在与活体相关的脏移植中使用自主介质干细胞的诱导疗法:一种随机对照试验
Jianming Tan1, Weizhen Wu, Xiumin Xu
1Organ Transplant Institute, Fuzhou General Hospital, Xiamen University and Fujian Key Laboratory of Transplant Biology, Fuzhou, China. tanjm156@yahoo.com.cn
JAMA
|March 23, 2012
概括
自主介质干细胞 (MSCs) 减少了移植患者的急性排斥和机会性感染. 与标准抗体诱导疗法相比,这种方法改善了功能,为移植接受者提供了一个有前途的替代方案.
科学领域:
- 腎臟病學 (nephrology) 是一種醫學專業.
- 免疫学 免疫学 免疫学
- 再生医学是一种再生医学.
背景情况:
- 移植受到急性排斥,机会性感染和氨酸抑制剂 (CNI) 毒性的挑战.
- 介质细胞干细胞 (MSCs) 在治疗移植对宿主疾病方面表现出潜力.
研究的目的:
- 评估自身的MSCs作为抗体诱导疗法的替代品,用于移植接受者.
- 评估MSCs在来自活体相关捐赠者的ABO兼容,交叉匹配阴性移植中的疗效和安全性.
主要方法:
- 一项前性,开放性,随机化研究,涉及159名移植患者.
- 患者在再注血时和移植后两周接受了来自骨髓的自身MSC.
- 对照组包括标准剂量CNI,低剂量CNI和抗IL-2受体抗体与标准剂量CNI.
主要成果:
- 自主性MSC显著降低了活检确认的急性排斥1年发生率 (7.5-7.7%对照组21.6%).
- 治疗MSC导致更快的功能恢复 (增加eGFR) 和机会性感染风险降低 (HR 0.42).
- 与对照组 (P=.02) 不同的是,MSC组中没有发生抗葡萄糖皮质激素的排斥.
结论:
- 自主性MSC为移植中抗体诱导疗法提供了可行的替代方案.
- 使用MSC导致急性排斥率降低,机会性感染减少,功能改善.
- 这种方法提高了移植接受者的患者结果和安全性.
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