年龄相关性黄斑变性替代治疗中移植排斥的综述

摘要

年龄相关性黄斑变性（ AMD）是世界老年人群致盲的主要原因，分为非新生血管性（干性）及新生血管性（湿性） AMD两类。疾病的主要病理改变为视网膜色素上皮（ RPE）细胞的功能障碍及丢失。随着近年来再生医学的发展，RPE细胞替代疗法成为了AMD疾病治疗的新思路，多项临床研究中取得了显著的疗效。但是，疗效的背后仍隐藏着许多至今未能解决的问题与挑战，其中之一是与移植相关的免疫排斥。本文介绍了生理情况下以及AMD发病过程中的视网膜下腔免疫环境，重点探讨了机体对同种异体RPE的免疫应答，以及应对该免疫排斥的多种策略。%•Age -related macular degeneration ( AMD ) is the leading cause of blindness among the elderly worldwide. AMD is classified as either neovascular ( wet ) or non-neovascular ( dry ) .The dysfunction and loss of retinal pigment epithelial ( RPE ) cells is regarded as the main pathological changes of AMD.The recent development of regenerative medicine has witnessed RPE cell -replacement therapy as a new approach to treat AMD, resulting in obvious visual improvement in various studies. However, there are still many problems and challenges that remain unsolved, including graft rejection. This review introduces subretinal immune environment under both normal and AMD condition, putting emphasis on immune response to allogeneic RPE. Lastly, strategies to prevent graft rejection are discussed.