title: Low molecular weight dextran sulfate as complement inhibitor and cytoprotectant in solid organ and islet transplantation.
abstract: Complement is an essential part of the innate immune system and plays a crucial role in organ and islet transplantation. Its activation, triggered for example by ischemia/reperfusion (I/R), significantly influences graft survival, and blocking of complement by inhibitors has been shown to attenuate I/R injury. Another player of innate immunity are the dendritic cells (DC), which form an important link between innate and adaptive immunity. DC are relevant in the induction of an immune response as well as in the maintenance of tolerance. Modulation or inhibition of both components, complement and DC, may be crucial to improve the clinical outcome of solid organ as well as islet transplantation. Low molecular weight dextran sulfate (DXS), a well-known complement inhibitor, has been shown to prevent complement-mediated damage of the donor graft endothelium and is thus acting as an endothelial protectant. In this review we will discuss the evidence for this cytoprotective effect of DXS and also highlight recent data which show that DXS inhibits the maturation of human DC. Taken together the available data suggest that DXS may be a useful reagent to prevent the activation of innate immunity, both in solid organ and islet transplantation.
authors: Department of Clinical Research, University of Bern, Switzerland.
authors: Rolf
authors: R
authors: Spirig
authors: Thusitha
authors: T
authors: Gajanayake
authors: Olle
authors: O
authors: Korsgren
authors: Bo
authors: B
authors: Nilsson
authors: Robert
authors: R
authors: Rieben
mesh_terms: D003165:Complement System Proteins / Q000378:metabolism*; D016264:Dextran Sulfate / Q000737:chemistry / Q000276:immunology / Q000494:pharmacology*; D006801:Humans; D016381:Islets of Langerhans Transplantation / Q000276:immunology*; D018448:Models, Immunological; D008970:Molecular Weight; D016377:Organ Transplantation; D020011:Protective Agents / Q000494:pharmacology*
chemical_list: D020011:Protective Agents; D003165:Complement System Proteins; D016264:Dextran Sulfate