肾移植抗体介导排斥反应新型药物治疗的研究进展

Research progress of novel drug therapy for antibody-mediated rejection in kidney transplantation

抗体介导的排斥反应(antibody-mediated rejection,AMR)是影响肾移植受者和移植肾远期预后的首要因素。目前,尚无一种药物能被普遍认可或者获得批准用于AMR的治疗。因此,亟需开展更多的新型药物研究与临床试验,以期改变肾移植受者的长期预后。基于预防和治疗AMR的核心原则,本文从清除供者特异性抗体、阻断抗体与补体介导的组织损伤、抑制产生抗体细胞的增殖与活化3个方面综述了目前最受关注的几类新型药物治疗AMR的作用原理与疗效。这些新兴药物已显示出在预防和治疗AMR、改善受者预后方面的潜力,有望在未来改变AMR治疗的 困局,为临床改善肾移植受者的长期预后提供更多有效的治疗选择。

Antibody-mediated rejection(AMR)is the primary factor affecting the long-term prognosis of kidney transplant recipients and kidney allograft.Currently,there is no universally recognized or approved drug for the treatment of AMR.Therefore,more novel drug studies and clinical trials are urgently needed in order to change the long-term prognosis of kidney transplant recipients.Based on the core principles of prevention and treatment of AMR,this paper discusses the mechanism and efficacy of several new types of drugs of most concern in the treatment of AMR from three aspects:removing donor specific antibody,blocking antibody-mediated and complement-mediated tissue damage,and inhibiting the proliferation and activation of antibody-producing cells.These emerging drugs have shown potential in preventing and treating AMR and improving the prognosis of recipients,which is expected to change the dilemma of AMR treatment in the future and provide more effective treatment options for improving the long-term prognosis of kidney transplant recipients.