Division of Nephrology, University of Heidelberg, Im Neuenheimer Feld 162, 69120, Heidelberg, Germany.
Department of Internal Medicine V, GMP Core Facility, University of Heidelberg, Heidelberg, Germany.
Pediatr Nephrol. 2018 Feb;33(2):199-213. doi: 10.1007/s00467-017-3599-2. Epub 2017 Feb 23.
Refinement of immunosuppressive strategies has led to further improvement of kidney graft survival in recent years. Currently, the main limitations to long-term graft survival are life-threatening side effects of immunosuppression and chronic allograft injury, emphasizing the need for innovative immunosuppressive regimens that resolve this therapeutic dilemma. Several cell therapeutic approaches to immunosuppression and donor-specific unresponsiveness have been tested in early phase I and phase II clinical trials in kidney transplantation. The aim of this overview is to summarize current cell therapeutic approaches to immunosuppression in clinical kidney transplantation with a focus on myeloid suppressor cell therapy by mitomycin C-induced cells (MICs). MICs show great promise as a therapeutic agent to achieve the rapid and durable establishment of donor-unresponsiveness in living-donor kidney transplantation. Cell-based therapeutic approaches may eventually revolutionize immunosuppression in kidney transplantation in the near future.
近年来,免疫抑制策略的不断完善使得肾移植的存活率进一步提高。目前,长期移植物存活率的主要限制因素是免疫抑制的危及生命的副作用和慢性同种异体移植物损伤,这强调了需要创新的免疫抑制方案来解决这一治疗难题。在肾移植的早期 I 期和 II 期临床试验中,已经测试了几种细胞治疗方法来进行免疫抑制和供体特异性无反应性。本文的目的是总结目前在临床肾移植中应用的细胞治疗免疫抑制方法,重点是通过丝裂霉素 C 诱导细胞(MICs)进行髓系抑制细胞治疗。MICs 作为一种治疗剂,有望在活体供肾移植中快速和持久地建立供体无反应性。细胞治疗方法可能在不久的将来彻底改变肾移植中的免疫抑制。