Abstract
Natural killer cells (NK) represent a population of lymphocytes involved in innate immune response. In addition to their role in anti-viral and anti-tumor defense, they also regulate several aspects of the allo-immune response in kidney transplant recipients. Growing evidence suggests a key role of NK cells in the pathogenesis of immune-mediated graft damage in kidney transplantation. Specific NK cell subsets are associated with operational tolerance in kidney transplant patients. On the other side, allo-reactive NK cells are associated with chronic antibody-mediated rejection and graft loss. Moreover, NK cells can prime the adaptive immune system and promote the migration of other immune cells, such as dendritic cells, into the graft leading to an increased allo-immune response and, eventually, to chronic graft rejection. Finally, activated NK cells can infiltrate the transplanted kidney and cause a direct graft damage. Interestingly, immunosuppression can influence NK cell numbers and function, thus causing an increased risk of post-transplant neoplasia or infection. In this review, we will describe how these cells can influence the innate and the adaptive immune response in kidney transplantation and how immunosuppression can modulate NK behavior.
Highlights
Natural killer cells (NK) represent a population of lymphocytes involved in innate immune response
Among the different lysosomalassociated membrane glycoproteins (LAMPs), CD107a/LAMP-1 has been widely used as a functional marker to identify NK cell activity, since its expression is significantly higher on the surface of NK cells after MHC stimulation and correlates with both cytokine secretion and NK cellmediated lysis of target cells [9, 10]
Conehn et al demonstrated that CD107a/LAMP-1 protects NK cells from self-destruction upon target cell killing, since CD107a/LAMP-1 deficiency, both in human and in mice NK cells, increased NK cell apoptosis after degranulation [11]
Summary
Natural killer cells (NK) represent a population of lymphocytes involved in innate immune response. In addition to their role in anti-viral and anti-tumor defense, they regulate several aspects of the allo-immune response in kidney transplant recipients. NK cells represent one of the main cellular components of innate immunity along with mast cells, eosinophils, basophils, macrophages, neutrophils, and dendritic cells They mediate immune responses against intracellular pathogens representing key mediators of the anti-viral and anti-neoplastic defense, but they play a key role, through the production and release of several cytokines, in many inflammatory diseases, including acute and chronic kidney diseases [2,3,4].
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