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Dendritic cells and graft versus host disease
(4) :429-33 .15 va-IntematiM, Wangz, XueY. eta1. EurJImmunol-2001,[link widoczny dla zalogowanych], 31 ( :2277-83 .16 $ taokYammahitaN, YamaahitaN, eta1. Immunity. 2003.18 (3) :367-79. Glucocorticoids in renal transplantation Review of Peter Wong Li Qiansheng wide revision 17MuffsT. VentijkR. SchramaE, etILBlood. 1999.93 (7) :2336-41 .18 VanLochemE. v8nderKeurM. MommanaAM, eta1. TratmplImmunol, 1996.4 (2) :151-7 .19 FujiiS, ShimizukFujimeloK. eta1.1zukLymphom. 2001,[link widoczny dla zalogowanych],42 (3) :357-69. Abstract Glucocorticoids have powerful and efficient anti-inflammatory and immunosuppressive effects. Has been the prevention and treatment of renal transplant rejection a key drug. However, glucocorticoids also have significant side effects, this article on kidney transplantation in the reasonable application are reviewed. Keywords Glucocorticoid a kidney transplant immune response of glucocorticoids in renal transplantation in the role and significance of glucocorticoid (hereinafter referred to as the hormone) was the first use of prevention and treatment of renal transplant rejection drugs. 2O years from the twentieth century to the 8O's, immunosuppressants used in renal transplantation has made great progress, but the hormone is not as essential medicines has been replaced】 【l. Increased cytoplasmic glucocorticoid signaling proteins IkB gene transcription, thereby affecting the cytoplasmic transcription factor NF-kB,[link widoczny dla zalogowanych], the final stop the production of multiple cytokines [21, such as a 2 block a few T lymphocytes, macrophages,[link widoczny dla zalogowanych], IL- 1 and IL-6 secretion; the same time by blocking ca carriers and other cells of the role of monocytes, inhibition of monocyte inflammatory zone to move, inhibition of chemokines, promoting infiltration of cytokine production and the synthesis and vasodilator release, which play a strong anti-inflammatory and suppress the entire immune system. 2 applications of glucocorticoid corticosteroids in renal transplantation is still being widely used, there are two commonly used programs. ① azathioprine (Aza) 100rag once a day for a total of two days, patients used methylprednisolone (MP) 1000rag infusion; patients with cyclosporine A (CsA), Aza and steroid (to plug the early stage Musson, third postoperative day, switching from prednisone) and triple immunosuppressive therapy. ② Aza200rag day before surgery, oral surgery to MP1000rag infusion, postoperative day Author: 400042 Chongqing. Institute of Field Surgery, Third Military Medical University transplant centers to be MPS00mg intravenous infusion of dialysis, three days later changed to oral preparations. The maximum oral dose of prednisone for the first month 2Omg,[link widoczny dla zalogowanych], the first three months as l5mg. A year later all patients can be changed every 13 medication. At present, many tend to use the second solution, because the conventional three days after high-dose intravenous infusion of MP helps to reduce the occurrence of early rejection. Anti-inflammatory and immunosuppressive effects of hormones are widely and rapidly, due to the complexity of rejection, hormone therapy is immunosuppression can not be completely replaced. After the application of the side effects of hormones such as muscle atrophy, moon face, electrolyte imbalance, hyperglycemia, and osteoporosis, are generally short-term higher dose applications will not occur, so in many acute and intensive treatment is still widely used, in the prevention of rejection after renal transplantation still play an important role. Different types of hormone treatment effects are different. Of methylprednisolone, dexamethasone, and prednisone for lymphocyte inhibition assay, observed suppression of the sensitivity of lymphocytes and found that the most obvious inhibition of lymphocyte MP, prednisone worst】. Rejection after renal transplantation should choose to use hormone sensitive, so as not to influence the treatment effect due to drug resistance, and the delay in the treatment of acute rejection. Occurrence of acute rejection in renal transplantation by steroid pulse therapy failed to control or non-recurrence of repeated rejection by the impact of treatment, so as not to cause a serious infection difficult to control. Only a few patients in clinical anti-hormone that acute rejection, this time can be monoclonal or polyclonal lymphocyte antibodies to treat intravenous drug use; for the humoral immune-based accelerated vascular rejection, plasma exchange and cooperate with appropriate immunosuppressive therapy has a certain effect, replacement fluid gel to complement the white
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