Immune response and histology of humoral rejection in kidney transplantation
Immune response and histology of humoral rejection in kidney transplantation
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DOI：
10.1016/j.nefro.2016.03.023
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发表时间：
2016-08-01
期刊：
影响因子：
--
通讯作者：
Hernandez, Domingo
中科院分区：
文献类型：
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作者：
González-Molina, Miguel;Ruiz-Esteban, Pedro;Hernandez, Domingo
适应性免疫反应是同种异体移植排斥反应的基础。它的武器是直接的细胞毒性，从器官移植开始就确定了，和/或抗体，仅限于预先形成的抗体的超急性排斥反应，而不是同种异体反应。这导致几十年来异体反应被认为只是细胞起源。但是，Gorer的实验研究表明，由于B淋巴细胞分泌的抗体对多态分子激活，同种异体移植物的组织损伤被忽视了。内皮细胞膜的抗体和抗原之间结合和解结合的特殊共存是证明体液异体反应延迟的原因。内皮细胞是抗体的靶组织，具有高周转率，抗原-抗体结合是非共价的。如果内皮细胞受到体液反应的攻击，免疫球蛋白通过脱落和/或内化迅速从其表面清除，并通过MCP、DAF和CD59的作用降解补体系统的成分。因此，补体蛋白在内皮细胞膜中的存在是短暂的。事实上，直到C4d补体片段沉积被鉴定出来，抗体介导的急性排斥反应才被证实，C4d补体片段沉积是唯一与内皮细胞共价结合的成分。本文综述了体液免疫反应与移植器官活检显示的急性和慢性组织学病变类型之间的关系。(C) 2016西班牙神经病学学会。这是一篇基于CC by-nc-nd许可（http://creativecommons.org/licenses/by-nc-nd/4.0/）的开放获取文章。
The adaptive immune response forms the basis of allograft rejection. Its weapons are direct cellular cytotoxicity, identified from the beginning of organ transplantation, and/or antibodies, limited to hyperacute rejection by preformed antibodies and not as an allogenic response. This resulted in allogenic response being thought for decades to have just a cellular origin. But the experimental studies by Gorer demonstrating tissue damage in allografts due to antibodies secreted by B lymphocytes activated against polymorphic molecules were disregarded.The special coexistence of binding and unbinding between antibodies and antigens of the endothelial cell membranes has been the cause of the delay in demonstrating the humoral allogenic response. The endothelium, the target tissue of antibodies, has a high turnover, and antigen-antibody binding is non-covalent. If endothelial cells are attacked by the humoral response, immunoglobulins are rapidly removed from their surface by shedding and/or internalization, as well as degrading the components of the complement system by the action of MCP, DAF and CD59. Thus, the presence of complement proteins in the membrane of endothelial cells is transient. In fact, the acute form of antibody-mediated rejection was not demonstrated until C4d complement fragment deposition was identified, which is the only component that binds covalently to endothelial cells.This review examines the relationship between humoral immune response and the types of acute and chronic histological lesion shown on biopsy of the transplanted organ. (C) 2016 Sociedad Espanola de Nefrologia. Published by Elsevier Espana, S.L.U. This is an open access article under the CC BY-NC-ND license (http://creativecommons.org/licenses/by-nc-nd/4.0/).