Wasowska Barbara A, Lee Chih-Yuan, Halushka Marc K, Baldwin William M
The Department of Pathology, Ross Research Building, Room 659, The Johns Hopkins University School of Medicine, 720 Rutland Avenue, Baltimore, MD 21205-2196, USA.
Cell Immunol. 2007 Jul;248(1):18-30. doi: 10.1016/j.cellimm.2007.04.009. Epub 2007 Oct 24.
In transplantation, activation of complement has largely been equated to antibody-mediated rejection, but complement is also important in recognition of apoptotic and necrotic cells as well as in modifying antigen presentation to T cells and B cells. As a part of the innate immune system, complement is one of the first responses to injury, and it can determine the direction and magnitude of the subsequent responses. Consequently, the effects of complement in allorecognition and graft rejection are increased when organs are procured from cadaver donors because these organs sustain a series of stresses from brain death, prolonged life support, ischemia and finally reperfusion that initiate proinflammatory processes and tissue injury. In addition, these organs are transplanted to patients, who frequently have been sensitized to histocompatibility antigens as the result of transfusions, pregnancies or transplants. Complement activation generates a series of biologically active effector molecules that can modulate graft rejection by directly binding to the graft or by modifying the response of macrophages, T and B cells of the recipient. However, complement is regulated and the process of regulation produces split products that can decrease as well as increase immune responses. Small animal models have been developed to test these variables. The guide for evaluating results from these models remains clinical findings because there are significant differences between the rodent and human complement systems.
在移植领域,补体激活在很大程度上被等同于抗体介导的排斥反应,但补体在识别凋亡和坏死细胞以及调节向T细胞和B细胞的抗原呈递方面也很重要。作为固有免疫系统的一部分,补体是对损伤的首批反应之一,它可以决定后续反应的方向和强度。因此,当从尸体供体获取器官时,补体在同种异体识别和移植排斥中的作用会增强,因为这些器官会承受一系列来自脑死亡、延长生命支持、缺血以及最终再灌注的应激,这些应激会引发促炎过程和组织损伤。此外,这些器官被移植给患者,这些患者由于输血、妊娠或移植,常常已对组织相容性抗原致敏。补体激活产生一系列生物活性效应分子,这些分子可通过直接结合到移植物上或通过改变受体的巨噬细胞、T细胞和B细胞的反应来调节移植排斥。然而,补体是受调控的,调控过程会产生裂解产物,这些产物既能降低也能增强免疫反应。已经建立了小动物模型来测试这些变量。评估这些模型结果的指南仍然是临床发现,因为啮齿动物和人类补体系统之间存在显著差异。