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The multifaceted role of complement in kidney transplantation

Biglarnia, Ali Reza LU orcid ; Huber-Lang, Markus ; Mohlin, Camilla ; Ekdahl, Kristina N. and Nilsson, Bo (2018) In Nature Reviews Nephrology 14(12). p.767-781
Abstract

Increasing evidence indicates an integral role for the complement system in the deleterious inflammatory reactions that occur during critical phases of the transplantation process, such as brain or cardiac death of the donor, surgical trauma, organ preservation and ischaemia–reperfusion injury, as well as in humoral and cellular immune responses to the allograft. Ischaemia is the most common cause of complement activation in kidney transplantation and in combination with reperfusion is a major cause of inflammation and graft damage. Complement also has a prominent role in antibody-mediated rejection (ABMR) owing to ABO and HLA incompatibility, which leads to devastating damage to the transplanted kidney. Emerging drugs and treatment... (More)

Increasing evidence indicates an integral role for the complement system in the deleterious inflammatory reactions that occur during critical phases of the transplantation process, such as brain or cardiac death of the donor, surgical trauma, organ preservation and ischaemia–reperfusion injury, as well as in humoral and cellular immune responses to the allograft. Ischaemia is the most common cause of complement activation in kidney transplantation and in combination with reperfusion is a major cause of inflammation and graft damage. Complement also has a prominent role in antibody-mediated rejection (ABMR) owing to ABO and HLA incompatibility, which leads to devastating damage to the transplanted kidney. Emerging drugs and treatment modalities that inhibit complement activation at various stages in the complement cascade are being developed to ameliorate the damage caused by complement activation in transplantation. These promising new therapies have various potential applications at different stages in the process of transplantation, including inhibiting the destructive effects of ischaemia and/or reperfusion injury, treating ABMR, inducing accommodation and modulating the adaptive immune response.

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author
; ; ; and
organization
publishing date
type
Contribution to journal
publication status
published
subject
keywords
Adaptive Immunity, Animals, Complement Activation, Complement System Proteins/metabolism, Graft Rejection/drug therapy, Humans, Immunomodulation, Inflammation/metabolism, Ischemia/physiopathology, Kidney Transplantation, Reperfusion/adverse effects
in
Nature Reviews Nephrology
volume
14
issue
12
pages
767 - 781
publisher
Nature Publishing Group
external identifiers
  • scopus:85055731914
  • pmid:30367174
ISSN
1759-5061
DOI
10.1038/s41581-018-0071-x
project
Kartläggning av inflammatoriska processer vid och efter organ transplantation - en stor longitudinell kohort studie
language
English
LU publication?
yes
id
6cf95581-5798-416f-85aa-acb16c61914c
date added to LUP
2018-11-20 11:08:54
date last changed
2025-12-20 02:27:15
@article{6cf95581-5798-416f-85aa-acb16c61914c,
  abstract     = {{<p>Increasing evidence indicates an integral role for the complement system in the deleterious inflammatory reactions that occur during critical phases of the transplantation process, such as brain or cardiac death of the donor, surgical trauma, organ preservation and ischaemia–reperfusion injury, as well as in humoral and cellular immune responses to the allograft. Ischaemia is the most common cause of complement activation in kidney transplantation and in combination with reperfusion is a major cause of inflammation and graft damage. Complement also has a prominent role in antibody-mediated rejection (ABMR) owing to ABO and HLA incompatibility, which leads to devastating damage to the transplanted kidney. Emerging drugs and treatment modalities that inhibit complement activation at various stages in the complement cascade are being developed to ameliorate the damage caused by complement activation in transplantation. These promising new therapies have various potential applications at different stages in the process of transplantation, including inhibiting the destructive effects of ischaemia and/or reperfusion injury, treating ABMR, inducing accommodation and modulating the adaptive immune response.</p>}},
  author       = {{Biglarnia, Ali Reza and Huber-Lang, Markus and Mohlin, Camilla and Ekdahl, Kristina N. and Nilsson, Bo}},
  issn         = {{1759-5061}},
  keywords     = {{Adaptive Immunity; Animals; Complement Activation; Complement System Proteins/metabolism; Graft Rejection/drug therapy; Humans; Immunomodulation; Inflammation/metabolism; Ischemia/physiopathology; Kidney Transplantation; Reperfusion/adverse effects}},
  language     = {{eng}},
  number       = {{12}},
  pages        = {{767--781}},
  publisher    = {{Nature Publishing Group}},
  series       = {{Nature Reviews Nephrology}},
  title        = {{The multifaceted role of complement in kidney transplantation}},
  url          = {{http://dx.doi.org/10.1038/s41581-018-0071-x}},
  doi          = {{10.1038/s41581-018-0071-x}},
  volume       = {{14}},
  year         = {{2018}},
}