Efficacy of Allogenic Cultured Keratinocyte Grafts for Burn Wounds

摘要

This proposal investigated the potential efficacy of cultured keratinocyteallografts for victims of massive burn wounds. The results of sequential studies have shown that cultured keratinocyte (CK) allografts do induce some immune responsiveness, but not the equivalent of full thickness skin allografts. This immune responsiveness is considerably decreased in recipients who have been burned, and this decrease is relative to bum size. Studies of the mechanism of this effect have demonstrated that burn injury decreases the immunogenicity of cultured keratinocyte allografts by down-regulating the antigen expression of donor cells, as well as impairing alloantigen processing and effector cell function of the recipients. Additional findings from this research have noted that the passenger fibroblasts that persist in cultured keratinocyte grafts can also contribute to the immune responsiveness to CK grafts and should be eliminated if possible. Although CK allografts are not totally devoid of the capacity to prime animals for rejection, the impaired sensitization in burn victims suggests that this approach may indeed be useful with additional investigation and continued improvement in techniques.