Rethinking de novo immune hepatitis, an old concept for liver allograft rejection: Relevance of glutathione S-transferase T1 mismatch
| Autor: | J.M. Sousa, Elena Aguado-Dominguez, Antonio Núñez-Roldán, Isabel Aguilera |
|---|---|
| Jazyk: | angličtina |
| Rok vydání: | 2018 |
| Předmět: |
Graft Rejection
medicine.medical_treatment Biopsy Plasma Cells T lymphocytes Context (language use) Autoimmune hepatitis Human leukocyte antigen 030230 surgery Liver transplantation Major histocompatibility complex Cell quantification 03 medical and health sciences 0302 clinical medicine Antigen Histocompatibility Antigens medicine Humans Transplantation Homologous Liver allograft rejection Autoantibodies Glutathione Transferase biology business.industry De novo autoimmune hepatitis Donor-specific antibodies Gastroenterology Autoantibody Glutathione S-transferase T1 mismatch Minireviews General Medicine NewCAST medicine.disease Allografts Plasma cell-rich rejection Liver Transplantation Hepatitis Autoimmune Liver Immunoglobulin G Immunology biology.protein 030211 gastroenterology & hepatology Antibody IgG4+ plasma cell business |
| Zdroj: | World Journal of Gastroenterology |
| Popis: | Antibody-mediated rejection (AMR) in liver transplantation has long been underestimated. The concept of the liver as an organ susceptible to AMR has emerged in recent years, not only in the context of the major histocompatibility complex with the presence of HLA donor-specific antibodies, but also with antigens regarded as “minor”, whose role in AMR has been demonstrated. Among them, antibodies against glutathione S-transferase T1 have been found in 100% of patients with de novo autoimmune hepatitis (dnAIH) when studied. In its latest update, the Banff Working Group for liver allograft pathology proposed replacing the term dnAIH with plasma cell (PC)-rich rejection. Antibodies to glutathione S-transferase T1 (GSTT1) in null recipients of GSTT1 positive donors have been included as a contributory but nonessential feature of the diagnosis of PC-rich rejection. Also in this update, non-organ-specific anti-nuclear or smooth muscle autoantibodies are no longer included as diagnostic criteria. Although initially found in a proportion of patients with PC-rich rejection, the presence of autoantibodies is misleading since they are not disease-specific and appear in many different contexts as bystanders. The cellular types and proportions of the inflammatory infiltrates in diagnostic biopsies have been studied in detail very recently. PC-rich rejection biopsies present a characteristic cellular profile with a predominance of T lymphocytes and a high proportion of PCs, close to 30%, of which 16.48% are IgG4+. New data on the relevance of GSTT1-specific T lymphocytes to PC-rich rejection will be discussed in this review. |
| Databáze: | OpenAIRE |
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