Multiple pathways to allograft rejection.

Abstract:

:Allograft rejection results from a complex process involving both the innate and acquired immune systems. The innate immune system predominates in the early phase of the allogeneic response, during which chemokines and cell adhesion play essential roles, not only for leukocyte migration into the graft but also for facilitating dendritic and T-cell trafficking between lymph nodes and the transplant. This results in a specific and acquired alloimmune response mediated by T cells. Subsequently, T cells and cells from innate immune system function synergistically to reject the allograft through nonexclusive pathways, including contact-dependent T cell cytotoxicity, granulocyte activation by either Th1 or Th2 derived cytokines, NK cell activation, alloantibody production, and complement activation. Blockade of individual pathways generally does not prevent allograft rejection, and long-term allograft survival is achieved only after simultaneous blockade of several of them. In this review, we explore each of these pathways and discuss the experimental evidence highlighting their roles in allograft rejection.

journal_name

Transplantation

journal_title

Transplantation

authors

Le Moine A,Goldman M,Abramowicz D

doi

10.1097/00007890-200205150-00001

subject

Has Abstract

pub_date

2002-05-15 00:00:00

pages

1373-81

issue

9

eissn

0041-1337

issn

1534-6080

journal_volume

73

pub_type

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