Research of the regulation pf acute allograft rejection in ABO-blood type incompatible kidney transplantation

ABO血型不合肾移植急性排斥反应调控研究

基本信息

批准号：
11470333
负责人：
TAKAHASHI Kota
金额：
$ 8.83万
依托单位：
NIIGATA UNIVERSITY
依托单位国家：
日本
项目类别：
Grant-in-Aid for Scientific Research (B)
财政年份：
1999
资助国家：
日本
起止时间：
1999 至 2001
项目状态：
已结题

来源：
https://kaken.nii.ac.jp/en/grant/KAKENHI-PROJECT-11470333/
关键词：
ABO-incompatible kidney transplantation Humoral rejection Standarization of anti-A B antibody titre estimation Elimination of antibodies Immunosuppressive therapy Splenectomy Pathological criteria Anti-endothelial cell antibody 抗体価測定標準化

项目摘要

ABO-blood type incompatible kidney transplantation is one of a big challenge to overcome the immunological barrier of humoral rejection caused by acquired natural antibodies. In this study we have achieved "the state of the art" today and published the books entitled "ABO incompatible kidney transplantation". In the article, head investigator Takahashi described about the history, patient and graft survival data update in Japan, antigenic molecules and antibodies, indication and peri-dperacive evaluation and management, immunosuppression, extra-corporeal immuno-modulation, standard operative methods of transplantation and splenectomy, infection control, clinico-pathological research and case reports, and future perspectives. In the article, we also present a new strategy of pathological croteria for allograft rejection in ABO-incompatible kidney transplantation.In addition, in order to evaluate pre-sensitization status and high risk group for acute rejection in kidney transplantation, we have developed cellular ELISA system to detect anti glomerular endothehal cell antibodies(AECA-GEC) and anti-human umbilical vein endothelial cells(AECA-HUVEG) in kidney transplant recipient serum.In the sequential serum examination in 22 recipients, AECA-GEC positive group showed significantly high frequency, of acute rejection.episodes This phenomena suggests that AECA-GEC positive status may indicate pre-sensitization status against organ-specific antigens expressed on renal glomerular endothelial cells which might cause the disturbance of microcirculation of the graft leading to acute humoral and cellular rejection.We also provide a possibility of an new strategy of immunosuppressive therapy including elimination of acquired antibodies and continuous immunosuppression of antibody production by lymphocytes in highly sensitized recipients.

不相容的肾脏移植是克服因获得的天然抗体引起的体液排斥的免疫障碍的最大挑战之一。在这项研究中，我们今天实现了“艺术状况”，并出版了名为“ ABO不兼容肾脏移植”的书籍。高桥首席研究员在文章中描述了日本的历史，患者和移植物生存数据更新，抗原分子和抗体，指示和痛觉性耐药性评估和管理，免疫抑制，体外免疫调节，外植入术和脾脏术的标准手术方法，感染对照，临床研究，临床研究和未来。在本文中，我们还提出了一种新的病理性链球菌策略，用于在不兼容的肾脏移植中拒绝同种异体移植。肾脏移植受者血清中的内皮细胞（AECA-HUVEG）。在22名受体中的顺序血清检查中，AECA-GEC阳性表现出明显高的频率，急性排斥的频率很高。该现象表明AECA-GEC表明AECA-GEC可能表明对肾小球的细胞对肾小球的敏感性可能表现为肾小球的敏感性，从而表达肾小球的肾小球效果，从而对肾脏的质量造成的影响，这是对肾脏的影响，这是对肾脏的质量的影响。移植物导致急性体液和细胞排斥。我们还提供了一种新的免疫抑制疗法策略，包括消除获得的抗体以及在高度敏化的受体中通过淋巴细胞对抗体产生的持续免疫抑制。