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摘要: 器官移植是治疗终末期器官功能衰竭的有效手段, 但因终身服用免疫抑制剂而增加了肿瘤、感染等风险, 并有可能导致受者死亡和移植物失功。因此, 免疫耐受一直是移植研究工作者的最终目标。近年来发现在一些停用免疫抑制剂的受者中发生自发耐受现象, 称之为可操作性耐受。可操作性耐受是指在不使用免疫抑制剂的情况下, 至少1年以上无发生移植物排斥反应, 获得移植器官长期存活的现象。这一现象引起了移植免疫学家的广泛关注。本文介绍了临床可操作性耐受的临床监控及机制(包括调节性T细胞、B细胞和天然免疫细胞)方面的研究进展, 以期为后续研究提供参考。
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[1] Bishop GA, Ierino FL, Sharland AF, et al. Approaching the promise of operational tolerance in clinical transplantation[J]. Transplantation, 2011, 91(10):1065-1074. doi: 10.1097/TP.0b013e318215e742 [2] Godfrey WR, Ge YG, Spoden DJ, et al. In vitro-expanded human CD4(+)CD25(+) T-regulatory cells can markedly inhibit allogeneic dendritic cell-stimulated MLR cultures[J].Blood, 2004, 104(2):453-461. doi: 10.1182/blood-2004-01-0151 [3] Bohne F, Martínez-Llordella M, Lozano JJ, et al. Intra-graft expression of genes involved in iron homeostasis predicts the development of operational tolerance in human liver transplantation[J]. J Clin Invest, 2012, 122(1):368-382. doi: 10.1172/JCI59411 [4] Schulz-Juergensen S, Marischen L, Wesch D, et al. Markers of operational immune tolerance after pediatric liver transplantation in patients under immunosuppression[J]. Pediatr Transplant, 2013, 17(4):348-354. doi: 10.1111/petr.2013.17.issue-4 [5] Feng S, Ekong UD, Lobritto SJ, et al. Complete immunosuppression withdrawal and subsequent allograft function among pediatric recipients of parental living donor liver transplants[J]. JAMA, 2012, 307(3):283-293. http://www.medscape.com/medline/abstract/22253395 [6] Tisone G, Orlando G, Cardillo A, et al. Complete weaning off immunosuppression in HCV liver transplant recipients is feasible and favourably impacts on the progression of disease recurrence[J]. J Hepatol, 2006, 44(4):702-709. doi: 10.1016/j.jhep.2005.11.047 [7] Banff Working Group on Liver Allograft Pathology. Importance of liver biopsy findings in immunosuppression management:biopsy monitoring and working criteria for patients with operational tolerance[J]. Liver Transpl, 2012, 18(10):1154-1170. doi: 10.1002/lt.v18.10 [8] Demetris AJ, Isse K. Tissue biopsy monitoring of operational tolerance in liver allograft recipients[J]. Curr Opin Organ Transplant, 2013, 18(3):345-353. doi: 10.1097/MOT.0b013e3283615d48 [9] Egawa H, Miyagawa-Hayashino A, Haga H, et al. Non-inflammatory centrilobular sinusoidal fibrosis in pediatric liver transplant recipients under tacrolimus withdrawal[J]. Hepatol Res, 2012, 42(9):895-903. doi: 10.1111/hepr.2012.42.issue-9 [10] Miyagawa-Hayashino A, Yoshizawa A, Uchida Y, et al. Progressive graft fibrosis and donor-specific human leukocyte antigen antibodies in pediatric late liver allografts[J]. Liver Transpl, 2012, 18(11):1333-1342. doi: 10.1002/lt.v18.11 [11] Yamada H, Kondou H, Kimura T, et al. Humoral immunity is involved in the development of pericentral fibrosis after pediatric live donor liver transplantation[J]. Pediatr Transplant, 2012, 16(8):858-865. doi: 10.1111/j.1399-3046.2012.01781.x [12] Yoshitomi M, Koshiba T, Haga H, et al. Requirement of protocol biopsy before and after complete cessation of immunosuppression after liver transplantation[J]. Transplantation, 2009, 87(4):606-614. doi: 10.1097/TP.0b013e318195a7cb [13] Ilyas JA, Vierling JM. An overview of emerging therapies for the treatment of chronic hepatitis C[J]. Med Clin North Am, 2014, 98(1):17-38. doi: 10.1016/j.mcna.2013.10.011 [14] Dugast E, Chesneau M, Soulillou JP, et al. Biomarkers and possible mechanisms of operational tolerance in kidney transplant patients[J]. Immunol Rev, 2014, 258(1):208-217. doi: 10.1111/imr.2014.258.issue-1 [15] Moraes-Vieira PM, Silva HM, Takenaka MC, et al. Differential monocyte STAT6 activation and CD4(+)CD25(+)Foxp3(+) T cells in kidney operational tolerance transplanted individuals[J]. Hum Immunol, 2010, 71(5):442-450. doi: 10.1016/j.humimm.2010.01.022 [16] Louis S, Braudeau C, Giral M, et al. Contrasting CD25hiCD4+T cells/FOXP3 patterns in chronic rejection and operational drug-free tolerance[J]. Transplantation, 2006, 81(3):398-407. doi: 10.1097/01.tp.0000203166.44968.86 [17] Moraes-Vieira PM, Takenaka MC, Silva HM, et al. GATA3 and a dominant regulatory gene expression profile discriminate operational tolerance in human transplantation[J]. Clin Immunol, 2012, 142(2):117-126. doi: 10.1016/j.clim.2011.08.015 [18] Braza F, Dugast E, Panov I, et al. Central role of CD45RA- Foxp3hi memory regulatory T cells in clinical kidney transplantation tolerance[J]. J Am Soc Nephrol, 2015, 26(8):1795-1805. doi: 10.1681/ASN.2014050480 [19] Taubert R, Pischke S, Schlue J, et al. Enrichment of regulatory T cells in acutely rejected human liver allografts[J]. Am J Transplant, 2012, 12(12):3425-3436. doi: 10.1111/ajt.2012.12.issue-12 [20] Silva HM, Takenaka MC, Moraes-Vieira PM, et al. Preserving the B-cell compartment favors operational tolerance in human renal transplantation[J]. Mol Med, 2012, 18:733-743. https://www.researchgate.net/profile/Pedro_Moraes-Vieira/publication/221754660_Preserving_the_B-cell_compartment_favors_operational_tolerance_in_human_renal_transplantation/links/00b7d521f5706c728a000000.pdf [21] Coelho V, Saitovitch D, Kalil J, et al. Rethinking the multiple roles of B cells in organ transplantation[J]. Curr Opin Organ Transplant, 2013, 18(1):13-21. doi: 10.1097/MOT.0b013e32835c8043 [22] Schulz-Juergensen S, Marischen L, Wesch D, et al. Markers of operational immune tolerance after pediatric liver transplantation in patients under immunosuppression[J]. Pediatr Transplant, 2013, 17(4):348-354. doi: 10.1111/petr.2013.17.issue-4 [23] Bohne F, Londoño MC, Benítez C, et al. HCV-induced immune responses influence the development of operational tolerance after liver transplantation in humans[J]. Sci Transl Med, 2014, 6(242):242ra81. doi: 10.1126/scitranslmed.3008793 [24] Sagoo P, Perucha E, Sawitzki B, et al. Development of a cross-platform biomarker signature to detect renal transplant tolerance in humans[J]. J Clin Invest, 2010, 120(6):1848-1861. doi: 10.1172/JCI39922 [25] Danger R, Pallier A, Giral M, et al. Upregulation of miR-142-3p in peripheral blood mononuclear cells of operationally tolerant patients with a renal transplant[J]. J Am Soc Nephrol, 2012, 23(4):597-606. doi: 10.1681/ASN.2011060543 [26] Brouard S, Mansfield E, Braud C, et al. Identification of a peripheral blood transcriptional biomarker panel associated with operational renal allograft tolerance[J]. Proc Natl Acad Sci U S A, 2007, 104(39):15448-15453. doi: 10.1073/pnas.0705834104
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