Shipkova Maria, Wieland Eberhard
Central Institute for Clinical Chemistry and Laboratory Medicine, Klinikum Stuttgart, Kriegsbergstrasse 62, D-70174 Stuttgart, Germany.
Clin Biochem. 2016 Mar;49(4-5):317-9. doi: 10.1016/j.clinbiochem.2016.01.005. Epub 2016 Jan 12.
Solid organ transplantation is inevitably associated with the activation of the immune system of the graft recipient. An advanced knowledge of the immunological mechanisms leading to acute and chronic rejection, the advent of powerful immunosuppressive drugs, and refined surgical techniques have made solid organ transplantation a standard therapy to replace irretrievable loss of vital functions. The immune system is a complex network involving immune cells, cytokines, chemokines, antibodies, and the complement system. Monitoring and ideally influencing the allo-response of the organ recipient against the donor antigens may help to personalize the immunosuppressive therapy including the disclosure of those patients who are suitable for weaning or even discontinuation of immunosuppression. Immune monitoring comprises as plethora of candidate biomarkers capable of reflecting the donor specific and non-donor specific net activation state of the immune system in transplant recipients both before and after initiation of the immunosuppressive therapy. This special issue of Clinical Biochemistry on Immune Monitoring addresses the basic effects of immune activation in solid organ transplantation and critically reviews candidate biomarkers for immune monitoring and their analytical as well as clinical performance.
实体器官移植不可避免地与移植受者免疫系统的激活相关。对导致急性和慢性排斥反应的免疫机制的深入了解、强效免疫抑制药物的出现以及精细的外科技术,使实体器官移植成为替代重要功能不可挽回丧失的标准疗法。免疫系统是一个复杂的网络,涉及免疫细胞、细胞因子、趋化因子、抗体和补体系统。监测并理想地影响器官受者对供体抗原的同种异体反应,可能有助于实现免疫抑制治疗的个体化,包括识别那些适合减少甚至停用免疫抑制的患者。免疫监测包括大量候选生物标志物,这些标志物能够反映移植受者在免疫抑制治疗开始前后免疫系统的供体特异性和非供体特异性净激活状态。本期《临床生物化学》关于免疫监测的特刊探讨了实体器官移植中免疫激活的基本效应,并批判性地综述了用于免疫监测的候选生物标志物及其分析和临床性能。