Emerging New Approaches in Desensitization: Targeted Therapies for HLA Sensitization.
Emerging New Approaches in Desensitization: Targeted Therapies for HLA Sensitization.
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DOI：
10.3389/fimmu.2021.694763
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发表时间：
2021
影响因子：
7.3
通讯作者：
Kwun J
中科院分区：
文献类型：
--
作者：
Choi AY;Manook M;Olaso D;Ezekian B;Park J;Freischlag K;Jackson A;Knechtle S;Kwun J
对于具有预先形成的或从头供体特异性 HLA 抗体 (DSA) 的致敏患者，迫切需要进行脱敏和抗体介导的排斥反应 (AMR) 的治疗干预。由于移植时预先检测到DSA或移植后HLA记忆重新激活，致敏患者发生AMR和同种异体移植物丢失的风险增加，导致急性和慢性AMR。或者，由于免疫抑制不足而在移植后发生的从头 DSA 可能再次导致急性和慢性 AMR，甚至同种异体移植物丢失。循环抗体是体液免疫反应的最终产物，一直是脱敏和AMR治疗的主要目标。然而，在许多情况下，这些方案无法有效去除所有 DSA，并且与非致敏患者相比，持续 DSA 患者的长期结果要差得多。我们相信，针对体液免疫的多个组成部分将改善此类患者的预后。在这篇综述中，我们将简要讨论针对抗体或 B 细胞去除的传统脱敏方法，然后提出一种针对浆细胞和体液反应的机械设计脱敏方案。
There is an urgent need for therapeutic interventions for desensitization and antibody-mediated rejection (AMR) in sensitized patients with preformed or de novo donor-specific HLA antibodies (DSA). The risk of AMR and allograft loss in sensitized patients is increased due to preformed DSA detected at time of transplant or the reactivation of HLA memory after transplantation, causing acute and chronic AMR. Alternatively, de novo DSA that develops post-transplant due to inadequate immunosuppression and again may lead to acute and chronic AMR or even allograft loss. Circulating antibody, the final product of the humoral immune response, has been the primary target of desensitization and AMR treatment. However, in many cases these protocols fail to achieve efficient removal of all DSA and long-term outcomes of patients with persistent DSA are far worse when compared to non-sensitized patients. We believe that targeting multiple components of humoral immunity will lead to improved outcomes for such patients. In this review, we will briefly discuss conventional desensitization methods targeting antibody or B cell removal and then present a mechanistically designed desensitization regimen targeting plasma cells and the humoral response.
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影响因子：
50.3
作者：
Anchoori RK;Karanam B;Peng S;Wang JW;Jiang R;Tanno T;Orlowski RZ;Matsui W;Zhao M;Rudek MA;Hung CF;Chen X;Walters KJ;Roden RB
通讯作者：
Roden RB
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影响因子：
3.7
作者：
Chung BH;Kim KW;Kim BM;Doh KC;Cho ML;Yang CW
通讯作者：
Yang CW
DOI：
10.1046/j.1526-0968.2000.004004275.x
发表时间：
2000-08-01
期刊：
Therapeutic apheresis : official journal of the International Society for Apheresis and the Japanese Society for Apheresis
影响因子：
--
作者：
Batocchi, A P;Evoli, A;Tonali, P
通讯作者：
Tonali, P
影响因子：
45.3
作者：
Czuczman, MS;Thall, A;Leigh, BR
通讯作者：
Leigh, BR
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影响因子：
5.3
作者：
Cheney, Carolyn M.;Stephens, Deborah M.;Byrd, John C.
通讯作者：
Byrd, John C.