The concept of "partial" clinical tolerance

Transplant Immunology
R Cortesini, N Suciu-Foca

Abstract

The status of "partial" tolerance to organ allografts versus the status of complete tolerance is the main topic of this paper. Progress made in immunosuppression, particularly by use of various lymphocyte depleting agents for "induction therapy", seems to favor the subsequent development of T cells with suppressor/regulatory properties. The effective deletion of alloreactive T helper and cytotoxic cells in conjunction with the expansion of antigen-specific suppressor (CD8 + CD28 - FOXP3+) and regulatory (CD4 + CD25+ FOXP3+) T cells creates a milieu in which the graft is well tolerated under an "umbrella" of low dosage immunosuppression. The most effective induction treatment is Campath-1H, although ATGAM at high dosage is also widely used. Total lymphoid irradiation (TLI) is another very effective pretreatment strategy in spite of the risks which are associated with it. The induction of "partial" tolerance is a step in the right direction for exploring strategies that may lead to the induction of complete tolerance. It is safe for the patients and can prolong significantly the function of the graft, preventing the onset of chronic rejection.

References

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Citations

Jun 27, 2009·Gastroentérologie Clinique Et Biologique·C Duvoux, D Samuel
Sep 27, 2008·Human Immunology·George VladNicole Suciu-Foca
Feb 20, 2007·Transplant Immunology·Raffaello Cortesini
Nov 5, 2008·Transplant International : Official Journal of the European Society for Organ Transplantation·Thomas HaudebourgBernard Vanhove
Mar 17, 2006·American Journal of Transplantation : Official Journal of the American Society of Transplantation and the American Society of Transplant Surgeons·G Roussey-KeslerJ-P Soulillou
Oct 18, 2014·American Journal of Transplantation : Official Journal of the American Society of Transplantation and the American Society of Transplant Surgeons·D MouA D Kirk
Feb 20, 2007·Transplant Immunology·Giuseppe TisoneMario Angelico
Feb 20, 2007·Transplant Immunology·Grégoire WieërsRaymond Reding
Apr 9, 2015·Transplant International : Official Journal of the European Society for Organ Transplantation·Daniel BaronSophie Brouard
Oct 9, 2009·International Reviews of Immunology·Volker Daniel, Gerhard Opelz
Dec 7, 2007·The Journal of Immunology : Official Journal of the American Association of Immunologists·Carole GuillonneauBernard Vanhove
Jul 25, 2019·World Journal of Gastroenterology : WJG·Nitin AbrolTimucin Taner

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