McQuiston Alexander, Emtiazjoo Amir, Angel Peggi, Machuca Tiago, Christie Jason, Atkinson Carl
Department of Microbiology and Immunology, Medical University of South Carolina, Charleston, SC, United States.
Division of Pulmonary, Critical Care and Sleep Medicine, University of Florida, Gainesville, FL, United States.
Front Immunol. 2021 Aug 11;12:711102. doi: 10.3389/fimmu.2021.711102. eCollection 2021.
Lung transplant patients have the lowest long-term survival rates compared to other solid organ transplants. The complications after lung transplantation such as primary graft dysfunction (PGD) and ultimately chronic lung allograft dysfunction (CLAD) are the main reasons for this limited survival. In recent years, lung-specific autoantibodies that recognize non-HLA antigens have been hypothesized to contribute to graft injury and have been correlated with PGD, CLAD, and survival. Mounting evidence suggests that autoantibodies can develop during pulmonary disease progression before lung transplant, termed pre-existing autoantibodies, and may participate in allograft injury after transplantation. In this review, we summarize what is known about pulmonary disease autoantibodies, the relationship between pre-existing autoantibodies and lung transplantation, and potential mechanisms through which pre-existing autoantibodies contribute to graft injury and rejection.
与其他实体器官移植相比，肺移植患者的长期生存率最低。肺移植后的并发症，如原发性移植功能障碍（PGD）以及最终的慢性肺移植功能障碍（CLAD），是导致这种有限生存率的主要原因。近年来，人们推测识别非HLA抗原的肺特异性自身抗体可能导致移植损伤，并与PGD、CLAD和生存率相关。越来越多的证据表明，自身抗体可在肺移植前的肺部疾病进展过程中产生，称为预先存在的自身抗体，并且可能在移植后参与同种异体移植损伤。在这篇综述中，我们总结了关于肺部疾病自身抗体的已知信息、预先存在的自身抗体与肺移植之间的关系，以及预先存在的自身抗体导致移植损伤和排斥反应的潜在机制。
