October 28, 2024, Immune Tolerance
In recent years, antibody-mediated rejection has emerged as a primary cause of graft dysfunction.
In humoral immunity, follicular T helper cells play a crucial role in the germinal center, where they facilitate the differentiation of naive B cells into memory B cells and antibody-secreting plasma cells. In this manner, they contribute to the production of donor-specific antibodies, which are the primary cause of antibody-mediated rejection in kidney transplants.
Our research at the Kidney Transplantation Center of Zhongshan Hospital, affiliated with Fudan University, demonstrated that the number and proportion of follicular T helper cells increase during rejection episodes, directly correlating with B-cell activation and antibody secretion. However, when rejection is intervened upon, the opposite outcome is observed, further confirming the critical role of follicular T helper cells in rejection.
Recent articles published in Frontiers in Immunology have reviewed and explored the potential applications of follicular T helper cells in kidney transplantation. Follicular T helper cells express several key targets, such as IL-6R, IL-21R, CD40L, and PD-1, among others.
The effects of several novel immunosuppressants targeting these markers on antibody-mediated rejection in kidney transplantation are under investigation, including belatacept, which we discussed earlier, as well as anti-inflammatory agents in the treatment of kidney transplant rejection, and numerous experimental drugs that have not yet entered clinical use. It is anticipated that the research outcomes of these drugs could offer a breakthrough in addressing antibody-mediated rejection.
Written by | Zhu Dong, Edited by | Zhu Dong, Photography | Greg
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