Department of Liver Surgery, Renji Hospital, Affiliated to Shanghai Jiao Tong University School of Medicine, Shanghai, China.
Front Immunol. 2020 Oct 22;11:2111. doi: 10.3389/fimmu.2020.02111. eCollection 2020.
Pediatric post-transplant idiopathic liver fibrosis is an unexplained graft fibrosis that occurs in symptom-free children without acute rejection and surgical complications. Despite a lack of consensus on the subject, the development of pediatric post-transplant idiopathic liver fibrosis is believed to be the result of multiple potential factors, including ischemia-reperfusion injury, allogeneic acute and chronic rejection, viral hepatitis recurrence, opportunistic infection, and drug-induced liver damage. Among them, there is growing evidence that innate immunity may also have a unique role in this progression. This study reviews the features of pediatric post-transplant idiopathic liver fibrosis and discusses current studies illustrating the potential mechanisms of liver allograft tolerance induced by intrahepatic innate immunity, the role of components including Toll-like receptors (TLRs), interferons (IFN), dendritic cells (DC), natural killer cells (NK cells), NKT cells, neutrophils, and Kupffer cells, as well as their possibly relevant role in the development of pediatric post-transplant idiopathic liver fibrosis.
儿童移植后特发性肝纤维化是一种无症状儿童中发生的不明原因的移植物纤维化，无急性排斥和手术并发症。尽管对此主题尚未达成共识，但人们认为儿童移植后特发性肝纤维化的发展是多种潜在因素的结果，包括缺血再灌注损伤、同种异体急性和慢性排斥、病毒性肝炎复发、机会性感染和药物性肝损伤。其中，越来越多的证据表明固有免疫可能在这一进展中也具有独特的作用。本研究综述了儿童移植后特发性肝纤维化的特征，并讨论了目前的研究，这些研究说明了肝内固有免疫诱导肝移植耐受的潜在机制，包括 Toll 样受体 (TLRs)、干扰素 (IFN)、树突状细胞 (DC)、自然杀伤细胞 (NK 细胞)、NKT 细胞、中性粒细胞和枯否细胞等成分的作用，以及它们在儿童移植后特发性肝纤维化发展中的可能相关作用。
