Harnessing Mechanisms of Immune Tolerance to Improve Outcomes in Solid Organ Transplantation: A Review

Overview

Journal Front Immunol

Specialty Allergy & Immunology

Date 2021 Jun 28

PMID 34177941

Citations 10

Authors

Priscila Ferreira Slepicka

Mahboubeh Yazdanifar

Alice Bertaina

Affiliations

Soon will be listed here.

Abstract

Survival after solid organ transplantation (SOT) is limited by chronic rejection as well as the need for lifelong immunosuppression and its associated toxicities. Several preclinical and clinical studies have tested methods designed to induce transplantation tolerance without lifelong immune suppression. The limited success of these strategies has led to the development of clinical protocols that combine SOT with other approaches, such as allogeneic hematopoietic stem cell transplantation (HSCT). HSCT prior to SOT facilitates engraftment of donor cells that can drive immune tolerance. Recent innovations in graft manipulation strategies and post-HSCT immune therapy provide further advances in promoting tolerance and improving clinical outcomes. In this review, we discuss conventional and unconventional immunological mechanisms underlying the development of immune tolerance in SOT recipients and how they can inform clinical advances. Specifically, we review the most recent mechanistic studies elucidating which immune regulatory cells dampen cytotoxic immune reactivity while fostering a tolerogenic environment. We further discuss how this understanding of regulatory cells can shape graft engineering and other therapeutic strategies to improve long-term outcomes for patients receiving HSCT and SOT.

Citing Articles

Role of Complement-dependent Cytotoxicity Crossmatch and HLA Typing in Solid Organ Transplant.

Tiwari A, Mukherjee S Rev Recent Clin Trials. 2023; 19(1):34-52.

PMID: 38155466 DOI: 10.2174/0115748871266738231218145616.

Continuation of immunosuppression vs. immunosuppression weaning in potential repeat kidney transplant candidates: a care management perspective.

Hickey M, Singh G, Lum E Front Nephrol. 2023; 3:1163581.

PMID: 37746029 PMC: 10513023. DOI: 10.3389/fneph.2023.1163581.

Differentially activated B cells develop regulatory phenotype and show varying immunosuppressive features: a comparative study.

Zheremyan E, Ustiugova A, Uvarova A, Karamushka N, Stasevich E, Gogoleva V Front Immunol. 2023; 14:1178445.

PMID: 37731503 PMC: 10509016. DOI: 10.3389/fimmu.2023.1178445.

A Comprehensive Landscape of Malignancy After Double Lung Transplantation.

Lee J, Yang A, Chung L, Yu J, Lee Y, Kim H Transpl Int. 2023; 36:11552.

PMID: 37663524 PMC: 10468575. DOI: 10.3389/ti.2023.11552.

Congenic hematopoietic stem cell transplantation promotes survival of heart allografts in murine models of acute and chronic rejection.

Sadozai H, Rojas-Luengas V, Farrokhi K, Moshkelgosha S, Guo Q, He W Clin Exp Immunol. 2023; 213(1):138-154.

PMID: 37004176 PMC: 10324556. DOI: 10.1093/cei/uxad038.

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