Prospects and strategies for clinical tolerance.
The morbidity and mortality associated with chronic immunosuppression provide a strong motivation for development of clinical tolerance. This paper discusses the definition(s) of clinical (operational) tolerance, the role of chimerism in experimental and clinical tolerance, and the special role of bone marrow in tolerance induction. The states of microchimerism and macrochimerism are defined and related to certain clinical observations in solid organ transplantation. Current clinical strategies already being tested in the clinic are briefly reviewed. Certain principles for induction of clinical (operational) tolerance are elaborated.
Monaco
A P
AP
Harvard Medical School, Boston, Massachusetts, USA.
D016026:Bone Marrow Transplantation / Q000276:immunology / Q000379:methods; D006801:Humans; D007108:Immune Tolerance / Q000502:physiology*; D007165:Immunosuppression Therapy / Q000009:adverse effects* / Q000379:methods*; D008212:Lymphocyte Depletion; D018183:Transplantation Chimera / Q000276:immunology; D014181:Transplantation Immunology