The Journal of Thoracic and Cardiovascular Surgery, Vol 94, 802-811, Copyright © 1987 by The American Association for Thoracic Surgery and The Western Thoracic Surgical Association
Immunoregulation: the key to transplantation and autoimmunity
GJ Nossal
Walter and Eliza Hall Institute of Medical Research, Royal Melbourne Hospital, Victoria, Australia.
Immune responses depend on a unique set of recognition structures, namely,
antibody molecules embedded in the B cell membrane for antibody formation
and alpha-beta chain heterodimers of the T cell receptor for cellular
immune receptors. These structures are coded for by genes, which undergo
rearrangements during the differentiation of B- and T- lymphocytes known as
somatic translocations. The end result of this process is the creation of
separate repertoires of B and T cells, each single cell displaying a unique
receptor. Antigen acts by selecting preexisting antigen-reactive cells for
division and further differentiation. Accessory cells such as macrophages
are essential for the initiation of most immune responses. Different
subsets of T- lymphocytes play a vital regulatory role, not only in
controlling cell- mediated immunity as such, but also in guiding B cell
function. Understanding the roles of accessory cells, regulatory T cells,
and the molecules on their surface is essential for understanding
immunoregulation. At present, immunosuppression in organ transplantation
and therapy of autoimmune diseases are largely nonspecific and empirical.
As the rules of the interactive immunoproliferative cascade are
progressively unraveled, more targeted immune manipulation will become
possible, and some future avenues of this sort are described.
