Article
Immunology
Vojtech Petr, Dorottya Csuka, Petra Hruba, Agnes Szilagyi, Marek Kollar, Antonij Slavcev, Zoltan Prohaszka, Ondrej Viklicky
Summary: De novo thrombotic microangiopathy (TMA) is associated with poor kidney graft survival, and there is a recipient-driven process with suspected genetic background. Carriers of the MCPggaac haplotype have a higher risk of graft loss, and longer cold ischemia time is associated with worse graft survival.
FRONTIERS IN IMMUNOLOGY
(2022)
Article
Immunology
Hiroshi Okamura, Hirohisa Nakamae, Takero Shindo, Katsuki Ohtani, Yoshihiko Hidaka, Yasufumi Ohtsuka, Yosuke Makuuchi, Masatomo Kuno, Teruhito Takakuwa, Naonori Harada, Mitsutaka Nishimoto, Yasuhiro Nakashima, Hideo Koh, Asao Hirose, Mika Nakamae, Nobutaka Wakamiya, Masayuki Hino, Norimitsu Inoue
Summary: The study found that plasma levels of Ba protein play a sensitive and predictive role as a biomarker in transplant-associated thrombotic microangiopathy, while complement-related genetic variants do not predict the development of TA-TMA.
FRONTIERS IN IMMUNOLOGY
(2021)
Review
Immunology
Rui Zhang, Meng Zhou, Jiaqian Qi, Wenjing Miao, Ziyan Zhang, Depei Wu, Yue Han
Summary: The study evaluated the efficacy and safety of Eculizumab for TA-TMA, finding that it can improve survival rate and overall response rate in patients, with the most common adverse event being infection. However, more high-quality studies are needed to further validate these findings.
FRONTIERS IN IMMUNOLOGY
(2021)
Review
Biochemistry & Molecular Biology
Ioanna Lazana
Summary: Transplant-associated thrombotic microangiopathy (TA-TMA) is a significant contributor to morbidity and mortality after allogenic hematopoietic stem cell transplantation (allo-HSCT). The diagnosis of TA-TMA is challenging due to lack of consensus diagnostic criteria and common clinical features mimicking other diseases. Therapeutic plasma exchange (TPE) has been traditionally used, but the efficacy is doubtful. Complement inhibitors, such as eculizumab, have shown promising results in clinical trials. Future goals include identifying specific risk factors and developing better treatment options.
INTERNATIONAL JOURNAL OF MOLECULAR SCIENCES
(2023)
Article
Transplantation
Antoine Decaestecker, Aghiles Hamroun, Francois Provot, Eric Rondeau, Stanislas Faguer, Marion Sallee, Dimitri Titeca-Beauport, Jean Michel Rebibou, Alexandra Forestier, Raymond Azar, Clement Deltombe, Alain Wynckel, Steven Grange, Veronique Fremeaux Bacchi, Claire Cartery
Summary: This study retrospectively analyzed the data of 59 patients with cancer-associated thrombotic microangiopathy (TMA) and compared the efficacy of different treatment methods. The results showed that urgent chemotherapy significantly improved the survival rate of patients, while eculizumab did not have a significant improvement on survival time and hematological remission rates.
NEPHROLOGY DIALYSIS TRANSPLANTATION
(2023)
Article
Hematology
Myrthe M. A. Toorop, Nienke van Rein, Suzanne C. Cannegieter, Felix J. M. van der Meer, Pieter H. Reitsma, Willem M. Lijfering, Mettine H. A. Bos
Summary: High sTM levels at the start of treatment are associated with major bleeding during vitamin K antagonist treatment, particularly in the presence of a high INR. The risk of major bleeding is dose-dependently associated with sTM levels, with a significant increase in risk for levels above the 85th percentile compared to the <25th percentile.
THROMBOSIS AND HAEMOSTASIS
(2021)
Article
Hematology
Will Thomas, Theodora Foukaneli, Joyce Cosgrove, Dunecan Massey, Jeremy Woodward, Stephen Middleton, Martin Besser, Neil Russell, Irum Amin, Andrew Butler, Lisa Sharkey
Summary: Descriptions of passenger lymphocyte syndrome (PLS), immune cytopenias, and transplant-associated thrombotic microangiopathy (TA-TMA) after intestine-containing transplants are rare. In this study of 96 patients who received 103 transplants, PLS, immune cytopenias, and TA-TMA were observed as common complications that required comprehensive treatment. Further research in this patient group is needed.
BRITISH JOURNAL OF HAEMATOLOGY
(2021)
Article
Critical Care Medicine
Nobuyasu Awano, Taisuke Jo, Takehiro Izumo, Minoru Inomata, Kojiro Morita, Hiroki Matsui, Kiyohide Fushimi, Hirokazu Urushiyama, Takahide Nagase, Hideo Yasunaga
Summary: This study investigated the effectiveness and safety of recombinant human soluble thrombomodulin (rTM) for the treatment of acute exacerbation of idiopathic pulmonary fibrosis (AE-IPF). The results showed that adding rTM to high-dose methylprednisolone (mPSL) treatment did not improve outcomes for patients with severe respiratory failure.
JOURNAL OF INTENSIVE CARE
(2022)
Article
Peripheral Vascular Disease
Yasunori Iida, Ryota Asano, Takashi Hachiya
Summary: This case demonstrates the successful treatment of chronic type B aortic dissection complicated by disseminated intravascular coagulopathy using TEVAR followed by rhTM administration. This treatment approach may be effective in patients with large intimal tears and false lumens.
Editorial Material
Hematology
Anthony Sabulski, Sonata Jodele
Summary: Transplant-associated thrombotic microangiopathy is a life-threatening complication of haematopoietic stem cell transplant, and some patients do not respond to current treatment methods. Qi et al. show that HIF-1α may be a previously unrecognized driver of this endothelial injury syndrome.
BRITISH JOURNAL OF HAEMATOLOGY
(2022)
Article
Hematology
Hideo Kato, Mao Hagihara, Nobuhiro Asai, Takumi Umemura, Jun Hirai, Nobuaki Mori, Yuka Yamagishi, Takuya Iwamoto, Hiroshige Mikamo
Summary: This meta-analysis evaluated the efficacy and safety of recombinant human soluble thrombomodulin (rhTM) therapy in patients with sepsis-induced DIC. The results showed that rhTM significantly reduced mortality and improved DIC resolution without increasing the risk of bleeding complications.
THROMBOSIS RESEARCH
(2023)
Article
Hematology
Jiaqian Qi, Tingting Pan, Tao You, Yaqiong Tang, Tiantian Chu, Jia Chen, Yi Fan, Shuhong Hu, Fei Yang, Changgeng Ruan, Depei Wu, Yue Han
Summary: This study found that levels of hypoxia-inducible factor-1 alpha (HIF-1 alpha) were significantly higher in patients with transplantation-associated thrombotic microangiopathy (TA-TMA) compared to controls. Upregulation of HIF-1 alpha led to an increase in membrane-bound complement C3 and dysfunction of endothelial cells. Increasing HIF-1 alpha in mice led to complement activation, thrombocytopenia, anemia, and increased lactate dehydrogenase (LDH) levels, mimicking the TA-TMA phenotype. The study suggests that HIF-1 alpha may play a role in the development of TA-TMA by inhibiting the transcription of complement factor H (CFH).
BRITISH JOURNAL OF HAEMATOLOGY
(2022)
Review
Immunology
Hamed Azhdari Tehrani, Maryam Darnahal, Mohammad Vaezi, Shirin Haghighi
Summary: This study reported four cases of COVID-19 patients presenting with symptoms of TTP, with peripheral blood smears showing numerous schistocytes, low ADAMTS13 antigen activity level and elevated antibody level, and positive COVID-19 PCR tests for all patients.
INTERNATIONAL IMMUNOPHARMACOLOGY
(2021)
Review
Biochemistry & Molecular Biology
Marija Malgaj Vrecko, Andreja Ales Rigler, Zeljka Veceric-Haler
Summary: COVID-19 can lead to multisystem disorders, including kidney injury in the form of thrombotic microangiopathy (TMA). TTP and aHUS are the most common presentations of COVID-19-associated TMA. Prompt and specific treatment of the TMA subtype can lead to good outcomes comparable to TMA caused by other factors.
INTERNATIONAL JOURNAL OF MOLECULAR SCIENCES
(2022)
Review
Oncology
Eleni Gavriilaki, Vincent T. Ho, Wilhelm Schwaeble, Thomas Dudler, Mohamed Daha, Teizo Fujita, Sonata Jodele
Summary: HSCT-TMA is a life-threatening syndrome that may be caused by endothelial injury and complement activation triggered by hematopoietic stem cell transplantation and associated risk factors. Activation of the complement system and the coagulation cascade may lead to a procoagulant state, ultimately resulting in organ damage and failure. Complement inhibitors targeting various complement pathways are being tested in clinical trials for the treatment of HSCT-TMA.
EXPERIMENTAL HEMATOLOGY & ONCOLOGY
(2021)
