Advances in Intestinal Transplantation, Part II, An Issue of Gastroenterology Clinics of North America

Cover image

Title page

Table of Contents

Copyright

Contributors

Forthcoming Issues

Preface

B-Cell Induction Therapies in Intestinal Transplantation

Key points

Background

Nature of the problem

Clinical evidence

Therapeutic options

Summary

Clinics care points

Innate and Adaptive Immune Responses in Intestinal Transplant Rejection: Through the Lens of Inflammatory Bowel and Intestinal Graft-Versus-Host Diseases

Key points

Introduction

Innate immunity in intestinal transplantation

Loss of paneth cells may contribute to worsening of intestinal transplant rejection

An overview of the mononuclear phagocyte system

M1 macrophages orchestrate allogeneic dysregulation between host and graft

M2 macrophages are effectors of chronic rejection

Regulatory macrophages maintain immunologic homeostasis that is critical to graft survival

Natural killer cells are capable of inducing both tolerance and tissue destruction

Overview of innate lymphoid cells

Type 1 innate lymphoid cells ILCS are effectors of proinflammatory immune dysregulation

Type 2 innate lymphoid cells do not appear to play a major role in the innate immunity of the intestine

Type 3 innate lymphoid cells population maintains immune homeostasis and tissue tolerance

ILC1:ILC3 ratio predicts outcome in inflammatory bowel disease and intestinal transplantation

Type 3 innate lymphoid cells can trans-differentiate into type 1 innate lymphoid cells

High levels of IL-22 secreted by ILC3S in intestinal allograft biopsies IS associated with graft tolerance and survival

Adaptive immunity in intestinal transplantation

T cell activation: a new player emerges—the inverted direct pathway

Type 1 and type 2 T helper cells are the foundations of intestinal inflammation

Intestinal graft rejection is driven by type 17 T helper cells

Regulatory T cells assume a proinflammatory TH1/TH17-like phenotype in ITX rejection, leading to loss of their immunosuppressive function

TH17/TREG paradigm: imbalance of relative TH17 and Treg cell populations and T cell plasticity potentially exacerbates intestinal transplantation rejection

Unconventional T cells in the GI tract may also contribute to intestinal transplant rejection

Summary

Clinics care points

Metabolomic Applications in Gut Microbiota-Host Interactions in Human Diseases

Key points

Introduction

Background

Approach

Integrating metabolomics in gut microbiome-disease interactions

Gut bacterial and metabolic alterations in gastrointestinal diseases

Gut bacterial and metabolic alterations in systemic diseases

Discussion

Metabolic Regulation of Microbiota and Tissue Response

Key points

Introduction

Regulation of nutrition

Regulation of barrier function and immunity

Concluding remarks

Funding

Chimerism-Mediated Tolerance in Intestinal Transplantation

Key points

Background

Discussion

Summary

Clinics care points

Vaccines and Vaccine Response in the Small Bowel Transplant Patient

Key points

Introduction

Clinics care points

Living Donor Intestinal Transplantation

Key points

Introduction

History

Donor selection and recipient evaluation

Surgical technique and postoperative care

Immunosuppression

Outcomes of living donor intestinal transplantation

Pediatric intestinal transplantation

Summary

Clinics care points

Intestinal Re-Transplantation

Key points

Introduction

History

Indication for intestinal re-transplantation

Immunosuppression

The liver effect

The role of the spleen

Operative considerations

Outcomes after intestinal re-transplantation

Summary

Clinics care points

Bioengineering of Intestinal Grafts

Key points

Main

Discussion

Summary

Clinics care points

The Stem Cell Niche in Short Bowel Syndrome

Key points

Introduction and background

Summary

A Novel Organoid-Based Strategy Using Hybrid Colon Interposition for Short Bowel Syndrome: A Mini Review of In Vivo Models and Possible Human Candidates

Key points

Introduction

In vivo animal models for intestinal organoid transplantation

Cases considered suitable for new surgical methods at centers treating with a high number of patients with SBS

Clinics care points

Update on Maintenance Immunosuppression in Intestinal Transplantation

Key points

Introduction

Maintenance immunosuppression background

Discussion

Clinics care points

Intestinal Transplantation in the Developing World

Key points

Introduction

Definitions

Current situation of intestinal transplantation in the world

Intestinal transplantation in the Middle East and Asia

Intestinal transplantation in Latin-America

Discussion

Clinics care points