Kawahara T, Yagita H, Kasai S, Sawa M, Kato K, Okumura K, Futagawa S, Mito M
Second Department of Surgery, Juntendo University School of Medicine, Tokyo, Japan.
J Gastroenterol Hepatol. 1998 Sep;13 Suppl:S119-23.
Hepatocyte transplantation is a potential therapeutic modality for overcoming the shortage of liver donors, and the clinical application of allogeneic hepatocyte transplantation has been considered. However, there are two major problems with allogeneic hepatocyte transplantation: protection of transplanted hepatocytes from rejection and stimulation of the rapid proliferation of surviving cells. Without immunosuppression, allogeneic hepatocytes are rapidly rejected within a few days after transplantation, even though it is relatively easy to induce immunotolerance after allogeneic whole liver transplantation. Accordingly, different rejection mechanisms seem to operate after allogeneic hepatocyte transplantation and whole liver transplantation. To overcome the rejection of transplanted hepatocytes, induction of donor-specific unresponsiveness to graft without compromising the host immune system would be ideal. We previously reported that the Fas-Fas ligand system plays a critical role in the CD28-independent pathway of hepatocyte rejection. Therefore, blockade of rejection using CTLA4 immunoglobulin (CTLA4Ig) or anti-CD80/86 monoclonal antibodies and anti-FasL monoclonal antibody may prolong the survival of transplanted allogeneic hepatocytes. Furthermore, administration of hepatocyte growth factor (HGF) can promote the proliferation of allogeneic hepatocytes and this may lead to the development of a functioning liver substitute.
肝细胞移植是克服肝脏供体短缺的一种潜在治疗方式,同种异体肝细胞移植的临床应用已得到考虑。然而,同种异体肝细胞移植存在两个主要问题:保护移植的肝细胞免受排斥以及刺激存活细胞的快速增殖。在没有免疫抑制的情况下,同种异体肝细胞在移植后几天内会迅速被排斥,尽管同种异体全肝移植后相对容易诱导免疫耐受。因此,同种异体肝细胞移植和全肝移植后似乎存在不同的排斥机制。为了克服移植肝细胞的排斥反应,在不损害宿主免疫系统的情况下诱导对移植物的供体特异性无反应性将是理想的。我们之前报道过,Fas - Fas配体系统在肝细胞排斥反应的CD28非依赖性途径中起关键作用。因此,使用CTLA4免疫球蛋白(CTLA4Ig)或抗CD80/86单克隆抗体以及抗FasL单克隆抗体阻断排斥反应可能会延长移植的同种异体肝细胞的存活时间。此外,给予肝细胞生长因子(HGF)可以促进同种异体肝细胞的增殖,这可能会导致功能性肝替代物的发展。