Autophagy: Basic Principles and Relevance to Transplant Immunity

Autophagy developed into a rapidly expanding field detailing its molecular mechanism and relevance in health and disease. Autophagy is an evolutionarily conserved process that summarizes a pathway in which intracellular material is degraded within the lysosome and where the macromolecular constituents are recycled. This “self‐eating” process was originally described in a cell under starvation but now numerous studies established autophagy as a cellular response to stress. As a consequence, the autophagy machinery interfaces with most cellular stress–response pathways, including those involved in controlling immune response and inflammation. Autophagy also influences adaptive immunity through its effect on antigen presentation, naïve T cell repertoire selection and homeostasis and TH cell polarization. Data are emerging that dysregulated autophagy has an impact on human pathologies including infectious diseases, cancers, aging and neurodegenerative conditions. This review focuses on recent findings elucidating the ability of autophagy to be of significance in the transplant setting. The process of autophagy was originally described in cells under starvation, but numerous studies now establish the link with most cellular stress‐response pathways, including those involved in controlling immune response and inflammation.