Immune Checkpoints in Solid Organ Transplantation

Allogenic graft acceptance is only achieved by life-long immunosuppression, which comes at the cost of significant toxicity. Clinicians face the challenge of adapting the patients’ treatments over long periods to lower the risks associated with these toxicities, permanently leveraging the risk of ex...

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Main Authors: Arnaud Del Bello, Emmanuel Treiner
Format: Article
Language:English
Published: MDPI AG 2023-10-01
Series:Biology
Subjects:
Online Access:https://www.mdpi.com/2079-7737/12/10/1358
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author Arnaud Del Bello
Emmanuel Treiner
author_facet Arnaud Del Bello
Emmanuel Treiner
author_sort Arnaud Del Bello
collection DOAJ
description Allogenic graft acceptance is only achieved by life-long immunosuppression, which comes at the cost of significant toxicity. Clinicians face the challenge of adapting the patients’ treatments over long periods to lower the risks associated with these toxicities, permanently leveraging the risk of excessive versus insufficient immunosuppression. A major goal and challenge in the field of solid organ transplantation (SOT) is to attain a state of stable immune tolerance specifically towards the grafted organ. The immune system is equipped with a set of inhibitory co-receptors known as immune checkpoints (ICs), which physiologically regulate numerous effector functions. Insufficient regulation through these ICs can lead to autoimmunity and/or immune-mediated toxicity, while excessive expression of ICs induces stable hypo-responsiveness, especially in T cells, a state sometimes referred to as exhaustion. IC blockade has emerged in the last decade as a powerful therapeutic tool against cancer. The opposite action, i.e., subverting IC for the benefit of establishing a state of specific hypo-responsiveness against auto- or allo-antigens, is still in its infancy. In this review, we will summarize the available literature on the role of ICs in SOT and the relevance of ICs with graft acceptance. We will also discuss the possible influence of current immunosuppressive medications on IC functions.
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spelling doaj.art-17526aa592ab4a19adb91c653fd5b7f22023-11-19T15:44:11ZengMDPI AGBiology2079-77372023-10-011210135810.3390/biology12101358Immune Checkpoints in Solid Organ TransplantationArnaud Del Bello0Emmanuel Treiner1Department of Nephrology, University Hospital of Toulouse, 31400 Toulouse, FranceFaculty of Medicine, University Toulouse III Paul Sabatier, 31062 Toulouse, FranceAllogenic graft acceptance is only achieved by life-long immunosuppression, which comes at the cost of significant toxicity. Clinicians face the challenge of adapting the patients’ treatments over long periods to lower the risks associated with these toxicities, permanently leveraging the risk of excessive versus insufficient immunosuppression. A major goal and challenge in the field of solid organ transplantation (SOT) is to attain a state of stable immune tolerance specifically towards the grafted organ. The immune system is equipped with a set of inhibitory co-receptors known as immune checkpoints (ICs), which physiologically regulate numerous effector functions. Insufficient regulation through these ICs can lead to autoimmunity and/or immune-mediated toxicity, while excessive expression of ICs induces stable hypo-responsiveness, especially in T cells, a state sometimes referred to as exhaustion. IC blockade has emerged in the last decade as a powerful therapeutic tool against cancer. The opposite action, i.e., subverting IC for the benefit of establishing a state of specific hypo-responsiveness against auto- or allo-antigens, is still in its infancy. In this review, we will summarize the available literature on the role of ICs in SOT and the relevance of ICs with graft acceptance. We will also discuss the possible influence of current immunosuppressive medications on IC functions.https://www.mdpi.com/2079-7737/12/10/1358immune checkpointsorgan transplantationtoleranceimmunotherapy
spellingShingle Arnaud Del Bello
Emmanuel Treiner
Immune Checkpoints in Solid Organ Transplantation
Biology
immune checkpoints
organ transplantation
tolerance
immunotherapy
title Immune Checkpoints in Solid Organ Transplantation
title_full Immune Checkpoints in Solid Organ Transplantation
title_fullStr Immune Checkpoints in Solid Organ Transplantation
title_full_unstemmed Immune Checkpoints in Solid Organ Transplantation
title_short Immune Checkpoints in Solid Organ Transplantation
title_sort immune checkpoints in solid organ transplantation
topic immune checkpoints
organ transplantation
tolerance
immunotherapy
url https://www.mdpi.com/2079-7737/12/10/1358
work_keys_str_mv AT arnauddelbello immunecheckpointsinsolidorgantransplantation
AT emmanueltreiner immunecheckpointsinsolidorgantransplantation