantation to recurrence, the episodes of steroid-resistant rejection (SRR) requiring OKT3, the number of rejection episodes, and the use of OKT3 induction. Recurrence was diagnosed based on elevated transaminases and characteristic histology. Hepatitis C recurred in 43 of 96 patients. Fifteen of 21 patients (71.4%) who previously had SRR had recurrence, versus 28 of 75 patients (37.3%) who either had no SRR (72 patients) or had it after recurrence was diagnosed (3 patients) (P < .01). Mean time to recurrence was 127 +/- 31 days in the 15 patients who had had SRR versus 246 +/- 42 days in the other 28 patients (P = .02). Recurrence and number of rejection episodes were clearly associated: 6 of 33 patients (18.2%) with no rejection had recurrence (P < .05), versus 11 of 26 patients (42.3%) with one rejection episode (P < .05) and 26 of 37 (70.2%) with more than 1 episode (P < .05). OKT3 induction was used in 15 patients; 9 of 15 patients had recurrence (ns) at 337 +/- 95 days. Of 72 patients who initially received triple immunosuppression, 30 patients had recurrence at 186 +/- 25 days (P = .05). Nine patients received primary FK506; 4 had recurrence at 68 +/- 14 days.(ABSTRACT TRUNCATED AT 250 WORDS)

Drug Resistance↗