Duke Transplant Center, Department of Surgery, Duke University School of Medicine, Durham, NC, United States.
Front Immunol. 2022 Jun 9;13:903068. doi: 10.3389/fimmu.2022.903068. eCollection 2022.
Despite dramatic improvement in kidney transplantation outcomes over the last decades due to advent of modern immunosuppressive agents, long-term outcomes remain poor. Antibody-mediated rejection (ABMR), a B cell driven process, accounts for the majority of chronic graft failures. There are currently no FDA-approved regimens for ABMR; however, several clinical trials are currently on-going. In this review, we present current mechanisms of B cell response in kidney transplantation, the clinical impact of sensitization and ABMR, the B cell response under current immunosuppressive regimens, and ongoing clinical trials for ABMR and desensitization treatment.
尽管由于现代免疫抑制剂的出现,肾移植的结果在过去几十年中得到了显著改善,但长期结果仍然不佳。抗体介导的排斥反应(ABMR)是一种 B 细胞驱动的过程,占大多数慢性移植物衰竭的原因。目前还没有 FDA 批准的 ABMR 治疗方案;然而,目前正在进行几项临床试验。在这篇综述中,我们介绍了肾移植中 B 细胞反应的当前机制、致敏和 ABMR 的临床影响、当前免疫抑制方案下的 B 细胞反应,以及正在进行的 ABMR 和脱敏治疗的临床试验。