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The role of immunologic response in chronic allograft rejection

100%

Boratynska M.

Postępy Higieny i Medycyny Doświadczalnej

2003

vol. 57

issue 4

405-424

Chronic allograft rejection is an active immunologic and inflammatory process leading to graft failure. It is associated with many disorders evidencing increased reactivity of the host against graft alloantigens. Among the most important ones are: de novo synthesis of antibodies against HLA class I and II, immunoglobin deposits on vascular endothelial and tubular basement membrane, C4d complement deposits in peritubular capillaries, increased proliferation of lymphocytes in response to mismatched HLA-DR, and elevated expression of cytokines on infiltrating mononuclears and tubular cells. Prevention of chronic rejection comprises of transplanting undamaged organs, avoidance of acute rejection, incorporation of medicines inhibiting remodelling of vascular wall into therapy, and elimination of factors accelerating graft damage. In case of humoral chronic rejection suppression of humoral arm immune response is required. Early diagnosis and effective suppression of antibody production may allow to avoid progression of allograft failure.

Wegener?s granulomatosis ? autoimmunity to neutrophil proteinase 3

51%

Watorek E., Boratynska M., Klinger M.

Archivum Immunologiae et Therapiae Experimentalis

2003

vol. 51

issue 3

157-167

Wegener?s granulomatosis is a small vessel vasculitis, associated with various clinical manifestations, among which the most common are respiratory tract disease and glomerulonephritis leading to renal failure. Pathogenesis of vascular injury in Wegener?s granulomatosis is ascribed to antineutrophil cytoplasmic antibodies directed (ANCA) mainly against proteinase 3, an enzyme from neutrophil granules. The reasons for breakdown of self-tolerance to proteinase 3 are unknown and together with molecular mechanisms underlying this immunoinflammation are the subject of research. Standard treatment of Wegener?s granulomatosis consists of cyclophosphamide and corticosteroids. In patients resistant to that therapy or with the refractory disease some alternative strategies involving tumor necrosis factor blocade, polyclonal antithymocyte globulin or monoclonal anti-T cell antibodies are applied.

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1 Archivum Immunologiae et Therapiae Experimentalis

1 Postępy Higieny i Medycyny Doświadczalnej

2 2003

2 Boratynska M.

1 Klinger M.

1 Watorek E.

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The role of immunologic response in chronic allograft rejection

Wegener?s granulomatosis ? autoimmunity to neutrophil proteinase 3