Bishop G A, McCaughan G W
A.W. Morrow Gastroenterology and Liver Laboratory, Centenary Institute, Royal Prince Alfred Hospital, Camperdown, Sydney, Australia.
Liver Transpl. 2001 Mar;7(3):161-72. doi: 10.1053/jlts.2001.22321.
Liver transplants in many animal models are unusual because often they are not rejected even when transplanted across complete major histocompatibility complex barriers without immunosuppression. Their paradoxical behavior is even more obvious when the immune mechanism of acceptance is examined. Instead of acceptance resulting from a lack of immune response to the graft, the opposite occurs, and there is an unusual extensive increase in immune activation in acceptance compared with rejection. This abnormal extensive immune activation is driven by donor leukocytes transferred with the liver and results in death of the recipient cells that would normally reject the transplant. Some forms of immunosuppression inhibit this activation-associated liver transplant tolerance. The significance of these findings and possible means to design future treatment protocols for clinical transplantation that optimize management of liver transplant recipients are discussed.
在许多动物模型中，肝脏移植情况较为特殊，因为即便在不进行免疫抑制的情况下，跨越完整的主要组织相容性复合体屏障进行移植时，肝脏通常也不会被排斥。当研究肝脏移植被接受的免疫机制时，其矛盾行为就更加明显了。移植被接受并非源于对移植物缺乏免疫反应，相反，与排斥反应相比，在移植被接受的过程中免疫激活出现了异常广泛的增加。这种异常广泛的免疫激活是由随肝脏一同转移的供体白细胞驱动的，会导致通常会排斥移植的受体细胞死亡。某些形式的免疫抑制会抑制这种与激活相关的肝脏移植耐受性。本文讨论了这些发现的意义以及为临床移植设计未来治疗方案的可能方法，这些方案可优化肝脏移植受者的管理。
