Chimerism and tolerance in transplantation
Chimerism and tolerance in transplantation
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移植中的嵌合和耐受
DOI：
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发表时间：
2004
影响因子：
11.1
通讯作者：
T. Starzl
中科院分区：
文献类型：
--
作者：
T. Starzl
在实验模型中的研究（1953-1956）表明，在免疫不成熟或辐射的动物中获得的供体特异性同种异体耐受与供体白细胞嵌合体密切相关。在免疫缺陷或细胞消融的人类受体中进行骨髓移植是一种合理的延伸（1968）。相反，临床（1959年）和实验性器官移植是在明显缺乏白细胞嵌合体的情况下系统地完成的。因此，多年来，人们一直认为器官和骨髓移植的成功涉及根本不同的机制。随着1992年在长期存活的器官受体的组织或血液中发现少量供体白细胞（微嵌合体），我们得出结论，器官移植是一种白细胞嵌合体依赖性部分耐受的形式。在这个最初有争议的范例中，两种移植后的同种异体移植是双重免疫反应的产物，其中共存的供体和受体免疫系统的相互反应导致可变的相互克隆耗尽，随后是外周克隆缺失。Rolf Zinkernagel提出，个体同种异体反应相当于MHC限制性T细胞对细胞内寄生虫的识别和宿主对细胞内寄生虫的反应，并且免疫应答或无应答的机制由相应抗原的迁移和定位控制。对无反应性机制（克隆耗竭-缺失和免疫忽略）及其调节的阐明消除了移植的许多历史神秘性。然后将这一见解应用于改善当前人类移植受者的免疫抑制的时机和剂量。
Studies in experimental models (1953–1956) demonstrated that acquired donor-specific allotolerance in immunologically immature or irradiated animals is strongly associated with donor leukocyte chimerism. Bone marrow transplantation in immune-deficient or cytoablated human recipients was a logical extension (1968). In contrast, clinical (1959) and then experimental organ transplantation was systematically accomplished in the apparent absence of leukocyte chimerism. Consequently, it was assumed for many years that success with organ and bone marrow transplantation involved fundamentally different mechanisms. With the discovery in 1992 of small numbers of donor leukocytes in the tissues or blood of long-surviving organ recipients (microchimerism), we concluded that organ engraftment was a form of leukocyte chimerism-dependent partial tolerance. In this initially controversial paradigm, alloengraftment after both kinds of transplantation is the product of a double immune reaction in which responses, each to the other, of coexisting donor and recipient immune systems results in variable reciprocal clonal exhaustion, followed by peripheral clonal deletion. It was proposed with Rolf Zinkernagel that the individual alloresponses are the equivalent of the MHC-restricted T cell recognition of, and host response to, intracellular parasites and that the mechanisms of immune responsiveness, or nonresponsiveness, are governed by the migration and localization of the respective antigens. Elucidation of the mechanisms of nonresponsiveness (clonal exhaustion-deletion and immune ignorance) and their regulation removed much of the historical mystique of transplantation. The insight was then applied to improve the timing and dosage of immunosuppression of current human transplant recipients.
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同种异体骨髓和肝移植的非清髓大鼠受体中的供体造血祖细胞。
影响因子：
6.2
作者：
Sakamoto,T;Ye,Q;Lu,L;Demetris,AJ;Starzl,TE;Murase,N
通讯作者：
Murase,N
具有或不具有辅助骨髓的同种异体心脏移植大鼠受体中供体白细胞嵌合体的淋巴/非淋巴区室化。
影响因子：
6.2
作者：
Terakura,M;Murase,N;Demetris,AJ;Ye,Q;Thomson,AW;Starzl,TE
通讯作者：
Starzl,TE
活体肾移植后同种异体移植物存活 26 至 29 年：光学显微镜分析、Y 染色体原位杂交和抗 HLA 抗体。
DOI：
10.1016/s0272-6386(12)80162-4
发表时间：
1994
期刊：
American journal of kidney diseases : the official journal of the National Kidney Foundation
影响因子：
--
作者：
Randhawa,PS;Starzl,T;Ramos,HC;Nalesnik,MA;Demetris,J
通讯作者：
Demetris,J
从历史临床经验中吸取器官诱导耐受的教训。
影响因子：
6.2
作者：
Starzl,ThomasE;Murase,Noriko;Demetris,AnthonyJ;Trucco,Massimo;Abu-Elmagd,Kareem;Gray,EdwardA;Eghtesad,Bijan;Shapiro,Ron;Marcos,Amadeo;Fung,JohnJ
通讯作者：
Fung,JohnJ
使用探针重复 Y 染色体序列来检测骨髓移植受者外周血中的宿主细胞。
影响因子：
3.5
作者：
Przepiorka,D;Thomas,ED;Durnam,DM;Fisher,L
通讯作者：
Fisher,L