Department of Internal Medicine, Erasmus MC, University Medical Center Rotterdam, Rotterdam, The Netherlands.
Curr Opin Organ Transplant. 2011 Feb;16(1):28-33. doi: 10.1097/MOT.0b013e3283425509.
Over the past decade, the role of the complement system in solid organ transplantation has received increased attention. A number of experimental and epidemiological studies have suggested that the lectin pathway plays a role in infectious complications, rejection and long-term outcome after transplantation. This review discusses recent data on the role of the lectin pathway in solid organ transplantation.
Studies on the role of mannose-binding lectin (MBL) in organ transplantation have shown an association of MBL-deficient states with an increased risk of infection after liver and simultaneous pancreas-kidney transplantation. On the contrary, a high MBL status in the recipient has been associated with poorer organ survival and increased rejection associated damage in various transplant settings. Experimental data points towards a role for MBL in ischemia-reperfusion damage in various organs. Several lines of evidence suggest that MBL may contribute to immunoglobulin-mediated complement activation in both ischemia-reperfusion and rejection. The interaction of MBL with IgM may be of particular importance in this setting.
We review recent epidemiological data on the role of MBL in solid organ transplantation. We relate these findings to the emerging experimental data and attempt to explain some of the conflicting results on beneficial and harmful effects of the lectin pathway.
过去十年中，补体系统在实体器官移植中的作用受到了越来越多的关注。许多实验和流行病学研究表明，凝集素途径在感染并发症、排斥反应和移植后的长期结果中发挥作用。本文讨论了凝集素途径在实体器官移植中的作用的最新数据。
关于甘露聚糖结合凝集素（MBL）在器官移植中的作用的研究表明，MBL 缺乏状态与肝和同时胰腺-肾移植后感染风险增加有关。相反，受者中高 MBL 状态与各种移植环境中的较差器官存活率和增加的排斥相关损伤相关。实验数据表明 MBL 在各种器官的缺血再灌注损伤中起作用。有几条证据表明 MBL 可能有助于缺血再灌注和排斥反应中的免疫球蛋白介导的补体激活。MBL 与 IgM 的相互作用在这种情况下可能特别重要。
我们综述了 MBL 在实体器官移植中的作用的最新流行病学数据。我们将这些发现与新兴的实验数据联系起来，并试图解释凝集素途径的有益和有害影响的一些相互矛盾的结果。
