Evolving approaches of hematopoietic stem cell-based therapies to induce tolerance to organ transplants: the long road to tolerance.

Evolving approaches of hematopoietic stem cell-based therapies to induce tolerance to organ transplants: the long road to tolerance.
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DOI:
10.1038/clpt.2012.201
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发表时间:
2013-01
影响因子:
6.7
通讯作者:
--
中科院分区:
医学2区
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--
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造血干细胞(HSC)的免疫调节特性已经被认识超过60年,开始于Owen(1945)报道共享共同胎盘的遗传上不同的自由马丁牛是红细胞嵌合体,随后当比灵厄姆,布伦特,和Medawar(1953)证明,通过输注供体来源的造血细胞制备的小鼠新生嵌合体表现出供体-对同种异体皮肤移植物的特异性耐受。在器官移植中使用HSC的各种方法使诱导器官移植受者的供体特异性耐受的梦想逐渐接近现实。需要克服几个障碍,特别是避免移植物抗宿主病、消融性预处理的毒性和消除对供体/受体密切匹配的需要。为了广泛接受,HSC治疗必须在不匹配的供体/受体组合中安全且可重复。其他学科的发现往往出乎意料地协同促进了进步。这篇综述从历史的角度介绍了器官移植耐受性的研究,强调了目前的临床方法。
The immunoregulatory properties of hematopoietic stem cells (HSC) have been recognized for over 60 years, beginning when Owen (1945) reported that genetically disparate freemartin cattle sharing a common placenta were red blood cell chimeras, and subsequently when Billingham, Brent, and Medawar (1953) demonstrated that murine neonatal chimeras prepared by infusion of donor-derived hematopoietic cells exhibited donor-specific tolerance to skin allografts. Various approaches using HSC in organ transplantation have gradually brought the dream of inducing donor-specific tolerance in organ transplant recipients closer to reality. Several hurdles needed to be overcome, especially avoiding graft-versus-host disease, the toxicity of ablative conditioning and eliminating the need for close donor/recipient matching. For wide acceptance, HSC therapy must be safe and reproducible in mismatched donor/recipient combinations. Discoveries in other disciplines have often unexpectedly and synergistically contributed to progress. This review presents an historic perspective of the quest for tolerance in organ transplantation, highlighting current clinical approaches.
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