1 苏州大学附属第一医院,江苏苏州,215006;
2 苏州大学附属第一医院心脏大血管外科,江苏苏州,215006;
摘要:心脏移植是各种疾病所导致的终末期心力衰竭患者的最佳治疗方法,供体器官严重短缺限制了其广泛应用。异种心脏异种移植有望解决心脏供体稀缺问题,但仍面临诸多挑战。近年来,基因编辑技术的发展和免疫抑制药的研发,为异种心脏移植的临床应用奠定新的基础。本文对异种心脏移植现状、面临问题及未来发展等方面进行综述,综合叙述了近年来异种移植仍存在的问题,为异种心脏移植的进一步研究及临床应用提供思考。
关键词:心脏异种移植;免疫抑制;转基因编辑
参考文献
[1]CALNE R Y, ALEXANDRE G P, MURRAY J E. A study of the effects of drugs in prolonging survival of homologous renal transplants in dogs [J]. Ann N Y Acad Sci, 1962, 99: 743-61.
[2]STARZL T E, MARCHIORO T L, PORTER K A, et al. The use of heterologous antilymphoid agents in canine renal and liver homotransplantation and in human renal homotransplantation [J]. Surg Gynecol Obstet, 1967, 124(2): 301-8.
[3]JOU S, MENDEZ S R, FEINMAN J, et al. Heart transplantation: advances in expanding the donor pool and xenotransplantation [J]. Nat Rev Cardiol, 2024, 21(1): 25-36.
[4]GRIFFITH B P, HARDESTY R L, DEEB G M,et al. Cardiac transplantation with cyclosporin A and prednisone [J].Ann Surg,1982,196(3):324-9.
[5]KINO T, HATANAKA H, MIYATA S, et al. FK-506, a novel immunosuppressant isolated from a Streptomyces. II. Immunosuppressive effect of FK-506 in vitro [J]. J Antibiot (Tokyo), 1987, 40(9): 1256-65.
[6]BYRNE G W, MCCURRY K R, MARTIN M J, et al. Transgenic pigs expressing human CD59 and decay-accelerating factor produce an intrinsic barrier to complement-mediated damage [J]. Transplantation, 1997, 63(1): 149-55.
[7]MOAZAMI N, STERN J M, KHALIL K, et al. Pig-to-human heart xenotransplantation in two recently deceased human recipients [J]. Nat Med, 2023, 29(8): 1989-97.
[8]ZHANG F, CONG L, LODATO S, et al. Efficient construction of sequence-specific TAL effectors for modulating mammalian transcription [J]. Nat Biotechnol, 2011, 29(2): 149-53.
[9]JINEK M, CHYLINSKI K, FONFARA I, et al. A programmable dual-RNA-guided DNA endonuclease in adaptive bacterial immunity [J]. Science, 2012, 337(6096): 816-21.
[10]ESTRADA J L, MARTENS G, LI P, et al. Evaluation of human and non-human primate antibody binding to pig cells lacking GGTA1/CMAH/β4GalNT2 genes [J]. Xenotransplantation, 2015, 22(3): 194-202.
[11]MOHIUDDIN M M, SINGH A K, CORCORAN P C, et al. Chimeric 2C10R4 anti-CD40 antibody therapy is critical for long-term survival of GTKO.hCD46.hTBM pig-to-primate cardiac xenograft [J]. Nat Commun, 2016, 7: 11138.
[12]LäNGIN M, MAYR T, REICHART B, et al. Consistent success in life-supporting porcine cardiac xenotransplantation [J]. Nature, 2018, 564(7736): 430-3.
[13]GRIFFITH B P, GOERLICH C E, SINGH A K, et al. Genetically Modified Porcine-to-Human Cardiac Xenotransplantation [J]. N Engl J Med, 2022, 387(1): 35-44.