ISSN:1087-2418    

出版商:OVID    

年代:1997

数据来源: OVID

摘要:

This article reviews the evidence supporting the emerging view that 1) indirect responses play an important role in allograft rejection, 2) a limited number of major histocompatibility complex peptides are critical for stimulating indirect responses, and 3) major histocompatibility complex peptide therapy might, therefore, be useful in preventing allograft rejection.

ISSN:1087-2418    

出版商:OVID    

年代:1997

数据来源: OVID

摘要:

RANTES (regulated on activation, novel T expressed, and secreted) is a chemoattractant cytokine (chemokine) first identified less than a decade ago. It functions in the process of attracting immune cells, including monocytes, T lymphocytes and eosinophils, into sites of inflammation. It is also involved in the activation of some cell types and prolongation of the immune response in space and time. For these reasons, it appears that RANTES may play an important role in cell-mediated and chronic forms of transplant rejection.

ISSN:1087-2418    

出版商:OVID    

年代:1997

数据来源: OVID

摘要:

It is widely believed that classic T cell-produced T-cell growth factors (TCGFs) (interleukin-2, interleukin-4) play an important role in the execution of T cell-mediated phenomena. But these cytokines play a less essential rolein vivo, even though they are critically important for T-cell proliferationin vitro. The sharing of common interleukin-2Rγ by multiple TCGF receptor complexes constitutes a structural basis for the functional redundancy of TCGFs. An identification of the specific TCGFs involved in allograft rejection and their individual roles may prove important in designing effective therapeutic strategies to promote long-term engraftment and tolerance.

ISSN:1087-2418    

出版商:OVID    

年代:1997

数据来源: OVID

摘要:

Over the past decade the fortunes of the Th1/Th2paradigm have fluctuated. A substantial body of work from two groups, in several animal models, has demonstrated that allograft rejection is associated with Th1activity, and acceptance with that of Th2s. Other studies have not obtained the same kind of associations, notably in human organ transplants, for reasons which are presently unclear. The procedures which have been used with success, for instance treatment with anti-CD4 monoclonal antibody, are likely to reduce signal strength within the responding T cells; experience with other (non-transplantation) systems indicates that this is indeed likely to drive-Th2differentiation. Oral and nasal tolerance offer another possible means of modulating Th1/Th2balance, although clinical trials have been disappointing. The genetics and pharmacology of the balance are surveyed for clues to mechanism.

ISSN:1087-2418    

出版商:OVID    

年代:1997

数据来源: OVID

摘要:

This article reviews recent reports that have addressed the role of multilineage donor hematopoietic cell microchimerism in the induction and maintenance of organ transplant tolerance. A major focus of the search for a mechanistic explanation for tolerance induction by microchimerism has been donor-derived dendritic cell progenitors that have been shown to have tolerogenic potential. Greater understanding of the bidirectional donor-host leukocyte interactions that occur after organ transplantation may allow development of improved therapeutic strategies based on tolerance-promoting manipulation of these interactions.

ISSN:1087-2418    

出版商:OVID    

年代:1997

数据来源: OVID

摘要:

The role of the Epstein-Barr virus in the development of post-transplant lymphomas is well established. However, not all lymphomas that arise in these patients contain Epstein-Barr virus, suggesting that other cofactors are involved in tumor pathogenesis. We propose that immunologic interactions that result from the introduction of immunocompetent donor cells during transplantation contribute to a lymphomagenic environment in the host. Murine models of lymphoma that arises following transfer of allogeneic hematopoietic cells are discussed and are related to the transplant setting. One contemporary viewpoint of transplantation immunology holds that interactions between the host and donor components of the immune system determine the ultimate degree of tolerance or reciprocal immunoreactivity (eg, rejection, graft-versus-host disease) within the transplant patient. We conclude that host-donor immunologic microchimerism may also be an overlooked factor in the development of posttransplant lymphomas.

ISSN:1087-2418    

出版商:OVID    

年代:1997

数据来源: OVID

摘要:

The elimination of graft-reactive immune cells is one of the most reliable means to facilitate transplant tolerance. The options for cytoreduction and cytoablation of immunocytes have generally centered on antibody-mediated killing, radiation, chemical toxicity or physical removal of lymphohematopoietic cells and lymphoid tissues, and combinations of these various methods. We detail how strategies to induce tolerance through cell death have evolved toward being more selective and discriminating of the cell populations that are targeted for removal. This review has a particular focus on the recent preclinical research involving primates, which is yielding promising results. Also briefly reviewed are methods that attempt to induce tolerance via blockade of cellular function, rather than with overt cell killing.

ISSN:1087-2418    

出版商:OVID    

年代:1997

数据来源: OVID

ISSN:1087-2418    

出版商:OVID    

年代:1997

数据来源: OVID

摘要:

Induction therapy is a heterogeneous application of perioperative antibody therapy used in combination with a base immuno-suppressive regimen in solid-organ transplantation. Its use has been demonstrated to decrease the incidence of rejection, lengthen the time to a first rejection episode, decrease the incidence of early graft function, and improve short-term graft function. Whether the reduction in early graft loss due to decreased early rejection actually translates into an improvement in long-term graft survival and a relative state of hyporesponsiveness by the recipient toward the graft has been difficult to demonstrate clearly. The use of perioperative antibody therapy has been demonstrated to be particularly beneficial in high-risk groups such as children, blacks, sensitized and retransplant recipients, and those with early dysfunction. The use of antiviral agents concomitant with the induction therapy has decreased some of the disadvantages to its use. Although these agents are costly, some reports have noted that because of their advantages, antibody therapy may actually provide a cost advantage. “Humanized” chimeric antibodies have recently been demonstrated to have significantly fewer side effects. The use of induction therapy in solid organ transplantation will continue to be scrutinized, especially in the light of the availability of a host of newer, more efficacious base immunosuppressants.

ISSN:1087-2418    

出版商:OVID    

年代:1997

数据来源: OVID