Abstract
Skin is the most immunogenic tissue of the human body. Its external location makes it the first barrier for invading pathogens and protects the individual from physical and chemical injury. In this chapter, we review skin immunology and its impact in reconstructive transplantation. The skin-resident immune system, mechanisms of leukocyte trafficking, the role of antigen-presenting cells, and potential tolerogenic mechanisms of the skin are highlighted in this chapter.
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References
Nestle F, Di Meglio P, Qin J, et al. Skin immune sentinels in health and disease. Nat Rev Immunol. 2009;9:679–91.
Uchi H, Terao H, Koga T, et al. Cytokines and chemokines in the epidermis. J Dermatol Sci. 2000;24:29.
Gaspari A, Katz S. Induction and functional characterization of class II MHC (Ia) antigens on murine keratinocytes. J Immunol. 1988;140:2956.
Wang L, Bursch L, Kissenpfennig A, et al. Langerin expressing cells promote skin immune responses under defined conditions. J Immunol. 2008;180:4722–7.
James W, Bullard D, Hickery M. Critical role of the alpha 4 integrin/VCAM-1 pathway in cerebral leukocyte trafficking in lupus-prone MRL/fas(lpr) mice. J Immunol 2003;170:520–7.
Deane J, Hickery M. Molecular mechanisms of leukocyte trafficking in T-cell-mediated skin inflammation: insights from intravital imaging. Exp Rev Mol Med 2009;11:25.
Clark R, Chong B, Mirchandani N, et al. The vast majority of CLA + T cells are resident in normal skin. J Immunol. 2006;176:4431–9.
Hirahara K, Lui L, Clark R, et al. The majority of human peripheral blood CD4+ CD25 high Foxp3+ regulatory T cells bear functional skin-homing receptors. J Immunol. 2006;177:4488–94.
Billingham R, Brent L. Quantitative studies on tissue transplantation immunity. IV. Induction of tolerance in newborn mice and studies on the phenomenon of runt disease. Philos Trans R Soc Lond B Biol Sci 1956;242:357–414.
Pescovitz M, Auchincloss H, Thistlethwaite R, et al. Transplantation in miniature swine: acceptance of class I antigen mismatched renal allografts. Transpl Proc 1983;15:1124.
Mathes D, Randolph M, Solari M, et al. Split tolerance to a composite tissue allograft in a swine model. Transplantation. 2003;75:25–31.
Petruzzo P, Badet L, Gazarian A, et al. Bilateral hand transplantation: six years after the first case. Am J Transplant. 2006;6:1718–24.
Schneeberger S, Gorantla V, Brandacher G, et al. Upper-extremity transplantation using a cell-based protocol to minimize immunosuppression. Ann Surg 2013;257:345–51.
Gorantla V, Brandacher G, Schneeberger S, et al. Favoring the risk-benefit balance for upper extremity transplantation—the Pittsburgh protocol. Hand Clin. 2011;27(4):511–20.
Eljaafari A, Badet L, Kanitakis J, et al. Isolation of regulatory T cells in the skin of a human hand-allograft, up to six years posttransplantation. Transplantation. 2006;82:1764–8.
Hautz T, Zelger B, Grahammer J, et al. Molecular markers and targeted therapy of skin rejection in composite tissue allotransplantation. Am J Transplant. 2010;10:1200–9.
Muthukumar T, Dadhania D, Ding R, et al. Messenger RNA for Foxp3 in the urine of renal-allograft recipients. N Engl J Med. 2005;353:2342–51.
Petruzzo P, Lanzetta M, Dubernard J, et al. The International Registry on Hand and Composite Tissue Transplantation. Transplantation. 2010;90:1590–4.
Kanitakis J. The challenge of dermatopathological diagnosis of composite tissue allograft rejection: a review. J Cutan Pathol. 2008;35:738–44.
Cendales L, Kanitakis J, Schneeberger S, et al. The Banff 2007 working classification of skin-containing composite tissue allograft pathology. Am J Transplant. 2008;8:1396–400.
Schneeberger S, Kreczy A, Brandacher G, et al. Steroid- and ATG-resistant rejection after double forearm transplantation responds to Campath-1H. Am J Transplant. 2004;4:1372–4.
Kanitakis J, Jullien D, Nicolas J, et al. Sequential histological and immunohistochemical study of the skin of the first human hand allograft. Transplantation. 2000;69:1380–5.
Schneeberger S, Gorantla V, van Riet R, et al. Atypical acute rejection after hand transplantation. Am J Transplant. 2008;8:688–96.
Kanitakis J, Jullien D, Petruzzo P, et al. Clinicopathologic features of graft rejection of the first human hand allograft. Transplantation. 2003;76:688–93.
Hautz T, Zelger B, Weissenbacher A, et al. Standardizing skin biopsy sampling to assess rejection in vascularized composite allotransplantation. Clin Transpl. 2013;27:81–90.
Mundinger G, Munivenkatappa R, Drachenberg C, et al. Histopathology of chronic rejection in a nonhuman primate model of vascularized composite allotransplantation. Transplantation. 2013;95:1204–10.
Robert C, Kupper T. Inflammatory skin diseases, T cells and immune surveillance. N Engl J Med. 1999;24:1817–28.
Schön M, Boehncke W. Psoriasis. N Engl J Med. 2005;18:1899–912.
Kaffenberger B, Wong H, Jarjour W, et al. Remission of psoriasis after allogeneic, but no not autologous, hematopoietic stem-cell transplantation. J Am Acad Dermatol. 2013;68:489–92.
Alon R, Feigelson S. From rolling to arrest on blood vessels: leukocyte tap dancing on endothelial integrin ligands and chemokines at sub-second contacts. Sem Immunol. 2002;14:93–104.
Schön M. The molecular basis for lymphocyte recruitment to the skin: clues for pathogenesis and selective therapies of inflammatory disorders. J Inv Dermatol. 2003;121:951–62.
Shamri R, Grabovsky V, Gauguet J, et al. Lymphocyte arrest requires instantaneous induction of an extended LFA-1 conformation mediated by endothelium-bound chemokines. Nat Immunol. 2005;6:497–506.
Patrick A, Rullo J, Bveaudin S, et al. Hepatic leukocyte recruitment in response to time-limited expression of TNF-alpha and IL-1beta. Am J Physiol Gastrointest Liver Physiol. 2007;293:663–72.
Li W, Nava R, Bribriesco A, et al. Intravital 2-photon imaging of leukocyte trafficking in beating heart. J Clin Invest. 2012;122:2499–508.
Fuhlbrigge R, Kiefer J, Armerding D, et al. Cutaneous lymphocyte antigen is a specialized form of PSGL-1 expressed on skin-homing T cells. Nature 1997;389:978–81.
Boyman O, Hefti C, Conrad B, et al. Spontaneous development of psoriasis in a new animal model shows an essential role for resident T cells and tumor necrosis factor-alpha. J Exp Med. 2004;199:731–36.
Butcher E, Williams M, Youngman K, et al. Lymphocyte trafficking and regional immunity. Adv Immunol 1999;72:209–53.
Bhushan M, Bleiker T, Ballsdon A, et al. Anti-E-selectin is ineffective in the treatment of psoriasis: a randomized trial. Br J Dermatol. 2002;146:824–31.
Schön M, Krahn T, Schön M, et al. Efomycine M, a new specific inhibitor of selectin, impairs leukocyte adhesion and alleviates cutaneous inflammation. Nat Med. 2002;4:366–72.
Boster A, Nicholas J, Topalli I, et al. Lessons learned from fatal progressive multifocal leukoencephalopathy in a patient with multiple sclerosis treated with natalizumab. JAMA Neurol. 2013;70:398–402.
Lebwohl M, Tyring S, Hamilton T, et al. A novel targeted T-cell modulator, efalizumab, for plaque psoriasis. N Engl J Med. 2003;349:2004–13.
Camirad G. New perspectives in transplantation through intravital microscopy imaging. Curr Op Org Transpl. 2013;18:6–12.
Germain R, Robei E, Cahalan M. A decade of imaging cellular motility and interaction dynamics in the immune system. Science. 2012;336:1676–81.
Horner B, Ferguson KK, Randolph M, et al. In vivo observations of cell trafficking in allotransplanted vascularized skin flaps and conventional skin grafts. J Plast Reconstr Aesth Surg. 2010;63:711–9.
Celli S, Albert M, Bousso P. Visualizing the innate and adaptive immune responses underlying allograft rejection by two-photon microscopy. Nat Med. 2011;17:744–49.
Garrod K, Liu F, Forrest L, et al. NK cell patrolling and elimination of donor-derived dendritic cells favor indicrect alloreactivity. J Immunol. 2010;71:418–21.
Min W, Gorczynski R, Huang X, et al. Dendritic cells genetically engineered to express Fas ligand induce donor-specific hyporesponsiveness and prolong allograft survival. J Immunol. 2000;164:161–7.
Emmer P, van der Vlag J, Adema G, et al. Dendritic cells activated by lipopolysaccharide after dexamethasone treatment induce donor-specific allograft hyporesponsiveness. Transplantation. 2006;81:1451–9.
Taner T, Hackstein H, Wang Z, et al. Rapamycin-treated, alloantigen-pulsed host dendritic cells induce Ag-specific T cell regulation and prolong graft survival. Am J Transplant. 2005;5:228–36.
Bonham C, Peng L, Liang X, et al. Marked prolongation of cardiac allograft survival by dendritic cells genetically engineered with NF-kB oligodeoxyribonucleotide decoys and adenoviral vectors encoding CTLA-Ig. J Immunol. 2002;169:3382–91.
Wang Z, Divito S, Shufesky W, et al. Dendritic cell therapies in transplantation revisited: deletion of recipient DCs deters the effect of therapeutic DCs. Am J Transplant. 2010;12:1398–408.
Schuler G, Steinman R. Murine epidermal Langerhans cells mature into potent immunostimulatory dendritic cells in vitro. J Exp Med. 1985;161:526–46.
Romani N, Clausen B, Stoitzner P. Langerhans cells and more: langerin-expressing dendritic cell subsets in the skin. Immunol Rev. 2010;234:120–41.
Romani N, Koide S, Crowley M, et al. Presentation of exogenous protein antigens by dendritic cells to T cell clones: intact protein is presented best by immature, epidermal Langerhans cells. J Exp Med. 1989;169:1169–78.
Steinman R. Decisions about dendritic cells: past, present, and future. Ann Rev Immunol. 2012;30:1–22.
Wang L, Bursch L, Kssenpfennig A, et al. Langerin expressing cells promote skin immune responses under defined conditions. J Immunol. 2008;180:4722–7.
Kanitakis J, Morelon E, Petruzzo P, et al. Self-renewal capacity of human epidermal Langerhans cells: observations made on a composite tissue allograft. Exp Dermatol. 2011;20:145–6.
Romani N, Tripp C, Stoitzner P. Langerhans cells come in waves. Immunity. 2012;37:766–8.
Van der Aar A, Picavet D, Müller F, et al. Langerhans cells favor skin flora tolerance through limited presentation of bacterial antigens and induction of regulatory T cells. J Invest Dermatol. 2013;133:1240–9.
Coombes J, Siddiqui K, Arancibia-Carcamo C, et al. A functionally specialized population of mucosal CD103+ DCs induces Foxp3+ regulatory T cells via TGF-beta and retinoic acid-dependent mechanism. J Exp Med. 2007;204:1757–64.
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Grahammer, J., Hautz, T., Pratschke, J., Schneeberger, S. (2015). Migration and Communication Patterns in Skin Rejection. In: Brandacher, G. (eds) The Science of Reconstructive Transplantation. Stem Cell Biology and Regenerative Medicine. Humana Press, New York, NY. https://doi.org/10.1007/978-1-4939-2071-6_11
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DOI: https://doi.org/10.1007/978-1-4939-2071-6_11
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