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  1. Article: Peering into the darkness of drug-induced thrombotic microangiopathy: complement, are you in there?

    Sabulski, Anthony / Jodele, Sonata

    Journal of gastrointestinal oncology

    2023  Volume 14, Issue 1, Page(s) 468–471

    Language English
    Publishing date 2023-01-15
    Publishing country China
    Document type Editorial ; Comment
    ZDB-ID 2594644-4
    ISSN 2219-679X ; 2078-6891
    ISSN (online) 2219-679X
    ISSN 2078-6891
    DOI 10.21037/jgo-2022-04
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  2. Article ; Online: Reeling in complement in transplant-associated thrombotic microangiopathy: You're going to need a bigger boat.

    Jodele, Sonata / Sabulski, Anthony

    American journal of hematology

    2023  Volume 98 Suppl 4, Page(s) S57–S73

    Abstract: Over the last decade there have been numerous advances in both the diagnosis and treatment of transplant-associated thrombotic microangiopathy (TA-TMA). These are largely the result of an improved understanding of complement activation in TA-TMA and the ... ...

    Abstract Over the last decade there have been numerous advances in both the diagnosis and treatment of transplant-associated thrombotic microangiopathy (TA-TMA). These are largely the result of an improved understanding of complement activation in TA-TMA and the ability to prevent end organ injury and death with timely initiation of complement-blocking therapies. In this article, we review our current understanding of the pathophysiology of TA-TMA, particularly as it pertains to complement activation, endothelial injury, and clinical management. We then review novel complement-blocking therapies that are currently under investigation for use in TA-TMA, as well as discuss special considerations for complement-blocking therapy in hematopoietic stem cell transplant recipients. Through these reviews we aim to answer or at least provide an educated discussion on the most commonly posed TA-TMA management questions and dilemmas.
    MeSH term(s) Humans ; Complement Activation ; Thrombotic Microangiopathies/etiology ; Thrombotic Microangiopathies/therapy ; Thrombotic Microangiopathies/diagnosis ; Hematopoietic Stem Cell Transplantation/adverse effects
    Language English
    Publishing date 2023-02-04
    Publishing country United States
    Document type Journal Article ; Review
    ZDB-ID 196767-8
    ISSN 1096-8652 ; 0361-8609
    ISSN (online) 1096-8652
    ISSN 0361-8609
    DOI 10.1002/ajh.26872
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  3. Article ; Online: What complements complement in transplant-associated thrombotic microangiopathy?

    Sabulski, Anthony / Jodele, Sonata

    British journal of haematology

    2022  Volume 199, Issue 4, Page(s) 477–479

    Abstract: Transplant-associated thrombotic microangiopathy remains a lethal complication of haematopoietic stem cell transplant and not all patients respond to terminal complement inhibitors. Qi et al. show that hypoxia-inducible factor-1α (HIF-1α) may be a ... ...

    Abstract Transplant-associated thrombotic microangiopathy remains a lethal complication of haematopoietic stem cell transplant and not all patients respond to terminal complement inhibitors. Qi et al. show that hypoxia-inducible factor-1α (HIF-1α) may be a previously unrecognized driver of this endothelial injury syndrome. Commentary on Qi et al. Upregulation of HIF-1α contributes to complement activation in transplantation-associated thrombotic microangiopathy. Br J Haematol. 2022 199:603-615.
    MeSH term(s) Humans ; Thrombotic Microangiopathies/etiology ; Complement System Proteins ; Complement Activation ; Complement Inactivating Agents ; Up-Regulation
    Chemical Substances Complement System Proteins (9007-36-7) ; Complement Inactivating Agents
    Language English
    Publishing date 2022-08-09
    Publishing country England
    Document type Journal Article
    ZDB-ID 80077-6
    ISSN 1365-2141 ; 0007-1048
    ISSN (online) 1365-2141
    ISSN 0007-1048
    DOI 10.1111/bjh.18402
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  4. Article ; Online: Complement in Pathophysiology and Treatment of Transplant-Associated Thrombotic Microangiopathies.

    Jodele, Sonata

    Seminars in hematology

    2018  Volume 55, Issue 3, Page(s) 159–166

    Abstract: Transplant-associated thrombotic microangiopathy (TA-TMA) is a form of microangiopathy specifically occurring in the context of hematopoietic stem cell transplantation. Similarly, to other microangiopathies, TA-TMA is characterized by hemolytic anemia, ... ...

    Abstract Transplant-associated thrombotic microangiopathy (TA-TMA) is a form of microangiopathy specifically occurring in the context of hematopoietic stem cell transplantation. Similarly, to other microangiopathies, TA-TMA is characterized by hemolytic anemia, thrombocytopenia, and organ failure due to endothelial injury. Although its clinical association with medications (eg, calcineurin inhibitors), immune reactions (eg, graft vs host disease) or infectious complications is well established, the pathophysiology remains largely unknown. Recent data have highlighted the role of complement in the pathophysiology of TA-TMA, which are frequently associated with a functional impairment (either inherited or acquired) of the endogenous regulation of the complement classic and alternative pathway. This manuscript will review the data supporting the involvement of complement in the pathophysiology of TA-TMA, as well as the clinical data supporting the use of anticomplement agents in this rare condition.
    MeSH term(s) Hematopoietic Stem Cell Transplantation/methods ; Humans ; Thrombotic Microangiopathies/physiopathology ; Thrombotic Microangiopathies/therapy ; Transplantation Conditioning/methods
    Language English
    Publishing date 2018-04-11
    Publishing country United States
    Document type Journal Article ; Review
    ZDB-ID 206923-4
    ISSN 1532-8686 ; 0037-1963
    ISSN (online) 1532-8686
    ISSN 0037-1963
    DOI 10.1053/j.seminhematol.2018.04.003
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  5. Article ; Online: Double trouble: Complement-mediated thrombotic microangiopathy in patients with hemoglobinopathies after stem cell transplantation.

    Jodele, Sonata

    Pediatric blood & cancer

    2017  Volume 64, Issue 9

    MeSH term(s) Complement System Proteins ; Hemoglobinopathies ; Humans ; Stem Cell Transplantation ; Thrombotic Microangiopathies
    Chemical Substances Complement System Proteins (9007-36-7)
    Language English
    Publishing date 2017-04-27
    Publishing country United States
    Document type Journal Article ; Comment
    ZDB-ID 2131448-2
    ISSN 1545-5017 ; 1545-5009
    ISSN (online) 1545-5017
    ISSN 1545-5009
    DOI 10.1002/pbc.26566
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  6. Article ; Online: Adopting Model-Informed Precision-Dosing for Eculizumab in Transplant Associated-Thrombotic Microangiopathy to Gene Therapies.

    Jodele, Sonata / Mizuno, Kana / Sabulski, Anthony / Vinks, Alexander A

    Clinical pharmacology and therapeutics

    2023  Volume 114, Issue 3, Page(s) 511–514

    MeSH term(s) Humans ; Thrombotic Microangiopathies/drug therapy ; Antibodies, Monoclonal, Humanized/therapeutic use
    Chemical Substances eculizumab (A3ULP0F556) ; Antibodies, Monoclonal, Humanized
    Language English
    Publishing date 2023-06-30
    Publishing country United States
    Document type Journal Article ; Research Support, N.I.H., Extramural
    ZDB-ID 123793-7
    ISSN 1532-6535 ; 0009-9236
    ISSN (online) 1532-6535
    ISSN 0009-9236
    DOI 10.1002/cpt.2966
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  7. Article ; Online: Transplant-associated thrombotic microangiopathy: elucidating prevention strategies and identifying high-risk patients.

    Jodele, Sonata / Sabulski, Anthony

    Expert review of hematology

    2021  Volume 14, Issue 8, Page(s) 751–763

    Abstract: Introduction: Hematopoietic stem cell transplantation-associated thrombotic microangiopathy (TA-TMA) is a severe complication of transplant. TA-TMA is a multifactorial disease where generalized endothelial dysfunction leads to microangiopathic hemolytic ...

    Abstract Introduction: Hematopoietic stem cell transplantation-associated thrombotic microangiopathy (TA-TMA) is a severe complication of transplant. TA-TMA is a multifactorial disease where generalized endothelial dysfunction leads to microangiopathic hemolytic anemia, intravascular platelet activation, and formation of microthrombi leading to end-organ injury. It is essential to identify patients at risk for this complication and to implement early interventions to improve TA-TMA associated transplant outcomes.
    Areas covered: Recognition of TA-TMA and associated multi-organ injury, risk predictors, contributing factors, differential diagnosis and targeting complement pathway in TA-TMA by summarizing peer reviewed manuscripts.
    Expert opinion: TA-TMA is an important transplant complication. Diagnostic and risk criteria are established in children and young adults and risk-based targeted therapies have been proposed using complement blockers. The immediate goal is to extend this work into adult stem cell transplant recipients by implementing universal TA-TMA screening practices. This will facilitate early TA-TMA diagnosis and targeted interventions, which will further improve survival. While complement blocking therapy is effective, about one third of patients are refractory to treatment and those patients commonly die. The next hurdle for the field is identifying reasons for failure, optimizing strategies for complement modifying therapy and searching for additional targetable pathways of endothelial injury.
    MeSH term(s) Complement System Proteins ; Hematopoietic Stem Cell Transplantation/adverse effects ; Humans ; Purpura, Thrombotic Thrombocytopenic/etiology ; Thrombosis/diagnosis ; Thrombosis/etiology ; Thrombosis/prevention & control ; Thrombotic Microangiopathies/diagnosis ; Thrombotic Microangiopathies/etiology ; Thrombotic Microangiopathies/prevention & control
    Chemical Substances Complement System Proteins (9007-36-7)
    Language English
    Publishing date 2021-08-04
    Publishing country England
    Document type Journal Article
    ZDB-ID 2516804-6
    ISSN 1747-4094 ; 1747-4086
    ISSN (online) 1747-4094
    ISSN 1747-4086
    DOI 10.1080/17474086.2021.1960816
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  8. Article ; Online: The Role of Complement in HSCT-TMA: Basic Science to Clinical Practice.

    Meri, Seppo / Bunjes, Donald / Cofiell, Roxanne / Jodele, Sonata

    Advances in therapy

    2022  Volume 39, Issue 9, Page(s) 3896–3915

    Abstract: Hematopoietic stem cell transplantation-associated thrombotic microangiopathy (HSCT-TMA) is a common complication occurring post-HSCT and is associated with substantial morbidity and mortality if not promptly identified and treated. Emerging evidence ... ...

    Abstract Hematopoietic stem cell transplantation-associated thrombotic microangiopathy (HSCT-TMA) is a common complication occurring post-HSCT and is associated with substantial morbidity and mortality if not promptly identified and treated. Emerging evidence suggests a central role for the complement system in the pathogenesis of HSCT-TMA. The complement system has also been shown to interact with other pathways and processes including coagulation and inflammation, all of which are activated following HSCT. Three endothelial cell-damaging "hits" are required for HSCT-TMA genesis: a genetic predisposition or existing damage, an endothelial cell-damaging conditioning regimen, and additional damaging insults. Numerous risk factors for the development of HSCT-TMA have been identified (including primary diagnosis, graft type, and conditioning regimen) and validated lists of relatively simple diagnostic signs and symptoms exist, many utilizing routine clinical and laboratory assessments. Despite the relative ease with which HSCT-TMA can be screened for, it is often overlooked or masked by other common post-transplant conditions. Recent evidence that patients with HSCT-TMA may also concurrently present with these differential diagnoses only serve to further confound its identification and treatment. HSCT-TMA may be treated, or even prevented, by removing or ameliorating triggering "hits", and recent studies have also shown substantial utility of complement-targeted therapies in this patient population. Further investigation into optimal management and treatment strategies is needed. Greater awareness of TMA post-HSCT is urgently needed to improve patient outcomes; the objective of this article is to clarify current understanding, explain underlying complement biology and provide simple tools to aid the early recognition, management, and monitoring of HSCT-TMA.
    MeSH term(s) Hematopoietic Stem Cell Transplantation/adverse effects ; Humans ; Risk Factors ; Thrombotic Microangiopathies/diagnosis ; Thrombotic Microangiopathies/etiology ; Thrombotic Microangiopathies/therapy
    Language English
    Publishing date 2022-07-04
    Publishing country United States
    Document type Journal Article ; Review ; Research Support, Non-U.S. Gov't
    ZDB-ID 632651-1
    ISSN 1865-8652 ; 0741-238X
    ISSN (online) 1865-8652
    ISSN 0741-238X
    DOI 10.1007/s12325-022-02184-4
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  9. Article ; Online: Tackling COVID-19 infection through complement-targeted immunotherapy.

    Jodele, Sonata / Köhl, Jörg

    British journal of pharmacology

    2020  Volume 178, Issue 14, Page(s) 2832–2848

    Abstract: The complement system is an ancient part of innate immunity sensing highly pathogenic coronaviruses by mannan-binding lectin (MBL) resulting in lectin pathway activation and subsequent generation of the anaphylatoxins (ATs) C3a and C5a as important ... ...

    Abstract The complement system is an ancient part of innate immunity sensing highly pathogenic coronaviruses by mannan-binding lectin (MBL) resulting in lectin pathway activation and subsequent generation of the anaphylatoxins (ATs) C3a and C5a as important effector molecules. Complement deposition on endothelial cells and high blood C5a serum levels have been reported in COVID-19 patients with severe illness, suggesting vigorous complement activation leading to systemic thrombotic microangiopathy (TMA). Complement regulator gene variants prevalent in African-Americans have been associated with a higher risk for severe TMA and multi-organ injury. Strikingly, severe acute respiratory syndrome Coronavirus 2 (SARS-CoV-2)-infected African-Americans suffer from high mortality. These findings allow us to apply our knowledge from other complement-mediated diseases to COVID-19 infection to better understand severe disease pathogenesis. Here, we discuss the multiple aspects of complement activation, regulation, crosstalk with other parts of the immune system, and the options to target complement in COVID-19 patients to halt disease progression and death. LINKED ARTICLES: This article is part of a themed issue on Canonical and non-canonical functions of the complement system in health and disease. To view the other articles in this section visit http://onlinelibrary.wiley.com/doi/10.1111/bph.v178.14/issuetoc.
    MeSH term(s) COVID-19 ; Endothelial Cells ; Humans ; Immunologic Factors ; Immunotherapy ; SARS-CoV-2
    Chemical Substances Immunologic Factors
    Keywords covid19
    Language English
    Publishing date 2020-07-27
    Publishing country England
    Document type Journal Article ; Research Support, N.I.H., Extramural ; Research Support, Non-U.S. Gov't ; Review
    ZDB-ID 80081-8
    ISSN 1476-5381 ; 0007-1188
    ISSN (online) 1476-5381
    ISSN 0007-1188
    DOI 10.1111/bph.15187
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  10. Article ; Online: Tackling COVID‐19 infection through complement‐targeted immunotherapy

    Jodele, Sonata / Köhl, Jörg

    British Journal of Pharmacology ; ISSN 0007-1188 1476-5381

    2020  

    Keywords Pharmacology ; covid19
    Language English
    Publisher Wiley
    Publishing country us
    Document type Article ; Online
    DOI 10.1111/bph.15187
    Database BASE - Bielefeld Academic Search Engine (life sciences selection)

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