title: The microbiome and its implications in intestinal transplantation.
abstract: OBJECTIVE
  This article summarizes the complex interplay between the microbiota and host immune responses, and its impact on intestinal transplantation and allograft rejection.
  
  
  RESULTS
  Recent findings highlight the importance of Paneth cells as crucial producers of antimicrobial peptides that control the intestinal host-microbial interface as well as the essential role of NOD2 as a master regulator of antimicrobial host defenses. Moreover, complex interactions between innate and adaptive immune responses have been shown to critically shape host antimicrobial Th17 responses, which may be key for the pathogenesis of inflammatory bowel diseases and intestinal allograft rejection.
  
  
  CONCLUSIONS
  A growing body of evidence indicates that crosstalk between the microbiome and innate and adaptive host immunity determines alloimmune responses and outcomes in intestinal transplantation. Elaboration of this emerging field might lead to novel mechanistic insight into these complex interactions and allow for new therapeutic approaches.
authors.affiliation: aMedStar Georgetown Transplant Institute, Georgetown University Hospital, Washington, DC, USA bGastroenterology Surgical Center, Department of Surgery, Mansoura University, Mansoura, Egypt.
authors.forename: Alexander
authors.initials: A
authors.lastname: Kroemer
authors.forename: Ahmed M
authors.initials: AM
authors.lastname: Elsabbagh
authors.forename: Cal S
authors.initials: CS
authors.lastname: Matsumoto
authors.forename: Michael
authors.initials: M
authors.lastname: Zasloff
authors.forename: Thomas M
authors.initials: TM
authors.lastname: Fishbein
mesh_terms: D006084:Graft Rejection; D006801:Humans; D007422:Intestines / Q000276:immunology / Q000382:microbiology* / Q000637:transplantation*; D064307:Microbiota; D019879:Paneth Cells / Q000382:microbiology; D058504:Th17 Cells / Q000276:immunology; D014184:Transplantation, Homologous