Cellular activation pathways and interaction networks in vascularized composite allotransplantation

Frontiers in Immunology

Immunology

Christine G. Lian¹  Sam Sadigh¹  Catherine A. A. Lee¹  George F. Murphy¹  Barbara Kern²  Andreas Schroeter³  Leonard Knoedler⁴  Adriana C. Panayi⁵  Lioba Huelsboemer⁶  Bohdan Pomahac⁶  Vikram Mookerjee⁶  Martin Kauke-Navarro⁶  Viola A. Stoegner⁷  Samuel Knoedler⁸  Stefan G. Tullius⁹ 

[1] Department of Pathology, Brigham and Women’s Hospital, Boston, MA, United States;Department of Plastic Surgery, Charité – Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin and Berlin Institute of Health, Berlin, Germany;Department of Plastic, Aesthetic, Hand and Reconstructive Surgery, Burn Center, Hannover Medical School, Hannover, Germany;Division of Transplant Surgery, Department of Surgery, Brigham and Women’s Hospital, Harvard Medical School, Boston, MA, United States;Department of Plastic, Hand and Reconstructive Surgery, University Hospital Regensburg, Regensburg, Germany;Division of Plastic Surgery, Department of Surgery, Yale New Haven Hospital, Yale School of Medicine, New Haven, CT, United States;Department of Surgery, Division of Plastic Surgery, Brigham and Women’s Hospital, Harvard Medical School, Boston, MA, United States;Department of Hand, Plastic and Reconstructive Surgery, Microsurgery, Burn Center, BG Trauma Center Ludwigshafen, University of Heidelberg, Ludwigshafen, Germany;Division of Plastic Surgery, Department of Surgery, Yale New Haven Hospital, Yale School of Medicine, New Haven, CT, United States;Division of Plastic Surgery, Department of Surgery, Yale New Haven Hospital, Yale School of Medicine, New Haven, CT, United States;Department of Plastic, Aesthetic, Hand and Reconstructive Surgery, Burn Center, Hannover Medical School, Hannover, Germany;Division of Plastic Surgery, Department of Surgery, Yale New Haven Hospital, Yale School of Medicine, New Haven, CT, United States;Department of Surgery, Division of Plastic Surgery, Brigham and Women’s Hospital, Harvard Medical School, Boston, MA, United States;Division of Transplant Surgery, Department of Surgery, Brigham and Women’s Hospital, Harvard Medical School, Boston, MA, United States;

关键词: transplant;    reconstructive surgery;    vascularized composite allotransplantation;    VCA;    alloimmune response;    acute rejection;    chronic rejection;   

DOI  :  10.3389/fimmu.2023.1179355

 received in 2023-03-04, accepted in 2023-04-28,  发布年份 2023

来源: Frontiers

【 摘 要 】

Vascularized composite allotransplantation (VCA) is an evolving field of reconstructive surgery that has revolutionized the treatment of patients with devastating injuries, including those with limb losses or facial disfigurement. The transplanted units are typically comprised of different tissue types, including skin, mucosa, blood and lymphatic vasculature, muscle, and bone. It is widely accepted that the antigenicity of some VCA components, such as skin, is particularly potent in eliciting a strong recipient rejection response following transplantation. The fine line between tolerance and rejection of the graft is orchestrated by different cell types, including both donor and recipient-derived lymphocytes, macrophages, and other immune and donor-derived tissue cells (e.g., endothelium). Here, we delineate the role of different cell and tissue types during VCA rejection. Rejection of VCA grafts and the necessity of life-long multidrug immunosuppression remains one of the major challenges in this field. This review sheds light on recent developments in decoding the cellular signature of graft rejection in VCA and how these may, ultimately, influence the clinical management of VCA patients by way of novel therapies that target specific cellular processes.

【 授权许可】

Unknown   
Copyright © 2023 Knoedler, Knoedler, Panayi, Lee, Sadigh, Huelsboemer, Stoegner, Schroeter, Kern, Mookerjee, Lian, Tullius, Murphy, Pomahac and Kauke-Navarro

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