<?xml version="1.0" encoding="ISO-8859-1"?><article xmlns:mml="http://www.w3.org/1998/Math/MathML" xmlns:xlink="http://www.w3.org/1999/xlink" xmlns:xsi="http://www.w3.org/2001/XMLSchema-instance">
<front>
<journal-meta>
<journal-id>0211-6995</journal-id>
<journal-title><![CDATA[Nefrología (Madrid)]]></journal-title>
<abbrev-journal-title><![CDATA[Nefrología (Madr.)]]></abbrev-journal-title>
<issn>0211-6995</issn>
<publisher>
<publisher-name><![CDATA[Sociedad Española de Nefrología]]></publisher-name>
</publisher>
</journal-meta>
<article-meta>
<article-id>S0211-69952016000400354</article-id>
<article-id pub-id-type="doi">10.1016/j.nefro.2016.03.023</article-id>
<title-group>
<article-title xml:lang="en"><![CDATA[Immune response and histology of humoral rejection in kidney transplantation]]></article-title>
<article-title xml:lang="es"><![CDATA[Respuesta inmune e histología de rechazo humoral en el trasplante renal]]></article-title>
</title-group>
<contrib-group>
<contrib contrib-type="author">
<name>
<surname><![CDATA[González-Molina]]></surname>
<given-names><![CDATA[Miguel]]></given-names>
</name>
<xref ref-type="aff" rid="Aff"/>
<xref ref-type="aff" rid="Aaf"/>
<xref ref-type="aff" rid="A a"/>
<xref ref-type="aff" rid="A5"/>
</contrib>
<contrib contrib-type="author">
<name>
<surname><![CDATA[Ruiz-Esteban]]></surname>
<given-names><![CDATA[Pedro]]></given-names>
</name>
<xref ref-type="aff" rid="Aff"/>
<xref ref-type="aff" rid="Aaf"/>
<xref ref-type="aff" rid="A a"/>
<xref ref-type="aff" rid="A5"/>
</contrib>
<contrib contrib-type="author">
<name>
<surname><![CDATA[Caballero]]></surname>
<given-names><![CDATA[Abelardo]]></given-names>
</name>
<xref ref-type="aff" rid="Aff"/>
<xref ref-type="aff" rid="Aaf"/>
<xref ref-type="aff" rid="A a"/>
<xref ref-type="aff" rid="A5"/>
</contrib>
<contrib contrib-type="author">
<name>
<surname><![CDATA[Burgos]]></surname>
<given-names><![CDATA[Dolores]]></given-names>
</name>
<xref ref-type="aff" rid="Aff"/>
<xref ref-type="aff" rid="Aaf"/>
<xref ref-type="aff" rid="A a"/>
<xref ref-type="aff" rid="A5"/>
</contrib>
<contrib contrib-type="author">
<name>
<surname><![CDATA[Cabello]]></surname>
<given-names><![CDATA[Mercedes]]></given-names>
</name>
<xref ref-type="aff" rid="Aff"/>
<xref ref-type="aff" rid="Aaf"/>
<xref ref-type="aff" rid="A a"/>
<xref ref-type="aff" rid="A5"/>
</contrib>
<contrib contrib-type="author">
<name>
<surname><![CDATA[Leon]]></surname>
<given-names><![CDATA[Miriam]]></given-names>
</name>
<xref ref-type="aff" rid="Aff"/>
<xref ref-type="aff" rid="Aaf"/>
<xref ref-type="aff" rid="A a"/>
<xref ref-type="aff" rid="A5"/>
</contrib>
<contrib contrib-type="author">
<name>
<surname><![CDATA[Fuentes]]></surname>
<given-names><![CDATA[Laura]]></given-names>
</name>
<xref ref-type="aff" rid="Aff"/>
<xref ref-type="aff" rid="Aaf"/>
<xref ref-type="aff" rid="A a"/>
<xref ref-type="aff" rid="A5"/>
</contrib>
<contrib contrib-type="author">
<name>
<surname><![CDATA[Hernandez]]></surname>
<given-names><![CDATA[Domingo]]></given-names>
</name>
<xref ref-type="aff" rid="Aff"/>
<xref ref-type="aff" rid="Aaf"/>
<xref ref-type="aff" rid="A a"/>
<xref ref-type="aff" rid="A5"/>
</contrib>
</contrib-group>
<aff id="Af1">
<institution><![CDATA[,Regional University Hospital of Malaga Nephrology Department ]]></institution>
<addr-line><![CDATA[Malaga ]]></addr-line>
<country>Spain</country>
</aff>
<aff id="Af4">
<institution><![CDATA[,Malaga University  ]]></institution>
<addr-line><![CDATA[ ]]></addr-line>
</aff>
<aff id="Af5">
<institution><![CDATA[,IBIMA  ]]></institution>
<addr-line><![CDATA[ ]]></addr-line>
</aff>
<aff id="Af2">
<institution><![CDATA[,Regional University Hospital of Malaga Immunology Department ]]></institution>
<addr-line><![CDATA[Malaga ]]></addr-line>
<country>Spain</country>
</aff>
<aff id="Af3">
<institution><![CDATA[,Regional University Hospital of Malaga Immunology Department ]]></institution>
<addr-line><![CDATA[Malaga ]]></addr-line>
<country>Spain</country>
</aff>
<pub-date pub-type="pub">
<day>00</day>
<month>08</month>
<year>2016</year>
</pub-date>
<pub-date pub-type="epub">
<day>00</day>
<month>08</month>
<year>2016</year>
</pub-date>
<volume>36</volume>
<numero>4</numero>
<fpage>354</fpage>
<lpage>367</lpage>
<copyright-statement/>
<copyright-year/>
<self-uri xlink:href="http://scielo.isciii.es/scielo.php?script=sci_arttext&amp;pid=S0211-69952016000400354&amp;lng=en&amp;nrm=iso"></self-uri><self-uri xlink:href="http://scielo.isciii.es/scielo.php?script=sci_abstract&amp;pid=S0211-69952016000400354&amp;lng=en&amp;nrm=iso"></self-uri><self-uri xlink:href="http://scielo.isciii.es/scielo.php?script=sci_pdf&amp;pid=S0211-69952016000400354&amp;lng=en&amp;nrm=iso"></self-uri><abstract abstract-type="short" xml:lang="en"><p><![CDATA[Abstract The adaptive immune response forms the basis of allograft rejection. Its weapons are direct cellular cytotoxicity, identified from the beginning of organ transplantation, and/or antibodies, limited to hyperacute rejection by preformed antibodies and not as an allogenic response. This resulted in allogenic response being thought for decades to have just a cellular origin. But the experimental studies by Gorer demonstrating tissue damage in allografts due to antibodies secreted by B lymphocytes activated against polymorphic molecules were disregarded. The special coexistence of binding and unbinding between antibodies and antigens of the endothelial cell membranes has been the cause of the delay in demonstrating the humoral allogenic response. The endothelium, the target tissue of antibodies, has a high turnover, and antigen-antibody binding is non-covalent. If endothelial cells are attacked by the humoral response, immunoglobulins are rapidly removed from their surface by shedding and/or internalization, as well as degrading the components of the complement system by the action of MCP, DAF and CD59. Thus, the presence of complement proteins in the membrane of endothelial cells is transient. In fact, the acute form of antibody-mediated rejection was not demonstrated until C4d complement fragment deposition was identified, which is the only component that binds covalently to endothelial cells. This review examines the relationship between humoral immune response and the types of acute and chronic histological lesion shown on biopsy of the transplanted organ.]]></p></abstract>
<abstract abstract-type="short" xml:lang="es"><p><![CDATA[Resumen La respuesta inmune adaptativa constituye la base del rechazo del aloinjerto. Sus armas lesivas son la citotoxicidad celular directa o los anticuerpos. La primera, identificada desde los inicios del trasplante de órganos y la segunda, limitada al rechazo hiperagudo por anticuerpos preformados y no como respuesta alogénica. Ello permitió mantener durante décadas que la respuesta alogénica tenía solo un origen celular. Pero se ignoraron los trabajos experimentales de Gorer que demostraban daño tisular en aloinjertos por anticuerpos secretados por linfocitos B activados frente a moléculas polimórficas. La especial convivencia de unión y desunión entre anticuerpos y antígenos de membrana de células endoteliales ha sido la causa que retrasó la demostración de la respuesta alogénica humoral. El endotelio, que es el tejido diana de los anticuerpos, tiene un turnover alto y la unión antígeno-anticuerpo no es covalente. Si las células endoteliales sufren el ataque de la respuesta humoral, eliminan rápidamente de su superficie las inmunoglobulinas mediante shedding o internalización y, a la vez, degradan los componentes del complemento por la acción de MCP, DAF y CD59. Así, la presencia de las proteínas del complemento en la membrana de las células endoteliales es pasajera. De hecho, la forma aguda de rechazo por anticuerpos no se demostró hasta identificar el depósito del fragmento C4d del complemento, que es el único de unión covalente a las células endoteliales. Esta revisión analiza la relación entre la respuesta inmune humoral y los tipos de lesión histológica aguda y crónica de la biopsia del órgano trasplantado.]]></p></abstract>
<kwd-group>
<kwd lng="en"><![CDATA[Immune response]]></kwd>
<kwd lng="en"><![CDATA[Antibodies]]></kwd>
<kwd lng="en"><![CDATA[Renal biopsy]]></kwd>
<kwd lng="en"><![CDATA[Humoral rejection]]></kwd>
<kwd lng="es"><![CDATA[Respuesta inmune]]></kwd>
<kwd lng="es"><![CDATA[Anticuerpos]]></kwd>
<kwd lng="es"><![CDATA[Biopsia renal]]></kwd>
<kwd lng="es"><![CDATA[Rechazo humoral]]></kwd>
</kwd-group>
</article-meta>
</front><back>
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