Evidence map›Paper›PMID 34526511›Full record

ArticleNature communications2021

C3 complement inhibition prevents antibody-mediated rejection and prolongs renal allograft survival in sensitized non-human primates.

Robin Schmitz, Zachary W Fitch, Paul M Schroder, Ashley Y Choi, Miriam Manook, Janghoon Yoon, Mingqing Song, John S Yi, Sanjay Khandelwal, Gowthami M Arepally and 5 more

Open access · goldAbstract read
In one paragraph

Article in Nature communications, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 34 papers.

0numbers the graph read from it
0cells of the map it votes in
34citing papers in PubMed
6.5field-weighted citation impact, top 2% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

34 citing papers in PubMed, 58 citations in OpenAlex.

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  6. A novel immunoglobulin G- and immunoglobulin cleaving enzyme MG (IceMG), for antibody-mediated rejection.American journal of transplantation : official journal of the American Society of Transplantation and the American Society of Transplant Surgeons · 2026
    Article
  7. Complement activation in kidney transplantation.Nephrology, dialysis, transplantation : official publication of the European Dialysis and Transplant Association - European Renal Association · 2026
    Review
  8. Therapeutic Potential of C1-Inhibitor in Vascular Diseases and Beyond.Arteriosclerosis, thrombosis, and vascular biology · 2026
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4 · The record

Corrections and comments

5 · Who and what money

Authors and funding

15 authors at 3 institutions in 1 country.

Robin SchmitzDuke Transplant Center, Department of Surgery, Duke University School of Medicine, Durham, NC, USA.ORCID 0000-0003-1286-0457
Zachary W FitchDuke Transplant Center, Department of Surgery, Duke University School of Medicine, Durham, NC, USA.ORCID 0000-0002-1395-1513
Paul M SchroderDuke Transplant Center, Department of Surgery, Duke University School of Medicine, Durham, NC, USA.
Ashley Y ChoiDuke Transplant Center, Department of Surgery, Duke University School of Medicine, Durham, NC, USA.ORCID 0000-0001-6624-6378
Miriam ManookDuke Transplant Center, Department of Surgery, Duke University School of Medicine, Durham, NC, USA.ORCID 0000-0002-6474-6122
Janghoon YoonDuke Transplant Center, Department of Surgery, Duke University School of Medicine, Durham, NC, USA.ORCID 0000-0001-8543-194X
Mingqing SongDuke Transplant Center, Department of Surgery, Duke University School of Medicine, Durham, NC, USA.ORCID 0000-0002-2462-9351
John S YiDivision of Surgical Sciences, Department of Surgery, Duke University, Durham, NC, USA.ORCID 0000-0001-7777-2437
Sanjay KhandelwalDepartment of Medicine, Duke University School of Medicine, Durham, NC, USA.ORCID 0000-0002-5661-3856
Gowthami M ArepallyDepartment of Medicine, Duke University School of Medicine, Durham, NC, USA.
Alton B FarrisDepartment of Pathology, Emory University School of Medicine, Atlanta, GA, USA.ORCID 0000-0001-5534-7763
Edimara S ReisDepartment of Pathology and Laboratory Medicine, University of Pennsylvania, Philadelphia, PA, USA.
John D LambrisDepartment of Pathology and Laboratory Medicine, University of Pennsylvania, Philadelphia, PA, USA.
Jean Kwun *Duke Transplant Center, Department of Surgery, Duke University School of Medicine, Durham, NC, USA. jean.kwun@duke.edu.ORCID 0000-0002-8563-5472
Stuart J Knechtle *Duke Transplant Center, Department of Surgery, Duke University School of Medicine, Durham, NC, USA. stuart.knechtle@duke.edu.ORCID 0000-0002-1625-385X
Duke University · USUniversity of Pennsylvania · USEmory University · US

Funding

The Risks and Opportunities of Homeostatic RepopulationU19AI131471 · NIAID · DUKE UNIVERSITY · PI Stuart Johnston Knechtle · 2017 to 2026
$30.4M
Nonhuman Primate Reagent ResourceU24AI126683 · NIAID · UNIV OF MASSACHUSETTS MED SCH WORCESTER · PI Diogo Magnani · 2016 to 2026
$20.1M
Role of complement in kidney disorders: from hemodialysis to transportationP01AI068730 · NIAID · UNIVERSITY OF PENNSYLVANIA · PI LAMBRIS, JOHN D · 2007 to 2018
$16.0M
Resource for Nonhuman Primate Cell Depleting AntibodiesR24OD010976 · OD · UNIV OF MASSACHUSETTS MED SCH WORCESTER · PI ENGELMAN, KATHLEEN, MAGNANI, DIOGO · 2012 to 2019
$4.7M
NIAID NIH HHS P01 AI068730NIAID NIH HHS U19 AI131471NIAID NIH HHS U24 AI126683NIH HHS R24 OD010976
6 · The paper itself

Abstract

Sensitized kidney transplant recipients experience high rates of antibody-mediated rejection due to the presence of donor-specific antibodies and immunologic memory. Here we show that transient peri-transplant treatment with the central complement component C3 inhibitor Cp40 significantly prolongs median allograft survival in a sensitized nonhuman primate model. Despite donor-specific antibody levels remaining high, fifty percent of Cp40-treated primates maintain normal kidney function beyond the last day of treatment. Interestingly, presence of antibodies of the IgM class associates with reduced median graft survival (8 vs. 40 days; p = 0.02). Cp40 does not alter lymphocyte depletion by rhesus-specific anti-thymocyte globulin, but inhibits lymphocyte activation and proliferation, resulting in reduced antibody-mediated injury and complement deposition. In summary, Cp40 prevents acute antibody-mediated rejection and prolongs graft survival in primates, and inhibits T and B cell activation and proliferation, suggesting an immunomodulatory effect beyond its direct impact on antibody-mediated injury.

Indexed as

AnimalsAntibodiesB-LymphocytesCell ProliferationComplement C3CytokinesGraft RejectionGraft SurvivalKidney TransplantationLymphocyte ActivationMacaca mulattaMalePyridonesT-LymphocytesTransplantation, Homologous1-(ethan-1-ol)-2-methyl-3-hydroxypyridin-4-oneAntibodiesComplement C3CytokinesPyridones

Identifiers

PMID34526511
PMCPMC8443599
OpenAlexW3199114514

What OpenQuestion holds

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LicenceCC BY
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Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.