单克隆免疫球蛋白病机体免疫微环境研究进展  

Immune microenvironment of monoclonal gammopathy

作　　者：徐维玮(综述) 黄湘华(审校) XU Weiwei;HUANG Xianghua(National Clinical Research Center for Kidney Diseases,Jinling Hospital,Nanjing 210016,China)

机构地区：[1]东部战区总医院国家肾脏疾病临床医学研究中心,南京210016

出　　处：《肾脏病与透析肾移植杂志》2024年第1期47-53,共7页Chinese Journal of Nephrology,Dialysis & Transplantation

基　　金：国家自然科学基金面上项目(82270767)。

摘　　要：单克隆免疫球蛋白疾病以克隆性浆细胞的增殖和单克隆免疫球蛋白的产生为特点,包括系统性轻链型淀粉样变性、多发性骨髓瘤、具有肾脏意义的单克隆免疫球蛋白病及这类疾病前期的意义未明的单克隆免疫球蛋白病等。这类疾病多累及肾脏。免疫微环境在单克隆免疫球蛋白病发病调控环节中发挥着重要作用。免疫细胞如T细胞、B细胞、单核巨噬细胞、自然杀伤细胞、树突状细胞及骨髓来源的抑制细胞等,与克隆性浆细胞之间存在着密切的相互作用,调节克隆性浆细胞的清除、免疫微环境与变异浆细胞的动态平衡及最终克隆性浆细胞的免疫逃逸,进而调控疾病进程。本文对单克隆免疫球蛋白病的机体免疫微环境调控机制及已有的治疗靶点进行总结,以助力探索这类疾病未来诊治的新方向。Monoclonal gammopathy is a group of diseases characterized as clonal plasma cell proliferation and monoclonal immunoglobin secretion.This kind of diseases include systemic light chain amyloidosis,multiple myeloma,monoclonal gammopathy of renal significance and monoclonal gammopathy of undetermined significance which was considered as the previous stage of these diseases.Kidney is frequently involved in these diseases.Immune microenvironment plays an important role in the emergence and progression of these diseases.Immune cells such as T cells,B cells,monocytes and macrophages,natural killer cells,dendritic cells and myeloid⁃derived suppressor cells interact with clonal plasma cells,thereby regulate the clearance of these plasma cells,maintain the balance of immune microenvironment and plasma cells,and the immune evasion of clonal plasma cells.We are going to review the immune microenvironment and the therapies targeted the immune system in monoclonal gammopathy.

关 键 词：单克隆免疫球蛋白病 系统性轻链型淀粉样变性 多发性骨髓瘤 免疫微环境 治疗 

分 类 号：R392[医药卫生—免疫学]