This book represents Part 2 of the two-part monograph in which the emerging role of “Innate Alloimmunity” in organ transplantation is comprehensively presented and described for the first time worldwide. In fact, during the last decade, accumulating experimental and clinical evidence has been published in favor and support of the author’s original Injury Hypothesis holding that it is the primary allograft injury that – in addition to its foreignness – induces innate immune pathways (1) leading to alloimmune-mediated allograft rejection, and (2) contributing to the development of alloatherosclerosis and allofibrosis as major features of chronic allograft dysfunction. Accordingly, in this book, the author has collected and meticulously described a wealth of those supporting experimental and clinical data that have recently led to those revolutionizing notions in transplant medicine.
In carefully selected chapters, the author addresses eight major topics dedicated to (1) early appreciation in the 1990s of the injured allograft as an acutely inflamed organ reflecting first clues to the existence of innate alloimmunity, (2) oxidative allograft injury as revisited at the beginning of the new millennium, (3) recognition by various pattern recognition receptors of damage-associated molecular patterns, the DAMPs that, for didactic reasons, are divided into four different classes, (4) role of pattern recognition receptors in mediating oxidative tissue injury via activation of dendritic cells, innate lymphocytes, and T lymphocytes, (5) experimental and clinical findings in direct and indirect support of the existence of innate alloimmunity, (6) chronic allograft dysfunction in terms of a model disease of innate immunity, (7) principles and options of pharmaceutics, biologics, and genetic engineering for designing innovative immunosuppressive strategies in light of innate alloimmunity – by also outlining the ethical problem and the background hurdles not to develop innate alloimmunity-suppressing drugs today, and (8) innate alloimmunity and blood coagulation in terms of a few remarks within an appendix.
The book must be considered an invaluable resource for anyone interested in this emerging field of transplant immunology – in particular, clinicians who work in the field of transplantation or transplantation-related medical disciplines, and strive for exploring innate immune mechanisms involved in the development of acute allograft rejection and chronic allograft dysfunction as well as injury-induced ”sterile” tissue inflammation in general.