Novel insights into non-HLA alloimmunity in kidney transplantation.
Transpl Int
; 33(1): 5-17, 2020 01.
Article
em En
| MEDLINE
| ID: mdl-31650645
ABSTRACT
Recognition of non-self structures on donor cells represents the main immunological barrier in solid organ transplantation. The human leukocyte antigens (HLA) are considered the most important non-self (allo)antigens in transplantation. Long-term graft attrition is mainly caused by the formation of alloreactive antibodies that are directed against non-self structures (i.e., epitopes) on cell surface proteins. Recently published data provided evidence for a similar importance of non-HLA mismatches between donors and recipients in acute rejection as well as long-term kidney allograft survival. These data suggest a broader concept of immunological non-self that goes beyond HLA incompatibility and expands the current concept of polymorphic non-self epitopes on cell surface molecules from HLA to non-HLA targets. Amino acid substitutions caused by single nucleotide variants in protein-coding genes or complete loss of gene expression represent the basis for polymorphic residues in both HLA and non-HLA molecules. To better understand these novel insights in non-HLA alloimmunity, we will first review basic principles of the alloimmune response with a focus on the HLA epitope concept in donor-specific antibody formation before discussing key publications on non-HLA antibodies.
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Texto completo:
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Base de dados:
MEDLINE
Assunto principal:
Transplante de Rim
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Rejeição de Enxerto
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Sobrevivência de Enxerto
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Histocompatibilidade
Limite:
Humans
Idioma:
En
Ano de publicação:
2020
Tipo de documento:
Article