Ebook Kidney transplantation (6/E): Part 2
➤ Gửi thông báo lỗi ⚠️ Báo cáo tài liệu vi phạmNội dung chi tiết: Ebook Kidney transplantation (6/E): Part 2
Ebook Kidney transplantation (6/E): Part 2
Chapter 23___________________________________________________Approaches to the Induction of ToleranceSatish N. Nadig • Gregor Warnecke • Kathryn J. Wo Ebook Kidney transplantation (6/E): Part 2oodHistorical Peri|XKtiv«Definition of ToleranceNeed for Tolerance in Clinkal TransplantationUnderstanding the Immunological Mechanisms behind Tolerance InductionOverview of T Cell ActivationMechanisms of Tolerance to Donor AntigensMetbocbcgy of Tolerance induction andMaintenanceInformation from Ana Ebook Kidney transplantation (6/E): Part 2lyzing Tolerant RecipientsCurrent Strategies Used to Induce Immunological Tolerance to an AllograftMixed ChimerismCostimulatcn Blocs-xwTargeting CD3 aEbook Kidney transplantation (6/E): Part 2
nd Accessory MoleculesLeukocyte Depletion at the Time ofTransplantationEffect of Immunosuppression on Tolerance InductionHISTORICAL PERSPECTIVEIn 1951Chapter 23___________________________________________________Approaches to the Induction of ToleranceSatish N. Nadig • Gregor Warnecke • Kathryn J. Wo Ebook Kidney transplantation (6/E): Part 2gy. In it, Billingham and Mcdawar provided the foundation for what would become the field of transplant immunology. Classic experimental observations, which included a noticeable acceleration in rejection responses after transplanting a second full-thickness allogeneic skin graft harvested from the Ebook Kidney transplantation (6/E): Part 2same donor as the initial graft, set the standard for what eventually would become the groundwork for immunological memory.1*"* Further work that wasEbook Kidney transplantation (6/E): Part 2
based on earlier writings of Owen”7 involved skin grafting dizygotic mammalian twin calves. The observations that these grafts are accepted by both hoChapter 23___________________________________________________Approaches to the Induction of ToleranceSatish N. Nadig • Gregor Warnecke • Kathryn J. Wo Ebook Kidney transplantation (6/E): Part 2o placental fusion.111These breakthroughs in research translated to the clinicin 1954, when Murray and colleagues performed the first successful kidney transplant between monozygotic twins at the Peter Bent Brigham Hospital in Boston, Massachusetts. The success of this operation was partly due to th Ebook Kidney transplantation (6/E): Part 2e lack of immunosuppression needed in the transplant of monozygotic twins.Allografts that were subsequently attempted failed initially because of uncoEbook Kidney transplantation (6/E): Part 2
ntrolled acute rejection responses. The quest to identify1 methods of immunosuppression and tolerance induction in transplantation began.1*-' The impaChapter 23___________________________________________________Approaches to the Induction of ToleranceSatish N. Nadig • Gregor Warnecke • Kathryn J. Wo Ebook Kidney transplantation (6/E): Part 2 the world.DEFINITION OF TOLERANCEGenerally, the concept of tolerance (operational) refers to the persistent survival of a transplanted allograft in the absence of continuing immunosuppressive therapy and an ongoing destructive immune response targeting the graft. The functional and nonspecific natu Ebook Kidney transplantation (6/E): Part 2re of this definition may be appropriate in that multiple immunological mechanisms and donor-recipient conditions arc required to induce and maintainEbook Kidney transplantation (6/E): Part 2
tolerance to a defined set of donor antigens in vivo. Achieving functional tolerance in transplant recipients mandates that specific allograft-destrucChapter 23___________________________________________________Approaches to the Induction of ToleranceSatish N. Nadig • Gregor Warnecke • Kathryn J. Wo Ebook Kidney transplantation (6/E): Part 2on tolerance hits to be donor-specific, as opposed to mere immunoincompctcncc, a requirement that can be tested experimentally by grafting third-party transplants and by challenging tolerant recipients to respond to virus infections and tumor loads. The concept of graftspecific tolerance is essentia Ebook Kidney transplantation (6/E): Part 2l to maintain long-term survival of the graft and host and to eliminate the adverse events associated with lifelong nonspecific immunosuppression.23NEEbook Kidney transplantation (6/E): Part 2
ED FOR TOLERANCE IN CLINICAL TRANSPLANTATIONThe human immune system broadly comprises a balance between the innate and adaptive responses.’*1"'2 FirstChapter 23___________________________________________________Approaches to the Induction of ToleranceSatish N. Nadig • Gregor Warnecke • Kathryn J. Wo Ebook Kidney transplantation (6/E): Part 2 and clear the body from potential harm. The key difference between the two pathways relies on antigen specificity, that is. the innate response neither IS specific nor is altered with multiple antigenic challenges; however, the adaptive response is specific for a particular antigen and “remembers" Ebook Kidney transplantation (6/E): Part 2the infectious agent on each successive insult. The adaptive response improves with each encounter of a particular foreign agent. When the immune systEbook Kidney transplantation (6/E): Part 2
em encounters an antigen, it has to decide which type of response to make. Multiple factors arc taken into account in making this decision,361Table 23Chapter 23___________________________________________________Approaches to the Induction of ToleranceSatish N. Nadig • Gregor Warnecke • Kathryn J. WoChapter 23___________________________________________________Approaches to the Induction of ToleranceSatish N. Nadig • Gregor Warnecke • Kathryn J. WoGọi ngay
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