Wang X H, Xie T
Department of Urology, Shanghai First People's Hospital, People's Republic of China.
Transplant Proc. 1996 Jun;28(3):1306-8.
Many factors can interfere with the therapeutic results for acute renal allograft rejection with anti-CD3 and CD4 MAbs. 1. When should we begin using MAbs and what about Scr levels while using MAbs? First-line treatment may be superior to rescue treatment; the earlier the better. 2. What is the level of blood concentration of CyA when rejection occurs? If the concentration of CyA is poor, the prognosis may be worse. 3. How do we maintain the dose of CyA during antirejection treatment with MAbs? Maintained use of CyA can play a coeffective role during antirejection treatment with MAbs. 4. What about the inhibiting degree of T-lymphocyte subsets after using MAbs? Whether CD3+ and CD4+/CD8+ decrease or not following the use of MAbs, the T-lymphocyte subsets may interfere significantly with the therapeutic results of MAbs. 5. The combined use of CD3 and CD4 MAbs seemed to get better results, especially for the intractable rejection cases. If we take care of the factors as referred to above, we may get a better therapeutic effect in reversing acute renal allograft rejection episodes with anti-CD3 and CD4 MAbs.
许多因素会干扰抗CD3和CD4单克隆抗体治疗急性肾移植排斥反应的疗效。1. 我们应何时开始使用单克隆抗体，使用单克隆抗体时血清肌酐水平如何？一线治疗可能优于挽救治疗；越早越好。2. 发生排斥反应时环孢素的血药浓度是多少？如果环孢素浓度不佳，预后可能更差。3. 在使用单克隆抗体进行抗排斥治疗期间，我们如何维持环孢素的剂量？持续使用环孢素在使用单克隆抗体进行抗排斥治疗期间可发挥协同作用。4. 使用单克隆抗体后T淋巴细胞亚群的抑制程度如何？无论使用单克隆抗体后CD3+和CD4+/CD8+是否降低，T淋巴细胞亚群都可能显著干扰单克隆抗体的治疗效果。5. CD3和CD4单克隆抗体联合使用似乎效果更好，尤其是对于难治性排斥反应病例。如果我们关注上述因素，在使用抗CD3和CD4单克隆抗体逆转急性肾移植排斥反应时可能会获得更好的治疗效果。
