Document Detail

The role of complement in antibody-mediated rejection in kidney transplantation.
MedLine Citation:
PMID:  23026942     Owner:  NLM     Status:  MEDLINE    
Over the past decade, several studies have suggested that the complement system has an active role in both acute and chronic allograft rejection. These studies have been facilitated by improved techniques to detect antibody-mediated organ rejection, including immunohistological staining for C4d deposition in the allograft and solid-phase assays that identify donor-specific alloantibodies (DSAs) in the serum of transplant recipients. Studies with eculizumab, a humanized monoclonal antibody directed against complement component C5, have shown that activation of the terminal complement pathway is necessary for the development of acute antibody-mediated rejection in recipients of living-donor kidney allografts who have high levels of DSAs. The extent to which complement activation drives chronic antibody-mediated injury leading to organ rejection is less clear. In chronic antibody-mediated injury, early complement activation might facilitate chemotaxis of inflammatory cells into the allograft in a process that later becomes somewhat independent of DSA levels and complement factors. In this Review, we discuss the different roles that the complement system might have in antibody-mediated allograft rejection, with specific emphasis on renal transplantation.
Mark D Stegall; Marcio F Chedid; Lynn D Cornell
Publication Detail:
Type:  Journal Article; Review     Date:  2012-10-02
Journal Detail:
Title:  Nature reviews. Nephrology     Volume:  8     ISSN:  1759-507X     ISO Abbreviation:  Nat Rev Nephrol     Publication Date:  2012 Nov 
Date Detail:
Created Date:  2012-10-24     Completed Date:  2013-04-01     Revised Date:  2013-11-25    
Medline Journal Info:
Nlm Unique ID:  101500081     Medline TA:  Nat Rev Nephrol     Country:  England    
Other Details:
Languages:  eng     Pagination:  670-8     Citation Subset:  IM    
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MeSH Terms
Adaptive Immunity / immunology
Antibodies / immunology
Antibodies, Monoclonal, Humanized
Complement Activation / immunology,  physiology*
Complement C4 / metabolism
Graft Rejection / immunology*
Kidney / immunology*,  pathology
Kidney Transplantation / immunology*
Kidney Tubules / immunology
Reg. No./Substance:
0/Antibodies; 0/Antibodies, Monoclonal, Humanized; 0/Complement C4; A3ULP0F556/eculizumab

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