PDF(Pubmed)
Abstract：
Balancing the immune response after solid organ transplantation (SOT) and vascularized composite allotransplantation (VCA) remains an ongoing clinical challenge. While immunosuppressants can effectively reduce acute rejection rates following transplant surgery, some patients still experience recurrent acute rejection episodes, which in turn may progress to chronic rejection. Furthermore, these immunosuppressive regimens are associated with an increased risk of malignancies and metabolic disorders. Despite significant advancements in the field, these IS related side effects persist as clinical hurdles, emphasizing the need for innovative therapeutic strategies to improve transplant survival and longevity. Cellular therapy, a novel therapeutic approach, has emerged as a potential pathway to promote immune tolerance while minimizing systemic side-effects of standard IS regiments. Various cell types, including chimeric antigen receptor T cells (CAR-T), mesenchymal stromal cells (MSCs), regulatory myeloid cells (RMCs) and regulatory T cells (Tregs), offer unique immunomodulatory properties that may help achieve improved outcomes in transplant patients. This review aims to elucidate the role of cellular therapies, particularly MSCs, T cells, Tregs, RMCs, macrophages, and dendritic cells in SOT and VCA. We explore the immunological features of each cell type, their capacity for immune regulation, and the prospective advantages and obstacles linked to their application in transplant patients. An in-depth outline of the current state of the technology may help SOT and VCA providers refine their perioperative treatment strategies while laying the foundation for further trials that investigate cellular therapeutics in transplantation surgery.
摘要：
在实体器官移植（SOT）和血管化复合同种异体移植（VCA）后平衡免疫应答仍然是一个持续的临床挑战。虽然免疫抑制剂可以有效降低移植手术后的急性排斥反应率，一些患者仍然经历反复的急性排斥反应发作，这反过来可能会发展为慢性排斥反应。此外，这些免疫抑制方案与恶性肿瘤和代谢紊乱的风险增加相关.尽管在该领域取得了重大进展，这些相关的副作用仍然是临床障碍，强调需要创新的治疗策略来提高移植的存活率和寿命。细胞疗法,一种新的治疗方法，已成为促进免疫耐受的潜在途径，同时将标准IS方案的全身副作用降至最低。各种细胞类型，包括嵌合抗原受体T细胞（CAR-T），间充质基质细胞（MSCs），调节性骨髓细胞（RMC）和调节性T细胞（Tregs），提供独特的免疫调节特性，可能有助于改善移植患者的预后。这篇综述旨在阐明细胞疗法的作用，特别是MSC，T细胞,Tregs,RMC,巨噬细胞，SOT和VCA中的树突状细胞。我们探索每种细胞类型的免疫学特征，他们的免疫调节能力，以及它们在移植患者中应用的潜在优势和障碍。该技术的当前状态的深入概述可能有助于SOT和VCA提供者完善其围手术期治疗策略，同时为研究移植手术中的细胞疗法的进一步试验奠定基础。
