Department of Thoracic Surgery, University Hospital Zurich, Zurich, Switzerland.
Department of Thoracic Surgery, University Hospital Zurich, Zurich, Switzerland; Department of Thoracic Surgery, Brandenburg Medical School, Neurupppin, Germany.
J Surg Res. 2019 Jan;233:74-81. doi: 10.1016/j.jss.2018.07.073. Epub 2018 Aug 17.
Human lung transplantation has evolved to an established treatment for pulmonary diseases in their end stages; however, the long-term outcome is worse when compared to all other solid transplantable organs. The major reason for this unfavorable outcome is rejection, either in its acute or chronic form, the latter termed as chronic lung allograft dysfunction.
A systematic review search was performed.
One of the most important immune cells responsible for rejection are T cells. Beside alloreactive CD8+ T cells, CD4+ T cells play a key role during the evolvement of allograft rejection. Certain subsets of these allograft CD4+ T cells have been identified which have been shown to exert either transplant-protective or transplant-injuring properties. These effects have been proven in various experimental models, mainly in rats and mice, and allowed for the gain of important insights into these proinflammatory and anti-inflammatory characteristics including their targetability: while the subsets Th1, Th17, Th22, and Tfh cells have been shown to act in a rather proinflammatory way, Tregs, Th2, and Th9 subsets exert anti-inflammatory effects. Chronic airway obstruction is mainly induced by IL17 as shown across models.
This review shall summarize and provide an overview of the current evidence about the role and effects of proinflammatory and anti-inflammatory CD4-+ T helper cell subsets during lung allograft rejection in experimental rodent models.
人类肺移植已经发展成为治疗终末期肺部疾病的一种成熟方法；然而，与所有其他可移植的实体器官相比，其长期预后较差。这种不利结果的主要原因是排斥反应，无论是急性还是慢性，后者称为慢性肺移植物功能障碍。
进行了系统的文献检索。
负责排斥反应的最重要的免疫细胞之一是 T 细胞。除了同种反应性 CD8+T 细胞外，CD4+T 细胞在移植物排斥的发展中起着关键作用。已经确定了这些同种异体 CD4+T 细胞的某些亚群，它们被证明具有移植保护或移植损伤特性。这些效应已在各种实验模型中得到证实，主要在大鼠和小鼠中，这为深入了解这些促炎和抗炎特性及其靶向性提供了重要的见解：虽然 Th1、Th17、Th22 和 Tfh 细胞亚群已被证明具有较强的促炎作用，但 Treg、Th2 和 Th9 亚群则具有抗炎作用。正如在模型中所显示的那样，慢性气道阻塞主要是由 IL17 引起的。
本文综述了在实验性啮齿动物模型中，促炎和抗炎 CD4+T 辅助细胞亚群在肺移植物排斥中的作用和影响的现有证据，并提供了概述。
