Immunology articles within Nature Reviews Nephrology

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  • Review Article |

    Renal dendritic cells and macrophages are key factors in the initiation and propagation of renal disease and tissue regeneration. In this Review, the authors discuss the common and distinct characteristics of dendritic cells and macrophages as well as current understanding of the renal-specific functions of these important phagocytic, antigen-presenting cell types in potentiating or mitigating intrinsic kidney disease.

    • Natasha M. Rogers
    • , David A. Ferenbach
    •  & Jeremy Hughes

  • News & Views |

    The role of the innate immune system in mediating allograft rejection is unclear. A new study demonstrates for the first time the ability of allografts to stimulate the differentiation of monocytes into inflammatory dendritic cells, which produce IL-12 and stimulate T cells, leading to graft rejection.

    • Deepak K. Nayak
    •  & Thalachallour Mohanakumar

  • Review Article |

    Data from studies in humans and rodents suggest that B cells have the capacity to control or regulate the immune response to a transplanted organ. Here, the authors describe the phenotypes and mechanisms that have been associated with regulatory B cell function and discuss the evidence for a role of these cells in transplant tolerance.

    • Jessica Stolp
    • , Laurence A. Turka
    •  & Kathryn J. Wood

  • News & Views |

    Kidney transplant recipients who also receive a partial liver allograft have better long-term outcomes than those who receive a kidney alone, despite the more-complex surgery. Understanding how the liver exerts these beneficial effects might enable their exploitation in the future.

    • Marc Martinez-Llordella
    •  & Alberto Sanchez-Fueyo

  • News & Views |

    Immunosuppressive drugs commonly used in transplantation and autoimmune diseases are unfortunately associated with increased cancer incidence. Now, a new study reports a direct relationship between the number of regulatory T cells in the blood and the risk of developing invasive skin cancer in kidney transplant recipients.

    • Fadi G. Lakkis

  • News & Views |

    The potential roles for autoantibodies in renal transplantation are increasing, as illustrated by a recent report of polyreactive autoantibodies produced by B-cell clones from a kidney transplant recipient that can bind apoptotic cells and activate complement. Such autoantibodies have the potential to amplify microcirculation injury caused by alloantibody in antibody-mediated transplant rejection.

    • Philip F. Halloran

  • Review Article |

    Co-inhibitory and co-stimulatory signals that are expressed upon T-cell-activation influence both autoreactive and alloreactive T-cell responses. Here, the authors describe the functional importance of T-cell co-stimulatory molecules in transplantation, tolerance and autoimmunity, and how therapeutic blockade of these pathways might be harnessed to manipulate the immune response to prevent or attenuate pathological immune responses.

    • Mandy L. Ford
    • , Andrew B. Adams
    •  & Thomas C. Pearson

  • News & Views |

    A new meta-analysis shows a strong association between low levels of preformed donor-specific HLA antibodies (DSAs) detected using sensitive solid-phase assays and an increased risk of renal allograft failure. These findings have important implications for stratifying patients with DSAs for organ allocation and for the use of alloantigen desensitization therapies.

    • Alexandre Loupy
    •  & Stanley C. Jordan

  • Review Article |

    Much progress has been made in understanding the processes underlying antibody-mediated rejection (AMR) of transplanted organs. In this Review, the authors discuss the role of the complement system in acute and chronic AMR, with specific emphasis on renal transplantation, and describe studies demonstrating that blockade of terminal complement activation can prevent AMR in sensitized renal transplant recipients.

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

  • Review Article |

    Improved understanding of the role of complement in the pathogenesis of a number of glomerular diseases has led to progress in disease classification and treatment. In this Review, Bomback and Appel re-examine the previous classification schemes for membranoproliferative glomerulonephritis (MPGN) and discuss the role of complement in the various MPGN lesions including the C3 glomerulopathies. In addition, they discuss the pathogenesis, diagnosis, treatment, and prognosis of the C3 glomerulopathies.

    • Andrew S. Bomback
    •  & Gerald B. Appel

  • Review Article |

    Atypical haemolytic uraemic syndrome (HUS), Shiga toxin-producingEscherichia coli-associated HUS and thrombotic thrombocytopaenic purpura are diseases characterized by microvascular thrombosis, with subsequent dysfunction of affected organs. In this Review, the authors discuss data indicating that complement dysregulation is a common pathogenetic effector of all three diseases, and describe the emerging evidence indicating that targeting complement may effectively treat these disease entities.

    • Marina Noris
    • , Federica Mescia
    •  & Giuseppe Remuzzi

  • News & Views |

    In a new study, Porcheray et al. provide evidence that a single antibody generated by alloimmunization can recognize multiple antigens in a paradigm-changing fashion. Although these results require confirmation, the presence of polyreactive antibody may offer an explanation as to why some patients with a single sensitizing event develop a wide breadth of panel-reactive antibody.

    • Robert A. Montgomery
    •  & Andrea A. Zachary

  • Review Article |

    Vitamin D has an important role in regulating the innate and adaptive immune response. Patients with kidney disease are often deficient in vitamin D, which could partly explain the high morbidity and mortality associated with infection that is commonly seen in these patients. In this Review, Sterling et al. describe the pleiotropic actions of vitamin D on the immune system and how vitamin D deficiency leads to immune dysfunction.

    • Kevin A. Sterling
    • , Parham Eftekhari
    •  & Dominic S. Raj

  • Review Article |

    A growing body of evidence indicates that monocytes, specifically intermediate (CD14++CD16+) monocytes, contribute to the development of atherogenesis and increase in number with worsening renal function. In this Review, Heine and colleagues on behalf of the EURECA-m working group of the ERA–EDTA, describe the developmental and functional characterization of monocyte subsets, with particular focus on prominent subsets in atherosclerosis and chronic kidney disease.

    • Gunnar H. Heine
    • , Alberto Ortiz
    •  & Danilo Fliser

  • Review Article |

    Reactivation of latent BK polyomavirus (BKV) infection is a major challenge in renal graft recipients and progression of BKV infection to BKV-associated nephropathy (BKVAN) leads to graft loss in up to 60% of affected patients. This Review discusses the available data on the diagnosis and monitoring of BKV infection and BKVAN, describes the known risk factors for BKV-related disease, and reviews current approaches to treatment and prevention of both BKV infection and BKVAN.

    • Nina Babel
    • , Hans-Dieter Volk
    •  & Petra Reinke

  • Review Article |

    Many immunosuppressive agents used in renal transplantation are associated with an increased risk of cancer, and malignancy is the third most common cause of death among renal transplant recipients at all time points after transplantation. In this Review, Rama and Grinyó describe the epidemiological and clinical characteristics of common tumor types that occur in renal transplant recipients. They also discuss the potential pathogenic mechanisms involved in tumor development in these patients, with a particular focus on the involvement of immunosuppressive treatments.

    • Inés Rama
    •  & Josep M. Grinyó

  • Review Article |

    The immune system has evolved to ensure protection against ever changing microbial pathogens. The potential of lymphocytes to recognize 'self' is controlled by a process called 'self tolerance'. Improved understanding of the mechanisms of immunological tolerance is key to understanding the pathogenesis of autoimmune disorders and cancers, and may lead to strategies to harness tolerance to replace the lifelong need for immunosuppressive drugs after organ transplantation. In this Review, Waldmann provides an overview of the mechanisms of self tolerance and assesses the prospects of translating this knowledge to patient care.

    • Herman Waldmann

  • Review Article |

    Promoting the development and maintenance of regulatory responses through the promotion of regulatory T (TREG) cells represents a promising approach for the induction of transplantation tolerance. In this Review, Li and Turka provide an overview of TREG cells, focusing on the challenges, opportunities, and emerging approaches in exploiting FOXP3+ TREGcells for the induction of transplant tolerance.

    • Xian Chang Li
    •  & Laurence A. Turka

  • Review Article |

    Finding a suitable donor kidney for renal transplant candidates who are allosensitized to human leukocyte antigen (HLA) can be challenging. In this Review, Gloor and Stegall discuss currently available strategies for screening and desensitization and new techniques that are under development. Treatments that target donor-specific antibodies have shown some success in reversing acute antibody-mediated rejection, a common complication in antibody-incompatible kidney transplantation. New treatments, such as anti-C5 antibody-mediated complement blockade and proteasome inhibitor-mediated plasma cell depletion, are promising therapeutic avenues.

    • James Gloor
    •  & Mark D. Stegall

  • Review Article |

    Toll-like receptors (TLRs) have a key role in the regulation of innate immunity by mediating signal transduction pathways that modulate the expression of proinflammatory cytokines and chemokines. This Review discusses the potential role of TLRs in the pathogenesis of renal conditions such as acute kidney injury, acute glomerulonephritis, and renal transplant rejection. The authors also describe studies that have used pharmacological inhibition of TLR signaling to modify the response to proinflammatory stimuli.

    • Anna Gluba
    • , Maciej Banach
    •  & Jacek Rysz

  • Review Article |

    A number of new promising agents for the prevention of acute and chronic transplant rejection have been or are being developed. In this Review, Antoine Durrbach and colleagues discuss agents that interfere with antibody-mediated rejection and those that deplete allogenic T cells or inhibit T-cell activation. The capacity of these agents to prevent acute rejection is also described.

    • Antoine Durrbach
    • , Helene Francois
    •  & Bernard Charpentier

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