Antibody-mediated rejection (ABMR) results from a pro-inflammatory cascade that occurs
following the binding of circulating anti-HLA antibodies to HLA on donor endothelial
cells. As such, pathogenic pathways of humoral immunity are considered key targets
for diagnostic and therapeutic focus. As one example, antibody-dependent cell-mediated
cytotoxicity (ADCC) is an important mechanism of ABMR, in which graft-bound anti-HLA
antibodies activate innate leukocytes such as natural killer (NK) cells and monocytes
via surface Fc gamma receptors for IgG
1
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