Drug therapy from lethal bacteria could reduce kidney transplant rejection

August 3, 2017, Cedars-Sinai Medical Center
Credit: CC0 Public Domain

An experimental treatment derived from a potentially deadly microorganism may provide lifesaving help for kidney transplant patients, according to an international study led by investigators at Cedars-Sinai.

The study, published in the New England Journal of Medicine, found that treating patients with the drug IdeS before transplantation significantly reduced, and in most cases eliminated, donor-specific that can cause rejection or failure of the new organ. These antibodies represent an often impenetrable immunologic barrier to transplantation.

IdeS is derived from an enzyme in the bacteria Streptococcus pyogenes, which causes disorders ranging from sore throats to life-threatening infections.

Stanley C. Jordan, MD, medical director of the Kidney Transplant Program at Cedars-Sinai, said the enzyme is the only one that can completely remove organ-rejecting antibodies and allow transplantation to take place. He noted that, one hour after infusion of the enzyme, antibodies declined drastically.

"We found that IdeS could immediately cut patient antibodies in half, making them powerless to attack and injure a newly transplanted kidney," said Jordan, the study's lead author. "We can put a new kidney in a patient without it being rejected."

All people have human leukocyte antigens (HLA), proteins that are key to the immune system's defense against bacteria, viruses and other potentially harmful invaders. Patients develop antibodies to foreign HLA due to failed , transfusions or pregnancy.

These antibodies persist over a patient's lifetime, causing their body to perceive a newly donated organ as a threat and so attack it. This response prevents patients from having a successful and they often remain on dialysis for years with diminished quality and length of life.

The study of IdeS involved two coordinated investigations, with a total of 25 patients treated in the U.S. and Sweden. Twenty-four of the patients were transplanted successfully after receiving the investigational therapy.

The special enzyme is produced by Hansa Medical of Sweden.

"IdeS could change the way we treat antibody rejections overall," said Jordan, who also directs the Human Leukocyte Antigen and Transplant Immunology Laboratory at Cedars-Sinai. "We think this approach to preventing organ rejection has the potential to offer significant benefits to those in need of heart, lung, liver and bone marrow transplants."

Nearly 128,000 people in the U.S. are waiting for organ transplants, according to the Organ Procurement and Transplantation Network, with more than 105,000 needing new kidneys. Many of them wait years for an organ to become available, only to have their bodies' immune systems attack it.

"We need larger studies to confirm the promising results of this unique approach to removing patient antibodies that threaten newly transplanted organs," Jordan said. "And we want to investigate any long-term impact IdeS therapy may have on overall antibody production in ."

Explore further: Timing of anti-donor antibody responses affects the survival of kidney transplants

More information: Stanley C. Jordan et al, IgG Endopeptidase in Highly Sensitized Patients Undergoing Transplantation, New England Journal of Medicine (2017). DOI: 10.1056/NEJMoa1612567

Related Stories

Timing of anti-donor antibody responses affects the survival of kidney transplants

March 2, 2017
New research provides insights on transplant recipients' antibody responses against donor kidneys and how the timing of those responses can have important implications. The findings appear in an upcoming issue of the Journal ...

Antibodies in the blood provide clues to transplant recipients' likelihood of rejection

August 20, 2015
The dominant antibody type present in the blood of transplant recipients may indicate their likelihood of experiencing organ rejection, according to a study appearing in an upcoming issue of the Journal of the American Society ...

Antibody response linked with rejection in pediatric kidney transplant recipients

February 28, 2013
A transplanted kidney has a finite life expectancy because it often becomes the target of the recipient's immune system, which may mount antibodies that attack the organ. Because there is a critical need to extend the life ...

US transplant centers frequently refuse deceased donor kidneys

July 27, 2017
A new study indicates that deceased donor kidneys are typically offered and declined many times before being accepted for transplantation. The study, which appears in an upcoming issue of the Clinical Journal of the American ...

Promising breakthrough for transplant patients

February 27, 2013
A team led by Dr. Marie-Josée Hébert from the University of Montreal Hospital Research Centre (CRCHUM) has discovered a new cause of organ rejection in some kidney transplant patients. Her team has identified a new class ...

Viral infection in transplant recipients increases risk of developing damaging antibodies

September 25, 2014
Kidney transplant recipients infected with BK virus are more likely to develop antibodies against their kidney transplants than uninfected patients, according to a study appearing in an upcoming issue of the Journal of the ...

Recommended for you

Tongue-in-cheek Nobels honor nutritional analysis of cannibalism, roller-coaster kidney stones treatment

September 14, 2018
A nutritional analysis of cannibalism and treating kidney stones on roller-coasters were research projects honored by tongue-in-cheek awards at Harvard University Thursday, designed to make you laugh first, and think later.

Pediatric robot patient offers new level of realism for doctors in training

September 10, 2018
A team of researchers and engineers at Gaumard Scientific has unveiled a new robot that raises the bar on medical training devices. The robot, called HAL, has been made to look like a five-year-old male patient and offers ...

Why men say they've had more lifetime sexual partners than women

July 25, 2018
The disparity between the number of sexual partners reported by men and women can largely be explained by a tendency among men to report extreme numbers of partners, and to estimate rather than count their lifetime total, ...

Censors jump into action as China's latest vaccine scandal ignites

July 22, 2018
Chinese censors on Sunday deleted articles and postings about the vaccine industry as an online outcry over the country's latest vaccine scandal intensified.

Revenge of a forgotten medical 'genius'

June 30, 2018
It's not an uncommon fate for a pioneering scientist: languishing unrecognised in his time before dying in obscurity. But as his 200th birthday approaches, the life-saving work of a Hungarian obstetrician is finally getting ...

Yes, you can put too much chlorine in a pool

June 2, 2018
(HealthDay)—Before you take a dip in the pool this summer, be sure there's not too much chlorine in the water.


Please sign in to add a comment. Registration is free, and takes less than a minute. Read more

Click here to reset your password.
Sign in to get notified via email when new comments are made.