Thaunat Olivier
Immunologie clinique et transplantation rénale, Hôpital Edouard Herriot, 5 place d'Arsonval, 69437 Lyon, et Inserm U851.
Bull Acad Natl Med. 2011 Apr-May;195(4-5):847-59; discussion 859.
Solid organs used for transplantation are subjected to ischemia-reperfusion, which induces cellular stress and tissue necrosis. Ischemia-reperfusion injury activates the complement cascade and triggers the release of danger-associated molecular signals. The latter bind to pattern-recognition receptors on innate immune cells, thereby eliciting a sterile inflammatory response that, together with complement activation, increases tissue damage. This sterile inflammatory response also triggers maturation of antigen-presenting cells (macrophages and dendritic cells), enabling them to present donor antigens efficiently to recipient lymphocytes. By initiating adaptive alloimmune responses in the recipient, innate immunity plays a central role in the rejection process, which remains a major cause of late graft failure. Strategies capable of dampening the sterile inflammatory response induced by ischemia-reperfusion could therefore be beneficial, both for immediate post-transplantation graft function and for long-term outcome.
用于移植的实体器官会经历缺血再灌注,这会引发细胞应激和组织坏死。缺血再灌注损伤会激活补体级联反应,并触发危险相关分子信号的释放。后者与天然免疫细胞上的模式识别受体结合,从而引发无菌性炎症反应,该反应与补体激活一起会增加组织损伤。这种无菌性炎症反应还会触发抗原呈递细胞(巨噬细胞和树突状细胞)的成熟,使其能够有效地将供体抗原呈递给受体淋巴细胞。通过在受体中引发适应性同种免疫反应,天然免疫在排斥过程中起着核心作用,而排斥反应仍然是晚期移植失败的主要原因。因此,能够减轻缺血再灌注诱导的无菌性炎症反应的策略,对于移植后立即的移植物功能以及长期结果都可能有益。