Department of Oral Surgery, Dentistry School, Fluminense Federal University, Niterói, Rio de Janeiro, Brazil.
Department of Dental Technics, School of Dentistry, Fluminense Federal University, Niterói, Rio de Janeiro, Brazil.
J Oral Pathol Med. 2020 May;49(5):395-403. doi: 10.1111/jop.12998. Epub 2020 Feb 7.
Although widely used, the potential for immunological sensitization of allogeneic bone grafts is still controversial in the literature. This systematic review aimed to evaluate the immune response of allogeneic bone graft procedures in humans.
An electronic search without language or date restrictions occurred in four databases for articles published until July 2019. Eligibility criteria included prospective cohort studies, controlled clinical trials, and randomized clinical trials that evaluated the potential of allogeneic bone grafts in sensitized immune system in humans through immunological or biological analysis. The protocol number of this SR registered in PROSPERO is CDR42019135491.
The search and selection process yielded eight prospective cohort studies published between 1984 and 2019. The percentage of patients' sensitization analyzed by human leukocyte antigens ranged from 21% to 67%, with a cumulative mean of 48 ± 17.3%. Bone soluble protein analysis demonstrates the sensitization of 55% of patients after allograft bone grafts. Also, a high level of circulating cell-free DNA took place in the immediate postoperative period.
Although studies report a low incidence of local complications, an average of 48% of the patients remain with the immune system sensitized after receiving allogeneic bone grafts. Future studies should better address the local and systemic consequences of such sensitization.
尽管异体骨移植物被广泛应用，但在文献中，其引发免疫原性的潜力仍存在争议。本系统评价旨在评估异体骨移植物在人体中的免疫反应。
我们在四个数据库中进行了无语言和日期限制的电子检索，以检索直至 2019 年 7 月发表的文章。纳入标准包括前瞻性队列研究、对照临床试验和随机临床试验，这些研究通过免疫学或生物学分析评估了异体骨移植物在人类致敏免疫系统中的潜在作用。本 SR 的 PROSPERO 注册号为 CDR42019135491。
搜索和选择过程共产生了 8 项发表于 1984 年至 2019 年之间的前瞻性队列研究。人类白细胞抗原分析的患者致敏率从 21%到 67%不等，累积平均值为 48±17.3%。骨可溶性蛋白分析显示，异体骨移植物后 55%的患者发生了致敏。此外，在术后即刻发生了高水平的循环无细胞游离 DNA。
尽管研究报告局部并发症发生率较低，但在接受异体骨移植物后，平均有 48%的患者的免疫系统仍保持致敏状态。未来的研究应更好地阐明这种致敏的局部和全身后果。
