Siemionow Maria, Kulahci Yalcin, Zor Fatih
Department of Orthopeadics, University of Illinois at Chicago, Chicago, Illinois.
Department of Surgery, Wake Forest School of Medicine, Winston Salem, North Carolina.
Curr Opin Organ Transplant. 2023 Dec 1;28(6):431-439. doi: 10.1097/MOT.0000000000001109. Epub 2023 Oct 6.
Vascularized composite allotransplantation (VCA) has become a clinical reality in the past two decades. However, its routine clinical applications are limited by the risk of acute rejection, and the side effects of the lifelong immunosuppression. Therefore, there is a need for new protocols to induce tolerance and extend VCA survival. Cell- based therapies have emerged as an attractive strategy for tolerance induction in VCA. This manuscript reviews the current strategies and applications of cell-based therapies for tolerance induction in VCA.
Cellular therapies, including the application of bone marrow cells (BMC), mesenchymal stem cells (MSC), adipose stem cells, regulatory T cells (Treg) cells, dendritic cells and donor recipient chimeric cells (DRCC) show promising potential as a strategy to induce tolerance in VCA. Ongoing basic science research aims to provide insights into the mechanisms of action, homing, functional specialization and standardization of these cellular therapies. Additionally, translational preclinical and clinical studies are underway, showing encouraging outcomes.
Cellular therapies hold great potential and are supported by preclinical studies and clinical trials demonstrating safety and efficacy. However, further research is needed to develop novel cell-based immunosuppressive protocol for VCA.
在过去二十年中，血管化复合组织异体移植（VCA）已成为临床现实。然而，其常规临床应用受到急性排斥反应风险以及终身免疫抑制副作用的限制。因此，需要新的方案来诱导免疫耐受并延长VCA的存活时间。基于细胞的疗法已成为VCA中诱导免疫耐受的一种有吸引力的策略。本文综述了基于细胞的疗法在VCA中诱导免疫耐受的当前策略和应用。
细胞疗法，包括应用骨髓细胞（BMC）、间充质干细胞（MSC）、脂肪干细胞、调节性T细胞（Treg）、树突状细胞和供体-受体嵌合细胞（DRCC），作为诱导VCA免疫耐受的策略显示出有前景的潜力。正在进行的基础科学研究旨在深入了解这些细胞疗法的作用机制、归巢、功能特化和标准化。此外，转化性临床前和临床研究正在进行中，显示出令人鼓舞的结果。
细胞疗法具有巨大潜力，并得到了证明安全性和有效性的临床前研究和临床试验的支持。然而，需要进一步研究来开发用于VCA的新型基于细胞的免疫抑制方案。
