CORRELATION OF IMMUNE PARAMETERS WITH OUTCOME

免疫参数与结果的相关性

• 批准号: 6300969
• 负责人: Nancy Louise Reinsmoen
• 金额: $ 9.97万
• 依托单位: UNIVERSITY OF MINNESOTA
• 依托单位国家: 美国
• 财政年份: 1999
• 资助国家: 美国
• 起止时间: 1999-12-01 至 2000-11-30
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/6300969
• 关键词: antibody formation; artificial immunosuppression; clinical research; heart transplantation; helper T lymphocyte; histocompatibility antigens; human subject; human therapy evaluation; immunologic assay /test; isoantibody; kidney transplantation; lung transplantation; outcomes research; transplant rejection; transplantation immunology

In most transplant programs, long-term transplant recipients tend to be treated with similar immunosuppressive protocols. However, such uniform treatment may lead to complications from over immunosuppression in some and under immunosuppression in others. Previous studies of withdrawal of one drug have not been successful. An important question is whether an individual immune parameter test or a battery of these tests would best predict long-term graft outcome in stable patients. Retrospective data from individual laboratories has suggested the immune parameters (donor antigen-specific hyporeactivity, allogeneic microchimerism, and the absence of donor antigen-specific HLA antibodies) predict successful long- term outcome after solid organ transplantation. However, each of these parameters has only been applied individuals and only to a subpopulation of transplant recipients. This grant will focus on the use of these three immunologic parameters to predict long-term graft success in a broad transplant population. We will determine whether donor antigen-specific hyporeactivity of the CD4 helped pathway (Specific Aim 1), peripheral blood allogeneic microchimerism (Specific Aim 2), and a lack of development (or regulation of) donor antigen-specific HLA antibodies (Specific Aim 3) correlate with improved long-term graft outcome. We will perform a prospective study, testing all three parameters for lung and heart recipients and the first and third parameters for kidney recipients transplant at the University of Minnesota. The transplant program at the University of Minnesota has a long-established mechanisms for clinical follow-up and clinical data collection. We will determine whether one parameter can be used in lieu of another in an organ specific manner. We plan to use these immune parameters to determine if immunosuppression can be individualized, If so, by selectively lowing immunosuppression in some recipient by maintaining it in others, we will provide significant long- term savings (cost, morbidity and outcome improvement) for solid organ transplant recipients.

在大多数移植项目中，长期移植受者往往是 用类似的免疫抑制剂治疗然而，这样的制服 治疗可能会导致并发症，从过度免疫抑制，在一些 而另一些则处于免疫抑制状态。先前的研究 有一种药物没有成功。一个重要的问题是， 个体免疫参数测试或这些测试的电池将最好 预测稳定患者的长期移植结局。回顾性数据 来自各个实验室的数据表明， 抗原特异性低反应性，同种异体微嵌合体， 缺乏供体抗原特异性HLA抗体）预测成功的长期- 实体器官移植后的远期疗效然而，每一个 参数仅适用于个体，且仅适用于子群体 移植接受者。这笔赠款将集中用于这三个 免疫学参数预测长期移植成功率 移植人口我们将确定供体抗原特异性 CD 4辅助途径的低反应性（特异性目的1），外周 血液同种异体微嵌合体（特异性目标2），以及缺乏 供体抗原特异性HLA抗体的产生（或调节） （具体目标3）与改善的长期移植结局相关。我们将 进行一项前瞻性研究，测试肺的所有三个参数， 心脏受体的第一和第三参数以及肾脏受体的第一和第三参数 在明尼苏达大学做移植手术移植计划在 明尼苏达大学拥有悠久的临床机制 随访和临床数据收集。我们将确定是否有一个 参数可以以器官特异性方式代替另一个参数使用。我们 计划使用这些免疫参数来确定免疫抑制是否可以 个体化，如果是这样，通过选择性地降低免疫抑制， 在其他人的帮助下，我们将为他们提供长期的支持。 实体器官的长期节省（成本、发病率和结局改善） 移植接受者