摘要
抗体介导的体液排斥反应(AMR)已经成为移植物丢失的主要原因。随着移植前分子配型技术等应用,使得患者体内预存供体特异性抗体(DSA)对移植后排斥发生的影响程度降低。移植后的治疗中免疫抑制药能否抑制体内移植后新生DSA(dnDSA)的产生也成为减少AMR,提高移植物生存率的关键。本文就DSA产生机制及其对预后的影响,T细胞在其中发挥的作用,dnDSA检测技术和免疫抑制治疗对dnDSA的影响,以及免疫抑制药治疗药物监测结果与dnDSA的关系等方面进行综述。
Antibody mediated rejection(AMR)is gradually becoming the main type of rejection occurring after transplantation.With the application of molecular matching technique before transplantation,the influence of donor-specific antibodies(DSA)declines.Therefore,whether immunosuppressant drugs can depress the formation of de novo donor-specific antibodies(dn DSA)after transplantation is the key for declining the risk of AMR and improving the transplantation survival.In this review,the association with prognosis,the function of T cell in the generation of dn DSA,the techniques used for dn DSA determination and influence of immunosuppressive therapy on dn DSAs were summarized,and the relationship between therapeutic drug monitoring(TDM)of immunosuppressants and the emergence of dn DSA were also reviewed.
作者
王曦晗
陈冰
Wan Xihan;Chen Bing(Department of Pharmacy,Ruijin Hospital,Shanghai Jiaotong University,School of Medicine,Shanghai 200025,China)
出处
《中国药师》
CAS
2020年第11期2243-2247,共5页
China Pharmacist
基金
国家自然科学基金项目(编号:81973387)。
关键词
供体特异性抗体
免疫抑制药
他克莫司
De novo donor-specific antibodies
Immunosuppressant drugs
Tacrolimus
