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Graft Rejection

Immunological tolerance refers to the lack of immune response to antigens, with self-tolerance preventing reactions against one's own tissues. Graft types include autografts, isografts, allografts, and xenografts, each with different donor sources. Rejection can occur in various forms, such as hyperacute, acute, and chronic rejection, influenced by T cell responses and antibodies, while the fetus is typically not rejected due to protective mechanisms like the placenta and immunosuppressive factors.

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7 views24 pages

Graft Rejection

Immunological tolerance refers to the lack of immune response to antigens, with self-tolerance preventing reactions against one's own tissues. Graft types include autografts, isografts, allografts, and xenografts, each with different donor sources. Rejection can occur in various forms, such as hyperacute, acute, and chronic rejection, influenced by T cell responses and antibodies, while the fetus is typically not rejected due to protective mechanisms like the placenta and immunosuppressive factors.

Uploaded by

jamal nasir
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© © All Rights Reserved
We take content rights seriously. If you suspect this is your content, claim it here.
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Immunological

tolerance
Immunological tolerance is unresponsiveness to an antigen .
SELF TOLERANCE ;refers to a lack of immune responsiveness to one’s own tissue antigens
CENTRAL TOLERANCE;IS THE DELETION OF SELF REACTIVE T and B lymphocytes during their
maturation in the lymphoid organs (thymus for T cells and bone marrow for B cells.)
PERIPHERAL TOLERANCE ;Self reactive T cells that escape negative selection in the thymus are
removed by functional inactivation or suppressed by regulatory T cells.
Types of grafts
• Autograft same individual
• Isograft identical twin such as kidney transplant from
monozygotic twin
• Allograft same species (different individual)

• Xenograft different species


T cell mediated rejection
• Donor class 1 and class II antigens and co stimulatory B7 molecules
are recognized by CD8+ cytotoxic T cells and CD4 helper T cells of the
host
• The interaction of CD4 + cells with peptides presented by class II
antigens leads to the proliferation of CD4+ T cells and release of
interleukin 2
• IL -2 further augments the proliferation of CD4+ cells
• It also helps for the differentiation of class I specific CD8 cells which
causes lysis of class I antigen bearing cells of the graft
• Other soluble mediators (lymphokines) that promote B cell
differentiation are produced by the CD4+ t cells
• Anti graft antibodies are produced by the sensitized B cells
• Macrophages also cause non specific damage
• Several mechanisms converge to destroy the graft
Hyper acute rejection
• the recipients has preformed antibodies

• Occurs within hours to days

• There is rapid vascular spasm , occlusion and failure of organ


Acute rejection
• It is due to sensitized T lymphocytes

• Occurs 10-30 days after transplantation

• There is infiltration of small lymphocytes and mononuclear cells


which destroy the graft
Chronic rejection
• Is characterized by slow loss of tissue function over a period of
months to years
• May be due to cellular immune response , antibody response or
combination of two.
GVH
GVH disease
disease in
in humans
humans
Why is fetus not rejected by the mother?

A/B C/D

A/C, A/D, B/C, B/D


Fetus as an allograft
Strain A Strain B
mate

Immunize with
father’s Ags

Skin graft fetus survives


rejected
Why is fetus not rejected?

 Placenta acts as a barrier or filter.


 It filters anti-MHC Abs.
 Trophoblast---outermost layer of fetal tissue---is
in direct contact with maternal blood.
 Trophoblast expresses weak or no MHC.
 progesterone---hormone---immunosuppressive..
 Spontaneous abortions are some times triggered
by maternal immune response against fetus.
Ethical aspects
Organs for sale !
Ethical aspects:
 Thanks to Allah
---MHC is
polymorphic.

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