Organ Redlerine Işık Tutabilecek Nakiller: Kompozit Doku Nakilleri

Son dönem böbrek ve karaciğer yetmezliği gibi ölümle sonuçlanabilecek hastalıkların kesin tedavisi olarak organ nakli Transplantasyon uygulanmaktadır. Organ nakilleri her ne kadar hastayı yaşama bağlayan bir yöntem olsa da; nakledilen organların reddedilme riski mevcuttur. Organ Rejeksiyonlarının organ nakillerinin önemli bir dezavantajı olmasından dolayı üzerinde yapılan araştırmaların sayısı fazladır.Son on yılda hastanın yaşam kalitesini artırmak için uygulanan kompozit doku nakillerinin sayısı artmıştır. Yapılan nakil sayılarının artması sonucu, kompozit doku nakillerinde gelişen kronik rejeksiyon sıklığının solid organ naklindekinden daha az olduğu görülmüştür. Daha immünolojik özellikteki dokuların nakledilmesine rağmen kronik rejeksiyon görülme sıklığının az olması merak uyandırıcıdır. Bu seyrek görülen rejeksiyonların altında yatan moleküler ve immünolojik nedenlerin aydınlatılması büyük önem taşımaktadır. Elde edilecek bilgiler doğrultusunda solid organ nakillerinde de oluşacak rejeksiyonların erken tanısı ve de önlenmesinde bilim camiası önemli bir ilerleme gösterecektir

Transplantations which might Shed Light on Organ Rejections: Composite Tissue Transplantations

Transplantation is used as a cure for the end-stage renal and liver failure that may be fatal. Although transplantation is an option for the patient to cling to life, there is a risk of rejection of the transplanted organ. Extensive research has been conducted on this subject as organ rejections are a major problem of transplantation.The number of composite tissue transplants, which are performed to improve the patient’s quality of life, has increased during the last decade. The frequency of chronic rejection in composite tissue transplantation with this method has been observed to be less than that of solid organ transplantation. A lower frequency of chronic rejection is intriguing given the fact that more immunogenic tissues are transplanted in composite tissue transplantation. The elucidation of molecular and immunological mechanisms underlying this “rare rejection” phenomenon is of utmost importance. The scientifi c community might make signifi cant progress in the early diagnosis and prevention of solid organ rejections data from future studies

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  • Josien R, Pannetier C, Douillard P, Cantarovich D, Menoret S, Bugeon L, Kourilsky P, Soulillou JP, Cuturi MC. Graft-infi ltrating T helper cells, CD45RC phenotype, and Th1/Th2-related cytokines in donor-specifi c transfusion- induced tolerance in adult rats. Transplantation 1995; 60: 1131-9.
  • Horak I, Lohler J, Ma A. Smith KA. Interleukin-2 defi cient mice: a new model to study autoimmunity and self-tolerance. Immunol Rev 1995; 148:35-44.
  • Refaeli Y, Van Parijs L, London CA, Tschopp J, Abbas AK. Biochemical mechanisms of IL-2-regulated Fas- mediated T cell apoptosis. Immunity 1998; 8: 615-23.
  • Irmler M, Thome M, Hahne M, Schneider P, Hofmann, K, Steiner V, Bodmer JL, Schroter M, Burns K, Mattmann C, Rimoldi D, French LE, Tschopp J. Inhibition of death receptor signals by cellular FLIP. Nature 1997; 388:190-5.
  • Li X. The common gammac-cytokines and transplantation tolerance. Cell Mol Immunol 2004; 1:167-72.
  • McLaughlin PJ, Aikawa A, Davies HM, Ward RG, Bakran A, Sells RA, Johnson PM. Evaluation of sequential plasma and urinary tumor necrosis factor alpha levels in renal allograft recipients. Transplantation 1991; 51:1225-9.
  • Deng MC, Plenz G, Labarrere C, Marboe C, Baba HA, Erre M, Itescu, S. The role of IL6 cytokines in acute cardiac allograft rejection. Transpl Immunol 2002; 9:115- 20.
  • Reinders ME, Sho M, Izawa A, Wang P, Mukhopadhyay D, Koss KE, Geehan CS, Luster AD, Sayegh MH, Briscoe DM. Proinfl ammatory functions of vascular endothelial growth factor in alloimmunity. J Clin Invest 2003; 112, 1655-65.
  • Luscinskas FW, Cybulsky MI, Kiely JM, Peckins CS, Davis VM, Gimbrone MA Jr. Cytokine-activated human endothelial monolayers support enhanced neutrophil transmigration via a mechanism involving both endothelial-leukocyte adhesion molecule-1 and intercellular adhesion molecule-1. J Immunol 1991; 146: 1617-25.
  • Tripp CS, Wolf SF, Unanue ER. Interleukin 12 and tumor necrosis factor alpha are costimulators of interferon gamma production by natural killer cells in severe combined immunodefi ciency mice with listeriosis, and interleukin 10 is a physiologic antagonist. Proc Natl Acad Sci USA 1993; 90: 3725-9.
  • Chang CH, Furue M, Tamaki K. Selective regulation of ICAM-1 and major histocompatibility complex class I and II molecule expression on epidermal Langerhans cells by some of the cytokines released by keratinocytes and T cells. Eur J Immunol 1994; 24: 2889-95.
  • Sandner SE, Clarkson MR, Salama AD, Sanchez-Fueyo A, Domenig C, Habicht A, Najafi an N, Yagita H, Azuma M, Turka LA, Sayegh MH. Role of the programmed death-1 pathway in regulation of alloimmune responses in vivo. J Immunol 2005; 174:3408-15.
  • Yamada J, Yoshida M, Taylor AW, Streilein JW. Mice with Th2-biased immune systems accept orthotopic corneal allografts placed in “high risk” eyes. J Immunol 1999; 162: 5247-55.
  • Niederkorn JY. Immune mechanisms of corneal allograft rejection. Curr Eye Res 2007; 32:1005-16.
  • Hargrave S, Chu Y, Mendelblatt D, Mayhew E, Niederkorn J. Preliminary fi ndings in corneal allograft rejection in patients with keratoconus. Am J Ophthalmol 2003; 135: 452-60.
  • Matzinger P. Friendly and dangerous signals: Is the tissue in control? Nat Immunol 2007; 8: 11-3.
  • Schwartz RH. Natural regulatory T cells and self- tolerance. Nat Immunol 2005; 6:327-30.
  • Monk NJ, Hargreaves RE, Simpson E, Dyson JP, Jurcevic S. Transplant tolerance: Models, concepts and facts. J Mol Med (Berl) 2006; 84, 295-304.
  • Kingsley CI, Karim M, Bushell AR, Wood KJ. CD25+CD4+ regulatory T cells prevent graft rejection: CTLA-4- and IL-10-dependent immunoregulation of alloresponses. J Immunol 2002; 168:1080-6.
  • Onodera K, Hancock WW, Graser E, Lehmann M, Sayegh MH, Strom TB, Volk HD, Kupiec-Weglinski JW. Type 2 helper T cell-type cytokines and the development of “infectious” tolerance in rat cardiac allograft recipients. J Immunol 1997; 158:1572-81.
  • Wells AD, Li XC, Li Y, Walsh MC, Zheng XX, Wu Z, Nunez G, Tang A, Sayegh M, Hancock WW, Strom TB, Turka LA. Requirement for T-cell apoptosis in the induction of peripheral transplantation tolerance. Nat Med 1999; 5:1303-7.
  • Dai Z, Konieczny BT, Baddoura FK, Lakkis FG. Impaired alloantigen-mediated T cell apoptosis and failure to induce long-term allograft survival in IL-2-defi cient mice. J Immunol 1998; 161: 1659-63.
  • Bushell A, Niimi M, Morris PJ, Wood KJ. Evidence for immune regulation in the induction of transplantation tolerance: A conditional but limited role for IL-4. J Immunol 1999; 162: 1359-66.
  • Li XC, Ima A, Li Y, Zheng XX, Malek TR, Strom TB. Blocking the common gamma-chain of cytokine receptors induces T cell apoptosis and long-term islet allograft survival. J Immunol 2000; 164: 1193-9.
  • Lu LF, Lind EF, Gondek DC, Bennett KA, Gleeson MW, Pino-Lagos K, Scott ZA, Coyle AJ, Reed JL, Van Snick J, Strom TB, Zheng XX, Noelle RJ. Mast cells are essential intermediaries in regulatory T-cell tolerance. Nature 2006; 442:997-1002.
  • Kielar ML, John R, Bennett M, Richardson JA, Shelton JM, Chen L, Jeyarajah DR, Zhou XJ, Zhou H, Chiquett B, Nagami GT, Lu CY. Maladaptive role of IL-6 in ischemic acute renal failure. J Am Soc Nephrol 2005; 16:3315-25.
  • Yoshida S, Haque A, Mizobuchi T, Iwata T, Chiyo M, Webb TJ, Baldridge LA, Heidler KM, Cummings OW, Fujisawa T, Blum JS, Brand DD, Wilkes DS. Anti-type V collagen lymphocytes that express IL-17 and IL-23 induce rejection pathology in fresh and well-healed lung transplants. Am J Transplant 2006; 6:724-35.
  • Chen Y, Wood KJ. Interleukin-23 and TH17 cells in transplantation immunity: Does 23+17 equal rejection? Transplantation 2007; 84:1071-4.
  • Li J, Simeoni E, Fleury S, Dudler J, Fiorini E, Kappenberger L, von Segesser LK, Vassalli G. Gene transfer of soluble interleukin-17 receptor prolongs cardiac allograft survival in a rat model. Eur J Cardiothorac Surg 2006; 29:779-83.
  • Tang JL, Subbotin VM, Antonysamy MA, Troutt AB, Rao AS, Thomson AW. Interleukin-17 antagonism inhibits acute but not chronic vascular rejection. Transplantation 2001; 72:348-50.
  • Antonysamy MA, Fanslow WC, Fu F, Li W, Qian S, Troutt AB, Thomson AW. Evidence for a role of IL-17 in organ allograft rejection: IL-17 promotes the functional differentiation of dendritic cell progenitors. J Immunol 1999; 162:577-84.
  • Cendales LC, Kanitakis J, Schneeberger S, Burns C, Ruiz P, Landin L, Remmelink M, Hewitt CW, Landgren T, Lyons B, Drachenberg CB, Solez K, Kirk AD, Kleiner DE, Racusen, L. The Banff 2007 working classifi cation of skin-containing composite tissue allograft pathology. Am J Transplant 2008; 8:1396-400.
  • Kaufman CL, Ouseph R, Blair B, Kutz JE, Tsai TM, Scheker LR, Tien HY, Moreno R, Ozyurekoglu T, Banegas R, Murphy E, Burns CB, Zaring R, Cook DF, Marvin MR. Graft vasculopathy in clinical hand transplantation. Am J Transplant 2012; 12:1004-16.
  • Kaufman CL, Ouseph R, Marvin MR, Manon-Matos Y, Blair B, Kutz JE. Monitoring and long-term outcomes in vascularized composite allotransplantation. Curr Opin Organ Transplant 2013; 18:652-8.
  • Kanitakis J, Morelon E, Petruzzo P, Badet L, Dubernard JM. Self-renewal capacity of human epidermal Langerhans cells: Observations made on a composite tissue allograft. Exp Dermatol 2011; 20:145-6.
  • Kanitakis J, Petruzzo P, Dubernard JM. Turnover of epidermal Langerhans’ cells. N Engl J Med2004; 351:2661-2.
  • Eljaafari A, Badet L, Kanitakis J, Ferrand C, Farre A, Petruzzo P, Morelon E, Dubosson M, Tiberghien P, Dubois V, Martin X, Miossec P, Dubernard JM. Isolation of regulatory T cells in the skin of a human hand-allograft, up to six years posttransplantation. Transplantation 2006; 82:1764-8.
  • Hautz T, Brandacher G, Zelger B, Muller HG, Lee AW, Fuchs D, Margreiter R, Schneeberger S. Indoleamine 2,3-dioxygenase and foxp3 expression in skin rejection of human hand allografts. Transplant Proc 2009; 41: 509-12.
  • Diefenbeck M, Nerlich A, Schneeberger S, Wagner F, Hofmann GO. Allograft vasculopathy after allogeneic vascularized knee transplantation. Transpl Int 2011; 24: e1-5.
  • Unadkat JV, Schneeberger S, Horibe EH, Goldbach C, Solari MG, Washington KM, Gorantla VS, Cooper GM, Thomson AW, Lee, WP. Composite tissue vasculopathy and degeneration following multiple episodes of acute rejection in reconstructive transplantation. Am J Transplant 2010; 10:251-61.
  • Unadkat JV, Schneeberger S, Goldbach C, Solari MG, Washington KM, Afrooz PN, Pulikkottil BJ, Zheng XX, Lee WP. Investigation of antibody-mediated rejection in composite tissue allotransplantation in a rat limb transplant model. Transplant Proc 2009; 41:542-5.
  • Hewitt CW, Black KS, Henson LE, Achauer BM, Nguyen JH. Lymphocyte chimerism in a full allogeneic composite tissue (rat-limb) allograft model prolonged with cyclosporine. Transplant Proc 1988; 20:272-8.
  • Granger DK, Briedenbach WC, Pidwell DJ, Jones JW, Baxter-Lowe LA, Kaufman CL. Lack of donor hyporesponsiveness and donor chimerism after clinical transplantation of the hand. Transplantation 2002; 74:1624-30.
  • Mundinger GS, Munivenkatappa R, Drachenberg CB, Ha JS, Vaca EE, Shipley ST, Papadimitriou JC, Bartlett ST, Rodriguez ED, Barth RN. Histopathology of chronic rejection in a nonhuman primate model of vascularized composite allotransplantation. Transplantation 2013; 95:1204-10.
  • Mundinger GS, Drachenberg CB. Chronic rejection in vascularized composite allografts. Curr Opin Organ Transplant 2014; 19:309-14.
  • Meuli-Simmen C, Eiman T, Alpert BS, Meyer VE, Buncke GM, Buncke HJ. Fibromuscular proliferation in fi nger arteries after hand replantation: a case report. Microsurgery 1996; 17:551-4.
Akdeniz Tıp Dergisi-Cover
  • Yayın Aralığı: Yılda 3 Sayı
  • Başlangıç: 2015
  • Yayıncı: Akdeniz Üniversitesi Tıp Fakültesi