Sorohan Bogdan Marian, Baston Cătălin, Tacu Dorina, Bucșa Cristina, Țincu Corina, Vizireanu Paula, Sinescu Ioanel, Constantinescu Ileana
Department of General Medicine, Carol Davila University of Medicine and Pharmacy, 020021 Bucharest, Romania.
Center for Uronephrology and Kidney Transplantation, Fundeni Clinical Institute, 022328 Bucharest, Romania.
Biomedicines. 2022 Jun 25;10(7):1506. doi: 10.3390/biomedicines10071506.
The polymorphic human leukocyte antigen (HLA) system has been considered the main target for alloimmunity, but the non-HLA antibodies and autoimmunity have gained importance in kidney transplantation (KT). Apart from the endothelial injury, secondary self-antigen exposure and the presence of polymorphic alloantigens, respectively, auto- and allo- non-HLA antibodies shared common steps in their development, such as: antigen recognition via indirect pathway by recipient antigen presenting cells, autoreactive T cell activation, autoreactive B cell activation, T helper 17 cell differentiation, loss of self-tolerance and epitope spreading phenomena. Both alloimmunity and autoimmunity play a synergic role in the formation of non-HLA antibodies, and the emergence of transcriptomics and genome-wide evaluation techniques has led to important progress in understanding the mechanistic features. Among them, non-HLA mismatches between donors and recipients provide valuable information regarding the role of genetics in non-HLA antibody immunity and development.
多态性人类白细胞抗原(HLA)系统一直被认为是同种免疫的主要靶点,但非HLA抗体和自身免疫在肾移植(KT)中变得越来越重要。除了内皮损伤、继发性自身抗原暴露和多态性同种抗原的存在外,自身和同种非HLA抗体在其发展过程中具有共同的步骤,例如:受体抗原呈递细胞通过间接途径识别抗原、自身反应性T细胞活化、自身反应性B细胞活化、辅助性T细胞17分化、自身耐受性丧失和表位扩展现象。同种免疫和自身免疫在非HLA抗体的形成中都起协同作用,转录组学和全基因组评估技术的出现导致在理解其机制特征方面取得了重要进展。其中,供体和受体之间的非HLA错配为遗传学在非HLA抗体免疫和发展中的作用提供了有价值的信息。