基因修饰猪-猴异种心脏移植模型免疫反应动态特征分析

Dynamic analysis of immune responses in heterotopic heart transplantation model of genetically modified pig-to-macaque

  • 摘要:
    目的  探讨联合免疫抑制方案调控基因修饰猪-猴异种心脏移植排斥反应的效果。
    方法 构建2例基因修饰猪-猴异种心脏移植模型,动态监测受体外周血免疫指标并观察移植物病理变化。
    结果 第1例方案主要通过B细胞清除+T细胞抑制+补体C3抑制降低了淋巴细胞水平,但未能完全控制急性体液性排斥反应及巨噬细胞浸润;第2例方案在第1例方案基础上增加了补体C5抑制及白细胞介素(IL)-6抑制,与第1例方案相比,在降低淋巴细胞的同时,显著抑制了急性体液性排斥反应及补体激活,减少了抗体沉积,但移植晚期仍出现细胞因子风暴及T细胞残留。
    结论 第2例方案通过多靶点干预降低超急性和急性排斥反应的风险,但需平衡药物复杂性与安全性,提示需优化细胞免疫调控,并通过动态多维度监测调整方案。

     

    Abstract:
    Objective To evaluate the efficacy of a combined immunosuppression regimen in modulating rejection in genetically modified pig-to-macaque xenogeneic heart transplantation.
    Methods Two xenogeneic heart transplantation models were constructed using genetically modified pigs and macaques . Dynamic monitoring of recipient peripheral blood immune parameters and observation of graft pathological changes were performed .
    Results Regimen 1, featuring B-cell depletion, T-cell inhibition, and C3 complement suppression, reduced lymphocyte levels but failed to control acute humoral rejection and macrophage infiltration. Regimen 2, adding C5 complement inhibition and interleukin (IL)-6 inhibition to Regimen 1, more effectively lowered lymphocyte levels, inhibited acute humoral rejection and complement activation, and decreased antibody deposition. However, a late-phase cytokine storm and residual T cells emerged.
    Conclusions Regimen 2 reduces the hyperacute and acute rejection risks through multi-target intervention. Yet, it requires balancing medication complexity and safety. This indicates the need to optimize cellular immune regulation and adjust the plan through dynamic multidimensional monitoring.

     

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