Infectious tolerance and the long‐term acceptance of transplanted tissue

H Waldmann, E Adams, P Fairchild… - Immunological …, 2006 - Wiley Online Library
H Waldmann, E Adams, P Fairchild, S Cobbold
Immunological reviews, 2006Wiley Online Library
Short courses of antibody treatment aimed at blocking the coreceptors CD4 and CD8 and/or
costimulatory molecules such as CD40L are able to bring about long‐term acceptance and
tolerance of allogeneic transplants. This tolerant state is operational, in that potential effector
cells remain but are tightly regulated through the induction of antigen‐specific CD4+
regulatory T cells (Tregs). CD4+ CD25+ FoxP3+ Tregs appear to play a prominent role,
although other categories of Tregs have been documented. Transforming growth factor β …
Summary
Short courses of antibody treatment aimed at blocking the coreceptors CD4 and CD8 and/or costimulatory molecules such as CD40L are able to bring about long‐term acceptance and tolerance of allogeneic transplants. This tolerant state is operational, in that potential effector cells remain but are tightly regulated through the induction of antigen‐specific CD4+ regulatory T cells (Tregs). CD4+CD25+FoxP3+ Tregs appear to play a prominent role, although other categories of Tregs have been documented. Transforming growth factor β (TGFβ) has been found to play a major role in the induction of the tolerant state with therapeutic antibodies as well as promoting the induction of FoxP3+ T cells from naïve populations. The observation that Tregs can be found in tolerated grafts has led to the idea that they may interact with the grafted tissue to establish a state of acquired privilege symmetrical with a similar privileged microenvironment around antigen‐presenting cells in lymphoid tissues. Dampening of aggressive immune responses by Tregs allows antigen to persist and be presented in an innocuous way to promote tolerance in new cohorts of T cells throughout the life of the tolerated graft. Regulation may operate at many stages of an immune response, even as a censor at the terminal differentiation stages of effector function.
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