Immunology and Donor-Specific Antibodies in Corneal Transplantation

IF 2.9 4区 医学 Q3 IMMUNOLOGY Archivum Immunologiae et Therapiae Experimentalis Pub Date : 2021-11-06 DOI:10.1007/s00005-021-00636-3
Joanna Major, Bartosz Foroncewicz, Jacek Paweł Szaflik, Krzysztof Mucha
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引用次数: 8

Abstract

The first human corneal transplantation was performed in 1905 by Eduard Zirm in the Olomouc Eye Clinic, now Czech Republic. However, despite great advancements in microsurgical eye procedures, penetrating keratoplasty in high-risk patients (e.g., vascularized or inflamed corneal tissue, consecutive transplants) remains a challenge. The difficulty is mainly due to the risk of irreversible allograft rejection, as an ocular immune privilege in these patients is abolished and graft rejection is the main cause of corneal graft failure. Therefore, tailored immunosuppressive treatment based on immunological monitoring [e.g., donor-specific antibodies (DSA)] is considered one of the best strategies to prevent rejection in transplant recipients. Although there is indirect evidence on the mechanisms underlying antibody-mediated rejection, the impact of DSA on cornea transplantation remains unknown. Determining the role of pre-existing and/or de novo DSA could advance our understanding of corneal graft rejection mechanisms. This may help stratify the immunological risk of rejection, ultimately leading to personalized treatment for this group of transplant recipients.

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角膜移植中的免疫学和供体特异性抗体
第一例人类角膜移植是1905年由爱德华·齐姆在奥洛穆茨眼科诊所(现捷克共和国)进行的。然而,尽管眼科显微外科手术取得了巨大的进步,但对于高风险患者(如血管化或发炎的角膜组织,连续移植)的穿透性角膜移植术仍然是一个挑战。困难的主要原因是由于不可逆的异体移植排斥反应的风险,因为这些患者的眼部免疫特权被取消,移植排斥反应是角膜移植失败的主要原因。因此,基于免疫监测的量身定制的免疫抑制治疗[例如,供体特异性抗体(DSA)]被认为是预防移植受者排斥反应的最佳策略之一。虽然有间接证据表明抗体介导的排斥反应机制,但DSA对角膜移植的影响尚不清楚。确定已有和/或新生DSA的作用可以促进我们对角膜移植排斥机制的理解。这可能有助于对排斥的免疫风险进行分层,最终导致对这组移植受者的个性化治疗。
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来源期刊
CiteScore
5.90
自引率
0.00%
发文量
26
审稿时长
>12 weeks
期刊介绍: Archivum Immunologiae et Therapiae Experimentalis (AITE), founded in 1953 by Ludwik Hirszfeld, is a bimonthly, multidisciplinary journal. It publishes reviews and full original papers dealing with immunology, experimental therapy, immunogenetics, transplantation, microbiology, immunochemistry and ethics in science.
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