Advertisement

Kongreß pp 18-36 | Cite as

Immunpathomechanismen der Abstoßung

  • K. Rother
Conference paper
Part of the Verhandlungen der Deutschen Gesellschaft für Innere Medizin book series (VDGINNERE, volume 93)

Zusammenfassung

Mehr als 10 000 Patienten wurde allein in Westdeutschland durch Überpflanzung fremder Nieren ein zweites Leben geschenkt. Von ca. 18 000 derzeit niereninsuffizienten dialysepflichtigen Patienten wartet die Mehrzahl auf eine Spenderniere, bei steigender Tendenz. Etwa 5000 von ihnen sind transplantationsbereit und stehen auf der Warteliste. Transplantationsmedizin ist Routineteil der Praxis geworden, und sie betrifft nicht nur Nieren. Herztransplantate reichen heute bereits an die Propose von Nierentransplantaten heran. Leber- and Lungenübertragungen stehen an der Schwelle der Bewährung. Während die chirurgisch-technischen Probleme heute weitgehend gelöst sind, sind es noch immer immunologische Abwehrreaktionen, die über Angehen oder Abstoßsung entscheiden.

Preview

Unable to display preview. Download preview PDF.

Unable to display preview. Download preview PDF.

Literatur

  1. Abbas AK, Corson JM, Carpenter CB, Galvanek EG, Merrill JP, Dammin GJ (1974) Immunologie enhancement of rat renal allografts. II. Immunohistology of acutely rejecting and passively enhanced grafts. Am J Pathol 75: 271–280PubMedGoogle Scholar
  2. Altman B (1963) Tissue transplantation: circulating antibody in the homotransplantation of kidney and skin. Ann Roy Cell Surg Engl 33: 79–104Google Scholar
  3. Arnos DB, Wakefield JD (1958) Growth of mouse ascites tumor cells in diffusion Chambers. I. Studies of growth rate of cells and of the rate of entry of antibody. J Nat Cancer Inst 21: 657–670Google Scholar
  4. Arnos DB, Wakefield JD (1959) Growth of mouse ascites tumor cells in diffusion Chambers. II. Lysis and growth inhibition by diffusible isoantibody. J Nat Cancer Inst 22: 1077–1092Google Scholar
  5. Anderson ND, Wyllie RG, Shaker IJ (1977) Pathogenesis of vascular injury in rejecting renal allografts. Johns Hopkins Med J 141: 135–147PubMedGoogle Scholar
  6. Austen KF (1974) Hageman-Factor-dependent coagulation, fibrinolysis, and kinin generation. Transplant Proc 6: 39–45PubMedGoogle Scholar
  7. Bainbridge DR (1983) Elimination of allogeneic lymphocytes by mice. Immunol Rev 73: 5–34PubMedCrossRefGoogle Scholar
  8. Bevan DJ, Chisholm PM (1986) Co-expression of CD4 and CD8-molecules and de novo expression of MHC class II antigens on activated rat T cells. Immunology 59: 621–625PubMedGoogle Scholar
  9. Brent L, Brown J, Medawar PB (1958) Skin transplantation immunity in relation to hypersensitivity. Lancet 11: 561–564CrossRefGoogle Scholar
  10. Busch GJ, Garovoy MR, Tilney NL (1979) Variant forms of arteritis in human renal allografts. Transplant Proc 11: 100–103PubMedGoogle Scholar
  11. Carpenter CB, Ruddy S, Shehadeh IH, Müller-Eberhard HJ, Merrill JP, Austen KF (1969) Complement metabolism in man: hypercatabolism of the fourth (C4) and third (C3) components in patients with renal allograft rejection and hereditary angioedema ( HAE ). J Clin Invest 48: 1495–1505PubMedCrossRefGoogle Scholar
  12. Carpenter CB, d’Apice AJF, Abbas AK (1976) The role of antibodies in the rejection and enhancement of organ allografts. Adv Immunol 22: 1–65PubMedCrossRefGoogle Scholar
  13. Chatterjee SN (1985) Monoclonal antibodies in transplantation. In: Chatterjee SN (ed) Monoclonal antibodies. Diagnostic and therapeutic use in tumor and transplantation. PSG, Littleton, p 35–42Google Scholar
  14. Ciavarra RP, Terres G (1984) Immune rejection mechanisms in murine leukemia. I. Timing of tumor cell rejection process relative to the development of humoral and cell-mediated cytotoxic immune responses. Int J Cancer 34: 681–688PubMedCrossRefGoogle Scholar
  15. Council Report (1985) Xenografts. Review of the literature and current status. JAMA 254: 3353–3357CrossRefGoogle Scholar
  16. Dallmann MJ, Mason DW (1982) Role of thymus-derived and thymus-independent cells in murine skin allograft rejection. Transplantation 33: 221–223CrossRefGoogle Scholar
  17. Dennert G, Weiss S, Warner JF (1981) T cells may express multiple acitvities: Specific allohelp, cytolysis, and delayed-type hypersensitivity are expressed by a cloned T-cell line. Proc Natl Acad Sci USA 78: 4540–4543PubMedCrossRefGoogle Scholar
  18. Dorsch SE, Roser B (1974) The adoptive transfer of first-set allograft responses by recirculating small lymphocytes in the rat. Aust J Exp Biol Med Sci 52: 33–44PubMedCrossRefGoogle Scholar
  19. Dvorak HF, Mihm MC, Dvorak AM, Barnes BA, Manseau EJ, Galli SJ (1979) Rejection of first set skin allografts in man. J Exp Med 150: 322–337PubMedCrossRefGoogle Scholar
  20. Engres HD, Glasebrook AL, Sorenson GD (1982) Allogeneic tumor rejection induced by the intravenous injection of Lyt-2+ cytotoxic T-lymphocyte clones. J Exp Med 156: 1280–1285CrossRefGoogle Scholar
  21. Flores RV, Gilmer PJ (1984) Differential recognition and lysis of EL4 target cells by cytotoxic T cells: Differences in H-2Kb antigenic density and cyto-skeletal proteins. J Immunol 132: 2767–2774PubMedGoogle Scholar
  22. Foker JE, Clark DS, Pickering RJ, Good AA, Varco RL (1969) Studies on the mechanism of canine renal allograft rejection. Transplant Proc 1: 296–304PubMedGoogle Scholar
  23. Gerlag PGG, Koene RAP, Hagemann JFHM, Wijdeveld PGAB (1975) Hyperacute rejection of skin allografts in the mouse. Transplantation 20: 308–313PubMedCrossRefGoogle Scholar
  24. Gerlag PGG, Capel PJA, Hagemann JFHM, Koene RAP (1980) Adaptation of skin grafts in the mouse and antibody mediated rejection. J Immunol 125: 583–586PubMedGoogle Scholar
  25. Gewürz H, Clark DS, Finstad J, Kelley WD, Varco RL, Good RA, Gabrielsen AE (1966) Role of the complement system in graft rejections in experimental animals and man. Ann N Y Acad Sci 129: 673–713CrossRefGoogle Scholar
  26. Gurley KE, Lowry RP, Forbes RD (1983) Immune mechanisms in organ allograft rejection. II. T helper cells, delayed-type hypersensitivity, and rejection of renal allografts. Transplantation 36: 401–405PubMedCrossRefGoogle Scholar
  27. Habal MB, Carpenter CB, Kobayashi K, Busch GJ, Misra M, Birtch AG (1973) The protective effect of F(ab’)2 and succinylated IgG in the early treatment of hyperacute rejection in the primate. Transplant Proc 5: 601–606PubMedGoogle Scholar
  28. Hänsch GM (1986) Einführung in die Immunbiologie. Fischer, Stuttgart, IX, 280 S (UTB für Wissenschaft: Uni-Taschenbücher; 1409 )Google Scholar
  29. Hänsch GM, Seitz M, Martinotti G, Betz M, Rauterberg EW, Gemsa D (1984) Macrophages release arachidonic acid, Prostaglandin E2, and thrombo-xane in response to late complement components. J Immunol 133: 2145–2150PubMedGoogle Scholar
  30. Häyry P, von Willebrand E, Parthenais E, Nemlander A, Soots A, Lautenschlager I, Alfoldy P, Renkonen R (1984) The inflammatory mechanisms of allograft rejection. Immunol Rev 77: 85–142PubMedCrossRefGoogle Scholar
  31. Hall BM, Dorsch SE, Roser B ( 1978 a) The cellular basis of allograft rejection in vivo. I. The cellular requirements for first-set rejection of heart grafts. J Exp Med 148: 878–889PubMedCrossRefGoogle Scholar
  32. Hall BM, Dorsch SE, Roser B ( 1978 b) The cellular basis of allograft rejection in vivo. II. The nature of memory cells mediating second-set heart graft rejection. J Exp Med 148: 890–902PubMedCrossRefGoogle Scholar
  33. Hancock WW, Thomson NM, Atkins RC (1983) Monoclonal antibody analysis of interstitial cell infiltrate during human renal allograft rejection. Transplant Proc XV: 352–355Google Scholar
  34. Hancock WW, Lord RH, Colby AJ, Diamantstein T, Rickles FR, Dijkstra C, Hogg N, Tilney NL (1987) Identification of IL 2R+ T cells and macrophages within rejecting rat cardiac allografts, and comparison of the effects of treatment with anti-IL 2R monoclonal antibody or cyclosporin. J Immunol 138: 164–170PubMedGoogle Scholar
  35. Henson PM (1974) Complement-dependent platelet and polymorphonuclear leukocyte reactions. Transplant Proc 6: 27–31PubMedGoogle Scholar
  36. Hess ML, Manson NH, Lower RR (1983) Leukocyte-generated hydrogen peroxide depression of cardiac sarcoplasmic reticulum calcium transport. A hypothetical effector mechanism of rejection. Transplantation 36: 117–119PubMedCrossRefGoogle Scholar
  37. Hobbs JB, Cliff WJ (1973) A study of allograft kidney rejection occurring simultaneously in whole organ and ear Chamber grafts in the rabbit. J Exp Med 137: 776–798PubMedCrossRefGoogle Scholar
  38. Holter AR, McKearn TJ, Neu MR, Fitch FW, Stuart FP (1972) Renal transplantation in the rabbit. I. Development of a model for study of hyperacute rejection and immunological enhancement. Transplantation 13: 244–249PubMedCrossRefGoogle Scholar
  39. Kincaid-Smith P (1967) Histological diagnosis of rejection of renal homografts in man. Lancet 11: 849–852CrossRefGoogle Scholar
  40. Klassen J, Milgrom F (1971) Studies on cortical necrosis in renal grafts. Transplant Proc 3: 598–601PubMedGoogle Scholar
  41. Kobayashi K, Hricko GM, Lukl P, Hunsicker L, Patel R, Reisner GS, Birtch AG (1971) Hyperacute renal allograft rejection in presensitized monkeys. Surg Forum 22: 246–248PubMedGoogle Scholar
  42. Kux M, PizaF, Stemberger H, Wagner O, Wiedermann G (1974) Immediate complement consumption in human renal allografts. A diagnostic and prognostic test. Eur Surg Res 6: 5–10PubMedCrossRefGoogle Scholar
  43. Lindquist RR, Guttmann RD, Merill JP, Dammin GJ (1968) Human renal allografts. Interpretation of morphologic and immunohistochemical observations. Am J Pathol 53: 851–881PubMedGoogle Scholar
  44. Lowenhaupt RW, Nathan P, Menefee MG (1971) Correlation of platelet aggregation in canine renal allotransplants with serum cytotoxic antibody following treatment with azathioprine. Transplant Proc 3: 453–456PubMedGoogle Scholar
  45. Lowry RP, Forbes RD (1985) Immune mechanisms in organ allograft rejection: IV. An overview of adoptive transfer studies on the pathogenesis of homograft rejection in the inbred rat. Transplant Proc XVII: 1963–1965Google Scholar
  46. Lowry RP, Gurley KE (1983) Immune mechanisms in organ allograft rejection. III. Cellular and humoral immunity in rejection of organ allografts transplanted across MHC subregion disparity RT1. B (RT1. D). Transplantation 36: 405–411PubMedCrossRefGoogle Scholar
  47. Lowry RP, Gurley KE, Forbes RD (1983) Immune mechanisms in organ allograft rejection. I. Delayed-type hypersensitivity and lymphocytotoxicity in heart graft rejection. Transplantation 36: 391–401PubMedCrossRefGoogle Scholar
  48. Lowry RP, Marghesco DM, Blackburn JH (1985) Immune mechanisms in organ allograft rejection. VI. Delayed-type hypersensitivity and lymphotoxin in experimental renal allograft rejection. Transplantation 40: 183–188PubMedCrossRefGoogle Scholar
  49. Lübbe FH, Eastham WN, van der Herik A (1972) The significance of early immunoglobulin and ß-ic-globulin deposition in the arterial walls of transplanted rat kidneys. Transplantation 14: 649–651PubMedCrossRefGoogle Scholar
  50. McCluskey RT (1980) Comments on targets in rejecting allografts. Transplant Proc XII [3 Suppl l]: 22–25Google Scholar
  51. McCluskey RT, Benacerraf B, McCluskey JW (1963) Studies on the specificity of the cellular infiltrate in delayed hypersensitivity reactions. J Immunol 90: 466–477PubMedGoogle Scholar
  52. McKenzie IFC, Wittingham S (1968) Deposits of immunoglobulin and fibrin in human allografted kidneys. Lancet 11: 1313–1316CrossRefGoogle Scholar
  53. McPhaul JJ Jr, Dixon FJ, Brettschneider L, Starzl TE (1970) Immunofluorescent examination of biopsies from long-term renal allografts. N Engl J Med 282: 412–417PubMedCrossRefGoogle Scholar
  54. Mason DW (1983) The mechanism of allograft rejection-progress and problems. Transplant Proc XV: 264–268Google Scholar
  55. Mason DW, Morris PJ (1986) Effector mechanisms in allograft rejection. Ann Rev Immunol 4: 119–145CrossRefGoogle Scholar
  56. Mason DW, Dalimann MJ, Arthur RP, Morris PJ (1984) Mechanisms of allograft rejection: the roles of cytotoxic T-cells and delayed-type hypersensitivity. Immunol Rev 77: 167–184PubMedCrossRefGoogle Scholar
  57. Mintz B, Silvers WK (1970) Histocompatibility antigens on melanocytes and hair follicles. Cell localised homograft rejection in allophenic skin grafts. Transplantation 9: 497–505PubMedCrossRefGoogle Scholar
  58. Najarian JS, Feldman JD ( 1962 a) Passive transfer of transplantation immunity. Tritiated lymphoid cells. II. Lymphoid cells in millipore Chambers. J Exp Med 115: 1083–1093PubMedCrossRefGoogle Scholar
  59. Najarian JS, Feldman JD (1962 b) The function of the sensitized lymphocyte in homograft rejection. Ann N Y Acad Sci 99: 470–476Google Scholar
  60. Nathan CF, Murray HW, Cohn ZA (1980) The macrophage as an effector cell. N Engl J Med 303: 622–626PubMedCrossRefGoogle Scholar
  61. Nemlander et al. unpublished results, zitiert nach Häyry et al. 1984Google Scholar
  62. Pedersen NC, Morris B (1970) The role of the lymphatic system in the rejection of homografts: a study of lymph from renal transplants. J Exp Med 131: 936–969PubMedCrossRefGoogle Scholar
  63. Phillips ME, Rother U, Rother K (1968) Serum complement in the rejection of sarcoma I ascites tumor grafts. J Immunol 100: 493–500PubMedGoogle Scholar
  64. Platt JL, LeBienTW, Michael AF (1982) Interstitialmononuclear cellpopulations in renal graft rejection. Identification by monoclonal antibodies in tissue sections. J Exp Med 155: 17–30PubMedCrossRefGoogle Scholar
  65. Podack ER, Königsberg PJ (1984) Cytolytic T cell granules: Isolation, structural, biochemical, and functional characterization. J Exp Med 160: 695–710PubMedCrossRefGoogle Scholar
  66. Porter KA (1967) Rejection intreated renal allografts. J Clin Pathol 20 [Suppl]: 518–534Google Scholar
  67. Porter KA, Calne RY (1960) Origin of the infiltrating cells in skin and kidney homografts. Transplant Bull 26: 458–464PubMedCrossRefGoogle Scholar
  68. Rapaport FT, Markowitz AS, McCluskey RT (1969) The bacterial induetion of homograft sensitivity. III. Effects of group A streptococcal membrane antisera. J Exp Med 129: 623–645PubMedCrossRefGoogle Scholar
  69. Rother K (1969) Die mögliche Bedeutung des Komplementsystems bei der Abwehr von Allotransplantaten. In: Heymer A, Ricken D (eds) Organtransplantation. Immunologie und Klinik. Schattauer, Stuttgart, p 123–132Google Scholar
  70. Rother K, Rother U (1986) Biological funetions of the complement system. In: Rother K, Rother U (eds) Hereditary and acquired complement deficiencies in animals and man. Progress in Allergy 39:24–100, Karger, Basel MünchenGoogle Scholar
  71. Paris-Rother U, Ballantyne DL, Cohen C, Rother K (1967) Allograft rejection in C’6 defective rabbits. J Exp Med 126: 565–579CrossRefGoogle Scholar
  72. Schneider TM, Kupiec-Weglinski JW, Towpik E, Strom TB, Tilney NL (1986) Studies on mechanisms of acute rejection of vascularized organ allografts. Hum Immunol 15: 320–329PubMedCrossRefGoogle Scholar
  73. Schubert WK, Fowler R, Martin LW, West CD (1960) Homograft rejection in children with congenital immunological defects: Agammaglobulinemia and Aldrich Syndrome. Transplant Bull 26: 125–128PubMedCrossRefGoogle Scholar
  74. Sellin D, Kövary M, Rother U, Rother K (1970) Intrarenal complement fixation by cytoxic antibodies. J Exp Med 132: 829–844PubMedCrossRefGoogle Scholar
  75. Spong FW, Feldman JD, Lee S (1968) Transplantation antibody associated with first-set renal homografts. J Immunol 101: 418–425PubMedGoogle Scholar
  76. Stetson CA, Demopoulos R (1958) Reactions of skin homografts with specific immune sera. Ann N Y Acad Sci 73: 687–692CrossRefGoogle Scholar
  77. Stetson CA (1963) The role of humoral antibody in the homograft reaction. Adv Immunol 3: 97–130CrossRefGoogle Scholar
  78. Strom TB, Kostick R, Tilney NL, Carpenter CB (1978 b) A characterization of the nature and control of cellular rejection. Nephron 22: 201–207Google Scholar
  79. Strom TB, Carpenter CB, Tilney NL, Suthanthiran M, Catto GRD, Lundin AP, Milford EL (1978 a) Intragraft immune events causing vascularized organ graft rejection. Transplant Proc 10: 389–394Google Scholar
  80. Sybesma JP, Kater L, Borst-Eilers E, de PlanqueBA, van Soelen T, Tuit G (1974) HLA antigens in kidney tissue. Localisation by means of an immunofluorescence technique. Transplantation 17: 576–579PubMedCrossRefGoogle Scholar
  81. von Willebrand E (1983) OKT4/8 ratio in the blood and in the graft during episodes of human renal allograft rejection. Cell Immunol 77: 196–201CrossRefGoogle Scholar
  82. Weitzel HK, Rother K (1970) Studies on the role of serum complement in allograft rejection and in Immunsuppression by antithymocyte serum ( ATS ). Eur Surg Res 2: 310–317PubMedCrossRefGoogle Scholar
  83. Williams GM, Hume DM, Hudson RP, Morris PJ, Kano K, Milgrom F (1968) „Hyperacute“ renal-homograft rejeciton in man. N Engl J Med 279: 611–618Google Scholar
  84. Winn HJ, Baldamus CA, Jooste SV, Russell PS (1973) Acute destruetion by humoral antibody of rat skin grafted to mice. J Exp Med 137: 893–910PubMedCrossRefGoogle Scholar

Copyright information

© J. F. Bergmann Verlag, München 1987

Authors and Affiliations

  • K. Rother
    • 1
  1. 1.Institut für ImmunologieUniversität HeidelbergDeutschland

Personalised recommendations