Induction of transplantation tolerance-the potential of regulatory T cells.

Solid organ transplantation is widely accepted as an effective treatment for end organ failure. Although the treatment with immunosuppressive drugs has undoubtedly greatly improved graft survival, chronic rejection still has considerable impact on long term outcome. This, together with the undesirab...

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Main Authors: Akl, A, Luo, S, Wood, K
Format: Journal article
Language:English
Published: 2005
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author Akl, A
Luo, S
Wood, K
author_facet Akl, A
Luo, S
Wood, K
author_sort Akl, A
collection OXFORD
description Solid organ transplantation is widely accepted as an effective treatment for end organ failure. Although the treatment with immunosuppressive drugs has undoubtedly greatly improved graft survival, chronic rejection still has considerable impact on long term outcome. This, together with the undesirable side effects associated with life long treatment with immunosuppressive drugs, have significant implications for long term outcomes. In a small number of patients, drug non-compliance as well as controlled reduction or removal of maintenance immune suppressive drug therapy has led to the uncovering of a tolerant state. The challenge of achieving improved monitoring of all transplant patients may allow tailoring of immunosupression in a proportion of recipients thereby increasing the opportunities for the induction of specific unresponsiveness to donor alloantigens in the future. The immune system using several mechanisms to both induce and maintain tolerance to alloantigens, including the deletion of allo-reactive T cells, the induction of anergy, clonal exhaustion, ignorance and active suppression (immunoregulation) of allo-responses. A minor subpopulation of CD4+ T cells, regulatory or suppressor CD4+ T cells that co-express the cell-surface molecule CD25 (IL2 alpha subunit) at a high level may play a major role in the maintenance of specific unresponsiveness and operational tolerance to donor antigens in vivo. Intensive investigation of these cells in recent years has started to uncover the mechanisms of active suppression by regulatory T cells in this setting.
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spelling oxford-uuid:8ffc50d4-1cfd-4366-bed5-bde00fe594952022-03-26T23:08:24ZInduction of transplantation tolerance-the potential of regulatory T cells.Journal articlehttp://purl.org/coar/resource_type/c_dcae04bcuuid:8ffc50d4-1cfd-4366-bed5-bde00fe59495EnglishSymplectic Elements at Oxford2005Akl, ALuo, SWood, KSolid organ transplantation is widely accepted as an effective treatment for end organ failure. Although the treatment with immunosuppressive drugs has undoubtedly greatly improved graft survival, chronic rejection still has considerable impact on long term outcome. This, together with the undesirable side effects associated with life long treatment with immunosuppressive drugs, have significant implications for long term outcomes. In a small number of patients, drug non-compliance as well as controlled reduction or removal of maintenance immune suppressive drug therapy has led to the uncovering of a tolerant state. The challenge of achieving improved monitoring of all transplant patients may allow tailoring of immunosupression in a proportion of recipients thereby increasing the opportunities for the induction of specific unresponsiveness to donor alloantigens in the future. The immune system using several mechanisms to both induce and maintain tolerance to alloantigens, including the deletion of allo-reactive T cells, the induction of anergy, clonal exhaustion, ignorance and active suppression (immunoregulation) of allo-responses. A minor subpopulation of CD4+ T cells, regulatory or suppressor CD4+ T cells that co-express the cell-surface molecule CD25 (IL2 alpha subunit) at a high level may play a major role in the maintenance of specific unresponsiveness and operational tolerance to donor antigens in vivo. Intensive investigation of these cells in recent years has started to uncover the mechanisms of active suppression by regulatory T cells in this setting.
spellingShingle Akl, A
Luo, S
Wood, K
Induction of transplantation tolerance-the potential of regulatory T cells.
title Induction of transplantation tolerance-the potential of regulatory T cells.
title_full Induction of transplantation tolerance-the potential of regulatory T cells.
title_fullStr Induction of transplantation tolerance-the potential of regulatory T cells.
title_full_unstemmed Induction of transplantation tolerance-the potential of regulatory T cells.
title_short Induction of transplantation tolerance-the potential of regulatory T cells.
title_sort induction of transplantation tolerance the potential of regulatory t cells
work_keys_str_mv AT akla inductionoftransplantationtolerancethepotentialofregulatorytcells
AT luos inductionoftransplantationtolerancethepotentialofregulatorytcells
AT woodk inductionoftransplantationtolerancethepotentialofregulatorytcells