留言板

尊敬的读者、作者、审稿人, 关于本刊的投稿、审稿、编辑和出版的任何问题, 您可以本页添加留言。我们将尽快给您答复。谢谢您的支持!

姓名
邮箱
手机号码
标题
留言内容
验证码

个体化免疫诱导方案在肾移植中的应用进展

朱焓 徐鸿 梁国标

朱焓, 徐鸿, 梁国标. 个体化免疫诱导方案在肾移植中的应用进展[J]. 器官移植, 2021, 12(6): 741-747. doi: 10.3969/j.issn.1674-7445.2021.06.015
引用本文: 朱焓, 徐鸿, 梁国标. 个体化免疫诱导方案在肾移植中的应用进展[J]. 器官移植, 2021, 12(6): 741-747. doi: 10.3969/j.issn.1674-7445.2021.06.015
Zhu Han, Xu Hong, Liang Guobiao. Application progress of individualized immune induction therapy in kidney transplantation[J]. ORGAN TRANSPLANTATION, 2021, 12(6): 741-747. doi: 10.3969/j.issn.1674-7445.2021.06.015
Citation: Zhu Han, Xu Hong, Liang Guobiao. Application progress of individualized immune induction therapy in kidney transplantation[J]. ORGAN TRANSPLANTATION, 2021, 12(6): 741-747. doi: 10.3969/j.issn.1674-7445.2021.06.015

个体化免疫诱导方案在肾移植中的应用进展

doi: 10.3969/j.issn.1674-7445.2021.06.015
基金项目: 

国家自然科学基金 81460135

贵州省教育厅创新群体重大研究项目 黔教合KY字[2017]045

遵义市科技计划项目 遵市科合HZ字(2020)210

详细信息
    作者简介:

    朱焓,男,1995年生,硕士研究生,住院医师,研究方向为肾脏移植,Email: hanzhu1995@163.com

    通讯作者:

    梁国标,男,1970年生,博士研究生导师,主任医师,研究方向为肾脏移植,Enail: lg111@126.com

  • 中图分类号: R617, R392.4

Application progress of individualized immune induction therapy in kidney transplantation

More Information
  • 摘要: 肾移植术后早期急性排斥反应发生的风险较高,严重影响受者的生存质量。2009年,改善全球肾脏病预后组织(KDIGO)建议将免疫诱导药物纳入肾移植术前免疫诱导方案中,其目的就是针对这一关键时期提供一定强度的免疫抑制,从而有效减少术后急性排斥反应的发生。目前全球各移植中心对于免疫诱导药物的选择及其有效性、安全性仍不确定。本文通过汲取国内外学者的研究成果,对比分析单克隆抗体包括白细胞介素-2受体拮抗剂、阿伦单抗、利妥昔单抗及多克隆抗体抗胸腺细胞球蛋白在肾移植术前免疫诱导中的应用效果,旨在为推动肾移植免疫诱导药物的个体化选择,提高受者的生存质量提供参考。

     

  • [1] JU A, JOSEPHSON MA, BUTT Z, et al. Establishing a core outcome measure for life participation: a standardized outcomes in nephrology-kidney transplantation consensus workshop report[J]. Transplantation, 2019, 103(6): 1199-1205. DOI: 10.1097/TP.0000000000002476.
    [2] 中华医学会器官移植学分会. 肾移植排斥反应临床诊疗技术规范(2019版)[J]. 器官移植, 2019, 10(5): 505-512. DOI: 10.3969/j.issn.1674-7445.2019.05.008.

    Branch of Organ Transplantation of Chinese Medical Association. Technical specifications for the diagnosis and treatment on rejection of renal transplant[J]. Organ Transplant, 2019, 10(5): 505-512. DOI: 10.3969/j.issn.1674-7445.2019.05.008.
    [3] COOPER JE. Evaluation and treatment of acute rejection in kidney allografts[J]. Clin J Am Soc Nephrol, 2020, 15(3): 430-438. DOI: 10.2215/CJN.11991019.
    [4] 中华医学会器官移植学分会. 器官移植免疫抑制剂临床应用技术规范(2019版)[J]. 器官移植, 2019, 10(3): 213-226. DOI: 10.3969/j.issn.1674-7445.2019.03.001.

    Branch of Organ Transplantation of Chinese Medical Association. Technical specification for clinical application of immunosuppressive agents in organ transplantation (2019 edition)[J]. Organ Transplant, 2019, 10(3): 213-226. DOI: 10.3969/j.issn.1674-7445.2019.03.001.
    [5] WEBSTER AC, WU S, TALLAPRAGADA K, et al. Polyclonal and monoclonal antibodies for treating acute rejection episodes in kidney transplant recipients[J]. Cochrane Database Syst Rev, 2017, 7(7): CD004756. DOI: 10.1002/14651858.CD004756.pub4.
    [6] ABBAS AK. The surprising story of IL-2: from experimental models to clinical application[J]. Am J Pathol, 2020, 190(9): 1776-1781. DOI: 10.1016/j.ajpath.2020.05.007.
    [7] GOLDBERG R, CLOUGH JN, ROBERTS LB, et al. A Crohn's disease-associated IL2RA enhancer variant determines the balance of T cell immunity by regulating responsiveness to IL-2 signaling[J]. J Crohns Colitis, 2021, DOI: 10.1093/ecco-jcc/jjab103[Epubaheadofprint].
    [8] COHAN SL, LUCASSEN EB, ROMBA MC, et al. Daclizumab: mechanisms of action, therapeutic efficacy, adverse events and its uncovering the potential role of innate immune system recruitment as a treatment strategy for relapsing multiple sclerosis[J]. Biomedicines, 2019, 7(1): 18. DOI: 10.3390/biomedicines7010018.
    [9] 侯杰. 巴利昔单抗在心脏移植免疫诱导治疗中的应用[J]. 天津药学, 2020, 32(3): 59-63. DOI: 10.3969/j.issn.1006-5687.2020.03.021.

    HOU J. Application of basiliximab for immune induction therapy in heart transplantation[J]. Tianjin Pharm, 2020, 32(3): 59-63. DOI: 10.3969/j.issn.1006-5687.2020.03.021.
    [10] 中华医学会器官移植学分会, 中国医师协会器官移植医师分会. 中国肾移植受者免疫抑制治疗指南(2016版)[J]. 器官移植, 2016, 7(5): 327-331. DOI: 10.3969/j.issn.1674-7445.2016.05.001.

    Branch of Organ Transplantation of Chinese Medical Association, Branch of Organ Transplant Physician of Chinese Medical Doctor Association. Guideline on immunosuppressive therapy of recipients with renal transplantation in China (2016 edition)[J]. Organ Transplant, 2016, 7(5): 327-331. DOI: 10.3969/j.issn.1674-7445.2016.05.001.
    [11] RODRÍGUEZ FABA O, BOISSIER R, BUDDE K, et al. European Association of Urology Guidelines on renal transplantation: update 2018[J]. Eur Urol Focus, 2018, 4(2): 208-215. DOI: 10.1016/j.euf.2018.07.014.
    [12] 邱涛, 周江桥, 刘修恒, 等. 标准双剂与单剂巴利昔单抗用于肾移植的对比研究[J]. 器官移植, 2015, 6(4): 230-234. DOI: 10.3969/j.issn.1674-7445.2015.04.005.

    QIU T, ZHOU JQ, LIU XH, et al. Comparative study of application of standard double- and single-dose of basiliximab in renal transplantation[J]. Organ Transplant, 2015, 6(4): 230-234. DOI: 10.3969/j.issn.1674-7445.2015.04.005.
    [13] CUNNINGHAM KC, HAGER DR, FISCHER J, et al. Single-dose basiliximab induction in low-risk renal transplant recipients[J]. Pharmacotherapy, 2016, 36(7): 823-829. DOI: 10.1002/phar.1774.
    [14] 陈致远, 邵蓉. 达利珠单抗诱导预防肾移植后急性免疫排斥反应的Meta分析[J]. 中国药物评价, 2016, 33(4): 239-245. DOI: 10.3969/j.issn.2095-3593.2016.04.014.

    CHEN ZY, SHAO R. Effects of daclizumab used in treatment for the acute rejection after renal transplant: a Meta-analysis[J]. Chin J Drug Eval, 2016, 33(4): 239-245. DOI: 10.3969/j.issn.2095-3593.2016.04.014.
    [15] VAN DER ZWAN M, BAAN CC, VAN GELDER T, et al. Review of the clinical pharmacokinetics and pharmacodynamics of alemtuzumab and its use in kidney transplantation[J]. Clin Pharmacokinet, 2018, 57(2): 191-207. DOI: 10.1007/s40262-017-0573-x.
    [16] EVAN JR, BOZKURT SB, THOMAS NC, et al. Alemtuzumab for the treatment of multiple sclerosis[J]. Expert Opin Biol Ther, 2018, 18(3): 323-334. DOI: 10.1080/14712598.2018.1425388.
    [17] GUNDROO A, ZACHARIAH M, SINGH N, et al. Alemtuzumab (Campath-1H) experience in kidney transplantation what we have learned; current practices; and scope for the future?[J]. Curr Opin Organ Transplant, 2015, 20(6): 638-642. DOI: 10.1097/MOT.0000000000000255.
    [18] SCHMITZ R, FITCH ZW, XU H, et al. Kidney transplantation using alemtuzumab, belatacept, and sirolimus: five-year follow-up[J]. Am J Transplant, 2020, 20(12): 3609-3619. DOI: 10.1111/ajt.16121.
    [19] YAKUBU I, RAVICHANDRAN B, SPARKES T, et al. Comparison of alemtuzumab versus basiliximab induction therapy in elderly kidney transplant recipients: a single-center experience[J]. J Pharm Pract, 2021, 34(2): 199-206. DOI: 10.1177/0897190019850934.
    [20] FLORESCU DF, SEAMAN JA, KALIL AC, et al. Opportunistic infections after induction with alemtuzumab or basiliximab: a 3-year kidney transplantation experience[J]. Transplant Proc, 2021, 53(3): 1058-1063. DOI: 10.1016/j.transproceed.2020.08.025.
    [21] GUTHOFF M, BERGER K, ALTHAUS K, et al. Low-dose alemtuzumab induction in a tailored immunosuppression protocol for sensitized kidney transplant recipients[J]. BMC Nephrol, 2020, 21(1): 178. DOI: 10.1186/s12882-020-01767-z.
    [22] 3C Study Collaborative Group, HAYNES R, HARDEN P, et al. Alemtuzumab-based induction treatment versus basiliximab-based induction treatment in kidney transplantation (the 3C Study): a randomised trial[J]. Lancet, 2014, 384(9955): 1684-1690. DOI: 10.1016/S0140-6736(14)61095-3.
    [23] MYRO AZ, BJERKE G, ZARNOVICKY S, et al. Diffuse alveolar hemorrhage during alemtuzumab infusion in a patient with multiple sclerosis: a case report[J]. BMC Pharmacol Toxicol, 2018, 19(1): 75. DOI: 10.1186/s40360-018-0267-5.
    [24] ALNAHDI MA, ALJARBA SI, AL MALIK YM. Alemtuzumab-induced simultaneous onset of autoimmune haemolytic anaemia, alveolar haemorrhage, nephropathy, and stroke: a case report[J]. Mult Scler Relat Disord, 2020, 41: 102141. DOI: 10.1016/j.msard.2020.102141.
    [25] BAYAS A, MENACHER M, SCHWAIBLMAIR M, et al. Alemtuzumab-associated diffuse alveolar damage - a case report[J]. BMC Neurol, 2020, 20(1): 357. DOI: 10.1186/s12883-020-01934-7.
    [26] 中华医学会器官移植学分会. ABO血型不相容亲属活体肾移植技术操作规范(2019版)[J]. 器官移植, 2019, 10(5): 533-539. DOI: 10.3969/j.issn.1674-7445.2019.05.012.

    Branch of Organ Transplantation of Chinese Medical Association. Technical operation specification for ABO-incompatible kidney transplantation from relative living donor[J]. Organ Transplant, 2019, 10(5): 533-539. DOI: 10.3969/j.issn.1674-7445.2019.05.012.
    [27] STEGALL MD, GLOOR JM. Deciphering antibody-mediated rejection: new insights into mechanisms and treatment[J]. Curr Opin Organ Transplant, 2010, 15(1): 8-10. DOI: 10.1097/MOT.0b013e3283342712.
    [28] 方佳丽, 陈正, 郭予和, 等. 利妥昔单抗联合ATG作为高致敏肾移植受者免疫诱导方案的安全性及有效性[J]. 中华医学杂志, 2019, 99(16): 1232-1236. DOI: 10.3760/cma.j.issn.0376-2491.2019.16.008.

    FANG JL, CHEN Z, GUO YH, et al. Clinical efficacy and safety of combined induction therapy with rituximab and ATG in highly sensitized kidney transplant recipients[J]. Nat Med J China, 2019, 99(16): 1232-1236. DOI: 10.3760/cma.j.issn.0376-2491.2019.16.008.
    [29] 蒋鸿涛, 秦国庆, 刘罗根, 等. 早期低剂量利妥昔单抗在ABO血型不相容肾移植中的应用[J]. 广东医学, 2017, 38(19): 3014-3018. DOI: 10.3969/j.issn.1001-9448.2017.19.027.

    JIANG HT, QIN GQ, LIU LG, et al. Early application of low dose rituximab in ABO incompatible kidney transplantation[J]. Guangdong Med J, 2017, 38(19): 3014-3018. DOI: 10.3969/j.issn.1001-9448.2017.19.027.
    [30] 诸慧, 周丰, 金剑. 56例利妥昔单抗不良反应文献分析[J]. 中国药物警戒, 2018, 15(1): 52-56. DOI: 10.3969/j.issn.1672-8629.2018.01.013.

    ZHU H, ZHOU F, JIN J. Literature analysis of 56 cases of adverse reactions induced by rituximab[J]. Chin J Pharmacovigil, 2018, 15(1): 52-56. DOI: 10.3969/j.issn.1672-8629.2018.01.013.
    [31] 徐江峰, 张颂, 王兰欣. 抗胸腺细胞球蛋白/抗淋巴细胞球蛋白的药理毒理学及其临床研究[J]. 中国生物制品学杂志, 2019, 32(8): 934-939. https://www.cnki.com.cn/Article/CJFDTOTAL-SWZP201908020.htm

    XU JF, ZHANG S, WANG LX. Pharmacological toxicology and clinical studies of anti-themocyte globulin and anti-lymphocyte globulin[J]. Chin J Biol, 2019, 32(8): 934-939. https://www.cnki.com.cn/Article/CJFDTOTAL-SWZP201908020.htm
    [32] 朱阳敏. 猪抗人淋巴细胞球蛋白与兔抗人胸腺细胞球蛋白治疗儿童再生障碍性贫血的疗效及安全性比较[D]. 北京: 中国医学科学院北京协和医学院, 2020.
    [33] 闫晓冬, 林俊, 张健, 等. 抗胸腺细胞球蛋白对再次肾移植受者尸体供肾移植免疫诱导的临床有效性和安全性[J]. 解放军医学杂志, 2021, 46(2): 136-141. DOI: 10.11855/j.issn.0577-7402.2021.02.05.

    YAN XD, LIN J, ZHANG J, et al. Clinical efficacy and safety of antithymocyte globulin prophylaxis for graft recipients in deceased donor kidney re-transplantation[J]. Med J Chin PLA, 2021, 46(2): 136-141. DOI: 10.11855/j.issn.0577-7402.2021.02.05.
    [34] KIM SJ, RHU J, YOO H, et al. Outcome comparison between low-dose rabbit anti-thymocyte globulin and basiliximab in low-risk living donor kidney transplantation[J]. J Clin Med, 2020, 9(5): 1320. DOI: 10.3390/jcm9051320.
    [35] NAFAR M, DALILI N, POOR-REZA-GHOLI F, et al. The appropriate dose of thymoglobulin induction therapy in kidney transplantation[J]. Clin Transplant, 2017, 31(6): e12977. DOI: 10.1111/ctr.12977.
    [36] ALI H, SOLIMAN KM, SHAHEEN I, et al. Rabbit anti-thymocyte globulin (rATG) versus IL-2 receptor antagonist induction therapies in tacrolimus-based immunosuppression era: a Meta-analysis[J]. Int Urol Nephrol, 2020, 52(4): 791-802. DOI: 10.1007/s11255-020-02418-w.
    [37] WANG K, XU X, FAN M. Induction therapy of basiliximab versus antithymocyte globulin in renal allograft: a systematic review and Meta-analysis[J]. Clin Exp Nephrol, 2018, 22(3): 684-693. DOI: 10.1007/s10157-017-1480-z.
    [38] PILCH NA, TABER DJ, MOUSSA O, et al. Prospective randomized controlled trial of rabbit antithymocyte globulin compared with IL-2 receptor antagonist induction therapy in kidney transplantation[J]. Ann Surg, 2014, 259(5): 888-893. DOI: 10.1097/SLA.0000000000000496.
    [39] HWANG SD, LEE JH, LEE SW, et al. Efficacy and safety of induction therapy in kidney transplantation: a network Meta-analysis[J]. Transplant Proc, 2018, 50(4): 987-992. DOI: 10.1016/j.transproceed.2018.01.022.
    [40] MORGAN RD, O'CALLAGHAN JM, KNIGHT SR, et al. Alemtuzumab induction therapy in kidney transplantation: a systematic review and Meta-analysis[J]. Transplantation, 2012, 93(12): 1179-1188. DOI: 10.1097/TP.0b013e318257ad41.
    [41] HILL P, CROSS NB, BARNETT AN, et al. Polyclonal and monoclonal antibodies for induction therapy in kidney transplant recipients[J]. Cochrane Database Syst Rev, 2017, 1(1): CD004759. DOI: 10.1002/14651858.CD004759.pub2.
    [42] THOMAS PG, WOODSIDE KJ, LAPPIN JA, et al. Alemtuzumab (Campath 1H) induction with tacrolimus monotherapy is safe for high immunological risk renal transplantation[J]. Transplantation, 2007, 83(11): 1509-1512. DOI: 10.1097/01.tp.0000263344.53000.a1.
    [43] CIANCIO G, GAYNOR JJ, GUERRA G, et al. Randomized trial of three induction antibodies in kidney transplantation: long-term results[J]. Transplantation, 2014, 97(11): 1128-1138. DOI: 10.1097/01.TP.0000441089.39840.66.
    [44] HAO WJ, ZONG HT, CUI YS, et al. The efficacy and safety of alemtuzumab and daclizumab versus antithymocyte globulin during organ transplantation: a Meta-analysis[J]. Transplant Proc, 2012, 44(10): 2955-2960. DOI: 10.1016/j.transproceed.2012.05.085.
    [45] SCHADDE E, D'ALESSANDRO AM, KNECHTLE SJ, et al. Alemtuzumab induction and triple maintenance immunotherapy in kidney transplantation from donors after cardiac death[J]. Transpl Int, 2008, 21(7): 625-636. DOI: 10.1111/j.1432-2277.2008.00642.x.
  • 加载中
图(1)
计量
  • 文章访问数:  76
  • HTML全文浏览量:  40
  • PDF下载量:  23
  • 被引次数: 0
出版历程
  • 收稿日期:  2021-07-16
  • 刊出日期:  2021-11-15

目录

    /

    返回文章
    返回