A Selective Cytopheretic Inhibitory Device to Treat the Immunological Dysregulation of Acute and Chronic Renal Failure
A Selective Cytopheretic Inhibitory Device to Treat the Immunological Dysregulation of Acute and Chronic Renal Failure
复制标题
DOI：
10.1159/000245645
复制
发表时间：
2010-01-01
影响因子：
3
通讯作者：
Song, Joon Ho
中科院分区：
文献类型：
--
作者：
Humes, H. David;Sobota, Joseph T.;Song, Joon Ho
背景资料：急性肾损伤（阿基）和终末期肾病（ESRD）患者长期透析的不良结局是由于与这些疾病相关的免疫失调。不断发展的证据表明，肾脏，特别是肾上皮细胞，在疾病状态下白细胞的免疫应答中起着重要作用。方法：在这方面，已经在临床前动物模型和临床试验中测试了利用肾上皮细胞和“智能”免疫调节膜的两种治疗方法的开发。结果如下：这两种方法已在II期人体试验中得到证实，可改善患有阿基和多器官衰竭的重症监护病房患者的生存率。在一项小型探索性临床试验中，也正在评估“智能”免疫调节膜的使用，以评估其对需要长期血液透析的ESRD患者免疫调节的影响。结论：使用肾祖细胞/干细胞疗法和/或细胞增殖膜可导致有效的治疗以改变急性或慢性肾衰竭的失调的免疫状态并改善这些疾病的结果。版权所有（C）2010 S. Karger AG，巴塞尔
Background: The poor outcomes in patients with acute kidney injury (AKI) and end-stage renal disease (ESRD) on chronic dialysis are due to immune dysregulation associated with these disorders. Evolving evidence suggests that the kidney, and specifically renal epithelial cells, plays an important role in the immunological response of leukocytes under disease states. Method: In this regard, the development of two therapeutic approaches utilizing renal epithelial cells and 'smart' immunomodulatory membranes has been tested in preclinical animal models and clinical trials. Results: These two approaches have been demonstrated in phase II human trials to improve the survival of intensive care unit patients with AKI and multiorgan failure. The use of a 'smart' immunomodulatory membrane is also being evaluated in a small exploratory clinical trial to assess its effects on immunoregulation in ESRD patients requiring chronic hemodialysis. Conclusions: The use of renal progenitor/stem cell therapy and/or cytopheretic membranes may result in effective treatments to alter the dysregulated immunological state of acute or chronic renal failure and improve the outcomes of these diseases. Copyright (C) 2010 S. Karger AG, Basel