Immune responses to self-antigens (autoimmunity) in allograft rejection

Many lung, heart, and kidney transplant recipients with clinically as well as pathologically diagnosed chronic rejection don't have detectable antibodies directed to the mismatched donor HLA in their sera. This has led to the hypothesis that antibody responses to other tissue-restricted antigens may contribute to the development of chronic rejection. Development of immune responses to self-antigens has been described following all solid organ transplantations. Studies have further presented evidence for a significant cross talk between the alloimmune and autoimmune responses. Experimental results demonstrate that blocking of the immune responses to self-antigens may prevent chronic rejection. In this review, we present recent evidence for an important role of immune responses to self-antigens in the development of chronic rejection following transplantation. Further, we discuss the implications of these findings in developing new therapeutic strategies towards preventing or treating chronic rejection following transplantation.