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| DC 欄位 | 值 | 語言 |
|---|---|---|
| dc.contributor.advisor | 林明燦(Min-Tsan Lin),江伯倫(Bor-Luan Chiang),蔡孟昆(Meng-Kun Tsai) | |
| dc.contributor.author | Ya-Wen Yang | en |
| dc.contributor.author | 楊雅雯 | zh_TW |
| dc.date.accessioned | 2022-11-24T03:11:29Z | - |
| dc.date.available | 2022-02-15 | |
| dc.date.available | 2022-11-24T03:11:29Z | - |
| dc.date.copyright | 2022-02-15 | |
| dc.date.issued | 2022 | |
| dc.date.submitted | 2022-02-10 | |
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Identification of the mitochondrial targeting signal of the human equilibrative nucleoside transporter 1 (hENT1): implications for interspecies differences in mitochondrial toxicity of fialuridine. J Biol Chem. 2006;281(24):16700-6. 136. Wu X, Cai S, Li Z, Zheng C, Xue X, Zeng J, et al. Potential effects of telbivudine and entecavir on renal function: a systematic review and meta-analysis. Virol J. 2016;13:64. 137. Jiang L, Hu S, He M, Tian D. Estimated glomerular filtration rate increases in chronic hepatitis B patients treated with telbivudine monotherapy and combination treatment. Hepat Mon. 2016;16(1):e32528. | |
| dc.identifier.uri | http://tdr.lib.ntu.edu.tw/jspui/handle/123456789/80639 | - |
| dc.description.abstract | " B型肝炎帶原接受腎臟移植病患須終身服用免疫抑制劑, 因此增加肝細胞癌以及肝臟相關併發症的發生率。口服抗病毒藥物lamivudine已被證實具有短期的好處。我們想進一步了解長期服用lamivudine是否能降低肝細胞癌以及其他併發症發生率。我們分析了26名 B型肝炎帶原接受腎臟移植病患預防性服用lamivudine (Group 1) 以及28名因移植後B型肝炎復發接受治療性 lamivudine 的B型肝炎帶原接受腎臟移植病患 (Group 2), 以及43名過去接受腎臟移植之B型肝炎帶原病患未接受lamivudine 治療 (Group 3)。分析結果Group 1 病患無任何一名發生肝細胞癌或肝臟相關併發症, 在Group 2 和Group 3的10年肝細胞癌發生率分別為4.2 和 34 %。進一步分析發現10年的病患以及移植腎臟存活率在Group 1及Group 2皆明顯高於Group 3。然而, 肝臟相關併發症發生率在Group 2 和 Group 3皆明顯高於 Group 1。比較起Group 2病患, Group 1病患明顯降低lamivudine抗藥性突變的發生率。 腎臟安全性是B型肝炎帶原接受腎臟移植病患選擇抗病毒藥物的重要考量之一。我們設計執行了一個前瞻性隨機分配臨床試驗計畫,預計收案腎臟移植術後服用lamivudine超過六個月病患以 1:2方式隨機分配至持續使用 lamivudine 或改服用telbivudine 並追蹤觀察24 個月腎臟功能變化情形。然而此計畫卻因telbivudine組別高比例出現臨床肌肉痛而提早終止。進一步分析已收案的17名病患發現4名持續服用lamivudine在追蹤24個月後比起收案時有腎臟功能降低的情形, 而服用telbivudine病患在追蹤24個月後觀察到腎臟功能提升, 然而這樣的差別並未達到統計學上顯著差異。 B型肝炎帶原接受腎臟移植病患體內的細胞性免疫反應是複雜的而且跟預後息息相關。我們抽血B型肝炎帶原末期腎病病患 (Group A), B型肝炎帶原接受腎臟移植病患同時服用免疫抑制劑與抗病毒藥物 (Group B) 以及病患服用免疫抑制劑卻無服用抗病毒藥物 (Group C), 定量B型肝炎專一性CD8+ T 細胞, 發現Groups B 和 Group C有較高的細胞型免疫反應 (較低的控制型T (Treg)/CD8+ T 細胞比值) 。由於Group B病患同時服用抗排斥藥物與抗病毒藥物測不出病毒量, 病患體內的CD8+ T 細胞與B型肝炎專一性CD8+ T 細胞數量和Groups A 相近。 Group C 病患因無服用抗病毒藥物因此體內能偵測到上升的病毒含量, 也因此有較高的 B型肝炎專一性CD8+ T 細胞以及IFN-γ分泌。 B型肝炎帶原接受腎臟移植病患須終身服用免疫抑制劑與抗病毒藥物, 因B型肝炎專一性CD8+ T 細胞功能失調, 體內會有較多的病毒複製。也因為B型肝炎帶原接受腎臟移植病患因體內有較高的細胞型免疫反應因此容易在病毒複製時造成較大的肝臟損傷及病變, 我們希望未來能更透徹研究出相關機轉及可能的臨床應用。" | zh_TW |
| dc.description.provenance | Made available in DSpace on 2022-11-24T03:11:29Z (GMT). No. of bitstreams: 1 U0001-0802202213033200.pdf: 3212477 bytes, checksum: 9d8396766a4bdfe761da3ca70d9507f9 (MD5) Previous issue date: 2022 | en |
| dc.description.tableofcontents | Table of Contents 口試委員會審定書…………………………………………………………… i 誌謝…………………………………………………………………………... ii 中文摘要 iiii Abstract v Table of Contents viii List of Tables x List of Figures xi Chapter 1 : Introductions 1 1.1 Incidence of HBV infection worldwide: 1 1.2 Incidence of HBV infection in ESRD patients: 1 1.3 Nucleoside analogue (NA) utility in HBsAg renal allograft recipients: 4 1.4 Prognosis of HBsAg positive renal allograft recipients: 2 1.5 Nucleoside analogue (NA) utility in HBsAg renal allograft recipients: 5 1.6 Dynamic changes of cellular immunity in HBsAg-positive renal allograft recipients under the complex interaction of immunosuppressive agents and nucleoside analogues: 6 1.6.1 CD8+ T-cell and HBV specific CD8+ T-cell responsiveness during HBV infection: 4 1.6.2 Negative signals of hepatitis B infection: 5 1.6.3 Regulatory T cells during HBV infection: 5 1.6.4 Programmed death 1 (PD-1) expression during HBV infection: 6 Chapter 2 : Motivations 8 Chapter 3 : Results 10 3.1 Long-term effects of prophylactic and therapeutic lamivudine treatments in hepatitis B surface antigen-positive renal allograft recipients 10 3.1.1 Rationale and approach: 10 3.1.2 Materials and Methods: 10 3.1.3 Results: 12 3.2 Telbivudine for renal transplant recipients with chronic hepatitis B infection: a randomized controlled trial with early termination 19 3.2.1 Rationale and approach: 19 3.2.2 Materials and Methods: 20 3.2.3 Results: 25 3.3 Dynamics of cellular immune responses in recipients of renal allografts positive for hepatitis B surface antigen 31 3.3.1 Rationale and approach: 31 3.3.2 Materials and Methods: 32 3.3.3 Results: 35 Chapter 4 : Discussions 45 Chapter 5 : Summary 59 References 61 Appendix 74 | |
| dc.language.iso | en | |
| dc.subject | 細胞型免疫 | zh_TW |
| dc.subject | B型肝炎病毒 | zh_TW |
| dc.subject | 腎臟移植 | zh_TW |
| dc.subject | 肝細胞癌 | zh_TW |
| dc.subject | Telbivudine | zh_TW |
| dc.subject | renal transplant | en |
| dc.subject | Hepatitis B virus (HBV) | en |
| dc.subject | cellular immunity | en |
| dc.subject | Telbivudine | en |
| dc.subject | hepatocellular carcinoma | en |
| dc.title | B型肝炎帶原接受腎臟移植病患接受免疫抑制劑與抗病毒藥物體內細胞性免疫之動態變化 | zh_TW |
| dc.title | Dynamic changes of cellular immunity in HBsAg-positive renal allograft recipients under immunosuppressive agents and nucleoside analogues | en |
| dc.date.schoolyear | 110-1 | |
| dc.description.degree | 博士 | |
| dc.contributor.oralexamcommittee | 高嘉宏(Erh-Min Lai),黃冠棠(Shih-Shun Lin),陳登偉(Nai-Chun Lin),(Shu-Yi Yang) | |
| dc.subject.keyword | B型肝炎病毒,腎臟移植,肝細胞癌,Telbivudine,細胞型免疫, | zh_TW |
| dc.subject.keyword | Hepatitis B virus (HBV),renal transplant,hepatocellular carcinoma,Telbivudine,cellular immunity, | en |
| dc.relation.page | 75 | |
| dc.identifier.doi | 10.6342/NTU202200370 | |
| dc.rights.note | 同意授權(限校園內公開) | |
| dc.date.accepted | 2022-02-10 | |
| dc.contributor.author-college | 醫學院 | zh_TW |
| dc.contributor.author-dept | 臨床醫學研究所 | zh_TW |
| 顯示於系所單位： | 臨床醫學研究所 | |
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