Leonard David A, McGrouther Duncan A, Kurtz Josef M, Cetrulo Curtis L
Transplantation Biology Research Center, Massachusetts General Hospital, Boston, MA 02129, USA.
Clin Dev Immunol. 2012;2012:863264. doi: 10.1155/2012/863264. Epub 2012 Dec 24.
Since the start of the clinical vascularized composite allotransplantation (VCA) era over a decade ago this field has witnessed significant developments in both basic and translational research. Transplant tolerance, defined as rejection-free acceptance of transplanted organs or tissues without long-term immunosuppression, holds the potential to revolutionize the field of VCA by removing the need for life-long immunosuppression. While tolerance of organ and vascularized composite transplants may be induced in small animal models by a variety of protocols, only mixed-chimerism-based protocols have successfully bridged the gap to preclinical study and to clinical trial in solid organ transplantation to date. In this paper we review the mixed-chimerism approach to tolerance induction, with specific reference to the field of VCA transplantation, and provide an overview of some novel cellular therapies as potential adjuvants to mixed chimerism in the development of tolerance induction protocols for clinical vascularized composite allotransplantation.
自十多年前临床血管化复合组织异体移植（VCA）时代开始以来，该领域在基础研究和转化研究方面都取得了重大进展。移植耐受被定义为在无长期免疫抑制的情况下对移植器官或组织的无排斥接受，它有可能通过消除终身免疫抑制的需求来彻底改变VCA领域。虽然通过各种方案可以在小动物模型中诱导器官和血管化复合移植的耐受，但迄今为止，只有基于混合嵌合体的方案成功地跨越了从临床前研究到实体器官移植临床试验的差距。在本文中，我们回顾了诱导耐受的混合嵌合体方法，特别提及VCA移植领域，并概述了一些新型细胞疗法，这些疗法作为混合嵌合体的潜在佐剂，用于临床血管化复合组织异体移植耐受诱导方案的开发。
