Department of Internal Medicine I, University Hospital Carl Gustav Carus, Technische Universität Dresden, Dresden, Germany.
Center for Regenerative Therapies (CRTD), Technische Universität Dresden, Dresden, Germany.
Front Immunol. 2023 Jul 12;14:1114842. doi: 10.3389/fimmu.2023.1114842. eCollection 2023.
T follicular helper cells comprise a specialized, heterogeneous subset of immune-competent T helper cells capable of influencing B cell responses in lymphoid tissues. In physiology, for example in response to microbial challenges or vaccination, this interaction chiefly results in the production of protecting antibodies and humoral memory. In the context of kidney transplantation, however, immune surveillance provided by T follicular helper cells can take a life of its own despite matching of human leukocyte antigens and employing the latest immunosuppressive regiments. This puts kidney transplant recipients at risk of subclinical and clinical rejection episodes with a potential risk for allograft loss. In this review, the current understanding of immune surveillance provided by T follicular helper cells is briefly described in physiological responses to contrast those pathological responses observed after kidney transplantation. Sensitization of T follicular helper cells with the subsequent emergence of detectable donor-specific human leukocyte antigen antibodies, non-human leukocyte antigen antibodies their implication for kidney transplantation and lessons learnt from other transplantation "settings" with special attention to antibody-mediated rejection will be addressed.
滤泡辅助 T 细胞包含了一群具有特殊功能、异质性的免疫辅助 T 细胞亚群，能够影响淋巴组织中的 B 细胞反应。例如，在生理状态下，为了应对微生物的挑战或疫苗接种，这种相互作用主要导致保护性抗体和体液记忆的产生。然而，在肾移植的背景下，尽管人类白细胞抗原匹配并采用了最新的免疫抑制方案，但滤泡辅助 T 细胞提供的免疫监视可能会自行发展。这使得肾移植受者面临亚临床和临床排斥反应的风险，从而导致移植物丢失的潜在风险。在这篇综述中，简要描述了滤泡辅助 T 细胞提供的免疫监视在生理反应中的作用，以对比肾移植后观察到的病理性反应。滤泡辅助 T 细胞的致敏，随后出现可检测到的供体特异性人类白细胞抗原抗体、非人类白细胞抗原抗体，以及它们对肾移植的影响，将从其他移植“环境”中吸取经验，特别关注抗体介导的排斥反应。
