实体器官移植中的抗体介导性排斥反应：表现、机制及治疗方法
Antibody-mediated rejection across solid organ transplants: manifestations, mechanisms, and therapies.
作者信息
Valenzuela Nicole M, Reed Elaine F
出版信息
J Clin Invest. 2017 Jun 30;127(7):2492-2504. doi: 10.1172/JCI90597. Epub 2017 Jun 12.
Abstract
Solid organ transplantation is a curative therapy for hundreds of thousands of patients with end-stage organ failure. However, long-term outcomes have not improved, and nearly half of transplant recipients will lose their allografts by 10 years after transplant. One of the major challenges facing clinical transplantation is antibody-mediated rejection (AMR) caused by anti-donor HLA antibodies. AMR is highly associated with graft loss, but unfortunately there are few efficacious therapies to prevent and reverse AMR. This Review describes the clinical and histological manifestations of AMR, and discusses the immunopathological mechanisms contributing to antibody-mediated allograft injury as well as current and emerging therapies.
摘要
实体器官移植是成千上万终末期器官衰竭患者的一种治愈性疗法。然而，长期疗效并未得到改善，近一半的移植受者在移植后10年内将失去其同种异体移植物。临床移植面临的主要挑战之一是由抗供体HLA抗体引起的抗体介导的排斥反应（AMR）。AMR与移植物丢失高度相关，但不幸的是，几乎没有有效的疗法来预防和逆转AMR。本综述描述了AMR的临床和组织学表现，并讨论了导致抗体介导的同种异体移植物损伤的免疫病理机制以及当前和新兴的疗法。
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