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Deprecated: Implicit conversion from float 211.6 to int loses precision in C:\Inetpub\vhosts\kidney.de\httpdocs\pget.php on line 534 Trends+Mol+Med 2015 ; 21 (5): 319-29 Nephropedia Template TP
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The Perfect Storm: HLA Antibodies, Complement, Fc?Rs and Endothelium in Transplant Rejection #MMPMID25801125
Thomas KA; Valenzuela NM; Reed EF
Trends Mol Med 2015[May]; 21 (5): 319-29 PMID25801125show ga
The pathophysiology of antibody-mediated rejection (AMR) in solid organ transplants is multi-faceted and predominantly caused by antibodies directed against polymorphic donor human leukocyte antigens (HLA). Despite the clearly detrimental impact of HLA antibodies (HLA-Ab) on graft function and survival, the prevention, diagnosis and treatment of AMR remain a challenge. Histological manifestations of AMR reflect signatures of HLA-Ab-triggered injury, specifically endothelial changes, recipient leukocytic infiltrate, and complement deposition. We review the interconnected mechanisms of HLA-Ab-mediated injury that might synergize in a ?perfect storm? of inflammation. Characterization of antibody features that are critical for effector functions may help identify HLA-Ab more likely to cause rejection. We also highlight recent advancements that may pave the way for new, more effective therapeutics.