肝细胞移植免疫排斥反应的研究与应用  

Studies and applications of immunological rejection after hepatocyte transplantation

作　　者：蔡鸿宇[1] 陈钟[1] 

机构地区：[1]南通大学附属医院普外科南通大学肝胆外科研究所,江苏省南通市226001

出　　处：《中国组织工程研究与临床康复》2007年第47期9538-9542,共5页Journal of Clinical Rehabilitative Tissue Engineering Research

基　　金：江苏省自然科学基金(BK200544);南通大学创新基金(CX0301)~~

摘　　要：学术背景:肝细胞移植有望成为治疗急慢性肝衰竭及肝脏相关遗传性疾病的一种新方法。近年来肝细胞移植研究取得了重大进展,但免疫排斥反应仍是制约该技术进一步发展的主要原因之一。目的:综合分析肝细胞移植后免疫排斥反应的研究进展。检索策略:由两位作者应用计算机检索中国知网(www.cnki.net)及Medline(www.pumed.com)1998-01/2007-06有关肝细胞移植免疫排斥反应的文献,中文检索词"肝细胞,移植,排斥";英文检索词"hepatocyte,transplan tation,rejection"。初检得到281篇文献,包括中文109篇,英文172篇。排除研究目的与肝细胞移植免疫排斥反应无关者72篇,内容重复性的文献41篇,保留168篇中英文文献进一步分析。其中动物实验和细胞学实验103篇,综述类文献28篇,临床研究37篇。按纳入标准筛选,共37篇文献满足全部纳入标准。凡同种或异种肝细胞培养、移植及生物人工肝研究中与免疫排斥反应相关的文献均纳入文献综述范围,与此无关者均排除。不采用未发表的文献。文献评价:所有文献均为随机对照试验。资料综合:肝细胞移植免疫排斥反应是影响肝细胞移植效果的重要因素。随着细胞生物学、移植免疫学的发展,肝细胞移植免疫排斥反应的机制将会进一步得到阐明。各种抑制免疫排斥的手段,尤其基因工程技术、纳米材料的应用有可能在肝细胞移植后抗原的识别、活化和发生效应的环节中以及抑制移植细胞的凋亡方面起到一定的作用。结论:肝细胞移植目前面临的主要问题是移植后的免疫排斥反应,其具体机制仍有待于进一步阐明。现阶段采取的抑制肝细胞移植后免疫排斥的方法均有一定的局限性,更有效的方法有待于继续探索。BACKGROUND： Hepatocyte transplantation has a possibility to become a new method to treat the acute or chronic hepatic failure and the hereditary diseases. In recent years, it has made a great progress in hepatocyte transplantation, but the immunologic rejection is still one of the key barriers in the process. OBJECTIVE： To review the progress of immunologic rejection after hepatocyte transplantation. RETRIEVE STRATEGY： The www.cnki.net and Medline www.pumed.com were searched for the related articles dated from January 1998 to June 2007 with the keywords of ＂hepatocyte, transplantation, rejection＂ in Chinese and English, respectively. 281 articles were collected including 109 in Chinese and 172 in English. Seventy-two articles that were independence to the objective and 41 repetitive articles were excluded. The rest 168 articles including 103 animal and cytology experimental studies, 28 review articles and 37 clinical researches were analyzed in detail. According to the inclusive criteria, 37 articles were included. Only the literatures associated with immunologic rejection in heptocyte transplantation and biological artificial liver system were accepted. And those not published were not included. LITERATURE EVALUATION： All of the literatures were randomized controlled trails. DATA SYNTHESIS： Immunologic rejection after hepatocyte transplantation is an important factor for the transplantation effect. With the development of cell biology and transplantation immunology, the mechanism of immunologic rejection after hepatocyte transplantation will be revealed. Various approaches that could inhibit immunologic rejection, especially the application of gene engineering technique and nanometer materials could play roles in the identification, activation and occurrence of antigen and inhibition of apoptosis. CONCLUSION： The immunological rejection is one of the key issues in hepatocyte transplantation, the specific mechanism of which is still not very clear. At present stage, all the methods adopted

关 键 词：细胞移植 肝 细胞学 移植物排斥 

分 类 号：R617[医药卫生—外科学]