贝拉西普——抗排斥反应战场上的新武器

孙赫; 孙旖旎; 程颖

doi:10.3969/j.issn.1674-7445.2021.03.005

贝拉西普——抗排斥反应战场上的新武器

doi: 10.3969/j.issn.1674-7445.2021.03.005

110001 沈阳，中国医科大学附属第一医院器官移植科暨肝胆外科（孙赫、程颖），重症医学科（孙旖旎）

基金项目:

辽宁省教育厅科学研究项目（自然科学类） FWZR2020002

详细信息

作者简介:
孙赫，男，1986年生，博士，主治医师，研究方向为移植免疫学，Email：sunxiaohong6@163.com

通讯作者:
程颖，女，1975年生，博士，教授，研究方向为器官移植，Email：chengying75@sina.com

中图分类号: R617, R392
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出版历程
- 收稿日期: 2021-01-11
- 网络出版日期: 2021-05-19
- 刊出日期: 2021-05-15

Belatacept: a new weapon in anti-rejection battlefield

Department of Organ Transplantation and Hepatobiliary Surgery, the First Hospital of China Medical University, Shenyang 110001, China

More Information

Corresponding author: Cheng Ying, Email: chengying75@sina.com

摘要

摘要: 贝拉西普作为针对CD28受体的共刺激阻滞剂，已在欧美国家获批并应用于器官移植排斥反应的治疗。贝拉西普已被证实较钙调磷酸酶抑制剂（CNI）可更好地提高受者及移植物的长期存活率，并改善移植物功能，但同时也存在排斥反应发生率较高的问题。鉴于此，移植工作者尝试优化贝拉西普免疫抑制方案，并取得了较好的临床疗效。诚然，贝拉西普已被证实对于记忆性T细胞的作用欠佳，但因其特异性针对免疫细胞及不良反应小的特点，在探索新的共刺激分子靶点以优化免疫抑制方案上仍具有潜在价值。本文从共刺激阻滞剂的问世、贝拉西普的临床疗效及临床应用、引起贝拉西普耐药性排斥反应的“元凶”等方面进行综述。
- 肾移植 /
- 免疫抑制方案 /
- 共刺激阻滞剂 /
- CD28 /
- 贝拉西普 /
- 排斥反应 /
- 细胞毒T淋巴细胞相关抗原-4 /
- 移植后淋巴组织增生性疾病
Abstract: As a co-stimulatory blocker against CD28 receptor, belatacept has been approved and applied to the treatment of rejection in organ transplantation in Europe and America. Belatacept has been proven to outperform calcineurin inhibitor (CNI) in improving the long-term survival rate of recipients and grafts, and enhancing graft function. Nevertheless, it might cause a high incidence of rejection. To resolve this issue, transplant workers have attempted to optimize belatacept immunosuppressive regimen and achieved good clinical efficacy. Although belatacept has been proven to exert poor effect on memory T cells, it has potential value in exploring new co-stimulatory molecular targets to optimize immunosuppressive regimes due to its specificity for immune cells and mild adverse effects. In this article, the advent of co-stimulatory blocker, clinical efficacy and application of belatacept, and the causes of belatacept-resistant rejection were reviewed.
- Renal transplantation /
- Immunosuppressive regime /
- Co-stimulatory blocker /
- CD28 /
- Belatacept /
- Rejection /
- Cytotoxic T lymphocyte-associated antigen-4 /
- Posttransplant lymphoproliferative disease

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