【正文】 es from being too robust. Not all apoptosis is the direct result of activation。 MHC, major histopatibility plex。 LFA, leukocyte functionassociated。 ICAM, intracellular adhesion molecule。 EBV, EpsteinBarr virus。 ligand for CD2 CD59 Broad Inhibits formation of plement MAC CDw70 Activated T and B cells, macrophages Binds CD27, costimulatory signals CD95 Multiple cell types Binds Fas ligand, mediates activationinduced cell death CD102 (ICAM2) Endothelial cells, monocytes, other leukocytes Ligand for CD11a。 celltocell adhesion CD55 Broad Regulation of plement activation。 activation of NK cells, ADCC CD16b Neutrophils Immune plex–mediated neutrophil activation CD57 NK cells, subset of T cells Adhesion PLATELET ASSOCIATED CD31 Platelets, monocytes, granulocytes, B cells, endothelial cells, T cells Adhesion molecule in leukocyte diapedesis CD41 Platelets, megakaryocytes Platelet aggregation and activation。 phagocytosis of iC3bcoated particles CD11c Granulocytes, monocytes, NK cells, dendritic cells Similar to CD11b。 ligand for CD28 and CD152 (CTLA4) CD86 (B72) B cells, monocytes Costimulator for Tcell activation。 receptor for CD154 (CD40 ligand)。 receptor for C3d, forms a coreceptor with CD19 and CD81 to deliver activated signals in B cells。 signal transduction, thymocyte development CD28 T cells (most CD4+ , some CD8+ ) Tcell receptor for costimulatory molecules CD80 (B71) and CD86 (B7–2) CD152 Activated T lymphocytes Inhibitory signaling in T cells, binds CD80 (B71) and CD86 (B72) on antigenpresenting cells CD154 Activated CD4+ T cells Activates B cells, macrophages, and endothelial cells。 thymocyte development。 ε is required for both expression and signal transduction CD4 Class II restricted T cells, thymocyte subsets, monocytes, and macrophages Adhesion molecule, binds to class II MHC。 endothelial activation MHC, major histopatibility plex。 neutrophil activator. Binds to CD120 Transforming growth factorbeta TGFβ T cells。 enhances Tcell function。 NKcell activation. Binds to CD118 Tumor necrosis factoralpha and beta TNFα, β NK and T cells。 fibroblastβ Mononuclear phagocyte increases class I MHC expression。 augments 5 TABLE 161 Summary of Cytokines and Their Associated Functions * Cytokine Cell Source Functions NKcell activity。 others NKcell and Tcell proliferation Interferon gamma IFNγ NK and T cells Increased expression of class I and class II MHC。 stimulates IgE and IgG isotype switching Interleukin14 IL14 T cells and some B cell tumors Enhances proliferation of activated B cells。 CD4+ Tcell differentiation Interleukin13 IL13 Activated T cells Inhibits cytokine and nitric oxide production by activated macrophages。 dendritic cells INFγ synthesis。 stimulates growth of plasmacytomas。 inhibition。 potent angiogenic factor Interleukin9 IL9 Activated TH 2 lymphocytes Enhances proliferation of T cells, mast cell lines, erythroid precursors, and megakaryoblastic cell lines Interleukin10 IL10 Mononuclear phagocytes。 increases liver acute phase reactants。 endothelial cells Bcell proliferation/differentiation。 T and mast cells growth factor. Binds to CDw124 Interleukin5 IL5 T cells Eosinophil proliferation/activation. Binds to CD125 Interleukin6 IL6 Mononuclear phagocytes。 growth/activation of NK cells. Binds to CD122 Interleukin4 IL4 CD4+ T cells。 increases liver protein synthesis. Binds to CD121 Interleukin2 IL2 Activated T cells Tcell growth factor, cytotoxic Tcell generation。 fever, inflammation。 neutrophils。 NK cells。 1 Chapter 16 Transplantation Immunology and Immunosuppression Transplantation of solid ans has bee the treatment of choice for endstage renal, hepatic, cardiac, and pulmonary disease. The field has progressed rapidly in the past 5 decades, primarily because of the development of safer and more effective immunosuppressive agents. Continued improvements in the control of rejection at both the cellular and molecular levels have been possible, owing to increased understanding of the plexity of the immune system and of the events that constitute the rejection process. Because outes may vary with the type of graft and the patient’s clinical history, the choice of immunosuppression depends on a plete understanding of the interrelationship between host and graft. In the past decade a diverse armamentarium of immunosuppressive agents targeting various aspects of the immune system has emerged. CONCEPTUAL APPROACHES TO IMMUNOSUPPRESSIVE THERAPY The rejection reaction begins when T lymphocytes recognize foreign histopatibility antigens on cells of the transplanted tissue. The foreign antigen is thought to be presented directly to host lymphocytes by antigenpresenting cells (APCs), most notably dendritic cells and macrophages, which phagocytose and then display the processed antigenic epitope on their surface. Whatever the APC, the ability to differentiate self from nonself resides with the lymphocytes. A lymphocyte, therefore, can recognize only one or a few closely related antigens. The range of possible antigen configurations is matched by a panoply of 2 lymphocyte clones arrayed against them. Immune specificity is acquired during early development, and it is postulated that fully petent clones of small resting lymphocytes await immunologic stimulation by foreign tissue antigens. Among the vast variety of antigens that can be recognized are the foreign antigens, which are governed by the major histopatibility plex (MHC). Stimulation of a resting lymphocyte by the antigen for which it is specific causes it to transform into a large active cell that secretes cytokines. These are soluble proteins or glycoproteins ( Table 16–1 ) that are effective across short distances and that, in turn, amplify the re