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Hospital","doi-asserted-by":"publisher","award":["NTUH-112-M0027"],"award-info":[{"award-number":["NTUH-112-M0027"]}],"id":[{"id":"10.13039\/501100005762","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100005762","name":"National Taiwan University Hospital","doi-asserted-by":"publisher","award":["NTUH-111-M0024"],"award-info":[{"award-number":["NTUH-111-M0024"]}],"id":[{"id":"10.13039\/501100005762","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100005762","name":"National Taiwan University Hospital","doi-asserted-by":"publisher","award":["NTUH-110-M4970"],"award-info":[{"award-number":["NTUH-110-M4970"]}],"id":[{"id":"10.13039\/501100005762","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["IJMS"],"abstract":"<jats:p>Chronic alloantibody-mediated rejection (cAMR) remains a major challenge in transplant immunology, with no FDA-approved targeted therapies currently available. Despite advancements in cellular immunosuppression, effective strategies to mitigate alloantibody-mediated rejection are still lacking. This review provides a comprehensive overview of transplant rejection with a particular focus on the pathophysiology and therapeutic landscape of cAMR. We highlight the role of plasma cell-driven alloantibody production and its susceptibility to endoplasmic reticulum (ER) stress, a pathway with potential for therapeutic intervention. Special attention is given to calcineurin inhibitors (CNIs), which, beyond their well-established T-cell inhibitory effects, exhibit differential impacts on ER stress and plasma cell viability. By delineating the mechanistic differences between cyclosporine and tacrolimus in regulating ER stress responses, we propose potential therapeutic implications for optimizing cAMR management. This review underscores the need for innovative strategies targeting plasma cell biology to improve long-term transplant outcomes.<\/jats:p>","DOI":"10.3390\/ijms26062711","type":"journal-article","created":{"date-parts":[[2025,3,18]],"date-time":"2025-03-18T04:34:43Z","timestamp":1742272483000},"page":"2711","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":5,"title":["Chronic Antibody-Mediated Rejection and Plasma Cell ER Stress: Opportunities and Challenges with Calcineurin Inhibitors"],"prefix":"10.3390","volume":"26","author":[{"ORCID":"https:\/\/orcid.org\/0009-0003-1767-9443","authenticated-orcid":false,"given":"Ching-Yi","family":"Tsai","sequence":"first","affiliation":[{"name":"Graduate Institute of Toxicology, College of Medicine, National Taiwan University, Taipei 100233, Taiwan"},{"name":"Department of Medical Research, National Taiwan University Hospital, Taipei 100225, Taiwan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5034-3544","authenticated-orcid":false,"given":"Chih-Yuan","family":"Lee","sequence":"additional","affiliation":[{"name":"Department of Surgery, National Taiwan University Hospital, Taipei 100225, Taiwan"},{"name":"Organ Transplant Center, National Taiwan University Hospital, Taipei 100225, Taiwan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2879-7624","authenticated-orcid":false,"given":"Jia-Huang","family":"Chen","sequence":"additional","affiliation":[{"name":"Graduate Institute of Toxicology, College of Medicine, National Taiwan University, Taipei 100233, Taiwan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9021-4616","authenticated-orcid":false,"given":"Chih-Kang","family":"Chiang","sequence":"additional","affiliation":[{"name":"Graduate Institute of Toxicology, College of Medicine, National Taiwan University, Taipei 100233, Taiwan"},{"name":"Department of Integrated Diagnostics & Therapeutics, National Taiwan University Hospital, Taipei 100225, Taiwan"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2025,3,18]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"2824","DOI":"10.1111\/ajt.16463","article-title":"Long-term kidney transplant graft survival-Making progress when most needed","volume":"21","author":"Poggio","year":"2021","journal-title":"Am. 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