The Interplay between Inflammation and Fibrosis in Kidney Transplantation
Torres, Irina B. (Hospital Universitari Vall d'Hebron)
Moreso, Francesc (Hospital Universitari Vall d'Hebron)
Sarró, Eduard (Hospital Universitari Vall d'Hebron. Institut de Recerca)
Meseguer Navarro, Anna (Hospital Universitari Vall d'Hebron. Institut de Recerca)
Seron, Daniel (Hospital Universitari Vall d'Hebron)
Universitat Autònoma de Barcelona

Data:	2014
Resum:	Serial surveillance renal allograft biopsies have shown that early subclinical inflammation constitutes a risk factor for the development of interstitial fibrosis. More recently, it has been observed that persistent inflammation is also associated with fibrosis progression and chronic humoral rejection, two histological conditions associated with poor allograft survival. Treatment of subclinical inflammation with steroid boluses prevents progression of fibrosis and preserves renal function in patients treated with a cyclosporine-based regimen. Subclinical inflammation has been reduced after the introduction of tacrolimus based regimens, and it has been shown that immunosuppressive schedules that are effective in preventing acute rejection and subclinical inflammation may prevent the progression of fibrosis and chronic humoral rejection. On the other hand, minimization protocols are associated with progression of fibrosis, and noncompliance with the immunosuppressive regime constitutes a major risk factor for chronic humoral rejection. Thus, adequate immunosuppressive treatment, avoiding minimization strategies and reinforcing educational actions to prevent noncompliance, is at present an effective approach to combat the progression of fibrosis.
Ajuts:	Ministerio de Ciencia e Innovación SAF2011-2950 Instituto de Salud Carlos III PI10/2496 Ministerio de Economía y Competitividad PIE13/00027 Ministerio de Economía y Competitividad 12/0021/0013
Drets:	Aquest document està subjecte a una llicència d'ús Creative Commons. Es permet la reproducció total o parcial, la distribució, la comunicació pública de l'obra i la creació d'obres derivades, fins i tot amb finalitats comercials, sempre i quan es reconegui l'autoria de l'obra original.
Llengua:	Anglès
Document:	Article ; recerca ; Versió publicada
Publicat a:	BioMed Research International, Vol. 2014 (june 2014) , ISSN 2314-6141

DOI: 10.1155/2014/750602
PMID: 24991565

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