The future of organ and tissue transplantation: can T-cell costimulatory pathway modifiers revolutionize the prevention of graft rejection?
Transplantation therapies have revolutionized care for patients with endstage organ (kidney, liver, heart, lung, and pancreatic beta-cell) failure, yet significant problems persist with treatments designed to prevent graft rejection. Antirejection therapies are not always effective, must be taken daily, and are both expensive and associated with well-known toxic effects. Recent advances have suggested that the immune system has more self-regulatory capability than previously appreciated. In this review, we discuss immune system function and new therapeutic agents that modify so-called costimulatory receptor signaling to support transplant function without generally suppressing the immune system.
Harlan
D M
DM
Navy Medical Research Center, NIDDK/Navy Transplantation and Autoimmunity Branch, and the Uniformed Service University of the Health Sciences, Bethesda, MD 20889, USA.
Kirk
A D
AD
D000818:Animals; D017951:Antigen Presentation; D015703:Antigens, CD; D006084:Graft Rejection / Q000276:immunology* / Q000517:prevention & control; D006801:Humans; D008024:Ligands; D008213:Lymphocyte Activation; D008562:Membrane Glycoproteins; D016377:Organ Transplantation / Q000009:adverse effects / Q000639:trends; D013601:T-Lymphocytes / Q000502:physiology*; D016378:Tissue Transplantation / Q000009:adverse effects / Q000639:trends; D014181:Transplantation Immunology
D015703:Antigens, CD; D008024:Ligands; D008562:Membrane Glycoproteins