New insights into the development of B cell responses: Implications for solid organ transplantation.
New insights into the development of B cell responses: Implications for solid organ transplantation.
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DOI：
10.1016/j.humimm.2018.09.003
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发表时间：
2019-06
期刊：
影响因子：
2.7
通讯作者：
Chong AS
中科院分区：
文献类型：
--
作者：
Chong AS
对实体器官移植后B细胞作用的重新关注是由表明抗体介导的排斥（AMR）是功能障碍和器官移植失败的主要原因的临床数据驱动的。这些观察结果表明，在一部分患者中，目前的免疫疗法未能控制同种抗体反应的发展，或未能逆转同种抗体的产生或作用。供体特异性抗体（DSA）的定量已被证明是AMR的不完美预测因子，改善DSA定量的努力预计这将提高预测能力。同时，控制ABMR的尝试集中在B细胞、浆细胞（PC）或循环抗体的非特异性消除上。在过去的十年中，我们对B细胞分化为生发中心（GC）依赖性或GC非依赖性记忆B细胞和抗体分泌PC的过程的理解有所提高。这些见解提出了更具体地靶向DSA反应的新方法，这可能导致更好的长期同种异体移植物存活结果，同时保留保护性免疫。在这篇综述中，新的见解，导致抗体生产的过程中，初级和二级抗原的遭遇进行了讨论，DSA生产和未来的调查领域，以控制AMR的潜在影响进行了讨论。
A resurgent interest in the role of B cells following solid organ transplantation is being driven by clinical data suggesting that antibody mediated rejection (AMR) is a major cause of dysfunction and organ transplant failure. These observations suggest that, in a subset of patients, current immunotherapies are failing to control the development of alloantibody responses, or failing to reverse the production or the effects of alloantibodies. Quantification of donor-specific antibodies (DSA) has proven to be an imperfect predictor of AMR, and efforts to improve DSA quantification anticipate that this will result in improved predictive power. At the same time, attempts to control of ABMR have focused on the non-specific elimination of B cells, plasma cells (PCs) or circulating antibodies. In the past decade, there has been an improvement in our understanding of the processes that drive B cell differentiation into germinal center (GC)-dependent or GC-independent memory B cells and antibody-secreting PC. These insights are suggesting new ways to more specifically target the DSA response, which may lead to better long-term allograft survival outcomes while preserving protective immunity. In this review, new insights into processes that lead to antibody production upon primary and secondary antigen encounter are discussed, and the potential implications to DSA production and future areas of investigation to control AMR are discussed.
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