Ciancio Gaetano, Burke George W, Warque Maria E, Miller Joshua
Department of Surgery, Division of Transplantation, University of Miami Miller School of Medicine, Miami, Florida 33101, USA.
BioDrugs. 2006;20(2):85-92. doi: 10.2165/00063030-200620020-00003.
An overview of the past 5 years of clinical renal transplantation would include progress in (i) the development of protocols with new induction agents (non-depleting versus depleting monoclonal and polyclonal antibodies) designed to reduce the incidence and severity of acute rejection, (ii) the attempt to reduce calcineurin inhibitor short- and long-term nephrotoxicity, and (iii) the attempt to reduce immunosuppression overall if an immunoregulatory state ('tolerance') against donor alloantigens could be achieved. One such induction agent is the humanized anti-CD52 monoclonal antibody alemtuzumab (Campath-1H), which depletes T cells (most potently), as well as B cells and other lymphoid subsets, and may decrease the dosage or need for concurrent maintenance immunosuppressive agents.
过去5年临床肾移植的概况包括以下方面的进展:(i)开发了使用新型诱导剂(非清除性与清除性单克隆及多克隆抗体)的方案,旨在降低急性排斥反应的发生率和严重程度;(ii)试图减轻钙调神经磷酸酶抑制剂的短期和长期肾毒性;(iii)如果能够实现针对供体同种异体抗原的免疫调节状态(“耐受”),则试图总体上减少免疫抑制。一种这样的诱导剂是人源化抗CD52单克隆抗体阿仑单抗(Campath-1H),它可清除T细胞(最有效)以及B细胞和其他淋巴细胞亚群,并可能减少同时使用的维持性免疫抑制剂的剂量或需求。