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靶向免疫治疗移植物抗宿主病的进展。

Advance in Targeted Immunotherapy for Graft-Versus-Host Disease.

机构信息

Institute of Clinical Pharmacology, Anhui Medical University, Key Laboratory of Anti-Inflammatory and Immunopharmacology of Education, Ministry of China, Anti-Inflammatory Immune Drugs Collaborative Innovation Center, Hefei, Anhui, China.

Division of Hematology, Department of Internal Medicine, College of Medicine, The Ohio State University, Columbus, OH, United States.

出版信息

Front Immunol. 2018 May 16;9:1087. doi: 10.3389/fimmu.2018.01087. eCollection 2018.

Abstract

Graft-versus-host disease (GVHD) is a serious and deadly complication of patients, who undergo hematopoietic stem cell transplantation (HSCT). Despite prophylactic treatment with immunosuppressive agents, 20-80% of recipients develop acute GVHD after HSCT. And the incidence rates of chronic GVHD range from 6 to 80%. Standard therapeutic strategies are still lacking, although considerable advances have been gained in knowing of the predisposing factors, pathology, and diagnosis of GVHD. Targeting immune cells, such as regulatory T cells, as well as tolerogenic dendritic cells or mesenchymal stromal cells (MSCs) display considerable benefit in the relief of GVHD through the deletion of alloactivated T cells. Monoclonal antibodies targeting cytokines or signaling molecules have been demonstrated to be beneficial for the prevention of GVHD. However, these remain to be verified in clinical therapy. It is also important and necessary to consider adopting individualized treatment based on GVHD subtypes, pathological mechanisms involved and stages. In the future, it is hoped that the identification of novel therapeutic targets and systematic research strategies may yield novel safe and effective approaches in clinic to improve outcomes of GVHD further. In this article, we reviewed the current advances in targeted immunotherapy for the prevention of GVHD.

摘要

移植物抗宿主病(GVHD)是接受造血干细胞移植(HSCT)的患者的一种严重且致命的并发症。尽管使用免疫抑制剂进行预防性治疗,但 20-80%的接受者在 HSCT 后会发生急性 GVHD。慢性 GVHD 的发生率范围为 6 至 80%。尽管在了解 GVHD 的易患因素、病理学和诊断方面取得了相当大的进展,但仍缺乏标准的治疗策略。靶向免疫细胞,如调节性 T 细胞,以及耐受原性树突状细胞或间充质基质细胞(MSCs),通过删除同种异体激活的 T 细胞,在缓解 GVHD 方面显示出相当大的益处。靶向细胞因子或信号分子的单克隆抗体已被证明对预防 GVHD 有益。然而,这些仍有待在临床治疗中验证。根据 GVHD 亚型、涉及的病理机制和阶段,考虑采用个体化治疗也很重要和必要。在未来,希望鉴定新的治疗靶点和系统的研究策略可能会为临床提供新的安全有效的方法,进一步改善 GVHD 的预后。在本文中,我们综述了目前靶向免疫疗法预防 GVHD 的进展。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/bfe9/5964137/96afba3a51c3/fimmu-09-01087-g001.jpg

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