| Project/Area Number |
17K16502
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| Research Category |
Grant-in-Aid for Young Scientists (B)
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| Allocation Type | Multi-year Fund |
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| Research Field |
General surgery
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| Research Institution | Tohoku University |
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Principal Investigator |
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| Project Period (FY) |
2017-04-01 – 2020-03-31
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| Project Status |
Completed (Fiscal Year 2019)
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| Budget Amount *help |
¥4,030,000 (Direct Cost: ¥3,100,000、Indirect Cost: ¥930,000)
Fiscal Year 2019: ¥1,040,000 (Direct Cost: ¥800,000、Indirect Cost: ¥240,000)
Fiscal Year 2018: ¥1,430,000 (Direct Cost: ¥1,100,000、Indirect Cost: ¥330,000)
Fiscal Year 2017: ¥1,560,000 (Direct Cost: ¥1,200,000、Indirect Cost: ¥360,000)
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| Keywords | 免疫抑制療法 / 臓器移植 / ドナー特異的抗HLA抗体 / 補体結合性抗体 / 肝線維化 / 肝移植後抗HLA抗体 / 抗HLA抗体 / 補体結合性 / IgGサブクラス / 小児肝移植 / 慢性拒絶反応 |
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| Outline of Final Research Achievements |
In the present study, we found that (1) the minimization or withdrawal of immunosuppressive treatment was an independent risk factor for donor-specific anti-HLA antibody development, (2) subgroup analyses for patients with anti-DQ anbitodies showed that low-trough level of calcineurin inhibitor was an independent risk factor for anti-class II DSA development, (3) most of anti-DR antibodies and all anti-C/DP antibodies detected in our cohort did not have complement-binding capacity, whereas most of anti-DQ antibodies had complement-binding capacity, (4) complement-binding capacity was strongly associated with mean fluorescence intensity, and (5) the complement-binding assay did not strengthen the predictive power of donor-specific antibodies for graft fibrosis in liver transplantation.
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| Academic Significance and Societal Importance of the Research Achievements |
免疫抑制療法とドナー特異的抗HLA抗体との関連、さらにはドナー特異的抗HLA抗体と肝移植後における臨床経過との関連を示す結果が得られたことで、免疫学的に寛容と考えられている肝移植においても、免疫抑制療法の至適化が重要であると考えられた。また、その免疫抑制療法の至適化を行う上で、血液検査で評価可能なドナー特異的抗HLA抗体は簡便で有用な指標となり得ることが示され、肝移植患者の安定した長期臓器機能維持を目的とした免疫抑制療法の調整に寄与する研究成果であると考えている。
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