肾移植术后抗体介导的排斥反应的新进展

Antibody-mediated rejection in kidney transplantation: an update

抗体介导的排斥反应(AMR)是肾移植术后常见的严重并发症。近年来大量研究探讨了抗体特征与临床表现、移植肾预后之间的关系。针对非抗HLA抗体的研究更加明确了这些抗体在肾移植中的意义和作用。AMR的诊断也在经历了巨大变革。与排斥诊断、预后相关的生物学标志物不断被发现及验证。小样本研究报道硼替佐米、利妥昔单抗、C1q单抗治疗AMR的疗效,初步表明这些药物的有效性和安全性。此外,在动物实验中多种药物显示了良好的预防/治疗AMR的效能。

The main conundrum complicating long-term survival of transplanted kidney is antibody-mediated rejection（ AMR）. Intense research intended to correlate antibody characteristics with clinical manifestations and graft prognosis.Research regarding antibodies against non-HLA antigens improved appreciation of their significance in kidney transplantation.The diagnosis of AMR changed dramatically and a host of bio-markers for kidney rejection and graft survival have been discovered and validated. The efficacy and safety profiles of bortezomib,rituximab and C1q monoclonal antibody use in the treatment of AMR have been reported with small number of patients. Furthermore,some drugs have been found to be effective in AMR prevention and treatment in animal studies.