慢性同种异体抗体介导的排斥反应。
Chronic alloantibody mediated rejection.
机构信息
Department of Pathology, Massachusetts General Hospital and Harvard Medical School, Boston, MA 02114, USA.
出版信息
Semin Immunol. 2012 Apr;24(2):115-21. doi: 10.1016/j.smim.2011.09.002. Epub 2011 Nov 2.
Abstract
Alloantibodies clearly cause acute antibody mediated rejection, and all available evidence supports their pathogenic etiology in the development of chronic alloantibody mediated rejection (CAMR). But the slow evolution of this disease, the on-going immunosuppression, the variations in titer of alloantibodies, and variation in antigenic targets all complicate identifying which dynamic factors are most important clinically and pathologically. This review highlights the pathological factors related to the diagnosis of CAMR, the time course and natural history of this disease. What is known about CAMR pathogenesis is discussed including alloantibodies, the role of complement, gene activation, and Fc effector cell function. Therapy, which is problematic for this disease, is also discussed, including on-going and potential therapies and their limitations.
摘要
同种抗体明显导致急性抗体介导的排斥反应，所有现有证据都支持其在慢性同种抗体介导的排斥反应（CAMR）发展中的发病机制。但是，这种疾病的缓慢进展、持续的免疫抑制、同种抗体滴度的变化以及抗原靶标的变化，都使得确定哪些动态因素在临床上和病理学上最重要变得复杂起来。本综述强调了与 CAMR 诊断相关的病理学因素、该疾病的时间进程和自然史。讨论了已知的 CAMR 发病机制，包括同种抗体、补体的作用、基因激活和 Fc 效应细胞功能。还讨论了该疾病的治疗方法，包括正在进行和潜在的治疗方法及其局限性。
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2
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Am J Transplant. 2011 Nov;11(11):2405-13. doi: 10.1111/j.1600-6143.2011.03757.x. Epub 2011 Sep 22.
3
Pretransplant IgG subclasses of donor-specific human leukocyte antigen antibodies and development of antibody-mediated rejection.移植前供体特异性人类白细胞抗原抗体的 IgG 亚类与抗体介导的排斥反应的发生。
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Clinical relevance and IgG subclass determination of non-HLA antibodies identified using endothelial cell precursors isolated from donor blood.使用从供体血液中分离的内皮细胞前体鉴定非 HLA 抗体的临床相关性和 IgG 亚类确定。
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