Tri-Institutional Training Program in Computational Biology & Medicine, Weill Cornell Medicine, New York, NY 10065, United States.
Department of Medicine (Cardiovascular Medicine), Stanford University and the Stanford Cardiovascular Research Institute, Stanford, CA 94305, USA.
Adv Drug Deliv Rev. 2017 May 15;114:272-284. doi: 10.1016/j.addr.2017.06.009. Epub 2017 Jun 15.
Pharmacological immunotherapies are a key component of post-transplant therapy in solid-organ and hematopoietic stem cell transplantation. In current clinical practice, immunotherapies largely follow a one-size fits all approach, leaving a large portion of transplant recipients either over- or under-immunosuppressed, and consequently at risk of infections or immune-mediated complications. Our goal here is to review recent and rapid advances in precision and genomic medicine approaches to monitoring of post-transplant immunotherapies. We will discuss recent advances in precision measurements of pharmacological immunosuppression, measurements of the plasma and gut microbiome, strategies to monitor for allograft injury and post-transplant malignancies via circulating cell-free DNA, and comprehensive measurements of the B and T cell immune cell repertoire.
药理免疫疗法是实体器官和造血干细胞移植后治疗的一个关键组成部分。在当前的临床实践中，免疫疗法在很大程度上采用一刀切的方法，使得很大一部分移植受者要么免疫过度，要么免疫不足，因此面临感染或免疫介导的并发症的风险。我们的目标是回顾最近在监测移植后免疫疗法的精准和基因组医学方法方面的快速进展。我们将讨论药理免疫抑制的精准测量、血浆和肠道微生物组测量、通过循环无细胞 DNA 监测移植物损伤和移植后恶性肿瘤的策略，以及 B 和 T 细胞免疫细胞库的综合测量方面的最新进展。
