Research progress on kidney transplantation rejection associated with non-HLA antibody
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摘要: 人类白细胞抗原（HLA）是由HLA基因复合体所编码的产物，定位于6号染色体短臂上，是异体免疫的主要靶点，但HLA抗体阳性并不能解释所有的肾移植排斥反应。非HLA抗体是同种异体肾移植中供者基因表达的产物，术中缺血-再灌注损伤、异体和自身免疫相互作用、细胞外囊泡的介导作用等都可以触发免疫系统反应，促使非HLA抗体产生。多项研究表明非HLA抗体是诱发排斥反应、影响肾移植结局的重要因素。因此，本文就肾移植非HLA抗体类型及形成机制进行综述，总结非HLA抗体相关肾移植排斥反应的研究进展，以期为肾移植术后非HLA抗体相关排斥反应的研究提供参考。Abstract: Human leukocyte antigen (HLA) is a product encoded by HLA gene complex, which is located on the short arm of chromosome 6 and is the main target of alloimmunity. However, positive HLA antibody is not responsible for all kinds of rejections in kidney transplantation. Non-HLA antibody is the product of donor gene expression in allogeneic kidney transplantation. Intraoperative ischemia-reperfusion injury, the interaction between alloimmunity and autoimmunity and the mediation of extracellular vesicles may trigger immune system response and promote the production of non-HLA antibody. Multiple studies have demonstrated that non-HLA antibody is an important factor of inducing rejection and affecting the outcomes of kidney transplantation. Consequently, the types and formation mechanism of non-HLA antibody in kidney transplantation were reviewed, and research progress on kidney transplantation rejection associated with non-HLA antibody was summarized, aiming to provide reference for in-depth study of kidney transplantation rejection associated with non-HLA antibody.
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