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Microvascular Inflammation of the Renal Allograft: A Reappraisal of the Underlying Mechanisms
Antibody-mediated rejection (ABMR) is associated with poor transplant outcomes and was identified as a leading cause of graft failure after kidney transplantation. Although the hallmark histological features of ABMR (ABMRh), i.e., microvascular inflammation (MVI), usually correlate with the presence...
Autores principales: | , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
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Frontiers Media S.A.
2022
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8980419/ https://www.ncbi.nlm.nih.gov/pubmed/35392097 http://dx.doi.org/10.3389/fimmu.2022.864730 |
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author | Lebraud, Emilie Eloudzeri, Maëva Rabant, Marion Lamarthée, Baptiste Anglicheau, Dany |
author_facet | Lebraud, Emilie Eloudzeri, Maëva Rabant, Marion Lamarthée, Baptiste Anglicheau, Dany |
author_sort | Lebraud, Emilie |
collection | PubMed |
description | Antibody-mediated rejection (ABMR) is associated with poor transplant outcomes and was identified as a leading cause of graft failure after kidney transplantation. Although the hallmark histological features of ABMR (ABMRh), i.e., microvascular inflammation (MVI), usually correlate with the presence of anti-human leukocyte antigen donor-specific antibodies (HLA-DSAs), it is increasingly recognized that kidney transplant recipients can develop ABMRh in the absence of HLA-DSAs. In fact, 40-60% of patients with overt MVI have no circulating HLA-DSAs, suggesting that other mechanisms could be involved. In this review, we provide an update on the current understanding of the different pathogenic processes underpinning MVI. These processes include both antibody-independent and antibody-dependent mechanisms of endothelial injury and ensuing MVI. Specific emphasis is placed on non-HLA antibodies, for which we discuss the ontogeny, putative targets, and mechanisms underlying endothelial toxicity in connection with their clinical impact. A better understanding of these emerging mechanisms of allograft injury and all the effector cells involved in these processes may provide important insights that pave the way for innovative diagnostic tools and highly tailored therapeutic strategies. |
format | Online Article Text |
id | pubmed-8980419 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2022 |
publisher | Frontiers Media S.A. |
record_format | MEDLINE/PubMed |
spelling | pubmed-89804192022-04-06 Microvascular Inflammation of the Renal Allograft: A Reappraisal of the Underlying Mechanisms Lebraud, Emilie Eloudzeri, Maëva Rabant, Marion Lamarthée, Baptiste Anglicheau, Dany Front Immunol Immunology Antibody-mediated rejection (ABMR) is associated with poor transplant outcomes and was identified as a leading cause of graft failure after kidney transplantation. Although the hallmark histological features of ABMR (ABMRh), i.e., microvascular inflammation (MVI), usually correlate with the presence of anti-human leukocyte antigen donor-specific antibodies (HLA-DSAs), it is increasingly recognized that kidney transplant recipients can develop ABMRh in the absence of HLA-DSAs. In fact, 40-60% of patients with overt MVI have no circulating HLA-DSAs, suggesting that other mechanisms could be involved. In this review, we provide an update on the current understanding of the different pathogenic processes underpinning MVI. These processes include both antibody-independent and antibody-dependent mechanisms of endothelial injury and ensuing MVI. Specific emphasis is placed on non-HLA antibodies, for which we discuss the ontogeny, putative targets, and mechanisms underlying endothelial toxicity in connection with their clinical impact. A better understanding of these emerging mechanisms of allograft injury and all the effector cells involved in these processes may provide important insights that pave the way for innovative diagnostic tools and highly tailored therapeutic strategies. Frontiers Media S.A. 2022-03-22 /pmc/articles/PMC8980419/ /pubmed/35392097 http://dx.doi.org/10.3389/fimmu.2022.864730 Text en Copyright © 2022 Lebraud, Eloudzeri, Rabant, Lamarthée and Anglicheau https://creativecommons.org/licenses/by/4.0/This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) and the copyright owner(s) are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms. |
spellingShingle | Immunology Lebraud, Emilie Eloudzeri, Maëva Rabant, Marion Lamarthée, Baptiste Anglicheau, Dany Microvascular Inflammation of the Renal Allograft: A Reappraisal of the Underlying Mechanisms |
title | Microvascular Inflammation of the Renal Allograft: A Reappraisal of the Underlying Mechanisms |
title_full | Microvascular Inflammation of the Renal Allograft: A Reappraisal of the Underlying Mechanisms |
title_fullStr | Microvascular Inflammation of the Renal Allograft: A Reappraisal of the Underlying Mechanisms |
title_full_unstemmed | Microvascular Inflammation of the Renal Allograft: A Reappraisal of the Underlying Mechanisms |
title_short | Microvascular Inflammation of the Renal Allograft: A Reappraisal of the Underlying Mechanisms |
title_sort | microvascular inflammation of the renal allograft: a reappraisal of the underlying mechanisms |
topic | Immunology |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8980419/ https://www.ncbi.nlm.nih.gov/pubmed/35392097 http://dx.doi.org/10.3389/fimmu.2022.864730 |
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