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

肾移植免疫诱导方案临床应用进展

何龙 王博谦

何龙, 王博谦. 肾移植免疫诱导方案临床应用进展[J]. 器官移植, 2021, 12(6): 682-686. doi: 10.3969/j.issn.1674-7445.2021.06.006
引用本文: 何龙, 王博谦. 肾移植免疫诱导方案临床应用进展[J]. 器官移植, 2021, 12(6): 682-686. doi: 10.3969/j.issn.1674-7445.2021.06.006
He Long, Wang Boqian. Clinical application progress of immune induction regimen for kidney transplantation[J]. ORGAN TRANSPLANTATION, 2021, 12(6): 682-686. doi: 10.3969/j.issn.1674-7445.2021.06.006
Citation: He Long, Wang Boqian. Clinical application progress of immune induction regimen for kidney transplantation[J]. ORGAN TRANSPLANTATION, 2021, 12(6): 682-686. doi: 10.3969/j.issn.1674-7445.2021.06.006

肾移植免疫诱导方案临床应用进展

doi: 10.3969/j.issn.1674-7445.2021.06.006
基金项目: 

辽宁省民生科技计划 2021JH2/10300089

详细信息
    作者简介:

    何龙,副主任医师,医学博士后,硕士研究生导师。现任中国人民解放军北部战区总医院器官移植中心副主任。兼任中国医疗保健国际交流促进会器官移植学分会委员、全军器官移植学会委员、中华医学会器官移植学分会青年委员、辽宁省医学会器官移植学分会委员。兼任《器官移植》杂志通讯编委。主持国家及省部级科研基金7项,在国内外杂志发表学术论文40余篇,主编专著3部,拥有国家专利3项

    通讯作者:

    何龙,Email:helongyh@vip.qq.com

  • 中图分类号: R617, R392.4

Clinical application progress of immune induction regimen for kidney transplantation

More Information
  • 摘要: 随着免疫抑制剂的发展和免疫抑制方案的优化,肾移植受者和移植物的存活率显著提高,术后急性排斥反应发生率和移植物功能延迟恢复发生率也明显降低。但是标准的三联免疫抑制方案(钙调磷酸酶抑制剂+ 抗代谢药物+ 糖皮质激素)仍无法有效控制移植肾排斥反应,因此提出在移植前进行免疫诱导方案。免疫诱导治疗可推迟钙调磷酸酶抑制剂的应用时间,降低其使用剂量,减少术后短期急性排斥反应的发生,改善受者中远期预后。本文将从单克隆抗体为主的免疫诱导方案、多克隆抗体为主的免疫诱导方案以及间充质干细胞为主的免疫诱导方案进行探讨,以期为优化肾移植选择免疫诱导方案提供参考。

     

  • [1] GOLSHAYAN D, PASCUAL M. Burden of end-stage renal disease and evolving challenges in kidney transplantation[J]. Transpl Int, 2019, 32(9): 889-891. DOI: 10.1111/tri.13490.
    [2] NAGARAJAN M, RAMANATHAN S, DHANAPRIYA J, et al. Impact of acute kidney injury on renal allograft survival[J]. Ren Fail, 2017, 39(1): 40-44. DOI: 10.1080/0886022X.2016.1244076.
    [3] POSNER J, BARRINGTON P, BRIER T, et al. Monoclonal antibodies: past, present and future[J]. Handb Exp Pharmacol, 2019, 260: 81-141. DOI: 10.1007/164_2019_323.
    [4] NELSON PN, REYNOLDS GM, WALDRON EE, et al. Monoclonal antibodies[J]. Mol Pathol, 2000, 53(3): 111- 117. DOI: 10.1136/mp.53.3.111.
    [5] 李聪然, 石炳毅, 蔡明, 等. 巴利昔单抗对肾移植排斥反应及移植物存活影响的Meta分析[J]. 解放军医学杂志, 2009, 34(8): 1012-1015. DOI: 10.3321/j.issn:0577-7402.2009.08.025.

    LI CR, SHI BY, CAI M, et al. Meta-analysis of the effect of basiliximab on renal graft rejection and survival[J]. Med J Chin PLA, 2009, 34(8): 1012-1015. DOI: 10.3321/j.issn:0577-7402.2009.08.025.j.issn:0577-7402.2009.08.025.
    [6] WANG X, DU W, ZHANG X, et al. The influence of different disease states on rituximab pharmacokinetics[J]. Curr Drug Metab, 2020, 21(12): 938-946. DOI: 10.2174/1389200221666200719004035.
    [7] OOMEN I, NASSAR-SHEIKH RASHID A, BOUTS AHM, et al. Anti-rituximab antibodies affect pharmacokinetics and pharmacodynamics of rituximab in children with immune-mediated diseases[J]. Clin Exp Rheumatol, 2021, [Epub ahead of print].
    [8] 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.
    [9] GENBERG H, HANSSON A, WERNERSON A, et al. Pharmacodynamics of rituximab in kidney transplantation[J]. Transplantation, 2007, 84(12 Suppl): S33-S36. DOI: 10.1097/01.tp.0000296122.19026.0f.
    [10] SINANGIL A, UCAR ZA, KOC Y, et al. Outcome of desensitization therapy in immunologically high-risk kidney transplantation: single-center experience[J]. Transplant Proc, 2019, 51(7): 2268-2273. DOI: 10.1016/j.transproceed.2019.04.068.
    [11] PARAJULI S, MANDELBROT DA, MUTH B, et al. Rituximab and monitoring strategies for late antibodymediated rejection after kidney transplantation[J]. Transplant Direct, 2017, 3(12): e227. DOI: 10.1097/TXD.0000000000000746.
    [12] JOOSTEN I, BAAS MC, KAMBUROVA EG, et al. Anti-B cell therapy with rituximab as induction therapy in renal transplantation[J]. Transpl Immunol, 2014, 31(4): 207-209. DOI: 10.1016/j.trim.2014.09.011.
    [13] 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.
    [14] HANAWAY MJ, WOODLE ES, MULGAONKAR S, et al. Alemtuzumab induction in renal transplantation[J]. N Engl J Med, 2011, 364(20): 1909-1919. DOI: 10.1056/NEJMoa1009546.
    [15] HERTIG A, ZUCKERMANN A. Rabbit antithymocyte globulin induction and risk of post-transplant lymphoproliferative disease in adult and pediatric solid organ transplantation: an update[J]. Transpl Immunol, 2015, 32(3): 179-187. DOI: 10.1016/j.trim.2015.04.003.
    [16] DESCOUROUEZ JL, JORGENSON MR, PARAJULI S, et al. Alemtuzumab induction for retransplantation after primary transplant with alemtuzumab induction[J]. Clin Nephrol, 2020, 93(2): 77-84. DOI: 10.5414/CN109934.
    [17] SABAH TK, KHALID U, ILHAM MA, et al. Induction with ATG in DCD kidney transplantation; efficacy and relation of dose and cell markers on delayed graft function and renal function[J]. Transpl Immunol, 2021, 66: 101388. DOI: 10.1016/j.trim.2021.101388.
    [18] GUIRADO L. Does rabbit antithymocyte globulin (thymoglobuline®) have a role in avoiding delayed graft function in the modern era of kidney transplantation?[J]. J Transplant, 2018: 4524837. DOI: 10.1155/2018/4524837.
    [19] RUAN V, CZER LS, AWAD M, et al. Use of anti-thymocyte globulin for induction therapy in cardiac transplantation: a review[J]. Transplant Proc, 2017, 49(2): 253-259. DOI: 10.1016/j.transproceed.2016.11.034.
    [20] KOYAWALA N, SILBER JH, ROSENBAUM PR, et al. Comparing outcomes between antibody induction therapies in kidney transplantation[J]. J Am Soc Nephrol, 2017, 28(7): 2188-2200. DOI: 10.1681/ASN.2016070768.
    [21] CREMASCHI L, VON VERSEN R, BENZING T, et al. Induction therapy with rabbit antithymocyte globulin versus basiliximab after kidney transplantation: a health economic analysis from a German perspective[J]. Transpl Int, 2017, 30(10): 1011-1019. DOI: 10.1111/tri.12991.
    [22] LEE KW, PARK JB, CHO CW, et al. The impact of donorspecific anti-human leukocyte antigen (HLA) antibody rebound on the risk of antibody mediated rejection in sensitized kidney transplant recipients[J]. Ann Transplant, 2017, 22: 166-176. DOI: 10.12659/aot.902266.
    [23] QIU J, LI J, CHEN G, et al. Induction therapy with thymoglobulin or interleukin-2 receptor antagonist for Chinese recipients of living donor renal transplantation: a retrospective study[J]. BMC Nephrol, 2019, 20(1): 101. DOI: 10.1186/s12882-019-1293-2.
    [24] ZHANG R. Donor-specific antibodies in kidney transplant recipients[J]. Clin J Am Soc Nephrol, 2018, 13(1): 182-192. DOI: 10.2215/CJN.00700117.
    [25] LEE H, LEE S, JEON JS, et al. Thymoglobulin versus basiliximab induction therapy in low-risk kidney transplant recipients: a single-center experience[J]. Transplant Proc, 2018, 50(5): 1285-1288. DOI: 10.1016/j.transproceed.2018.02.088.
    [26] SAIDI RF, MOGHADASALI R, SHEKARCHIAN S. Utilization of mesenchymal stem cells in kidney transplantation: from bench to bedside[J]. Iran J Kidney Dis, 2019, 13(4): 213-224.
    [27] WANG X, YANG C, HU L, et al. Tolerance induction with donor hematopoietic stem cell infusion in kidney transplantation: a single-center experience in China with a 10-year follow-up[J]. Ann Transl Med, 2020, 8(21): 1378. DOI: 10.21037/atm-20-2502a.
    [28] PERICO N, CASIRAGHI F, TODESCHINI M, et al. Long-term clinical and immunological profile of kidney transplant patients given mesenchymal stromal cell immunotherapy[J]. Front Immunol, 2018, 9: 1359. DOI: 10.3389/fimmu.2018.01359.
    [29] HAFAZEH L, CHANGIZI-ASHTIYANI S, GHASEMI F, et al. Stem cell therapy ameliorates ischemia-reperfusion induced kidney injury after 24 hours reperfusion[J]. Iran J Kidney Dis, 2019, 13(6): 380-388.
    [30] ZILBERMAN-ITSKOVICH S, ABU-HAMAD R, ZARURA R, et al. Human mesenchymal stromal cells ameliorate complement induced inflammatory cascade and improve renal functions in a rat model of ischemiareperfusion induced acute kidney injury[J]. PLoS One, 2019, 14(9): e0222354. DOI: 10.1371/journal.pone.0222354.
    [31] VOLAREVIC V, GAZDIC M, SIMOVIC MARKOVIC B, et al. Mesenchymal stem cell-derived factors: immuno-modulatory effects and therapeutic potential[J]. Biofactors, 2017, 43(5): 633-644. DOI: 10.1002/biof.1374.
    [32] SONG N, SCHOLTEMEIJER M, SHAH K. Mesenchymal stem cell immunomodulation: mechanisms and therapeutic potential[J]. Trends Pharmacol Sci, 2020, 41(9): 653-664. DOI: 10.1016/j.tips.2020.06.009.
    [33] NAJAR M, FAYYAD-KAZAN M, MERIMI M, et al. Mesenchymal stromal cells and natural killer cells: a complex story of love and hate[J]. Curr Stem Cell Res Ther, 2019, 14(1): 14-21. DOI: 10.2174/1574888X13666180912125736.
    [34] GUGJOO MB, HUSSAIN S, AMARPAL, et al. Mesenchymal stem cell-mediated immuno-modulatory and anti- inflammatory mechanisms in immune and allergic disorders[J]. Recent Pat Inflamm Allergy Drug Discov, 2020, 14(1): 3-14. DOI: 10.2174/1872213X14666200130100236.
    [35] DEBOSSCHERE Y, DEPUYDT E, PAUWELYN G, et al. Safety and immunomodulatory properties of equine peripheral blood-derived mesenchymal stem cells in healthy cats[J]. Vet Immunol Immunopathol, 2020, 227: 110083. DOI: 10.1016/j.vetimm.2020.110083.
    [36] 王媞尔, 史明霞. 间充质干细胞旁分泌作用的研究进展[J]. 实用医学杂志, 2021, 37(13): 1651-1654. DOI: 10.3969/j.issn.1006-5725.2021.13.001.

    WANG TE, SHI MX. Research advance in paracrine role of mesenchymal stem cells[J]. J Pract Med, 2021, 37(13): 1651-1654. DOI: 10.3969/j.issn.1006-5725.2021.13.001.
    [37] ZHAO L, HU C, HAN F, et al. Induction therapy with mesenchymal stromal cells in kidney transplantation: a Meta-analysis[J]. Stem Cell Res Ther, 2021, 12(1): 158. DOI: 10.1186/s13287-021-02219-7.
    [38] SANABRIA-DE LA TORRE R, QUIÑONES-VICO MI, FERNÁNDEZ-GONZÁLEZ A, et al. Alloreactive immune response associated to human mesenchymal stromal cells treatment: a systematic review[J]. J Clin Med, 2021, 10(13): 2991. DOI: 10.3390/jcm10132991.
    [39] PERICO N, CASIRAGHI F, INTRONA M, et al. Autologous mesenchymal stromal cells and kidney transplantation: a pilot study of safety and clinical feasibility[J]. Clin J Am Soc Nephrol, 2011, 6(2): 412-422. DOI: 10.2215/CJN.04950610.
    [40] CASIRAGHI F, AZZOLLINI N, TODESCHINI M, et al. Localization of mesenchymal stromal cells dictates their immune or proinflammatory effects in kidney transplantation[J]. Am J Transplant, 2012, 12(9): 2373- 2383. DOI: 10.1111/j.1600-6143.2012.04115.x.
  • 加载中
图(1)
计量
  • 文章访问数:  111
  • HTML全文浏览量:  30
  • PDF下载量:  44
  • 被引次数: 0
出版历程
  • 收稿日期:  2021-08-18
  • 刊出日期:  2021-11-15

目录

    /

    返回文章
    返回