Everly Matthew J
One Lambda, Inc., Canoga Park, California, USA.
Clin Transpl. 2010:353-62.
Based on the analysis of the 52 patient cases submitted for the Antibody Treatment Report of Clinical Transplants 2010, there is growing evidence that bortezomib is a viable option for antibody mediated rejection (AMR). Today, some centers have even chosen to use bortezomib as a first line agent in their AMR cases. In desensitization, from the current available data the use of bortezomib to desensitize patients is still under investigation. The optimal number of cycles as well as predictors of those who bortezomib may be useful still remain major questions. Continued data in this area is necessary and at this point bortezomib is a viable option and should be considered as part of some patients' desensitization regimen. Finally, in the area of chronic alloantibody mediated rejection (CAMR), there is exciting new data that bortezomib may have additional benefits and may provide a few more months of survival based on its effect to reduce proteinuria. However, in the CAMR cases it is clear that the damage that has already occurred due to persistent alloantibody is irreversible. This indicates that earlier treatment of alloantibodies in patients should occur to provide the best chance of allograft success.
基于对提交至《2010年临床移植抗体治疗报告》的52例患者病例的分析，越来越多的证据表明硼替佐米是抗体介导排斥反应（AMR）的一种可行选择。如今，一些中心甚至已选择在其AMR病例中将硼替佐米用作一线药物。在脱敏治疗方面，从目前可得的数据来看，使用硼替佐米使患者脱敏仍在研究中。最佳疗程数以及硼替佐米可能对哪些患者有用的预测指标仍然是主要问题。该领域持续的数据是必要的，目前硼替佐米是一种可行选择，应被视为部分患者脱敏方案的一部分。最后，在慢性同种异体抗体介导排斥反应（CAMR）领域，有令人振奋的新数据表明，基于硼替佐米减少蛋白尿的作用，它可能具有额外益处，并可能使患者多存活几个月。然而，在CAMR病例中，很明显由于持续存在的同种异体抗体已经造成的损害是不可逆转的。这表明应对患者的同种异体抗体进行更早的治疗，以提供同种异体移植成功的最佳机会。
