|
|
| St. Louis Second Wind
Lung Transplant Association
Newsletter |
|
| Volume 11 Issue 6 | June 2010 |
|
|
Quick Links |
OUR SPONSORs
Hampton Gardens Apts.
|
|
Dear Members, Friends and Family,
Congratulations to Dr. Ramsey and Christine Hachem on the birth of their daughter, Lauren Abigail.
Best Wishes for restful nights.
Tom Archer314.664.6360
Toll Free: 1.888.855.9463 |
|
Ramsey R. Hachem, M.D. 
Washington University School of Medicine
Barnes-Jewish Hospital
Division of Pulmonary and Critical Care
Humoral Immunity in Lung Transplantation
The immune system can be broadly divided into two parts based on the predominant response mechanism. Cells play the critical role in the cellular immune response. Specialized immune cells recognize an invading microorganism, such as a virus or bacteria, or a transplanted organ and respond by attacking the foreign substance. In contrast, the humoral immune response is characterized by circulating immune proteins known as antibodies. Antibodies have a wide diversity in specificity and can bind to the wall of foreign substances and activate complement or cells that can directly injure the foreign tissue. Specialized immune cells called B-cells and plasma cells produce antibodies, so at one level both forms of immune responses are cellular. In fact in the early history of transplant immunology, there was great debate about whether cells or antibodies caused organ rejection. Experimental evidence supported the cellular immune response as the primary mechanism for rejection. However, in rare cases organs were rejected immediately after transplantation by antibodies. We recognize today that both cells and antibodies can mediate rejection, and more importantly that the two arms of the immune system are linked, usually working in concert.
Aside from refinements in surgical techniques, the development of medical regimens that primarily suppress the cellular immune response made organ transplantation a clinically feasible and widespread treatment. Specifically, the advent of cyclosporine A was the primary medical advancement in the field of organ transplantation. However, this medical regimen has little effect on B-cells and plasma cells and minor inhibitory effects on the humoral immune response in general. Yet, organs are only rarely rejected rapidly after transplantation, and although rejection remains the primary obstacle to better long-term outcomes after lung transplantation, other organ transplants including kidneys, hearts, and livers are significantly less susceptible to rejection. However, a particularly aggressive form of rejection after kidney transplantation that was poorly responsive to the typical immunosuppressive treatments, including steroids and anti-thymocyte globulin, was increasingly identified in the 1990's. Ultimately, this was recognized as antibody-mediated, or humoral, rejection and diagnostic criteria were developed as experience with this form of rejection grew.
It has long been recognized that preformed antibodies specific to donor human leukocyte antigens (HLA) could cause immediate graft rejection and failure after kidney, heart, and lung transplantation. As a result, patients who have preformed antibodies cannot undergo transplantation with organs from donors with the reactive HLA. This approach of avoiding donors with an incompatible HLA profile has reduced the incidence of hyperacute rejection considerably. However, antibodies specific to the donor's HLA can develop after transplantation, and these can cause antibody-mediated rejection. In kidney transplantation, the diagnosis of antibody-mediated rejection is made based on characteristic pathology, special staining for complement factor deposition, and the presence of circulating donor-specific antibodies. However, no such diagnostic criteria exist in lung transplantation primarily because the "characteristic" pathology of antibody-mediated rejection in the transplanted lung is unknown. Nonetheless, the development of antibodies specific to the donor's HLA after lung transplantation has long been recognized as an important risk factor for acute (cellular) rejection and chronic rejection. In addition, experimental studies using mouse models of lung transplantation suggest that these antibodies can be directly injurious to the transplanted organ. As a result, we developed a clinical protocol to screen for the development of antibodies and a treatment regimen to block the injurious effects of antibodies and deplete them. Surprisingly, over 50% of lung transplant recipients develop donor-specific antibodies after transplantation. Clearly, the standard maintenance immunosuppressive regimen consisting of tacrolimus, azathioprine, and prednisone does not sufficiently suppress the humoral immune response. Our current practice is to add intravenous immune globulin (IVIG) and rituximab when patients develop antibodies. IVIG has multiple effects on humoral immunity including blocking antibodies from binding to the donor organ, inhibiting complement activation, and abrogating antibody formation. Rituximab is a chemotherapeutic agent used in the treatment of lymphoma that depletes B-cells and also abrogates antibody formation. However, the use of this regimen is not widely accepted because its efficacy and safety have not been confirmed, but a randomized controlled trial evaluating this regimen's effectiveness is being planned.
The role of humoral immunity in lung transplantation is not yet completely understood, but the evidence suggests that antibodies are harmful to the transplanted lung. Clearly, this is a focus of intense investigation and developing a definition and diagnostic criteria of antibody-mediated rejection after lung transplantation is a high-priority objective. This will allow uniformity among centers and will facilitate clinical research to improve patient outcomes.
|
Picnic 2010
Please Join Us for a fun-filled Second Wind Family Picnic on Sunday, July 11. We'll gather at Tower Grove Park in South St. Louis at 2:00 pm for an afternoon of good food and great fellowship. We have reserved the Stupp Center* with both indoor and outdoor spaces to accommodate the weather and those who need to be out of the sun.
Do to tight financial restraints, this year we are asking each adult for a $10.00 minimun donation. But if your finances are tight as well. don't let this keep you from attending the picnic. Just let Tom Archer know when you RSVP.
Please RSVP by July 7th to Tom via email tea3440@sbcglobal.net or call (314) 664-6360 and let us know the names of the children and adults in your group. Also, you may mail your picnic donation to Tom at 3440 Halliday Avenue, St. Loius, MO 63118.
Second Wind will provide beverages, barbequed burgers and other meat entrées from Hendri's Catering and each family is asked to bring a dish to share for potluck. In order to have a variety, we'd like to use the following assignment list as a guide:
Last names beginning -
A - F Salads/fruits - healthy stuff
G - L Casseroles - pasta, potatoes, etc. - filling stuff
M - R Vegetable dishes - the "almost healthy if it weren't covered with cherse" kind
S - Z Desserts - the most important food group!
These are guidelines only and we want everyone attending to enjoy the meal, so if there is a dish that your family is crazy about, by all means, make it! We also want this to be affordable for everyone, so if money is tight, a bag of chips will do. Really tight? Then just come out and enjoy the efforts of the rest of the crew. We want as many of our Second Wind family members as possible to be together and have a day to remember.
* The Stupp Center is located just inside Tower Grove Park off of South Grand Blvd. - the East Entrance of the park. Once in the park, take the first left on Osborne and follow for a short distance to the green copper-clad roof of the Center.
The address for Tower Grove Park is 4256 Magnolia Ave, St Louis, MO 63110 for those who would like to google or Mapquest directions.
We are looking forward to a great picnic!
Marian Frentzel, Annette Carr and Tom Archer
|
Preparations for 7th Annual Lung Walk Under Way
 By Josh Stegeman
The hustle and bustle of minds and bodies is busily preparing for the 7th Annual St. Louis Second Wind Lung Walk. The Lung Walk is scheduled for Saturday, October 16, 2010 in familiar and historic Forest Park. The Planning Committee met on June 15, 2010. The Planning Committee could use any assistance that members or friends could offer.
Some of the tasks and activities to which members could contribute include:
1) Preparing a basket for the basket raffle.
2) Collecting free items for goodie bags.
3) Collecting gift certificates and other free items from local businesses for prizes.
4) Collecting monetary donations from family, friends, and businesses.
5) Forming teams of people to walk at the race.
6) Writing to family and friends through email or letters to ask for donations and/or sponsorship.
7) Coming to Forest Park to walk and celebrate the gift of life.
The lung walk website (http://www.secondwindstl.org/) has a links where you can register for the Walk or make donations. This is a great resource for family and friends to contribute.
The Walk registration forms will be mailed in August, but this year the forms will emailed to all members with email addresses on file. We hope this measure will save some money in postage.
The Lung Walk will include many of familiar things such as the band, the great food, and wonderful people. Please help the Planning Committee get the word out about the Walk and encouraging others to participate or donate. Please contact Tom Archer, tea3440@sbcglobal.net, or Joshua Stegeman, stegeman_2nd_wind_lung@yahoo.com, with any questions.
|
|
 Basket Raffle for Lung Walk '10
By Annette Carr
Well it's been so much fun, we're doing it again - Lung Walk Basket Raffle! And we need your donations of ready-to-raffle goodie baskets, items for someone else to put a basket together, or a monetary donation and we'll do all the work!
For those who would like to create one on their own, we are looking for moderately priced, themed baskets. Some of last year's entries featured themes were "Italian Dinner for Two, Pet Care, Holiday, Spa Sampler".The possibilities are endless and it's easy to do.
Once again, tickets will be just $1 each or 6 for $5. We would ask that the total value of the items be no more than about $50 maximum per basket - unless, of course, if you collect donated items from local businesses or friends - then the sky's the limit!!
And yes, absolutely everyone can help! If you live too far away to prepare a basket and bring it to the Lung Walk, you can send a donation and we will pool the resources to make baskets. Monetary contributions will be used to purchase items to create a basket.. If you have items you wish to send, do so in care of Annette Carr 775 Trago Creek Dr., Ballwin, MO 63021. When sending a monetary donation, be sure to note "Basket Raffle" on your check made out to Second Wind Lung Walk.
If you are attending the Lung Walk on October 17th, don't forget to raid your piggy banks or bring the checkbook to buy tickets and take a chance on some of these fun and useful baskets while supporting fellow transplant families through the Assistance Fund. Now more than ever, we need you, your family and friends to help make it possible to provide assistance to lung transplant patients.
If you have been helped by the Assistance Fund, you know what a blessing it is to have this resource when you need it most. And if you are blessed not to have needed it, then all the more reason to share your blessings with other transplant families.
|
A Thank You Note from Toni McEuen
Many of you know Toni McEuen who owns and manages Almost Home. Toni has always been very supportive of lung transplant patients.
Toni's husband, Harry, passed away recently. The following is a thank you note from Toni in response to a sympathy card from Second Wind.
"Thank you so much for your thoughts and prayers, they are greatly appreciated. It's been a long hard year for many of us, but with the love and support of our families and wonderful friends, and above all, God's grace, we will be okay."
Toni |
| Treasurer's Report
y  Linda Nottestad
Because of your generosity Second Wind provided $3433. in assistance during April, $3747. in assistance during May and $7235. in assistance during June. The payments were for lodging in St. Louis, travel expenses, food and medicine.
Welcome to New Members
Peggy and Dennis Diaz, Collinsville, IL 62234
Memorial for Mary Ann Barnes
Christopher Boehm
Memorials for John Burke
Patricia Ashbridge, Frank Bonifas, Patty and Mike Chappie, Marian Frentzel, Ronald and Marla Hamlin, Marilyn Hawk, Chuck and Becky Karlan, Larry and Jan Kwasigroh, Gary and Sylvia Miller, Cletus and Pauline Muhlenkamp, Ken and Linda Nottestad, Mame and Randy Nowlin, Tom and Jennifer O'Brien, Michael and Alyce Pendergraft, Amy Puthoff, Richard and Barbara Rhyner, Lorri and Roger Stephens, Corsha Sudhoff, Vera Wei Viher, Jane Wendel, Ronald and Margaret Wolff and Patricia Ann Woods
Memorials for Darlene Daurelle
Robert and Andrea Blohm, Family of Darlene Daurelle, Eric and Cathy Fullick, Ralph Knickrehm, Scott and Lisa Lammers, George and Linda Pickup, Cameron and Susan Risser, Lorri and Garry Steffe
Memorial for June Feltz
Mary Bryant
Memorials for Stan Henderson
Alison Bond, Diane and Howard Burkom, Elvira and Stephen Butler, F. L. Chiles, Donna Cutler, Marian Frentzel, Joan Huber, Barbara and Douglas Meadows, Daniel and Margaret Schramm, Wayne Schramm, Anita and David Steck, Jerrold and Linda Vesper, Linde Wiedow
Memorials for Carl Johnson, Sr.
Mame and Randy Nowlin, James and Alice Scherzberg
Memorial for Denise Oravez
Robert Baldino
Memorial for Jack Ritchie
Dorothy Ritchie
Memorials for Allen Warnecke
M. Jean Foege, Judith Sullivan
Thank You to Members Who Paid Their Dues
Marla Hamlin, Danny and Teresa White, Joy Williamson
Special Thanks to Members Who Made a Donation with Their Membership Renewal
Joy Williamson
Matching Gifts
Debbie Stegeman and Monsanto Fund, Jean Belford and JP Morgan Chase & Co, Peter Nicastro and Pfizer
Reminder Regarding Matching Donations
Some of our members are affiliated with companies which make matching gifts. In the past 12 months we have received matching donations from Monsanto, Pfizer, and Chase Bank to name a few. Please check with your place of business to see if they will match your donations to St. Louis Second Wind Lung Transplant Association.
Car Donation to Second Wind
Jack Crump
|
Lung Transplant Anniversaries By Jan and Larry Kwasigroh |
|
 CALENDAR
July 11, SECOND WIND PICNIC - Tower Grove Park, located in St. Louis City. RSVP TODAY by calling Tom Archer, 314.664.6360, ASAP please.
August 1: National Minority Donor Awareness Day
August 8, 2:00 PM, Second Sunday Social at Chris' Pancake and Dining.
September 12, 2:00 PM, Second Sunday Social at Chris' Pancake and Dining.
October 10, 2:00 PM, Second Sunday Social at Chris' Pancake and Dining.
October 16, 2010, LUNG WALK in Forest Park.
November: National Marrow Awareness Month
November 14, 2:00 PM, Second Sunday Social at Chris' Pancake and Dining.
November: National Donate Life Month
December 12, SECOND WIND CHRISTMAS PARTY |
|
|
|
|
|
|
|
