資源描述:
《抗體誘導(dǎo)療法在器官移植領(lǐng)域的臨床應(yīng)用.pdf》由會(huì)員上傳分享,免費(fèi)在線閱讀,更多相關(guān)內(nèi)容在行業(yè)資料-天天文庫(kù)。
1、2010年11月第4卷第4期ChinJTransplant(ElectronicEdition),November2010,Vol4,No.4·27··講座·抗體誘導(dǎo)療法在器官移植領(lǐng)域的臨床應(yīng)用馬磷磷【摘要】近年來(lái)抗體誘導(dǎo)療法的應(yīng)用越來(lái)越廣泛,2009年美國(guó)腎移植數(shù)據(jù)統(tǒng)計(jì)分析報(bào)告顯示,83%腎移植受者接受誘導(dǎo)療法。隨著生物學(xué)技術(shù)的不斷進(jìn)步,用于誘導(dǎo)治療的生物制劑經(jīng)歷了3個(gè)不同時(shí)期。目前除了預(yù)防急性排斥反應(yīng)、增強(qiáng)免疫抑制,誘導(dǎo)療法還作為免疫抑制劑聯(lián)合應(yīng)用中的一部分,旨在減少維持期的藥物劑量和毒副作用。目前
2、臨床批準(zhǔn)使用的誘導(dǎo)治療制劑包括了以抗淋巴細(xì)胞球蛋白為代表的多克隆抗體、以抗CD3T淋巴細(xì)胞單克隆抗體和IL一2受體阻斷劑為代表的單克隆抗體,還有一些進(jìn)入移植臨床試驗(yàn)階段的制劑,如抗CD20單克隆抗體和抗CD52單克隆抗體等。我國(guó)2010年版《臨床診療指南——器官移植學(xué)分冊(cè)》明確了誘導(dǎo)療法的應(yīng)用原則和誘導(dǎo)抗體選擇原則。最后提出,除了藥物,能降低受者T淋巴細(xì)胞對(duì)異基因抗原識(shí)別過(guò)程導(dǎo)致的免疫應(yīng)答反應(yīng)、最大限度地降低臨床排斥反應(yīng)所采取的手段,都可以作為誘導(dǎo)治療?!娟P(guān)鍵詞】器官移植;抗體;誘導(dǎo)治療;免疫抑制;排斥
3、反應(yīng);臨床診療指南Inductiontherapyw訓(xùn)hantibodiesinorgantransplantationBering100050,ChinaCorrespondingauthor:MALin—lin,Email:Zinlinma@hotmail.corn【Abstract】Withmoreunderstandingofacuterejectionfactorsaffectinglong—termsurvivalofallografts,antibodyinductiontherapyha
4、sbeenextensivelyacceptedinthefieldoftransplantationinrecentyears.In2009,UnitedNetworkofOrganSharingdatashowedthat83%ofrenaltransplantrecipi·entsreceivedantibodyinductiontherapyasaprophylactictreatmentforpreventingacuterejection.Thedevelopmentofinductiont
5、herapyhasenteredintoanewphaseasadvancesinbiologicaltechnology.Inclinicalpractice,theaseofinductiontherapyisnotonlytopreventacuter~ection,butalsotoreduceconventionalimmunosuppressantsdosesandtheirtoxiticandadverseeffects.Agentsthathavebeengivenapprovalfor
6、usingonpatientsincludedpolyclonalandmonoclonalantibodiesasexemplifiedbyanti—thymoeyteglobulinandanti—CD3antibody.Someotherinductionantibodiesthathavebeenproceededintoclinicaltrialincludedanti—CD20monoclona1antibodyfrituxin)andanti.CD52monoclonalantibody(
7、alemtuzumab).In2010,ChineseMedicalAssociationtheBranchofOrganTransplantationSocietyestablishedorgantransplantationclinicalpracticeguidelines,inwhichrecommendationsforinductiontherapyintransplantationisgivenindetail.Wepresentedtheconceptsof“broaddefinitio
8、nofinductiontherapy’’and‘‘chronicinduction”.BothofthemaimtodecreaseimmuneresponseofTcellswhenallogenicantigensappearintransplantrecipientsandtopreventacuteandchronicrejection.【Keywords】Organtransplantation;Antibody;Inducti