Review
Immunology
Dimitrios Moris, Linda C. Cendales
Summary: Vascularized composite allotransplantation (VCA) has emerged as an alternative option for severe disfiguring defects, but concerns remain regarding lifelong immunosuppressive therapy, immunosuppression associated complications, and host immune response. Antibody-mediated rejection, DSA formation and graft rejection in the context of VCA are still poorly understood, with alloantibodies primarily targeting MHC mismatches. The efficacy of desensitization protocols and outcomes in sensitized VCA recipients remains unknown.
FRONTIERS IN IMMUNOLOGY
(2021)
Review
Immunology
Abraham J. Matar, Rebecca L. Crepeau, Gerhard S. Mundinger, Curtis L. Cetrulo, Radbeh Torabi
Summary: Significant technical progress has been made in the field of VCA in recent years, with large animal models playing a crucial role in testing the translatability of immune modulation methods.
FRONTIERS IN IMMUNOLOGY
(2021)
Review
Immunology
Lei Zhang, Isabel Arenas Hoyos, Cedric Zubler, Robert Rieben, Mihai Constantinescu, Radu Olariu
Summary: Joint allotransplantation (JA) in vascularized composite allotransplantation (VCA) has the potential for functional reconstruction of severely damaged joints. However, immune rejection limits its clinical use. A systematic review identified 14 relevant articles, showing success in small animal models and failure in human patients with knee allotransplantations.
FRONTIERS IN IMMUNOLOGY
(2023)
Review
Biochemistry & Molecular Biology
Madonna Rica Anggelia, Hui-Yun Cheng, Ping-Chin Lai, Yun-Huan Hsieh, Chih-Hung Lin, Cheng-Hung Lin
Summary: Cell therapy has emerged as a promising strategy to improve allograft outcomes by modulating the immune system, reducing immunosuppressant drug dosages, and inducing allograft tolerance.
BIOMEDICAL JOURNAL
(2022)
Article
Immunology
Ashti M. Shah, Ali Mubin Aral, Ruben Zamora, Nitin Gharpure, Fayten El-Dehaibi, Fatih Zor, Yalcin Kulahci, Huseyin Karagoz, Derek A. Barclay, Jinling Yin, Warren Breidenbach, Dmitry Tuder, Vijay S. Gorantla, Yoram Vodovotz
Summary: Vascularized composite allotransplantation (VCA) is often complicated by inflammation spanning multiple tissues. In this study, nerve repair and immunosuppressive therapy were found to potentially lead to dysregulated and mis-compartmentalized inflammation, calling for mitigation strategies.
FRONTIERS IN IMMUNOLOGY
(2023)
Article
Cell Biology
Zhizhao Chen, Shuai Xue, Sheng Zhang, Ke Cheng, Qifa Ye
Summary: The study found that exosomes from donor-derived adipose-derived mesenchymal stem cells can prolong graft survival and suppress rejection responses. Additionally, ADMSC-exo also promotes an increase in donor cell chimerism and regulatory T cells, while decreasing CD4(+) T cells and Th1 cells in the transplantation setting.
JOURNAL OF CELLULAR PHYSIOLOGY
(2021)
Article
Surgery
Maureen Beederman, Chad M. Teven, Lawrence J. Gottlieb
Summary: This article discusses the ethical implications of living donor vascularized composite allotransplantation.
PLASTIC AND RECONSTRUCTIVE SURGERY
(2022)
Review
Immunology
Leonard Knoedler, Samuel Knoedler, Adriana C. Panayi, Catherine A. A. Lee, Sam Sadigh, Lioba Huelsboemer, Viola A. Stoegner, Andreas Schroeter, Barbara Kern, Vikram Mookerjee, Christine G. Lian, Stefan G. Tullius, George F. Murphy, Bohdan Pomahac, Martin Kauke-Navarro
Summary: Vascularized composite allotransplantation (VCA) is a field of reconstructive surgery that has transformed the treatment of patients with devastating injuries. The transplanted units consist of various tissue types and the antigenicity of certain components, such as skin, can lead to strong rejection responses. This review highlights the role of different cell and tissue types in VCA rejection and explores novel therapeutic approaches targeting specific cellular processes.
FRONTIERS IN IMMUNOLOGY
(2023)
Article
Surgery
Hui-Yun Cheng, Chih-Fan Lin, Madonna Rica Anggelia, Ping-Chin Lai, Ling-Yi Shih, Shiao-Chin Liu, Fu-Chan Wei, Cheng-Hung Lin
Summary: This study evaluated the outcome of VCA surgery on reciprocal rodent donor-recipient combinations and found that the same immunosuppression regimen produced different results in different donor-recipient combinations. Modification of the model and immunosuppression regimen is needed based on the results.
PLASTIC AND RECONSTRUCTIVE SURGERY
(2023)
Review
Surgery
David Milek, Laura T. Reed, Scott R. Echternacht, Kumaran Shanmugarajah, Curtis L. Cetrulo Jr, Alexandre G. Lellouch, Howard N. Langstein, Jonathan I. Leckenby
Summary: Complications related to vascularized composite allotransplantation (VCA) are a significant source of morbidity and potential mortality. The incidence of these complications is higher than previously reported and should be strongly emphasized in the patient consent process. Strict patient selection criteria, complex preoperative evaluation, consideration of alternatives, and thorough disclosure to patients should be routinely performed prior to VCA indication.
JOURNAL OF SURGICAL RESEARCH
(2023)
Article
Biochemistry & Molecular Biology
Dante De Paz, Ana Elena Avina, Esteban Cardona, Chin-Ming Lee, Chia-Hsien Lin, Cheng-Hung Lin, Fu-Chan Wei, Aline Yen Ling Wang
Summary: The study investigated the impact of the mandible on facial allograft survival and found that the facial osteomyocutaneous allograft including the mandible showed significant prolongation of survival under immunosuppressive drugs, demonstrating anti-inflammatory effects and mixed chimerism.
INTERNATIONAL JOURNAL OF MOLECULAR SCIENCES
(2021)
Review
Surgery
Valeria P. Bustos, Joseph M. Escandon, Eric Santamaria, Pedro Ciudad, Antonio J. Forte, Roberto Hernandez-Alejandro, Jonathan Leckenby, Howard N. Langstein, Oscar J. Manrique
Summary: Abdominal wall vascularized composite allotransplantation (AW-VCA) is a safe and efficient alternative for patients with large and complex abdominal wall defects, utilizing surgical techniques with high flap survival rates and low complication rates, as well as providing functionality through appropriate flaps and nerves. Future studies with better levels of evidence are needed to evaluate functionality and differences between surgical techniques.
JOURNAL OF RECONSTRUCTIVE MICROSURGERY
(2022)
Article
Immunology
Haibo Li, Yuan Fang, Xu Li, Jingting Chen, Yao Xiong, Yongzhou Shi, Shengli Li, Lincai Ye, Shoubao Wang, Jianda Zhou
Summary: This study investigated the molecular mechanisms underlying acute rejection caused by VCA using animal models, and identified miRNAs as potential diagnostic and prognostic biomarkers that can assist clinicians in adjusting immunosuppressive programs during acute rejection.
JOURNAL OF INFLAMMATION RESEARCH
(2022)
Article
Medicine, General & Internal
Valentin Haug, Adriana C. Panayi, Samuel Knoedler, Sina Foroutanjazi, Martin Kauke-Navarro, Sebastian Fischer, Gabriel Hundeshagen, Yannick Diehm, Ulrich Kneser, Bohdan Pomahac
Summary: This article discusses the impact of organ or bone marrow transplantation, as well as recent limb or facial transplantation, on forensic medicine. By analyzing relevant technologies and methods, it highlights the issue of patients evading legal tracking by taking advantage of chimera and emphasizes the challenges faced by facial and fingerprint recognition in this context.
JOURNAL OF CLINICAL MEDICINE
(2023)
Review
Immunology
Nathaniel Oberholtzer, Carl Atkinson, Satish N. Nadig
Summary: Research is focused on cell-based therapies for inducing graft tolerance. Using regulatory cell types helps produce graft-specific tolerance. Significant progress has been made, but many questions remain to be answered.
FRONTIERS IN IMMUNOLOGY
(2021)
Article
Public, Environmental & Occupational Health
Todd L. Benham, Alexander Hart, Michelangelo Bortolin, Michael Court, John Groves, Anthony Kraus, Brad Newbury, Amalia Voskanyan, Madeline Yogman, Fahad AlHajjaj, Yousef AlMalki, Bader Alossaimi, Oluwafunbi Awoniyi, Adham Sameer Bardeesi, Srihari Cattamanchi, Bridget Edwards, Anthony Hernandez, Fadi Issa, Philip Manners, Michael Molloy, Douglas Romney, Debra Weiner, Gregory R. Ciottone
Summary: Health care workers actively managing COVID-19 patients face potential psychosocial consequences and increased risk of PTSD. Strategies are recommended to mitigate risk and build resilience.
DISASTER MEDICINE AND PUBLIC HEALTH PREPAREDNESS
(2022)
Article
Anesthesiology
E. Li
Summary: Surgical patients with peri-operative or recent SARS-CoV-2 infection are at increased risk of postoperative venous thromboembolism compared to those without a history of SARS-CoV-2. However, the optimal prophylaxis and treatment for venous thromboembolism in this patient population remains unknown. Venous thromboembolism is independently associated with 30-day mortality.
Article
Immunology
Matthew J. Bottomley, Matthew O. Brook, Sushma Shankar, Joanna Hester, Fadi Issa
Summary: Cellular therapies offer an attractive solution to immunosuppression in organ transplantation, and some cell types have shown initial success. However, there are still outstanding issues in the field, although there is hope for breakthroughs.
TRENDS IN IMMUNOLOGY
(2022)
Letter
Urology & Nephrology
Sushma Shankar, Joseph Beckett, Tom Tipton, Ane Ogbe, Mwila Kasanyinga, Christina Dold, Sheila Lumley, Fungai Dengu, Gianluca Rompianesi, Faysal Elgilani, Stephanie Longet, Alexandra Deeks, Rebecca P. Payne, Christopher J. A. Duncan, Alex Richter, Thushan I. de Silva, Lance Turtle, Katherine Bull, Martin Barnardo, Peter J. Friend, Susanna J. Dunachie, Joanna Hester, Fadi Issa, Eleanor Barnes, Miles W. Carroll, Paul Klenerman
Summary: This study reports a high incidence of reinfection in hemodialysis patients, and shows that T cell responses do not predict protection against reinfection. The study also reveals highly variable T cell responses during the primary infection.
JOURNAL OF THE AMERICAN SOCIETY OF NEPHROLOGY
(2022)
Article
Emergency Medicine
Moza M. Alnoaimi, Alexander Hart, Fadi Issa, Attila Hertelendy, Amalia Voskanyan, Gregory Ciottone
Summary: The absence of local EMS educational programs in Bahrain has resulted in a workforce comprised mainly of expatriate personnel with varying educational backgrounds. A qualitative variance analysis compared the desired core competencies for EMS practice in Saudi Arabia with the curricula of major countries from which expatriate providers originate. The study identified major core competencies that are not covered in the expatriate providers' curricula, emphasizing the need for customized training programs to improve and standardize EMS care in Bahrain.
OPEN ACCESS EMERGENCY MEDICINE
(2022)
Review
Immunology
Oliver McCallion, Merve Bilici, Joanna Hester, Fadi Issa
Summary: Regulatory T cells (Tregs) have significant therapeutic potential in treating immunopathologies characterized by abnormal immune activation. However, implementing Treg cell therapy outside of clinical trials remains challenging. This review examines the current landscape of Treg cell therapy, discusses emerging approaches and technologies to engage Tregs, and reflects on the progress needed to deliver their therapeutic capabilities to patients.
CLINICAL AND EXPERIMENTAL IMMUNOLOGY
(2023)
Editorial Material
Immunology
Guido Lewik, Fadi Issa
Article
Immunology
Matthew J. Bottomley, Paul N. Harden, Kathryn J. Wood, Joanna Hester, Fadi Issa
Summary: The monocytic HLA-DR density remains stable in long-term renal transplant recipients and is associated with myeloid-derived suppressor-like cells accumulation. Decreased HLA-DR density is linked to a higher risk of subsequent malignancy, indicating a potential novel marker for excess immunosuppression. Further research is needed to understand the underlying mechanism behind this association.
FRONTIERS IN IMMUNOLOGY
(2022)
Article
Immunology
Athena Cavounidis, Sumeet Pandey, Melania Capitani, Matthias Friedrich, Amy Cross, Lisa Gartner, Dominik Aschenbrenner, Seunghee Kim-Schulze, Ying Ka Lam, Georgina Berridge, Dermot P. B. McGovern, Benedikt Kessler, Roman Fischer, Paul Klenerman, Joanna Hester, Fadi Issa, Esther A. Torres, Fiona Powrie, Bernadette R. Gochuico, William A. Gahl, Louis Cohen, Holm H. Uhlig
Summary: Hermansky-Pudlak syndrome (HPS) types 1 and 4, caused by defective vesicle trafficking, lead to inflammation, lung fibrosis, and macrophage lipid accumulation. This study explored the cellular basis of inflammation in HPS-1 and found that HPS-1 patients exhibit an inflammatory phenotype and accumulate inflammatory macrophages in the intestine. Additionally, they have transcriptional signatures indicative of lipid storage and metabolic defect. The research also revealed that HPS1 deficiency alters metabolic program and activates Rab32-mediated mTOR signaling, leading to impaired bacterial clearance. Inhibition of mTORC1 rescues the bacterial clearance defect.
MUCOSAL IMMUNOLOGY
(2022)
Editorial Material
Immunology
Conor Hennessy, Milena Deptula, Fadi Issa
Article
Surgery
Riyam Mistry, Fadi Issa
Summary: This study aimed to compare the long-term scar outcomes of surgical treatment and conservative treatment in paediatric burns patients. The results from the questionnaire survey showed no significant difference in the scores of patients treated surgically and those treated conservatively according to the BBSIP. This suggests that clinicians need not worry about the long-term impact of scars when deciding on the treatment approach for paediatric burns patients.
FRONTIERS IN SURGERY
(2022)
Article
Critical Care Medicine
Ignacio Melero, Maria Villalba-Esparza, Borja Recalde-Zamacona, Daniel Jimenez-Sanchez, Alvaro Teijeira, Alan Argueta, Laura Garcia-Tobar, Laura Alvarez-Gigli, Cristina Sainz, David Garcia-Ros, Estefania Toledo, Marta Abengozar-Muela, Mirian Fernandez-Alonso, Mariano Rodriguez-Mateos, Gabriel Reina, Francisco Carmona-Torre, Jorge Augusto Quiroga, Jose L. Del Pozo, Amy Cross, Alvaro Lopez-Janeiro, David Hardisson, Jose Echeveste, Maria D. Lozano, Ling-Pei Ho, Paul Klenerman, Fadi Issa, Manuel F. Landecho, Carlos E. de Andrea
Summary: Abundant neutrophils undergoing NETosis are found in the lungs of patients with fatal COVID-19, but no correlation was found with viral loads. The strong association between NETs and IL-8 points to this chemokine as a potentially causative factor. The function of cytotoxic T-lymphocytes in the immune responses against SARS-CoV-2 may be interfered with by the presence of NETs.
Article
Surgery
Nina Pilat, Fadi Issa, Xunrong Luo, Anita Chong, Jonathan Bromberg, Katja Kotsch
Summary: The second International Transplant Science (ITS) meeting, held in Berlin in May 2022, served as a global platform for discussions and presentations on the latest advancements in transplantation. Topics such as tolerance mechanisms, biomarkers, big data, and artificial intelligence were covered. Attendees not only gained knowledge but also found inspiration and excitement through networking sessions and discussions with fellow scientists.
TRANSPLANT INTERNATIONAL
(2022)
Meeting Abstract
Gastroenterology & Hepatology
Tiong Yeng Lim, Elena Perpinan, Maria Carlota Londono, Rosa Miquel, Paula Ruiz, Ada Kurt, Elisavet Codela, Amy Cross, Claudia Berlin, Joanna Hester, Fadi Issa, Abdel Douiri, Felix Volmer, Richard Taubert, Evangelia Williams, Jake Demetris, Andrew Lesniak, Gilbert Bensimon, Juanjo Lozano, Marc Martinez-Llordella, Timothy Tree, Alberto Sanchez-Fueyo
JOURNAL OF HEPATOLOGY
(2022)
Review
Engineering, Multidisciplinary
Sabrina Wright, Conor Hennessy, Joanna Hester, Fadi Issa
Summary: Chimeric antigen receptors (CARs) are a breakthrough in genetic engineering that redirect cells to specific targets. They have been shown to improve accuracy, potency, and reduce off-target effects in cancer therapy. Regulatory T cells (Tregs) are important in suppressing immune activation and regulating the immune response. CAR-Tregs hold potential for treating autoimmune diseases, GVHD, and organ transplant rejection.