Research of Small-Molecule Therapeutics in Transplantation and Tolerance

A special issue of Biomedicines (ISSN 2227-9059). This special issue belongs to the section "Cell Biology and Pathology".

Deadline for manuscript submissions: 30 April 2024 | Viewed by 903

Special Issue Editor


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Guest Editor
David Geffen School of Medicine at UCLA, Los Angeles, CA, USA
Interests: molecular biochemistry; cell biology; immunology; small molecule pharmacokinetics

Special Issue Information

Dear Colleagues,

Organ transplantation is the best curative treatment for patients with end-stage organ disease. An unavoidable complication leading to early allograft dysfunction is mediated primarily by ischemia-reperfusion injury (IRI). This peri-transplant clinical condition is characterized by interrelated phases involving donor-tissue ischemic necrosis and recipient reperfusion, which introduces the innate-adaptive immune interface that promotes pro- and anti-inflammatory responses. As the consequences of I/R injury remain vast, understanding the mechanistic factors leading to I/R injury remains a top priority. Determining the peak induction potential of the signaling networks that attenuate antioxidant, detoxification, and homeostatic functions may be the key to understanding why specific therapeutic strategies fail to advance through clinical trials.

In the past year, small-molecule therapeutics, comprised of RNA, protein, and/or drug-based molecules, have achieved impressive results regulating gene expression networks involved in pro- and anti-inflammatory responses to organ transplantation injury. They have been shown to significantly increase the capacity to prevent organ rejection by reducing oxidative stress and inflammation, modulating the immune response, and stimulating the production of protective enzymes that promote tissue repair. The aim of this Special Issue is to illustrate how these small molecules hold the potential to improve the survival of patients undergoing solid organ transplantation.

Dr. Kenneth J. Dery
Guest Editor

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Keywords

  • organ transplantation
  • oxidative stress
  • ischemia-reperfusion injury
  • short-activating RNA
  • small-molecule therapeutics
  • early allograft dysfunction
  • morpholinos

Published Papers (1 paper)

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Research

11 pages, 816 KiB  
Article
Prevention of Delayed Graft Function in Kidney Transplant Recipients through a Continuous Infusion of the Prostaglandin Analogue Iloprost: A Single-Center Prospective Study
by Massimiliano Veroux, Floriana Sanfilippo, Giuseppe Roscitano, Martina Giambra, Alessia Giaquinta, Giordana Riccioli, Domenico Zerbo, Daniela Corona, Massimiliano Sorbello and Pierfrancesco Veroux
Biomedicines 2024, 12(2), 290; https://doi.org/10.3390/biomedicines12020290 - 26 Jan 2024
Viewed by 679
Abstract
Background: Delayed graft function (DGF) is common after kidney transplantation from deceased donors and may significantly affect post-transplant outcomes. This study aimed to evaluate whether an innovative approach, based on the administration of the intravenous prostaglandin analogue iloprost, could be beneficial in reducing [...] Read more.
Background: Delayed graft function (DGF) is common after kidney transplantation from deceased donors and may significantly affect post-transplant outcomes. This study aimed to evaluate whether an innovative approach, based on the administration of the intravenous prostaglandin analogue iloprost, could be beneficial in reducing the incidence of DGF occurring after kidney transplantation from deceased donors. Methods: This prospective, randomized (1:1), placebo-controlled study enrolled all consecutive patients who received a kidney transplant from a deceased donor from January 2000 to December 2012 and who were treated in the peri-transplant period with the prostaglandin analogue iloprost at 0.27 μg/min through an elastomeric pump (treatment group) or with a placebo (control group). Results: A total of 476 patients were included: DGF was reported in 172 (36.1%) patients in the entire cohort. The multivariate analysis showed that the donor’s age > 70 years (OR 2.50, 95% confidence interval (CI): 1.40–3.05, p < 0.001), cold ischemia time > 24 h (OR 2.60, 95% CI: 1.50–4.51, p < 0.001), the donor’s acute kidney injury (OR 2.71, 95% CI: 1.61–4.52, p = 0.021) and, above all, the recipient’s arterial hypotension (OR 5.06, 95% CI: 2.52–10.1, p < 0.0001) were the strongest risk factors for developing post-transplant DGF. The incidence of DGF was 21.4% in the treatment group and 50.9% in the control group (p < 0.001). Interestingly, among patients who developed DGF, those who received iloprost had a shorter duration of post-transplant DGF (10.5 ± 8.3 vs. 13.4 ± 6.7, days, p = 0.016). Conclusions: This study showed that the use of a continuous infusion of iloprost could safely and effectively reduce the incidence of DGF in recipients of deceased-donor kidneys, allowing a better graft functionality as well as a better graft survival. Full article
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