Hennessy Conor, Lewik Guido, Cross Amy, Hester Joanna, Issa Fadi
Transplantation Research Immunology Group, Nuffield Department of Surgical Sciences, University of Oxford, John Radcliffe Hospital, Oxford, OX3 9DU, UK.
Fac Rev. 2021 Feb 25;10:21. doi: 10.12703/r/10-21. eCollection 2021.
Organ transplantation is a life-saving treatment for end-stage organ failure. However, despite advances in immunosuppression, donor matching, tissue typing, and organ preservation, many organs are still lost each year to rejection. Ultimately, tolerance in the absence of immunosuppression is the goal, and although this seldom occurs spontaneously, a deeper understanding of alloimmunity may provide avenues for future therapies which aid in its establishment. Here, we highlight the recent key advances in our understanding of the allograft response. On the innate side, recent work has highlighted the previously unrecognised role of innate lymphoid cells as well as natural killer cells in promoting the alloresponse. The two major routes of allorecognition have recently been joined by a third newly identified pathway, semi-direct allorecognition, which is proving to be a key active pathway in transplantation. Through this review, we detail these newly defined areas in the allograft response and highlight areas for potential future therapeutic intervention.
器官移植是终末期器官衰竭的一种挽救生命的治疗方法。然而，尽管在免疫抑制、供体匹配、组织分型和器官保存方面取得了进展，但每年仍有许多器官因排斥反应而丧失。最终，在无免疫抑制情况下实现免疫耐受是目标，尽管这种情况很少自发发生，但对同种异体免疫的更深入理解可能为有助于建立免疫耐受的未来治疗方法提供途径。在此，我们重点介绍了我们对同种异体移植反应理解方面的近期关键进展。在固有免疫方面，近期的研究突出了固有淋巴细胞以及自然杀伤细胞在促进同种异体反应中以前未被认识到的作用。同种异体识别的两条主要途径最近又增加了第三条新发现的途径，即半直接同种异体识别，事实证明这是移植中的一条关键活性途径。通过本综述，我们详细阐述了同种异体移植反应中这些新定义的领域，并突出了未来潜在治疗干预的领域。
