Tolerance induction by removal of alloreactive T cells: in-vivo and  pruning strategies.
OBJECTIVE
Current depletion strategies used in clinical transplantation can prevent acute rejection of a transplanted organ; however, they are nonspecific and are limited by their efficacy or the side effects of wide ranging cellular depletion. This review will focus on strategies that prevent rejection of allografts using specific allodepletion of the T cells that mediate rejection.


RESULTS
Strategies that use either in-vivo targeting of alloreactive T cells or ex-vivo manipulation to specifically reduce the alloreactive T-cell pool have been developed. The advantage of these approaches is that they are specific, by depleting cells that cause rejection while leaving the remaining immune system intact, thereby minimizing the detrimental complications associated with standard immunosuppression.


CONCLUSIONS
Strategies to reduce the proportion of alloreactive T cells that initiate transplant rejection are emphasized. This factor has the specific advantage of leaving the remaining T-cell repertoire intact and may therefore be used in combination with other immunemodulating and tolerance strategies.
Watson
Debbie
D
Centre for Kidney Research, Children's Hospital at Westmead, Westmead, New South Wales, Australia.
Hu
Min
M
Zhang
Geoff Y
GY
Wang
Yuan Min
YM
Alexander
Stephen I
SI
D000818:Animals; D049109:Cell Proliferation; D006084:Graft Rejection / Q000276:immunology / Q000517:prevention & control*; D006801:Humans; D007165:Immunosuppression Therapy / Q000009:adverse effects / Q000379:methods*; D008213:Lymphocyte Activation; D008212:Lymphocyte Depletion / Q000009:adverse effects; D016377:Organ Transplantation / Q000009:adverse effects; D015398:Signal Transduction; D013601:T-Lymphocytes / Q000276:immunology*; D023001:Transplantation Tolerance; D014184:Transplantation, Homologous