Mulders-Manders Catharina M, Baas Marije C, Molenaar Femke M, Simon Anna
Department of Internal Medicine and Expertise Center for Immunodeficiency and Autoinflammation, Radboud University Medical CenterNijmegen, Netherlands.
Department of Nephrology, Radboud University Medical CenterNijmegen, Netherlands.
Front Pharmacol. 2017 May 31;8:342. doi: 10.3389/fphar.2017.00342. eCollection 2017.
In patients undergoing solid organ transplantation, the presence of an interleukin-1 (IL-1) driven disease may require the addition of IL-1 inhibiting drugs to the standard immunosuppressive regimen to protect against inflammation and negative graft outcome. Three patients undergoing renal transplantation were treated perioperatively with the interleukin-1 receptor antagonist anakinra. Kidney function increased rapidly in all three and the only complications seen were minor infections. studies report associations between serum and urinary levels of IL-1β and IL-1 receptor antagonist and negative graft outcome, and studies in animals and two small human trials illustrate a possible protective effect of anti-IL-1 therapy after solid organ transplantation. Peri- and postoperative use of anakinra is safe and effective in patients undergoing renal transplantation.
在接受实体器官移植的患者中，若存在白细胞介素-1（IL-1）驱动的疾病，可能需要在标准免疫抑制方案中添加IL-1抑制药物，以预防炎症和移植失败的不良后果。三名接受肾移植的患者在围手术期接受了白细胞介素-1受体拮抗剂阿那白滞素治疗。所有三名患者的肾功能均迅速改善，仅出现了轻微感染等并发症。研究报告了血清和尿液中IL-1β及IL-1受体拮抗剂水平与移植失败不良后果之间的关联，动物研究和两项小型人体试验表明，实体器官移植后抗IL-1治疗可能具有保护作用。阿那白滞素在肾移植患者围手术期及术后使用是安全有效的。
