Microchimerism, macrochimerism, and tolerance.

Microchimerism, macrochimerism, and tolerance.
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微嵌合、大嵌合和耐受性。

DOI:
10.1034/j.1399-0012.2000.t01-1-140412.x
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发表时间:
2000
期刊:
Clinical transplantation.
影响因子:
--
通讯作者:
Murase,N
Murase,N
中科院分区:
--
文献类型:
--
作者:
Starzl,TE;Murase,N

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Sahota et al. (I)提示器官接受者中供体白细胞微嵌合体是一个“真实的发现”,其随移植器官和术后取样时间而变化。并且可以用适当的技术从一个中心检测到另一个中心。荟萃分析也反映了对微嵌合体的意义缺乏共识。这种不确定性一直存在的部分错误归因于我们的意见,微嵌合体意味着从排斥的风险和/或它的存在或水平可以用来指导药物断奶的自由。Sahota等人(I)避免了这些错误。尽管如此。对这一效应的不准确引用(1)被用于支持器官移植的机制不同于骨髓诱导耐受的机制的论点(3-5)。器官移植的临床领域是基于宿主对移植物的反应这一事实。该mayor可能不强到足以引起排斥的临床和/或组织病理学发现。容易逆转,并且通常会导致抗移植物反应性下降,这反映在对免疫抑制的需求减少(6)。
The meta-analysis of Sahota et al.(I) suggests that donor leukocyte microchimerism in organ recipients is a'real finding'that varies with the organ transplanted and the time of post-operative sampling. and is detectable with the appropriate technology from center to center. The meta-analysis also reflects the lack of consensus about the significance of microchimerism. This uncertainty has been perpetuated in part by incorrectly attributing to us the opinion that microchimerism implies freedom from risk of rejection and or that its presence or level can be used to guide drug weaning. Sahota et al.(I) have avoided these errors. Nevertheless. inaccurate citations to this effect (1) have been used secondarily to support the contention that the mechanisms of organ engraftment are different than those of bone marrow-induced tolerance (3-5).The clinical field of organ transplantation is based on the fact that a host response against the graft. which mayor may not be strong enough to cause clinical and or histopathologic findings of rejection. is readily reversible and often is succeeded by a decline in the antigraft reactivity that is reflected by a reduced need for immunosuppression (6).
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