This review will summarize the key contribution of complement regulators in the immune response to an allograft.
Over the past 10 years, compelling evidences have been accumulated in support of a critical role of complement in the pathological phenomena related to organ transplantation. In addition to recurrence of complement-mediated disease after graft, complement is involved in situations as diverse as brain death induced tissue damages, ischaemia–reperfusion and antibody-mediated rejections. This complement activation is counterbalanced by various regulatory mechanisms.
We discuss the role of physiological and therapeutic complement regulators that are designed to overcome the impact of complement overactivation with the aim of improving long-term transplant outcomes. We will focus primarily on renal allograft, but the discussed mechanisms take place to a different degree in any kind of organ transplantation.
aINSERM UMRS 872, Centre de Recherche des Cordeliers
bUniversité Paris Descartes Sorbonne Paris-Cité
cUniversité Pierre et Marie Curie (UPMC-Paris-6)
dHôpital Necker, Service de Transplantation
eAssistance Publique–Hôpitaux de Paris, Hôpital Européen Georges Pompidou, Service d’Immunologie Biologique, Paris, France
Correspondence to Dr Véronique Fremeaux-Bacchi, Service d’Immunologie Biologique, Hôpital Européen Georges Pompidou, 20–40 rue Leblanc, 75908 Paris cedex 15, France. Tel: +33 1 56 09 39 41; fax: +33 1 56 09 20 80; e-mail: firstname.lastname@example.org