Comprehensive Transplant Center, Cedars-Sinai Medical Center, Los Angeles, CA 90048, USA.
J Immunol Res. 2017;2017:6804678. doi: 10.1155/2017/6804678. Epub 2017 Jan 3.
HLA (Human Leucocyte Antigen) sensitization is a significant barrier to successful kidney transplantation. It often translates into difficult crossmatch before transplant and increased risk of acute and chronic antibody mediated rejection after transplant. Over the last decade, several immunomodulatory therapies have emerged allowing for increased access to kidney transplantation for the immunologically disadvantaged group of HLA sensitized end stage kidney disease patients. These include IgG inactivating agents, anti-cytokine antibodies, costimulatory molecule blockers, complement inhibitors, and agents targeting plasma cells. In this review, we discuss currently available agents for desensitization and provide a brief analysis of data on novel biologics, which will likely improve desensitization outcomes, and have potential implications in treatment of antibody mediated rejection.
HLA（人类白细胞抗原）致敏是成功进行肾移植的重大障碍。它通常会导致移植前的交叉配型困难，并增加移植后急性和慢性抗体介导排斥反应的风险。在过去的十年中，出现了几种免疫调节疗法，使免疫劣势的 HLA 致敏终末期肾病患者群体能够更多地接受肾移植。这些疗法包括 IgG 失活剂、抗细胞因子抗体、共刺激分子阻滞剂、补体抑制剂和针对浆细胞的药物。在这篇综述中，我们讨论了目前用于脱敏的药物，并简要分析了新型生物制剂的数据，这些药物可能会改善脱敏效果，并对治疗抗体介导的排斥反应产生潜在影响。
