Local complement synthesis-A process with near and far consequences for ischemia reperfusion injury and transplantation.
Local complement synthesis-A process with near and far consequences for ischemia reperfusion injury and transplantation.
复制标题
局部补体合成-对缺血再灌注损伤和移植具有近远影响的过程。
DOI：
10.1111/imr.13144
复制
发表时间：
2023
影响因子：
8.7
通讯作者：
Nauser CL
中科院分区：
文献类型：
--
作者：
Nauser CL
实体器官作为循环补体沉积在损伤部位的靶点的模型多年来掩盖了补体在器官移植中的更广泛影响。局部合成补体的研究，特别是在移植中的研究，为补体更广泛地参与缺血再灌注损伤、供体抗原呈递和最终排斥反应提供了新的视角。然而，缺乏明确性的是，涉及哪些补体激活途径以及它们是如何被触发的，最重要的是，这种区别是否相关。在移植中，由于对已经接受强效免疫抑制剂的患者寻求精确治疗，并且有机会进行适时干预，因此需要明确。本次审查将提出新的证据凝集素途径的新兴作用，权衡旁边的替代途径作为补体系统的放大器的作用，并对经典途径的贡献。希望这种理解将有助于辩论精确靶向与广泛作用的治疗创新，以实现安全的长期移植物接受。
The model of the solid organ as a target for circulating complement deposited at the site of injury, for many years concealed the broader influence of complement in organ transplantation. The study of locally synthesized complement especially in transplantation cast new light on complement's wider participation in ischaemia‐reperfusion injury, the presentation of donor antigen and finally rejection. The lack of clarity, however, has persisted as to which complement activation pathways are involved and how they are triggered, and above all whether the distinction is relevant. In transplantation, the need for clarity is heightened by the quest for precision therapies in patients who are already receiving potent immunosuppressives, and because of the opportunity for well‐timed intervention. This review will present new evidence for the emerging role of the lectin pathway, weighed alongside the longer established role of the alternative pathway as an amplifier of the complement system, and against contributions from the classical pathway. It is hoped this understanding will contribute to the debate on precisely targeted versus broadly acting therapeutic innovation within the aim to achieve safe long term graft acceptance.