Hemophilia factor VIII therapy. B- and T-cell tolerance: from basic concepts to clinical practice.
Recent advances in the understanding of the mechanisms by which tolerance develops in both B- and T- cells have led to a re-appraisal of possible methods which could be applicable in clinical settings such as hemophilia patients with inhibitors. Thus, it is now clear that a number of mechanisms operate in such a way as to actively induce anergy of B- or T- cells, or even to specifically delete cells in the periphery. The characteristics inherent to the B- and T- cell repertoires and peripheral pools play a major role in the efficiency and maintenance of tolerance induction. The purpose of this manuscript is to review the mechanisms of tolerance induction briefly so as to provide a framework for the understanding of current and future attempts to achieve Factor VIII unresponsiveness in hemophilia A patients.
Saint-Remy
J M
JM
Center for Molecular and Vascular Biology, University of Leuven, Belgium. jeanmarie.saint-Remy@med.kuleuven.ac.be
D001402:B-Lymphocytes / Q000276:immunology; D006467:Hemophilia A / Q000276:immunology; D006801:Humans; D007108:Immune Tolerance; D008213:Lymphocyte Activation / Q000187:drug effects; D008214:Lymphocytes / Q000276:immunology*; D013601:T-Lymphocytes / Q000276:immunology