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Effects of immunoadsorption combined with membrane filtration on complement markers – results of a randomized, controlled, crossover study

Federica Defendi 1 Paolo Malvezzi 2 Farsad Eskandary 3 Jean-Yves Cesbron 4, 1 Lionel Rostaing 2 Georg Böhmig 3 Chantal Dumestre-Pérard 4, 1
4 TIMC-IMAG-BNI - Barrière Naturelle et Infectiosité
TIMC-IMAG - Techniques de l'Ingénierie Médicale et de la Complexité - Informatique, Mathématiques et Applications, Grenoble - UMR 5525
Abstract : The complement system has been implicated in several kidney diseases, such as antibody-mediated rejection after kidney transplantation. Antibody-depletion techniques allow successful ABO- and/or HLA-incompatible transplantation. Considering the IgG removal, the use of semi-selective immunoadsorption (IA) has been advocated. However, because of results on incomplete IgM depletion, the adjunctive use of membrane filtration (MF) has been proposed to enhance the removal of macromolecules and to interfere with complement activation. This secondary endpoint analysis of a recently published randomized, controlled, cross-over trial was designed to investigate the effect of combined treatment IA + MF compared to IA alone on complement depletion. Two treatment sequences, a single session of IA + MF followed by IA (and vice versa), were analyzed with regard to C5b-9, properdin, and mannose-binding lectin (MBL) levels. Neither IA alone nor IA + MF provoked complement activation as demonstrated by stable low levels of C5b-9 after the procedure as compared to the previous. The combined treatment substantially lowered properdin (77% vs. 26% reduction, P < 0.0001) as well as MBL concentrations (81% vs. 11% reduction, P < 0.0001). Recovery of properdin and MBL levels appears to be longer after IA alone compared to IA + MF. Depletion of properdin and MBL levels may have potential clinical implications in the setting of kidney transplantation.
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https://hal.archives-ouvertes.fr/hal-02107571
Contributeur : Cordelia Bisanz <>
Soumis le : mardi 23 avril 2019 - 16:52:39
Dernière modification le : jeudi 25 avril 2019 - 11:16:35

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Federica Defendi, Paolo Malvezzi, Farsad Eskandary, Jean-Yves Cesbron, Lionel Rostaing, et al.. Effects of immunoadsorption combined with membrane filtration on complement markers – results of a randomized, controlled, crossover study. Transplant International, Wiley, 2019, ⟨10.1111/tri.13431⟩. ⟨hal-02107571⟩

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