Exosomes, nanovesicles shown to regulate physiological processes in vivo, have been implicated in pathological conditions including cancer, autoimmune disease, infectious disease, neurodegenerative disease, and allograft rejection. Studies of lung transplant recipients with primary graft dysfunction, respiratory viral infection, and (acute) rejection have demonstrated circulating exosomes containing donor-mismatched human leukocyte antigen and lung-associated self-antigens, K-alpha 1 tubulin and collagen V, indicating that exosomes are originating from the transplanted organ. These circulating exosomes likely play a role in activating immune responses that lead to increased risk of chronic lung allograft dysfunction, as exosomes efficiently present their antigens to the immune system by all known pathways of antigen recognition (i.e., direct, indirect, and semidirect pathways). Here, we discuss exosome biogenesis, describe their contents, and address the mechanism of exosome-mediated activation of immune responses that lead to allograft rejection, especially after lung transplantation.

中文翻译：

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慢性同种异体移植功能异常：循环外来体与肺相关的自身抗原诱导的免疫反应。

外来体，纳米囊泡被证明可以调节体内的生理过程，已被证实与包括癌症，自身免疫性疾病，传染性疾病，神经退行性疾病和同种异体移植排斥在内的病理状况有关。对具有原发性移植物功能障碍，呼吸道病毒感染和（急性）排斥的肺移植受者的研究表明，循环的外泌体含有供体不匹配的人白细胞抗原和肺相关的自身抗原，K-alpha 1微管蛋白和胶原蛋白V，表明该外泌体来自移植器官。这些外泌体可能在激活免疫应答中发挥作用，导致慢性肺同种异体移植功能障碍的风险增加，因为外泌体通过所有已知的抗原识别途径（即直接，间接和半直接途径）。在这里，我们讨论外泌体的生物发生，描述其内容，并解决外泌体介导的免疫反应的激活机制，该反应导致同种异体移植排斥，尤其是在肺移植后。