Department of General Surgery, Tianjin Medical University General Hospital, No. 154, Anshan Road, Heping District, Tianjin 300052, China; Department of Gastroenterology, The First Affiliated Hospital of Anhui Medical University, No. 218, Jixi Road, Shushan District, Hefei, Anhui 230022, China.
Department of General Surgery, Tianjin Medical University General Hospital, No. 154, Anshan Road, Heping District, Tianjin 300052, China.
Transpl Immunol. 2021 Aug;67:101411. doi: 10.1016/j.trim.2021.101411. Epub 2021 May 18.
Organ transplantation is the preferred treatment option for end-stage organ failure. Although immunosuppressants are effective for preventing the occurrence of acute rejection, they also cause a series of side effects in transplant recipients. To improve the quality of patient survival, a new therapeutic strategy that has fewer side effects than current immunosuppressive regimens and can induce allograft immune tolerance and effectively prevent transplant rejection is needed. In this context, regulatory T cells (Tregs) are considered to be promising research targets. With the increasing understanding of the immunomodulatory role of Tregs, the use of Treg-based cellular therapies has shifted from prevention/treatment of autoimmune diseases to clinical trials for organ transplantation. This review describes the phenotype and in vitro expansion of Tregs and the mechanisms by which they exert immunomodulatory effects in transplantation immunity, highlights recent clinical trial data on Treg-based cellular therapies in transplantation, and describes future directions and limitations.
器官移植是治疗终末期器官衰竭的首选方法。虽然免疫抑制剂可有效预防急性排斥反应的发生,但也会导致移植受者出现一系列副作用。为了提高患者生存质量,需要一种新的治疗策略,该策略比现有免疫抑制方案的副作用更少,能够诱导同种异体免疫耐受并有效预防移植排斥反应。在这种情况下,调节性 T 细胞(Treg)被认为是很有前途的研究靶点。随着对 Treg 免疫调节作用认识的不断深入,基于 Treg 的细胞治疗已从预防/治疗自身免疫性疾病转变为器官移植的临床试验。本综述描述了 Treg 的表型和体外扩增及其在移植免疫中发挥免疫调节作用的机制,重点介绍了基于 Treg 的细胞治疗在移植中的最新临床试验数据,并描述了未来的方向和局限性。