Department of Physiological Sciences, University of Arizona, Tucson, AZ, USA.
Department of Surgery, University of Arizona, Tucson, AZ, USA.
Xenotransplantation. 2018 Sep;25(5):e12399. doi: 10.1111/xen.12399. Epub 2018 May 6.
There is currently a significant disparity between the number of patients who need lifesaving transplants and the number of donated human organs. Xenotransplantation is a way to address this disparity and attempts to enable the use of xenogeneic tissues have persisted for centuries. While immunologic incompatibilities have presented a persistent impediment to their use, encapsulation may represent a way forward for the use of cell-based xenogeneic therapeutics without the need for immunosuppression. In conjunction with modern innovations such as the use of bioprinting, incorporation of immune modulating molecules into capsule membranes, and genetic engineering, the application of xenogeneic cells to treat disorders ranging from pain to liver failure is becoming increasingly realistic. The present review discusses encapsulation in the context of xenotransplantation, focusing on the current status of clinical trials, persistent issues such as antigen shedding, oxygen availability, and donor selection, and recent developments that may address these limitations.
目前,需要救生器官移植的患者数量与捐赠的人类器官数量之间存在显著差距。异种移植是解决这一差距的一种方法,几个世纪以来,人们一直试图利用异种组织。虽然免疫不相容性一直是它们应用的一个持续障碍,但封装可能代表了在不需要免疫抑制的情况下使用基于细胞的异种治疗的一种前进方式。与生物打印等现代创新技术相结合,将免疫调节分子纳入胶囊膜中,并进行基因工程改造,将异种细胞应用于治疗从疼痛到肝衰竭等各种疾病的方法变得越来越现实。本文综述了异种移植背景下的封装,重点讨论了临床试验的现状、持续存在的问题,如抗原脱落、氧气供应和供体选择,以及可能解决这些局限性的最新进展。