Harnessing Mechanisms of Immune Tolerance to Improve Outcomes in Solid Organ Transplantation: A Review.
Adaptive Immunity
Animals
Graft Rejection
/ immunology
Graft Survival
Hematopoietic Stem Cell Transplantation
/ adverse effects
Humans
Immunity, Innate
Immunosuppressive Agents
/ adverse effects
Immunotherapy
Organ Transplantation
/ adverse effects
Risk Factors
Transplantation Tolerance
Transplantation, Homologous
Treatment Outcome
adaptive immunity
hematopoietic stem cell transplantation
immune tolerance
innate immunity
solid organ transplantation
Journal
Frontiers in immunology
ISSN: 1664-3224
Titre abrégé: Front Immunol
Pays: Switzerland
ID NLM: 101560960
Informations de publication
Date de publication:
2021
2021
Historique:
received:
30
03
2021
accepted:
24
05
2021
entrez:
28
6
2021
pubmed:
29
6
2021
medline:
28
10
2021
Statut:
epublish
Résumé
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.
Identifiants
pubmed: 34177941
doi: 10.3389/fimmu.2021.688460
pmc: PMC8222735
doi:
Substances chimiques
Immunosuppressive Agents
0
Types de publication
Journal Article
Research Support, N.I.H., Extramural
Research Support, Non-U.S. Gov't
Review
Langues
eng
Sous-ensembles de citation
IM
Pagination
688460Subventions
Organisme : NIDDK NIH HHS
ID : T32 DK098132
Pays : United States
Informations de copyright
Copyright © 2021 Slepicka, Yazdanifar and Bertaina.
Déclaration de conflit d'intérêts
The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest.
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