The role of complement in antibody-mediated rejection in kidney transplantation

Mark D Stegall, Marcio F. Chedid, Lynn D. Cornell

Research output: Contribution to journalArticle

135 Citations (Scopus)

Abstract

Over the past decade, several studies have suggested that the complement system has an active role in both acute and chronic allograft rejection. These studies have been facilitated by improved techniques to detect antibody-mediated organ rejection, including immunohistological staining for C4d deposition in the allograft and solid-phase assays that identify donor-specific alloantibodies (DSAs) in the serum of transplant recipients. Studies with eculizumab, a humanized monoclonal antibody directed against complement component C5, have shown that activation of the terminal complement pathway is necessary for the development of acute antibody-mediated rejection in recipients of living-donor kidney allografts who have high levels of DSAs. The extent to which complement activation drives chronic antibody-mediated injury leading to organ rejection is less clear. In chronic antibody-mediated injury, early complement activation might facilitate chemotaxis of inflammatory cells into the allograft in a process that later becomes somewhat independent of DSA levels and complement factors. In this Review, we discuss the different roles that the complement system might have in antibody-mediated allograft rejection, with specific emphasis on renal transplantation.

Original languageEnglish (US)
Pages (from-to)670-678
Number of pages9
JournalNature Reviews Nephrology
Volume8
Issue number11
DOIs
StatePublished - Nov 2012

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Kidney Transplantation
Allografts
Isoantibodies
Complement Activation
Antibodies
Tissue Donors
Complement C5
Antibodies, Monoclonal, Humanized
Living Donors
Wounds and Injuries
Chemotaxis
Rejection (Psychology)
Staining and Labeling
Kidney
Serum

ASJC Scopus subject areas

  • Nephrology

Cite this

The role of complement in antibody-mediated rejection in kidney transplantation. / Stegall, Mark D; Chedid, Marcio F.; Cornell, Lynn D.

In: Nature Reviews Nephrology, Vol. 8, No. 11, 11.2012, p. 670-678.

Research output: Contribution to journalArticle

Stegall, Mark D ; Chedid, Marcio F. ; Cornell, Lynn D. / The role of complement in antibody-mediated rejection in kidney transplantation. In: Nature Reviews Nephrology. 2012 ; Vol. 8, No. 11. pp. 670-678.
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