Stages of Cell mediated graft refusal:
1. Sensitization stage2. Effector stage.Sensitization stage:
During this stage CD4+ and CD8+ T cells identify the allo-antigens (i.e., antigens existed on the allograft) and proliferate inresponse. Both minor and major histocompatibility antigens are acknowledged. Host T4 cell becomes activated whenever it interacts with an antigen–representing cell. Identification of the alloantigens stated on the cells of a graft induces vigorous T cell proliferation in the host. The main proliferating cell is the CD4+ T cell that identifies Class II alloantigens. This amplified population of activated TH cells is thought to play an essential role in inducing the different effector mechanisms or allograft refusal.Effector stage:
A diversity of effector mechanisms participate in allograft refusal. The most significant ones are cell mediated (i.e., T cell mediated) reactions that comprise delayed type hypersensitivity and cytotoxic lymphocyte mediated cytotoxicity. Antibody plus complement mediated lysis and antibody dependent cell mediated cytotoxicity are very less common.
Graft rejection based upon the kind of tissue or organ grafted and also the immune response. Hyper acute rejection takes place within the primary 24 hours, after transplantation. Acute reaction starts in the first few weeks after transplantation and chronic refusal reactions takes place from months to years after transplantation.
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