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IMMUNOLOGICAL TOLERANCE IN LIVER TRANSPLANT RECIPIENTS: PUTATIVE INVOLVEMENT OF NEUROENDOCRINE-IMMUNE INTERACTIONS
Regulatory microenvironment
Neuroendocrine-immune interaction
Adrenergic receptor
Cholinergic receptor
Immunological tolerance
Author
Affilliation
Oswaldo Cruz Foundation. Oswaldo Cruz Institute. Laboratory of Cellular Communication. Rio de Janeiro, RJ, Brazil / Federal Fluminense University. Biology Institute. Department of Immunobiology. Laboratory of Immunopathology. Gragoatá, Niterói, Brazil.
Oswaldo Cruz Foundation. Oswaldo Cruz Institute. Laboratory of Cellular Communication. Rio de Janeiro, RJ, Brazil.
Federal Institute of Rio de Janeiro. Department of Biotechnology. Rio de Janeiro, RJ, Brazil.
Federal Fluminense University. Biology Institute. Department of Immunobiology. Laboratory of Immunopathology. Gragoatá, Niterói, Brazil.
Oswaldo Cruz Foundation. Oswaldo Cruz Institute. Laboratory of Innovations in Therapies, Education, and Bioproducts. Rio de Janeiro, RJ, Brazil,
Oswaldo Cruz Foundation. Oswaldo Cruz Institute. Laboratory of Cellular Communication. Rio de Janeiro, RJ, Brazil.
Oswaldo Cruz Foundation. Oswaldo Cruz Institute. Laboratory of Cellular Communication. Rio de Janeiro, RJ, Brazil.
Federal Institute of Rio de Janeiro. Department of Biotechnology. Rio de Janeiro, RJ, Brazil.
Federal Fluminense University. Biology Institute. Department of Immunobiology. Laboratory of Immunopathology. Gragoatá, Niterói, Brazil.
Oswaldo Cruz Foundation. Oswaldo Cruz Institute. Laboratory of Innovations in Therapies, Education, and Bioproducts. Rio de Janeiro, RJ, Brazil,
Oswaldo Cruz Foundation. Oswaldo Cruz Institute. Laboratory of Cellular Communication. Rio de Janeiro, RJ, Brazil.
Abstract
The transplantation world changed significantly following the introduction of immunosuppressants, with millions of people saved. Several physicians have noted that liver recipients that do not take their medication for different reasons became tolerant regarding kidney, heart, and lung transplantations at higher frequencies. Most studies have attempted to explain this phenomenon through unique immunological mechanisms and the fact that the hepatic environment is continuously exposed to high levels of pathogen-associated molecular patterns (PAMPs) or non-pathogenic microorganism-associated molecular patterns (MAMPs) from commensal flora. These components are highly inflammatory in the periphery but tolerated in the liver as part of the normal components that arrive via the hepatic portal vein. These immunological mechanisms are discussed herein based on current evidence, although we hypothesize the participation of neuroendocrine-immune pathways, which have played a relevant role in autoimmune diseases. Cells found in the liver present receptors for several cytokines, hormones, peptides, and neurotransmitters that would allow for system crosstalk. Furthermore, the liver is innervated by the autonomic system and may, thus, be influenced by the parasympathetic and sympathetic systems. This review therefore seeks to discuss classical immunological hepatic tolerance mechanisms and hypothesizes the possible participation of the neuroendocrine-immune system based on the current literature.
Keywords
Liver transplantationRegulatory microenvironment
Neuroendocrine-immune interaction
Adrenergic receptor
Cholinergic receptor
Immunological tolerance
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