Autoantibody formation in human and rat studies of chronic rejection and primary graft dysfunction

Lung transplantation is considered a definitive treatment for many lung diseases. However, rejection and other pathologic entities are major causes of morbidity and mortality for lung transplant recipients. Primary graft dysfunction (PGD) and obliterative bronchiolitis (OB) are the leading causes of early and late mortality, respectively. While the immune basis of PGD has not been clearly defined, evidence is emerging about roles for autoantibodies in this process. Similarly, the pathogenesis of OB has been linked recently to autoimmunity. This review will highlight the current understanding of autoantibodies in PGD and OB post lung transplantation.

► Autoimmunity is linked to the pathogenesis of lung transplant rejection.
► Autoantibodies may contribute to primary graft dysfunction and obliterative bronchiolitis.
► The role of complement in autoantibody-mediated pathology is remains.
► IL-17 appears to have a key role in autoantibody induction.