Salis Paola, Caccamo Chiara, Verzaro Roberto, Gruttadauria Salvatore, Artero Mary
Division of Nephrology and Division of Abdominal Transplantation, Istituto Mediterraneo per i Trapianti e Terapie ad Alta Specializzazione, Palermo, Italy.
Biologics. 2008 Jun;2(2):175-88. doi: 10.2147/btt.s1437.
Basiliximab is a chimeric mouse-human monoclonal antibody directed against the alpha chain of the interleukin-2 (IL-2) receptor on activated T lymphocytes. It was shown in phase III trials to reduce the number and severity of acute rejection episodes in the first year following renal transplantation in adults and children, with a reasonable cost-benefit ratio. The drug does not increase the incidence of opportunistic infections or malignancies above baseline in patients treated with conventional calcineurin inhibitor-based immunosuppression. In the field of renal transplantation, basiliximab does not increase kidney or patient survival, despite the reduction in the number of rejection episodes. Basiliximab may reduce the incidence of delayed graft function. In comparison with lymphocyte-depleting antibodies basiliximab appears to have equal efficacy in standard immunological risk patients. Recently, IL-2 receptor monoclonal antibodies have been used with the objective of reducing or eliminating the more toxic elements of the standard immunosuppression protocol. Several trials have incorporated basiliximab in protocols designed to avoid or withdraw rapidly corticosteroids, as well as protocols which substitute target-of-rapamycin (TOR) inhibitors for calcineurin inhibitors.
巴利昔单抗是一种嵌合型鼠源-人源单克隆抗体，可作用于活化T淋巴细胞上的白细胞介素-2（IL-2）受体α链。在III期试验中表明，它可降低成人和儿童肾移植后第一年急性排斥反应的发作次数和严重程度，成本效益比合理。在接受基于钙调神经磷酸酶抑制剂的传统免疫抑制治疗的患者中，该药物不会使机会性感染或恶性肿瘤的发生率高于基线水平。在肾移植领域，尽管排斥反应发作次数减少，但巴利昔单抗不会提高肾脏或患者的生存率。巴利昔单抗可能会降低移植肾功能延迟的发生率。与淋巴细胞清除抗体相比，巴利昔单抗在标准免疫风险患者中似乎具有同等疗效。最近，使用IL-2受体单克隆抗体的目的是减少或消除标准免疫抑制方案中毒性更强的成分。多项试验已将巴利昔单抗纳入旨在避免或迅速停用皮质类固醇的方案，以及用雷帕霉素靶蛋白（TOR）抑制剂替代钙调神经磷酸酶抑制剂的方案中。
