REVERSAL OF TRANSPLANT REJECTION BY MONOCLONAL ANTIBLAST ANTIBODY
REVERSAL OF TRANSPLANT REJECTION BY MONOCLONAL ANTIBLAST ANTIBODY
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单克隆抗母细胞抗体逆转移植排斥
DOI：
10.1016/s0140-6736(83)91212-6
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发表时间：
1983
期刊：
影响因子：
--
通讯作者：
R. Billing
中科院分区：
文献类型：
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作者：
H. Takahashi;P. Terasaki;T. Kinukawa;D. Chia;K. Miura;H. Okazaki;Y. Iwaki;Y. Taguchi;S. Hardiwidjaja;M. Ishizaki;R. Billing
描述了抗母细胞单克隆抗体 CBL1 治疗肾同种异体移植排斥反应的首次临床试验。先前描述的一项研究证明了这种抗体可能会破坏细胞的活性克隆而不会产生重大副作用的理论，该研究显示恒河猴皮肤同种异体移植物的存活时间得以延长。 CBL1 用于治疗 11 名具有单一单倍型相同相关供体移植物并经过供体特异性输血预刺激的患者和 8 名经过多次输血预刺激的尸体移植物患者的肾同种异体移植排斥反应。其中 15 例拒绝接受类固醇治疗。尽管 CBL1 对外周血淋巴细胞计数没有影响，但 19 名患者中有 17 名出现了排斥反应。 11 名相关供体移植物受者中有 1 名移植物丢失，而尸体供体移植物患者中有 3 名移植物丢失。在接受 CBL1 治疗的任何患者中均未出现与施用抗淋巴细胞血清相关的副作用，即寒战、发烧和血小板减少。据推测，在肾脏排斥期间施用抗母细胞单克隆抗体只会杀死那些对移植物起反应的细胞。这可能导致维持正常的淋巴细胞数量和针对其他抗原的免疫功能。
The first clinical trial of an antiblast monoclonal antibody, CBL1, in the treatment of kidney allograft rejection is described. The theory that this antibody might destroy active clones of cells without major side effects was given validity by a previously described study showing prolongation of skin allograft survival in rhesus monkeys. CBL1 was used to treat kidney allograft rejections in 11 patients with a one-haplotype-identical related-donor graft who had been prestimulated with donor-specific transfusions and 8 patients with cadaver grafts who had been prestimulated with multiple transfusions. 15 of the rejections were steroid-resistant. Although CBL1 had no effect on the peripheral blood lymphocyte counts, rejections were reversed in 17 of 19 patients. There was 1 graft loss in the 11 recipients of relateddonor grafts and 3 in patients with cadaver-donor grafts. Side effects associated with administration of antilymphocyte serum—ie, chills, fever, and thrombocytopenia—did not develop in any of the patients treated with CBL1. It is postulated that administration of an antiblast monoclonal antibody during rejection of a kidney kills only those cells that are reacting against the graft. This could result in the maintenance of normal lymphocyte numbers and immunological functions against other antigens.