title: Regulatory T cells as modulators of chronic allograft dysfunction.
abstract: Chronic allograft dysfunction (CAD) in solid organ transplantation is a principal cause of patient morbidity and late allograft loss. The pathogenesis of CAD is largely secondary to chronic damage by the adaptive immune system and long-term immunosuppression. Manipulating these factors may be possible with the use of regulatory T cells (Treg), which have the ability to suppress specific immune responses and therefore potentially remove the need for immunosuppressive drugs. Studies of CAD in experimental models have demonstrated the capacity for both mouse and human Treg cellular therapy to prevent the development of some manifestations of CAD. Furthermore, a role for Treg has been demonstrated in clinically tolerant transplant patients. Certain immunosuppressive therapies are also proving to be 'Treg friendly' and may be helpful in promoting Treg while maintaining other immunosuppressive activity. With this in mind, monitoring for biomarkers of operational tolerance with tailored immunosuppressive therapy or controlled weaning in conjunction with Treg cellular therapy may be a useful strategy to pursue.
authors.affiliation: Transplantation Research Immunology Group, Nuffield Department of Surgical Sciences, University of Oxford, United Kingdom.
authors.forename: Fadi
authors.initials: F
authors.lastname: Issa
authors.forename: Deepak
authors.initials: D
authors.lastname: Chandrasekharan
authors.forename: Kathryn J
authors.initials: KJ
authors.lastname: Wood
mesh_terms: D056704:Adaptive Immunity; D000818:Animals; D015703:Antigens, CD / Q000276:immunology; D015415:Biomarkers / Q000032:analysis; D051858:Forkhead Transcription Factors / Q000235:genetics / Q000276:immunology; D006084:Graft Rejection / Q000276:immunology / Q000517:prevention & control*; D006801:Humans; D056747:Immunomodulation; D007165:Immunosuppression Therapy; D007166:Immunosuppressive Agents / Q000008:administration & dosage; D017710:Lymphocyte Transfusion / Q000379:methods*; D051379:Mice; D016377:Organ Transplantation; D050378:T-Lymphocytes, Regulatory / Q000166:cytology / Q000276:immunology*; D023001:Transplantation Tolerance
chemical_list: D015703:Antigens, CD; D015415:Biomarkers; C418974:FOXP3 protein, human; D051858:Forkhead Transcription Factors; C498833:Foxp3 protein, mouse; D007166:Immunosuppressive Agents