Title
Multiple pathways to allograft rejection Multiple pathways to allograft rejection
Author
Faculty/Department
Faculty of Medicine and Health Sciences
Publication type
article
Publication
Philadelphia :Lippincott williams & wilkins ,
Subject
Human medicine
Source (journal)
Transplantation. - Baltimore, Md, 1963, currens
Volume/pages
73(2002) :9 , p. 1373-1381
ISSN
0041-1337
ISI
000175933100001
Carrier
E
Target language
English (eng)
Full text (Publishers DOI)
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.
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