Thaunat Olivier, Patey Natacha, Morelon Emmanuel, Michel Jean-Baptiste, Nicoletti Antonino
Université Pierre et Marie Curie-Paris 6, INSERM UMR S 681, Centre de recherche des Cordeliers, 15 rue de l'Ecole de Médecine, 75006 Paris, France.
Curr Opin Immunol. 2006 Oct;18(5):576-9. doi: 10.1016/j.coi.2006.07.006. Epub 2006 Aug 1.
Although chronic rejection is currently the main cause of long-term allograft failure, its pathogenesis remains elusive, hereby preventing the development of effective therapy. Recent advances in the comprehension of the pathophysiology of chronic inflammatory diseases could shed new light on the pathogenesis of chronic rejection. Lymphoid neogenesis is a mechanism responsible for the progressive organization of chronic inflammatory infiltrates into functional ectopic germinal centers, and has been evidenced recently in various pathological situations sharing a common feature: the failure of the immune response to eradicate the targeted antigen(s). Chronic rejection is such a situation as it results from a sustained alloimmune response against the donor's antigens that are constantly replenished by the grafted tissue. Accordingly, functional ectopic germinal centers develop within chronically rejected organs. This implies that, during chronic rejection, graft is at the same time the target and the site of elicitation of the alloimmune response.
尽管慢性排斥反应目前是长期同种异体移植失败的主要原因，但其发病机制仍不清楚，从而阻碍了有效治疗方法的开发。对慢性炎症性疾病病理生理学理解的最新进展可能为慢性排斥反应的发病机制提供新的线索。淋巴样新生是一种机制，负责将慢性炎症浸润逐渐组织成功能性异位生发中心，最近在各种具有共同特征的病理情况下得到了证实：免疫反应未能根除靶向抗原。慢性排斥反应就是这样一种情况，因为它是由针对供体抗原的持续同种异体免疫反应引起的，而移植组织会不断补充这些抗原。因此，在慢性排斥的器官内会形成功能性异位生发中心。这意味着，在慢性排斥反应期间，移植物同时是同种异体免疫反应的靶点和激发部位。
