托西利祖马布治疗微血管炎症和慢性活性抗体中介排斥在移植中的治疗
Edmund Huang1, Michie Adjei2, Alice Peng1
1Division of Nephrology, Department of Medicine, Comprehensive Transplant Center, Cedars-Sinai Medical Center, West Hollywood, CA.
Transplantation direct
|October 8, 2025
概括
托西利祖马布是一种干白素-6 (IL-6) 抑制剂,可以稳定慢性活性抗体中介排斥 (AMR) 患者的移植功能. 需要进一步的研究来证实这种IL-6治疗AMR的疗效.
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
- 移植医学 移植医学
背景情况:
- 洲际蛋白-6 (IL-6) 在幽默免疫中起着关键作用,是移植中抗体介导排斥 (AMR) 的治疗标.
- 现有的关于IL-6抑制用于AMR治疗的数据是混合的,有效性不确定的.
- 慢性活性AMR是移植患者的一个重大问题.
研究的目的:
- 为了研究月度托西利祖马布输液和估计的淋巴细胞过率 (eGFR) 轨迹之间的关联.
- 评估托西利祖马布对脏移植患者的影响,这些患者具有慢性活性AMR的组织学特征.
主要方法:
- 在85名患有慢性活性AMR的成年移植患者进行了回顾性观察性研究.
- 治疗包括每月一次静脉注射托西利祖马布 (8毫克/公斤).
- 用零碎的线性混合效应模型来比较eGFR轨迹12个月前和之后开始托西利祖马布.
主要成果:
- 接受脏移植的接受者在托西利祖马布治疗前的EGFR下降为-0.70 mL/min/1.73 m2/mo,治疗后稳定至-0.07 mL/min/1.73 m2/mo (斜率差异:0.59 mL/min/1.73 m2/mo,P=.002).
- 在65名具有捐赠者特异性抗体 (DSA) 的患者中,22%的患者在治疗后1年实现了DSA阴性.
- 一个移植损失和两个COVID-19相关的死亡发生在治疗开始后12个月内.
结论:
- 每月接受托西利祖马布治疗可能会稳定移植功能,在患有慢性活性AMR的移植患者中.
- 需要进一步的研究来证实托西利祖马布对AMR的疗效.
- 托西利祖马布在脏移植中显示出作为治疗治疗慢性活性AMR的治疗选择的潜力.
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