Pőcze Balázs, Németh Péter, Langer Róbert
Semmelweis Egyetem, Általános Orvostudományi Kar Transzplantációs és Sebészeti Klinika Budapest.
Orv Hetil. 2012 Aug 19;153(33):1294-301. doi: 10.1556/OH.2012.29343.
Solid organ transplantation has shown improvement in patient and graft survival rates due to the development of immunosuppression in the last fifty years; however only the last two decades led to the development of new, baseline immunosuppressive drugs that avoid the unlikely side effects of calcineurin inhibitors, especially nephrotoxicity. The transplanted organ is foreign to the host and, therefore, it induces a complex immune response of the recipient. In this review, a brief outline of immune response is given, followed by the introduction of new immunosuppressive drugs acting via variant pathways. These are compounds which are already in use or becoming shortly available and are potential future alternatives for the calcineurin inhibitors. This paper highlights the role of co-stimulation blockade with belatacept and the recently even more intensively studied field of tolerance induction.
在过去五十年中,由于免疫抑制技术的发展,实体器官移植在患者和移植物存活率方面已有改善;然而,仅在过去二十年才开发出新型的基线免疫抑制药物,这些药物可避免钙调神经磷酸酶抑制剂不太可能出现的副作用,尤其是肾毒性。移植器官对于宿主来说是异体的,因此会引发受体复杂的免疫反应。在本综述中,先简要概述免疫反应,然后介绍通过不同途径发挥作用的新型免疫抑制药物。这些化合物已经在使用或即将上市,并且是钙调神经磷酸酶抑制剂未来潜在的替代药物。本文重点介绍了贝拉西普共刺激阻断的作用以及最近研究更为深入的诱导耐受领域。