Xenotransplantation Program, Department of Surgery, University of Alabama at Birmingham, Birmingham, AL, USA.
Revivicor, Blacksburg, VA, USA.
Xenotransplantation. 2021 Mar;28(2):e12652. doi: 10.1111/xen.12652. Epub 2020 Oct 14.
Xenotransplantation research has made considerable progress in recent years, largely through the increasing availability of pigs with multiple genetic modifications, effective immunosuppressive therapy, and anti-inflammatory therapy to protect pig tissues from the primate immune and inflammatory responses and correct molecular incompatibilities. Further study is required regarding identification and investigation of physiological incompatibilities. Although the exact cause remains uncertain, we and others have observed relatively rapid growth of kidney xenografts after transplantation into nonhuman primates (NHPs). There has also been some evidence of growth, or at least ventricular hypertrophy, of the pig heart after orthotopic transplantation into NHPs. Rapid growth could be problematic, particularly with regard to the heart within the relatively restricted confines of the chest. It has been suggested that the problem of rapid growth of the pig organ after transplantation could be resolved by growth hormone receptor (GHR) gene knockout in the pig. The GHR, although most well-known for regulating growth, has many other biological functions, including regulating metabolism and controlling physiological processes. Genetically modified GHRKO pigs have recently become available. We provide data on their growth compared to comparable pigs that do not include GHRKO, and we have reviewed the literature regarding the effect of GHRKO, and its relevance to xenotransplantation.
异种移植研究近年来取得了相当大的进展,主要是通过越来越多的具有多种基因修饰的猪、有效的免疫抑制治疗和抗炎治疗,来保护猪组织免受灵长类动物的免疫和炎症反应以及纠正分子不相容性的影响。需要进一步研究以确定和调查生理不相容性。尽管确切的原因仍不清楚,但我们和其他人已经观察到,将肾脏异种移植物移植到非人类灵长类动物(NHP)后,其生长速度相对较快。也有一些证据表明,猪心脏在 NHP 中进行原位移植后会生长,或者至少出现心室肥厚。快速生长可能会带来问题,尤其是对于猪心而言,因为它在相对有限的胸腔内。有人提出,通过敲除猪的生长激素受体(GHR)基因,可以解决猪器官在移植后快速生长的问题。GHR 虽然最著名的是调节生长,但它还有许多其他生物学功能,包括调节代谢和控制生理过程。最近,经过基因改造的 GHRKO 猪已经问世。我们提供了它们与不包括 GHRKO 的可比猪的生长数据,并回顾了关于 GHRKO 及其与异种移植相关性的文献。