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At least 811 records · Page 45Linked to original sources

Steroid withdrawal in renal transplant recipients: pro point of view.

Steroid-free immunosuppression remains an attractive goal in an era in which the transplant community should be promoting long-term allograft survival by reducing cardiovascular risk and maximizing long-term patient survival. In the cyclosporine era, the risks of steroid withdrawal outweighed the benefits of steroid withdrawal in a substantial minority of patients. A number of new immunosuppressants may prove to be more steroid sparing than cyclosporine alone and promise to increase the safety of steroid-free immunosuppression for renal transplant recipients.

Costs and Cost Analysis↗

Hypocomplementemic idiopathic membranous glomerulopathy.

Two asymptomatic teenage females with proteinuria, hematuria, and persistent hypocomplementemia are presented. Renal biopsy studies revealed membranous glomerulopathy. During follow-up periods of 4.0 and 4.5 years, the clinical courses and sequential monitoring of immunologic studies failed to demonstrate lupus erythematosus or other systemic disorders. Serum complement levels were consistent with activation of the alternate complement pathway in the first patient and the classic pathway in the second. In both cases further depression in serum complement levels occurred during intervals of greater urinary protein excretion. These findings suggest that the complement system may play a more important role in the pathogenesis of idiopathic membranous glomerulopathy than realized previously.

Adolescent↗

Cancer immunosurveillance and immunoediting: the roles of immunity in suppressing tumor development and shaping tumor immunogenicity.

Cellular transformation and tumor development result from an accumulation of mutational and epigenetic changes that alter normal cell growth and survival pathways. For the last 100 years, there has been a vigorous debate as to whether the unmanipulated immune system can detect and eliminate such altered host derived cells despite the fact that cancer cells frequently express either abnormal proteins or abnormal levels of normal cellular proteins that function as tumor antigens. In this review, we discuss the current state of this argument and point out some of the recent key experiments demonstrating that immunity not only protects the host from cancer development (i.e., provides a cancer immunosurveillance function) but also can promote tumor growth, sometimes by generating more aggressive tumors. The terminology "cancer immunoediting" has been used to describe this dual host protective and tumor promoting action of immunity, and herein we summarize the ever-increasing experimental and clinical data that support the validity of this concept.

Animals↗