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The Role of Alloimmune T Cell Responses in Obliterative Bronchiolitis

  • Tereza MartinuEmail author
Chapter
Part of the Respiratory Medicine book series (RM, volume 8)

Abstract

Obliterative bronchiolitis (OB) is the pathology thought to result from chronic lung allograft rejection. Anti-donor alloimmune T cells have been considered to be the main culprits in development of OB, although non-transplant and non-alloimmune etiologies of OB have also been identified. This chapter reviews basic concepts of transplant immunology, generation of alloimmune T cells, and T cell-mediated tissue injury. It further discusses the evidence supporting a role of alloimmune T cells in OB, based on human data and available animal models. Interactions between alloimmune T cells and other arms of the immune system immune system, such as the antibody response and innate immune cells, are described. New concepts in lung transplant immunology and recent landmark studies are reviewed, including data on regulatory T cells, Th17 responses, and local intrapulmonary immune events, which may have important implications for the future direction of basic lung transplant immunology research and development of therapeutics.

Keywords

Alloimmune Allorecognition Alloantigen T cell Adaptive immunity Lung transplant Obliterative bronchiolitis Chronic rejection Cytokine Major histocompatibility complex 

Notes

Acknowledgments

The author would like to thank Drs. Kymberly M. Gowdy, Scott M. Palmer, and Rebecca A. Shilling for their critical feedback on this manuscript, as well as Dr. David N. Howell for providing the OB pathology photomicrographs.

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Copyright information

© Springer Science+Business Media New York 2013

Authors and Affiliations

  1. 1.Department of MedicineDuke University Medical CenterDurhamUSA

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