Pankewycz Oleh, Soliman Karim, Laftavi Mark R
Department of Medicine, State University of New York at Buffalo, School of Medicine and Biomedical Sciences , Buffalo, New York , USA and.
Immunol Invest. 2014;43(8):775-89. doi: 10.3109/08820139.2014.910016.
Historically, cellular rather than humoral immunity has gathered the most attention in kidney transplantation. As the specter of cellular acute rejection and early graft loss has faded due to the availability of highly effective immunosuppressive therapy, scientific and clinical studies now focus on improving long-term graft survival. It is increasingly appreciated that alloantibodies directed against HLA and non-HLA antigens are key factors in determining graft longevity. Significant efforts are now being made to better understand the critical impact that B cells and alloantibodies make on organ allocation and graft survival. Future therapies directed specific for the humoral alloresponse will undoubtedly lead to improved outcomes after kidney transplantation. This review will cover some of the advances in the understanding and management of the continuum of humoral immunity in renal transplantation in the pre, peri and post-transplant periods.
从历史上看，细胞免疫而非体液免疫在肾移植中受到了最多关注。由于高效免疫抑制疗法的出现，细胞急性排斥反应和早期移植物丢失的威胁已经消退，科学和临床研究现在聚焦于提高移植物的长期存活率。人们越来越认识到，针对HLA和非HLA抗原的同种异体抗体是决定移植物寿命的关键因素。目前正在做出重大努力，以更好地理解B细胞和同种异体抗体对器官分配和移植物存活的关键影响。针对体液同种异体反应的未来疗法无疑将改善肾移植后的结果。本综述将涵盖肾移植术前、术中和术后体液免疫连续体的理解和管理方面的一些进展。
