抗体介导的排斥治疗标准
Georg A Böhmig1, Maarten Naesens2, Ondrej Viklicky3
1Division of Nephrology and Dialysis, Department of Medicine III, Medical University of Vienna, Vienna, Austria.
概括
抗体中介排斥 (AMR) 治疗缺乏强有力的证据. 目前的类固醇和利图西马布等疗法没有得到强有力的支持,但针对炎症的新方法显示了对移植存活的希望.
科学领域:
- 移植免疫学 移植免疫学
- 腎臟病學 (nephrology) 是一種醫學.
- 移植生存研究研究 移植生存研究
背景情况:
- 抗体介导排斥 (AMR) 是移植失败的主要驱动因素,造成了相当大的临床和经济负担.
- 尽管有数十年的认可,但AMR治疗缺乏标准化和监管机构批准的治疗方法.
- 目前对AMR治疗的证据有限,许多试验产生了负面结果.
研究的目的:
- 对抗体介导排斥治疗策略的现有证据基础进行批判性重新评估.
- 在缺乏强大的,批准的AMR疗法的情况下,为临床决策提供信息.
- 确定有前途的治疗目标和方法,为未来的AMR治疗开发.
主要方法:
- 对AMR治疗方法的现有临床试验数据进行系统审查和批判性评估.
- 分析专家共识建议及其证据基础.
- 对针对AMR病理生物学的新兴治疗策略的评估.
主要成果:
- 目前关于在AMR治疗中使用类固醇,rituximab,bortezomib和IL-6抗剂的证据不足.
- 免疫吸附和潜在的高剂量IVIG被认为是早期AMR,支持数据有限.
- 新兴的CD38抗体通过向内皮炎症表现出潜力,补充抑制是严重早期AMR的一个选择.
结论:
- 缺乏支持常见AMR治疗的强有力的证据,需要对临床实践进行重新评估.
- 针对细胞炎症 (例如CD38抗体) 和补充通路的新疗法为未来提供了希望.
- 对于efgartigimod,tocilizumab和felzartamab等药物的正在进行的临床试验可能会导致批准的,有效的AMR治疗.
关键词:
CD38 CD38 CD38 CD38 CD38 CD38 CD38 CD38 CD38 CD38 CD38 CD38 CD38 CD38通过抗体介导的排斥.这就是Apheresis.提供者特异性抗体.自然杀手细胞是自然杀手细胞.更多相关视频
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