Author
van Willem Son
Other affiliations: University Medical Center Groningen
Bio: van Willem Son is an academic researcher from University of Groningen. The author has contributed to research in topics: Transplantation & Kidney transplantation. The author has an hindex of 12, co-authored 34 publications receiving 1502 citations. Previous affiliations of van Willem Son include University Medical Center Groningen.
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TL;DR: MMF significantly reduced the rate of biopsy-proven rejection or other treatment failure during the first 6 months after transplantation and was well tolerated, although the 3 g dose was somewhat less well tolerated.
1,014 citations
TL;DR: Donor nephrectomy unmasked an age‐ and overweight‐induced loss of reserve capacity and younger donors with obesity should be carefully monitored.
82 citations
TL;DR: In this paper, the authors investigated the effect of C5a on human renal tissue by stimulating human kidney slices with C5A using a newly developed precision-cut method, and found that systemic generation of c5a mediates renal inflammation in brain-dead donor grafts via tubular C-5a-C5aR interaction.
66 citations
TL;DR: Vagus nerve stimulation variably affected gene expression in donor organs and improved renal function in recipients and inhibition of serum TNFα through vagal stimulation is demonstrated.
52 citations
TL;DR: The recently developed early antigen immunofluorescence (IF) method for the detection of infectious cytomegalovirus (CMV) in clinical specimens has hardly been applied on blood samples and is clearly much faster and more sensitive than the conventional cell culture method.
Abstract: The recently developed early antigen immunofluorescence (IF) method for the detection of infectious cytomegalovirus (CMV) in clinical specimens has hardly been applied on blood samples. We compared the CMV early antigen detection technique with the conventional cell culture method in 415 different buffy coat samples from 85 different immunocompromised patients. Duplicate coverslips were stained with two different monoclonal antibodies 4-6 days after inoculation. The conventional cultures were examined for typical cytopathic effects (CPE) during 10 weeks. Forty samples from 19 patients were positive by the IF technique, most of them with both monoclonal antibodies. Only 22 of these samples were positive in the conventional cell culture assay, on average after 15.8 days. CMV viraemia was detected exclusively by the IF method in 18 samples, 7 of which were from five patients without any further evidence of an active CMV infection. CMV viraemia was detected exclusively by the CPE method in eight samples, on average after no less than 36.6 days. CMV viraemia was not found in blood samples from 10 patients with laboratory proven active CMV infections and 53 patients without any evidence of an active CMV infection. In our hands the early antigen method for the detection of infectious CMV in blood is nearly as specific (at least 98.1%) and clearly much faster and more sensitive than the conventional cell culture method. The early CMV antigen detection method is therefore a very useful tool for the rapid detection of infectious CMV in blood.
49 citations
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TL;DR: This review considers the use of immunosuppressive drugs in organ transplantation, focusing on renal transplantation.
Abstract: Suppression of allograft rejection is central to successful organ transplantation; thus, immunosuppressive agents are crucial for successful allograft function. Immunosuppressive drugs are used for induction (intense immunosuppression in the initial days after transplantation), maintenance, and reversal of established rejection. This review considers the use of immunosuppressive drugs in organ transplantation, focusing on renal transplantation.
1,342 citations
TL;DR: The overwhelming evidence indicates that ATP and Ado are important endogenous signaling molecules in immunity and inflammation, and it is proposed that their immunological role is both interdependent and multifaceted, meaning that the nature of their effects may shift from immunostimulatory to immunoregulatory or vice versa depending on extracellular concentrations as well as on expression patterns of purinergic receptors and ecto-enzymes.
963 citations
Université catholique de Louvain1, Royal London Hospital2, Université libre de Bruxelles3, Katholieke Universiteit Leuven4, University of Cagliari5, University of Siena6, Istanbul University7, Sheba Medical Center8, Military Medical Academy9, University of Belgrade10, University of Brescia11, University of Barcelona12
TL;DR: The data from the ELNT indicate that in European SLE patients with proliferative lupus nephritis, a remission-inducing regimen of low-dose IV CYC (cumulative dose 3 gm) followed by AZA achieves clinical results comparable to those obtained with a high-dose regimen.
Abstract: OBJECTIVE: Glomerulonephritis is a severe manifestation of systemic lupus erythematosus (SLE) that is usually treated with an extended course of intravenous (IV) cyclophosphamide (CYC). Given the side effects of this regimen, we evaluated the efficacy and the toxicity of a course of low-dose IV CYC prescribed as a remission-inducing treatment, followed by azathioprine (AZA) as a remission-maintaining treatment. METHODS: In this multicenter, prospective clinical trial (the Euro-Lupus Nephritis Trial [ELNT]), we randomly assigned 90 SLE patients with proliferative glomerulonephritis to a high-dose IV CYC regimen (6 monthly pulses and 2 quarterly pulses; doses increased according to the white blood cell count nadir) or a low-dose IV CYC regimen (6 fortnightly pulses at a fixed dose of 500 mg), each of which was followed by AZA. Intent-to-treat analyses were performed. RESULTS: Followup continued for a median of 41.3 months in the low-dose group and 41 months in the high-dose group. Sixteen percent of those in the low-dose group and 20% of those in the high-dose group experienced treatment failure (not statistically significant by Kaplan-Meier analysis). Levels of serum creatinine, albumin, C3, 24-hour urinary protein, and the disease activity scores significantly improved in both groups during the first year of followup. Renal remission was achieved in 71% of the low-dose group and 54% of the high-dose group (not statistically significant). Renal flares were noted in 27% of the low-dose group and 29% of the high-dose group. Although episodes of severe infection were more than twice as frequent in the high-dose group, the difference was not statistically significant. CONCLUSION: The data from the ELNT indicate that in European SLE patients with proliferative lupus nephritis, a remission-inducing regimen of low-dose IV CYC (cumulative dose 3 gm) followed by AZA achieves clinical results comparable to those obtained with a high-dose regimen.
912 citations
Johns Hopkins University School of Medicine1, Oregon Health & Science University2, Massachusetts Eye and Ear Infirmary3, University of California, Los Angeles4, Duke University5, National Institutes of Health6, University of Illinois at Urbana–Champaign7, Washington University in St. Louis8, University of Arizona9
TL;DR: A 12-person panel of physicians with expertise in ophthalmologic, pediatric, and rheumatologic disease, in research, and in the use of immunosuppressive drugs in patient care was formed in 1999 to provide recommendations for the use in the treatment of patients with ocular inflammatory disorders as discussed by the authors.
902 citations
TL;DR: The enzymatic activities of CD39 and CD73 play strategic roles in calibrating the duration, magnitude, and chemical nature of purinergic signals delivered to immune cells through the conversion of ADP/ATP to AMP and AMP to adenosine, suggesting these ectoenzymes are novel therapeutic targets for managing a variety of disorders.
858 citations