Background: The Interaction between anti-tuberculous and immunosuppressive drugs which may increase the risk of graft rejections is a major challenge in managing transplant recipients with tuberculosis (TB). Instead of rifampicin (RFM), most guidelines recommended the use of rifabutin (RFB) because of its reduced capacity to induce immunosuppressant metabolism while maintaining the same efficacy as RFM against TB. However, there has been no available data directly comparing the outcome of RFB from RFM-based anti-TB regimens in liver transplant patients with TB. This study aimed to compare the effects of RFB from RFM-based treatment in terms of the drug interaction with immunosuppressants, as well as the safety, efficacy and clinical outcomes of living donor liver transplant (LDLT) recipients with active TB.
Methods: A retrospective study was conducted on all adult LDLT recipients diagnosed with active TB from June 1994 to May 2016 that had concurrently and continuously received either RFB or RFM-based treatment and immunosuppressants.
Results: Twenty-two patients were included. Twelve (55%) patients were in the RFM group. Ten (45%) patients were in the RFB group. RFB group showed a lesser rate of immunosuppressant trough level reduction (20% vs 50%, p = 0.009) during TB treatment. There was no TB recurrence and no significant change in platelet or leukocyte count in either group. Acute cellular rejection (ACR), rate of TB-treatment completion and overall survival, rates were excellent and statistically similar in both groups.
Conclusion: The use of RFB in LDLT recipients with active TB, had a lesser drug interaction than when RFM was used. However, RFB did not significantly reduced the rate of ACR. RFB and RFM are both effective and safe to use in LDLT recipients with active TB.
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http://dx.doi.org/10.1016/j.bj.2020.08.010 | DOI Listing |
Br J Clin Pharmacol
December 2024
Department of Pharmacology, Toxicology and Pharmacovigilance, CHU de Limoges, Limoges, France.
Aims: Mycophenolic acid (MPA), the active component of enteric-coated mycophenolate sodium (EC-MPS), exhibits highly variable pharmacokinetics. Only a few population pharmacokinetic (popPK) models and Bayesian estimators (MAP-BE) exist for estimating MPA AUC and all in renal transplantation. This study aimed to develop a popPK model and MAP-BE for MPA AUC estimation using a limited sampling strategy (LSS) in solid organ transplant (SOT), haematopoietic stem cell (HSC) recipients and patients with autoimmune diseases (AID) on EC-MPS.
View Article and Find Full Text PDFBMC Geriatr
December 2024
Assistive Robot Center, National Center for Geriatrics and Gerontology Research Institute, Obu, Aichi, Japan.
Background: Socially assistive robots introduced in nursing care settings have multidimensional psychological impacts on care recipients and caregivers. This study aims to explore the longitudinal changes induced by socially assistive robots, focusing on a chain of human behaviors.
Methods: In this qualitative study, nine participants from two nursing homes who had experience in manipulating socially assistive robots were interviewed in a semi-structured focus group using a topic guide to explore the changes in care recipients and caregivers.
Mol Biol Rep
December 2024
Production Engineering Division, Momoshima Field Station, Fisheries Technology Institute, Japan Fisheries Research and Education Agency, 1760 Momoshima, Onomichi, Hiroshima, 722-0061, Japan.
Background: As part of stock enhancement programs for marine fishery species, the stocking of hatchery-produced seedlings into sea areas has been implemented worldwide. DNA markers are vital for responsible stock enhancement practices that aim to conserve the genetic diversity of recipient wild populations. We report novel single-nucleotide polymorphism (SNP) markers and multiplex SNP panels developed for the west Pacific pen shell Atrina lischkeana (Clessin, 1891), a large bivalve that is expected to be a subject of stock enhancement activity as the natural resource has dwindled, especially in Japan.
View Article and Find Full Text PDFBiochim Biophys Acta Rev Cancer
December 2024
Institute of Interdisciplinary Integrative Medicine Research, Shanghai University of Traditional Chinese Medicine, Shanghai 201203, China. Electronic address:
Mitochondrial DNA (mtDNA), a circular double-stranded DNA located within mitochondria, plays a pivotal role in mitochondrial-induced innate immunity, particularly via the cyclic GMP-AMP synthase (cGAS)-STING pathway, which recognizes double-stranded DNA and is crucial for pathogen resistance. Recent studies elucidate the interplay among mtDNA, the cGAS-STING pathway, and neutrophil extracellular traps (NETs) in the context of cancer. mtDNA uptake by recipient cells activates the cGAS-STING pathway, while mtDNA leakage reciprocally regulates NET release, amplifying inflammation and promoting NETosis, a mechanism of tumor cell death.
View Article and Find Full Text PDFJ Clin Virol
December 2024
Division of Infectious Diseases, Department of Medicine, Duke University, Durham, NC, USA. Electronic address:
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