Jiang SM, Li XJ, Wang ZL, Chen ZW, Liu ZL, Li Q, Chen XL. Role of autophagy in rejection after solid organ transplantation: A systematic review of the literature. World J Transplant 2025; 15(3): 103163 [DOI: 10.5500/wjt.v15.i3.103163]
Corresponding Author of This Article
Xiao-Long Chen, Department of Hepatobiliary Surgery, The First Affiliated Hospital of Jinan University, No. 613 Huangpu Avenue, Guangzhou 510630, Guangdong Province, China. chenxl0406@jnu.edu.cn
Research Domain of This Article
Transplantation
Article-Type of This Article
Minireviews
Open-Access Policy of This Article
This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
Shu-Min Jiang, Zi-Lin Wang, Zhi-Wei Chen, Zhi-Long Liu, Qiang Li, Xiao-Long Chen, Department of Hepatobiliary Surgery, The First Affiliated Hospital of Jinan University, Guangzhou 510630, Guangdong Province, China
Xue-Jiao Li, Guangdong Key Laboratory of Liver Disease Research, The Third Affiliated Hospital of Sun Yat-Sen University, Guangzhou 510630, Guangdong Province, China
Co-first authors: Shu-Min Jiang and Xue-Jiao Li.
Co-corresponding authors: Qiang Li and Xiao-Long Chen.
Author contributions: Jiang SM, Li XJ, and Chen XL were responsible for drafting the manuscript; Jiang SM and Li XJ contributed equally to this paper and are the co-first authors of this manuscript; Wang ZL, Chen ZW, and Liu ZL were responsible for data acquisition; Li Q and Chen XL were responsible for submitting the version for final approval, they contributed equally to this paper and are the co-corresponding authors of this manuscript; Chen XL was responsible for conception and design, manuscript revision, and funding; and all authors thoroughly reviewed and endorsed the final manuscript.
Supported by the National Natural Science Foundation of China, No. 82100691; and China Postdoctoral Science Foundation, No. 2021M693631.
Conflict-of-interest statement: All the authors report no relevant conflicts of interest for this article.
Open Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Xiao-Long Chen, Department of Hepatobiliary Surgery, The First Affiliated Hospital of Jinan University, No. 613 Huangpu Avenue, Guangzhou 510630, Guangdong Province, China. chenxl0406@jnu.edu.cn
Received: November 18, 2024 Revised: January 21, 2025 Accepted: February 6, 2025 Published online: September 18, 2025 Processing time: 152 Days and 4.6 Hours
Abstract
Organ transplantation has long been recognized as an effective treatment for end-stage organ failure, metabolic diseases, and malignant tumors. However, graft rejection caused by major histocompatibility complex mismatch remains a significant challenge. While modern immunosuppressants have made significant strides in reducing the incidence and risk of rejection, they have not been able to eliminate it completely. The intricate mechanisms underlying transplant rejection have been the subject of intense investigation by transplant immunologists. Among these factors, autophagy has emerged as a key player. Autophagy is an evolutionarily conserved mechanism in eukaryotic cells that mediates autophagocytosis and cellular protection. This process is regulated by autophagy-related genes and their encoded protein families, which maintain the material and energetic balance within cells. Additionally, autophagy has been reported to play crucial roles in the development, maturation, differentiation, and responses of immune cells. In the complex immune environment following transplantation, the role and mechanisms of autophagy are gradually being revealed. In this review, we aim to explore the current understanding of the role of autophagy in solid organ rejection after transplantation. Furthermore, we delve into the therapeutic advancements achieved by targeting autophagy involved in the rejection process.
Core Tip: The intricate mechanisms underlying transplant rejection have been the subject of intense investigation by transplant immunologists. As an evolutionarily conserved self-regulatory protective mechanism in eukaryotic cells, autophagy also plays a crucial role in the development, maturation, differentiation and response of immune cells. Our article reviews the role and mechanisms of autophagy of different types of immune cells in the rejection after solid organ transplantation, so as to provide a theoretical basis for better understanding the profound connotation of graft rejection and potential treatment approaches by targeting autophagy in the future.
