Department of Nephrology and Transplantation Medicine, Wroclaw Medical University, Wrocław, Poland.
Department of Nephrology and Transplantation Medicine, Wroclaw Medical University, Wrocław, Poland.
Transpl Immunol. 2022 Feb;70:101505. doi: 10.1016/j.trim.2021.101505. Epub 2021 Nov 15.
Antibody-mediated rejection is the leading cause of deterioration of graft function and graft loss after kidney transplantation. Recent studies have reported an increasing role of non-HLA antibodies in the humoral injury after kidney transplantation. We decided to present the influence of non-HLA antibodies - anti-endothelin II type A receptor (ETAR) on a transplanted kidney and characterize the significance of their receptor.
The role of non-HLA antibodies is still uncertain. Many studies suggest that the presence of non-HLA antibodies, including anti-ETAR antibodies, is among the risk factors for antibody-mediated rejection, graft injury, and graft loss. The discovery of new antigen targets and antibodies, which participate in the humoral response, has provided a significantly better understanding of the mechanism of antibody-mediated rejection after organ transplantation.
Endothelin and its receptors play an important role in physiology and pathophysiology after solid organ transplantation. ETAR and antibodies against ETAR may participate in humoral rejection and graft damage. The measurement of anti-ETAR antibodies may identify patients with an increased risk of rejection and even loss of a transplanted organ. Expression of ETAR detected in biopsy of transplant could become an additional tool used to better understand humoral activity. More research is needed to address many questions about non-HLA directed rejection and graft damage.
抗体介导的排斥反应是肾移植后移植物功能恶化和移植物丢失的主要原因。最近的研究报告称,非 HLA 抗体在肾移植后的体液损伤中发挥着越来越重要的作用。我们决定介绍非 HLA 抗体——抗内皮素 II 型 A 受体(ETAR)对移植肾的影响,并描述其受体的重要性。
非 HLA 抗体的作用仍不确定。许多研究表明,包括抗 ETAR 抗体在内的非 HLA 抗体的存在是抗体介导的排斥反应、移植物损伤和移植物丢失的危险因素之一。新抗原靶标和参与体液反应的抗体的发现,使人们对器官移植后抗体介导的排斥反应机制有了更深入的了解。
内皮素及其受体在实体器官移植后的生理和病理生理学中发挥着重要作用。ETAR 和针对 ETAR 的抗体可能参与体液排斥反应和移植物损伤。抗 ETAR 抗体的检测可能有助于识别排斥反应风险增加甚至移植器官丢失的患者。在移植活检中检测到的 ETAR 表达可能成为另一种用于更好地理解体液活性的工具。需要更多的研究来解决许多关于非 HLA 介导的排斥反应和移植物损伤的问题。