Role of autoimmunity in organ allograft rejection: A focus on immunity to type V collagen in the pathogenesis of lung transplant rejection

Tina L. Sumpter, David S. Wilkes

Research output: Contribution to journalReview article

72 Scopus citations

Abstract

Lung transplantation is the only definitive treatment modality for many forms of end-stage lung disease. However, the lung is rejected more often than any other type of solid organ allograft due to chronic rejection known as bronchiolitis obliterans (BO). Indeed, BO is the primary reason why the 5- and 7-yr survival rates are worse for the lung than for any other transplanted organ. Alloimmunity to donor antigens is established as the primary mechanism that mediates rejection responses. However, newer immunosuppressive regimens designed to abrogate alloimmune activation have not improved survival. Therefore, these data suggest that other antigens, unrelated to donor transplantation antigens, are involved in rejection. Utilizing human and rodent studies of lung transplantation, our laboratory has documented that a native collagen, type V collagen [col(V)], is a target of the rejection response. Col(V) is highly conserved; therefore, these data indicate that transplant rejection involves both alloimmune and autoimmune responses. The role of col(V) in lung transplant rejection is described in this review article. In addition, the potential role of regulatory T cells that are crucial to modulating autoimmunity and alloimmunity is also discussed.

Original languageEnglish (US)
Pages (from-to)L1129-L1139
JournalAmerican Journal of Physiology - Lung Cellular and Molecular Physiology
Volume286
Issue number6 30-6
DOIs
StatePublished - Jun 1 2004

Keywords

  • Bronchiolitis obliterans
  • Major histocompatibility complex
  • Regulatory T cell

ASJC Scopus subject areas

  • Pulmonary and Respiratory Medicine
  • Cell Biology
  • Physiology

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