生物制剂在预防和治疗移植排斥反应中的应用。

Springer seminars in immunopathology Pub Date : 2006-06-01 Epub Date: 2006-05-09 DOI:10.1007/s00281-006-0014-7
Reinhard Marks, Jürgen Finke
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引用次数: 5

摘要

生物制剂在实体器官移植和造血干细胞移植(HSCT)中用于诱导和维持免疫抑制。在实体器官移植中,针对T细胞的抗体是诱导方案的一部分,用于在器官移植期间和移植后持续期间启动免疫抑制,以防止移植排斥。几项同种异体肾移植的临床试验为生物制剂在这种临床环境中的有效性和安全性提供了数据。生物制剂的应用也允许减少钙调磷酸酶抑制剂,从而降低毒性和改善长期移植物功能。在急性排斥期,抗T细胞抗体在类固醇耐药病例中建立。干扰可溶性细胞因子活性的策略很少应用于实体器官移植。在造血干细胞移植中,T细胞定向抗体作为调节方案的一部分可改善移植并降低有害移植物抗宿主病(GvHD)的发生率。在急性GvHD中,针对T细胞和细胞因子(如tnf - α)的抗体都是诱导缓解的既定治疗方法。
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Biologics in the prevention and treatment of graft rejection.

Biologics are used in solid organ allografting and hematopoietic stem cell transplantation (HSCT) for the induction and maintenance of immunosuppression. In solid organ transplantation, antibodies targeting T cells are part of induction protocols administered for initiation of immunosuppression during organ transfer and during sustained post transplant periods for prevention of graft rejection. Several clinical trials in renal allografting provide data for the efficacy and safety of biologics in this clinical setting. Application of biologics also allows the reduction of calcineurin inhibitors, thereby reducing toxicity and improving long-term graft function. In acute rejection periods, anti T cell antibodies are established in steroid-resistant cases. Strategies interfering with the activity of soluble cytokines are less frequently applied for solid organ transplantation. In HSCT, T cell directed antibodies as part of conditioning protocols improve engraftment and reduce the incidence of detrimental graft vs host disease (GvHD). In acute GvHD, both antibodies targeting T cells and cytokines like TNF-alpha are established therapeutics for remission induction.

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