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受体淋巴细胞对甲基前列尼索隆的敏感性影响尸体移植存活率
Lancet (London, England)
|June 7, 1986
概括
接受者的类固醇敏感性显著影响移植存活率. 较低的甲基普雷迪尼索隆ED50值与混合淋巴细胞培养不相容的移植中更好的移植存活率相关.
科学领域:
- 腎臟病學 (nephrology) 是一種醫學.
- 免疫学 免疫学 免疫学
- 移植 移植 移植 移植
背景情况:
- 移植对于末期病至关重要.
- 混合淋巴细胞培养 (MLC) 不兼容的移植面临拒绝的挑战.
- 免疫抑制疗法,包括类固醇,对于移植的生存至关重要.
研究的目的:
- 研究受体类固醇敏感性与脏移植结果之间的相关性.
- 为了确定移植前的淋巴细胞类固醇敏感性是否预测了移植的存活率.
- 评估类固醇敏感性对MLC不兼容脏移植的存活率的影响.
主要方法:
- 在移植前的淋巴细胞中确定甲基prednisolone ED50 (有效剂量抑制了50%的植物血凝素反应).
- 分析了接受低甲基普雷迪尼索隆ED50与高甲基普雷迪尼索隆ED50的受体的1年移植存活率.
- 在接受常规免疫抑制 (阿扎西奥普林,类固醇) 和基于环素的治疗方案的患者中比较结果.
主要成果:
- 在常规免疫抑制下,甲基前尼索隆ED50值较低的接受者中,移植一年的存活率 (86%vs. 29%) 显著更高 (p < 0.0002).
- 在接受循环氨酸治疗时,患者的ED50值较低,但在统计学上不显著,观察到向更好的移植存活率 (76%vs. 57%) 的趋势.
- 接受者的类固醇敏感性强烈影响MLC不匹配的脏移植存活率.
结论:
- 移植前确定类固醇敏感性是移植成功的有价值预测指标.
- 类固醇敏感性可能引导接受者选择HLA-DR不匹配移植.
- 评估类固醇敏感性可以为个性化的免疫抑制剂剂量策略提供信息.
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