Hall B M
Division of Nephrology, Stanford University School of Medicine, CA 94305-5114.
Am J Kidney Dis. 1989 Nov;14(5 Suppl 2):71-7.
The assumption that CD8+-cytotoxic cells effect graft rejection has diverted many in clinical and experimental transplantation into ignoring the tremendous potential of anti-CD4 monoclonal antibodies as immunosuppressive therapy. Experimental studies over the past several years has shown that anti-CD4 monoclonal antibodies have effects on prolonging graft survival equal to or greater than those of cyclosporine. This therapy has the unique capacity to induce tolerance to the monoclonal antibody itself, thus preventing the production both of antiidiotypic and antimouse immunoglobulin antibodies. Further, many animals develop tolerance to other antigens, including grafted tissue, raising the potential of eliminating the need for long-term immunosuppression. Synergy between anti-CD4 monoclonal antibodies and other immunosuppressives, including anti-CD8 antibodies and cyclosporine, has also been demonstrated. Continued investigation to determine the best monoclonal antibody to use in humans with respect to its epitope, immunoglobulin subclass, and capacity to deplete CD4+ cells is required to maximize the potential of this therapy before clinical trial.
认为CD8+细胞毒性细胞导致移植排斥的假设，使许多临床和实验移植领域的人员忽视了抗CD4单克隆抗体作为免疫抑制疗法的巨大潜力。过去几年的实验研究表明，抗CD4单克隆抗体在延长移植物存活方面的效果等同于或优于环孢素。这种疗法具有诱导对单克隆抗体自身产生耐受性的独特能力，从而防止抗独特型抗体和抗小鼠免疫球蛋白抗体的产生。此外，许多动物对包括移植组织在内的其他抗原产生耐受性，这增加了消除长期免疫抑制需求的可能性。抗CD4单克隆抗体与其他免疫抑制剂（包括抗CD8抗体和环孢素）之间的协同作用也已得到证实。在进行临床试验之前，需要继续研究以确定就其表位、免疫球蛋白亚类和耗尽CD4+细胞的能力而言，最适合用于人类的单克隆抗体，以最大限度地发挥这种疗法的潜力。
