Department of Cardiothoracic Surgery, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China.
Xenotransplantation Program, Department of Surgery, University of Alabama at Birmingham, Birmingham Alabama, USA.
Xenotransplantation. 2019 Jul;26(4):e12517. doi: 10.1111/xen.12517. Epub 2019 Apr 29.
The role of complement in xenotransplantation is well-known and is a topic that has been reviewed previously. However, our understanding of the immense complexity of its interaction with other constituents of the innate immune response and of the coagulation, adaptive immune, and inflammatory responses to a xenograft is steadily increasing. In addition, the complement system plays a function in metabolism and homeostasis. New reviews at intervals are therefore clearly warranted. The pathways of complement activation, the function of the complement system, and the interaction between complement and coagulation, inflammation, and the adaptive immune system in relation to xenotransplantation are reviewed. Through several different mechanisms, complement activation is a major factor in contributing to xenograft failure. In the organ-source pig, the detrimental influence of the complement system is seen during organ harvest and preservation, for example, in ischemia-reperfusion injury. In the recipient, the effect of complement can be seen through its interaction with the immune, coagulation, and inflammatory responses. Genetic-engineering and other therapeutic methods by which the xenograft can be protected from the effects of complement activation are discussed. The review provides an updated source of reference to this increasingly complex subject.
补体在异种移植中的作用是众所周知的，也是之前已经综述过的一个话题。然而，我们对其与先天免疫反应的其他成分以及对异种移植物的凝血、适应性免疫和炎症反应的相互作用的复杂性的理解正在稳步提高。此外，补体系统在代谢和稳态中发挥作用。因此，定期进行新的综述显然是有必要的。本文综述了补体激活途径、补体系统的功能以及补体与凝血、炎症和适应性免疫系统在异种移植中的相互作用。通过几种不同的机制，补体激活是导致异种移植物失功的主要因素。在器官供体猪中，补体系统的有害影响可见于器官采集和保存过程中，例如缺血再灌注损伤。在受者中，可以通过补体与免疫、凝血和炎症反应的相互作用来观察其作用。本文还讨论了可以保护异种移植物免受补体激活影响的基因工程和其他治疗方法。本综述为这个日益复杂的主题提供了最新的参考来源。
