Kidney Transplantation: The Challenge of Human Leukocyte Antigen and Its Therapeutic Strategies
Kidney transplantation remains the treatment of choice for end-stage renal failure. When the immune system of the recipient recognizes the transplanted kidney as a foreign object, graft rejection occurs. As part of the host immune defense mechanism, human leukocyte antigen (HLA) is a major challenge...
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| Main Authors: | , , , , , |
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| Format: | Article |
| Language: | English |
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Wiley
2018-01-01
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| Series: | Journal of Immunology Research |
| Online Access: | http://dx.doi.org/10.1155/2018/5986740 |
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| author | Tilahun Alelign Momina M. Ahmed Kidist Bobosha Yewondwossen Tadesse Rawleigh Howe Beyene Petros |
| author_facet | Tilahun Alelign Momina M. Ahmed Kidist Bobosha Yewondwossen Tadesse Rawleigh Howe Beyene Petros |
| author_sort | Tilahun Alelign |
| collection | DOAJ |
| description | Kidney transplantation remains the treatment of choice for end-stage renal failure. When the immune system of the recipient recognizes the transplanted kidney as a foreign object, graft rejection occurs. As part of the host immune defense mechanism, human leukocyte antigen (HLA) is a major challenge for graft rejection in transplantation therapy. The impact of HLA mismatches between the donor and the potential recipient prolongs the time for renal transplantation therapy, tethered to dialysis, latter reduces graft survival, and increases mortality. The formation of pretransplant alloantibodies against HLA class I and II molecules can be sensitized through exposures to blood transfusions, prior transplants, and pregnancy. These preformed HLA antibodies are associated with rejection in kidney transplantation. On the other hand, the development of de novo antibodies may increase the risk for acute and chronic rejections. Allograft rejection results from a complex interplay involving both the innate and the adaptive immune systems. Thus, further insights into the mechanisms of tissue rejection and the risk of HLA sensitization is crucial in developing new therapies that may blunt the immune system against transplanted organs. Therefore, the purpose of this review is to highlight facts about HLA and its sensitization, various mechanisms of allograft rejection, the current immunosuppressive approaches, and the directions for future therapy. |
| format | Article |
| id | doaj-art-3641a89dea2d418496505afff3f87400 |
| institution | Kabale University |
| issn | 2314-8861 2314-7156 |
| language | English |
| publishDate | 2018-01-01 |
| publisher | Wiley |
| record_format | Article |
| series | Journal of Immunology Research |
| spelling | doaj-art-3641a89dea2d418496505afff3f874002025-02-03T05:59:21ZengWileyJournal of Immunology Research2314-88612314-71562018-01-01201810.1155/2018/59867405986740Kidney Transplantation: The Challenge of Human Leukocyte Antigen and Its Therapeutic StrategiesTilahun Alelign0Momina M. Ahmed1Kidist Bobosha2Yewondwossen Tadesse3Rawleigh Howe4Beyene Petros5College of Natural Sciences, Department of Microbial, Cellular and Molecular Biology, Addis Ababa University, P.O. Box 1176, Addis Ababa, EthiopiaSt. Paul’s Hospital Millennium Medical College and Addis Ababa University, Addis Ababa, EthiopiaArmauer Hansen Research Institute, Addis Ababa, EthiopiaSchool of Medicine, College of Health Sciences, Addis Ababa University, Addis Ababa, EthiopiaArmauer Hansen Research Institute, Addis Ababa, EthiopiaCollege of Natural Sciences, Department of Microbial, Cellular and Molecular Biology, Addis Ababa University, P.O. Box 1176, Addis Ababa, EthiopiaKidney transplantation remains the treatment of choice for end-stage renal failure. When the immune system of the recipient recognizes the transplanted kidney as a foreign object, graft rejection occurs. As part of the host immune defense mechanism, human leukocyte antigen (HLA) is a major challenge for graft rejection in transplantation therapy. The impact of HLA mismatches between the donor and the potential recipient prolongs the time for renal transplantation therapy, tethered to dialysis, latter reduces graft survival, and increases mortality. The formation of pretransplant alloantibodies against HLA class I and II molecules can be sensitized through exposures to blood transfusions, prior transplants, and pregnancy. These preformed HLA antibodies are associated with rejection in kidney transplantation. On the other hand, the development of de novo antibodies may increase the risk for acute and chronic rejections. Allograft rejection results from a complex interplay involving both the innate and the adaptive immune systems. Thus, further insights into the mechanisms of tissue rejection and the risk of HLA sensitization is crucial in developing new therapies that may blunt the immune system against transplanted organs. Therefore, the purpose of this review is to highlight facts about HLA and its sensitization, various mechanisms of allograft rejection, the current immunosuppressive approaches, and the directions for future therapy.http://dx.doi.org/10.1155/2018/5986740 |
| spellingShingle | Tilahun Alelign Momina M. Ahmed Kidist Bobosha Yewondwossen Tadesse Rawleigh Howe Beyene Petros Kidney Transplantation: The Challenge of Human Leukocyte Antigen and Its Therapeutic Strategies Journal of Immunology Research |
| title | Kidney Transplantation: The Challenge of Human Leukocyte Antigen and Its Therapeutic Strategies |
| title_full | Kidney Transplantation: The Challenge of Human Leukocyte Antigen and Its Therapeutic Strategies |
| title_fullStr | Kidney Transplantation: The Challenge of Human Leukocyte Antigen and Its Therapeutic Strategies |
| title_full_unstemmed | Kidney Transplantation: The Challenge of Human Leukocyte Antigen and Its Therapeutic Strategies |
| title_short | Kidney Transplantation: The Challenge of Human Leukocyte Antigen and Its Therapeutic Strategies |
| title_sort | kidney transplantation the challenge of human leukocyte antigen and its therapeutic strategies |
| url | http://dx.doi.org/10.1155/2018/5986740 |
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