Ippoliti Giovanbattista, Lucioni Marco, Leonardi Giuseppe, Paulli Marco
Giovanbattista Ippoliti, Internal Medicine, Policlinico di Monza, 20900 Monza, Italy.
World J Transplant. 2015 Dec 24;5(4):261-6. doi: 10.5500/wjt.v5.i4.261.
Rabbit anti-thymocyte globulin's manifold mechanisms of action may be attribuited to its polyclonal nature. Its T-cell depleting effect on lymphoid cells is well established: Occurring in the blood and secondary lymphoid tissues, depletion proceeds through complement-dependent lysis, opsonization and apoptotic pathways. Clinical studies have shown that rabbit anti-thymocyte globulin's immunomodulatory effect extends beyond the initial T-cell depletion and up to the period during which lymphocyte populations begin to recover. The drug is able to mediate immunomodulation and graft tolerance by functionally inactivating cell surface receptors involved in antigen recognition, leukocyte trafficking and leukocyte endothelium adhesion. The complex and prolonged immunomodulation induced by this drug contributes to its efficacy in solid organ transplantation, mainly by reducing the incidence of acute graft rejection.
兔抗胸腺细胞球蛋白的多种作用机制可能归因于其多克隆性质。其对淋巴细胞的T细胞耗竭作用已得到充分证实：这种耗竭发生在血液和二级淋巴组织中，通过补体依赖性裂解、调理作用和凋亡途径进行。临床研究表明，兔抗胸腺细胞球蛋白的免疫调节作用不仅限于最初的T细胞耗竭，还持续到淋巴细胞群体开始恢复的时期。该药物能够通过使参与抗原识别、白细胞运输和白细胞内皮黏附的细胞表面受体功能失活来介导免疫调节和移植耐受。这种药物诱导的复杂而持久的免疫调节作用有助于其在实体器官移植中的疗效，主要是通过降低急性移植排斥反应的发生率。
