RT Journal Article
T1 Immune response and histology of humoral rejection in kidney transplantation.
A1 González-Molina, Miguel
A1 Ruiz-Esteban, Pedro
A1 Caballero, Abelardo
A1 Burgos, Dolores
A1 Cabello, Mercedes
A1 Leon, Miriam
A1 Fuentes, Laura
A1 Hernandez, Domingo
K1 Antibodies
K1 Anticuerpos
K1 Biopsia renal
K1 Humoral rejection
K1 Immune response
K1 Rechazo humoral
K1 Renal biopsy
K1 Respuesta inmune
AB The adaptive immune response forms the basis of allograft rejection. Its weapons are direct cellular cytotoxicity, identified from the beginning of organ transplantation, and/or antibodies, limited to hyperacute rejection by preformed antibodies and not as an allogenic response. This resulted in allogenic response being thought for decades to have just a cellular origin. But the experimental studies by Gorer demonstrating tissue damage in allografts due to antibodies secreted by B lymphocytes activated against polymorphic molecules were disregarded. The special coexistence of binding and unbinding between antibodies and antigens of the endothelial cell membranes has been the cause of the delay in demonstrating the humoral allogenic response. The endothelium, the target tissue of antibodies, has a high turnover, and antigen-antibody binding is non-covalent. If endothelial cells are attacked by the humoral response, immunoglobulins are rapidly removed from their surface by shedding and/or internalization, as well as degrading the components of the complement system by the action of MCP, DAF and CD59. Thus, the presence of complement proteins in the membrane of endothelial cells is transient. In fact, the acute form of antibody-mediated rejection was not demonstrated until C4d complement fragment deposition was identified, which is the only component that binds covalently to endothelial cells. This review examines the relationship between humoral immune response and the types of acute and chronic histological lesion shown on biopsy of the transplanted organ.
YR 2016
FD 2016-06-03
LK http://hdl.handle.net/10668/10156
UL http://hdl.handle.net/10668/10156
LA en
LA es
DS RISalud
RD Apr 7, 2025