Gay W A, O'Connell J G, Burton N A, Karwande S V, Renlund D G, Bristow M R
Utah Cardiac Transplant Program, Salt Lake City.
Ann Surg. 1988 Sep;208(3):287-90. doi: 10.1097/00000658-198809000-00005.
OKT3 is a murine monoclonal antibody that is reactive against the CD3 surface antigen on T lymphocytes. This antigen appears to be essential for recognition of foreign antigen and for initiation of the process of cell-mediated rejection. One hundred and two patients having orthotopic cardiac transplantation in a single program during a 3-year period received prophylactic immune suppression with OKT3, along with azathioprine and low-dose steroids. Patients began receiving cyclosporine on Day 11; steroid-weaning was attempted 3 weeks after transplantation. In this group of patients, the time to the first rejection was 76 +/- 11 days (mean +/- SEM), and 85% were successfully weaned from maintenance steroids. Avoidance of the side effects of cyclosporine and/or high dose steroids during the perioperative period, combined with a long rejection-free interval and the likelihood of long-term maintenance free of steroids, make the use of OKT3 or similar agents an attractive alternative to conventional immunosuppression.
OKT3是一种鼠单克隆抗体，可与T淋巴细胞表面的CD3抗原发生反应。该抗原似乎对于识别外来抗原以及启动细胞介导的排斥反应过程至关重要。在一个为期3年的项目中，102例接受原位心脏移植的患者接受了OKT3联合硫唑嘌呤和低剂量类固醇的预防性免疫抑制治疗。患者在第11天开始接受环孢素治疗；移植后3周尝试逐渐减少类固醇用量。在这组患者中，首次发生排斥反应的时间为76±11天（平均值±标准误），85%的患者成功停用维持性类固醇。在围手术期避免环孢素和/或高剂量类固醇的副作用，加上较长的无排斥间隔时间以及长期无需类固醇维持治疗的可能性，使得使用OKT3或类似药物成为传统免疫抑制治疗的一个有吸引力的替代选择。
