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The Role of Alloimmune T Cell Responses in Obliterative Bronchiolitis

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Bronchiolitis Obliterans Syndrome in Lung Transplantation

Part of the book series: Respiratory Medicine ((RM,volume 8))

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Abstract

Obliterative bronchiolitis (OB) is the pathology thought to result from chronic lung allograft rejection. Anti-donor alloimmune T cells have been considered to be the main culprits in development of OB, although non-transplant and non-alloimmune etiologies of OB have also been identified. This chapter reviews basic concepts of transplant immunology, generation of alloimmune T cells, and T cell-mediated tissue injury. It further discusses the evidence supporting a role of alloimmune T cells in OB, based on human data and available animal models. Interactions between alloimmune T cells and other arms of the immune system immune system, such as the antibody response and innate immune cells, are described. New concepts in lung transplant immunology and recent landmark studies are reviewed, including data on regulatory T cells, Th17 responses, and local intrapulmonary immune events, which may have important implications for the future direction of basic lung transplant immunology research and development of therapeutics.

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Acknowledgments

The author would like to thank Drs. Kymberly M. Gowdy, Scott M. Palmer, and Rebecca A. Shilling for their critical feedback on this manuscript, as well as Dr. David N. Howell for providing the OB pathology photomicrographs.

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  1. Department of Medicine, Duke University Medical Center, 106 Research Drive, MSRB2, Suite 2073, 103000, Durham, NC, 27710, USA

    Tereza Martinu M.D.

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  1. Tereza Martinu M.D.
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Correspondence to Tereza Martinu M.D. .

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  1. School of Medicine & Public Health, Dept. Internal Medicine, Sect. Allergy, University of Wisconsin, Highland Avenue 600, Madison, 53792-9988, Wisconsin, USA

    Keith C. Meyer

  2. Lung Transplant Unit, St. Vincent's Hospital, Victoria Street, Darlinghurst, Sydney, 2010, New South Wales, Australia

    Allan R. Glanville

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Martinu, T. (2013). The Role of Alloimmune T Cell Responses in Obliterative Bronchiolitis. In: Meyer, K., Glanville, A. (eds) Bronchiolitis Obliterans Syndrome in Lung Transplantation. Respiratory Medicine, vol 8. Humana Press, New York, NY. https://doi.org/10.1007/978-1-4614-7636-8_6

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