title: Biologics in organ transplantation.
abstract: The last two decades have witnessed a pandemic in antibody development, with over 600 entering clinical studies and a total of 28 approved by the FDA and European Union. The incorporation of biologics in transplantation has made a significant impact on allograft survival. Herein, we review the armamentarium of clinical and preclinical biologics used for organ transplantation--with the exception of belatacept--from depleting and IL-2R targeting induction agents to costimulation blockade, B-cell therapeutics, BAFF and complement inhibition, anti-adhesion, and anti-cytokine approaches. While individual agents may be insufficient for tolerance induction, they provide possibilities for reduction of steroid or calcineurin inhibitor use, alternatives to rejection episodes refractory to conventional therapies, and specialized immunosuppression for highly sensitized patients.
authors.affiliation: Department of Surgery, Emory University Hospital, Atlanta, GA, USA.
authors.forename: Eugenia K
authors.initials: EK
authors.lastname: Page
authors.forename: Wasim A
authors.initials: WA
authors.lastname: Dar
authors.forename: Stuart J
authors.initials: SJ
authors.lastname: Knechtle
mesh_terms: D000818:Animals; D000911:Antibodies, Monoclonal / Q000737:chemistry*; D053264:B-Cell Activating Factor / Q000378:metabolism; D001402:B-Lymphocytes / Q000166:cytology; D001688:Biological Products / Q000627:therapeutic use*; D018106:CD28 Antigens / Q000378:metabolism; D019703:Calcineurin / Q000494:pharmacology; D003165:Complement System Proteins; D016207:Cytokines / Q000378:metabolism; D005060:Europe; D006801:Humans; D007155:Immunologic Factors / Q000494:pharmacology; D007166:Immunosuppressive Agents / Q000627:therapeutic use; D053645:Interleukin-2 Receptor alpha Subunit / Q000378:metabolism; D008954:Models, Biological; D016377:Organ Transplantation / Q000379:methods*; D013256:Steroids / Q000627:therapeutic use; D014481:United States
chemical_list: D000911:Antibodies, Monoclonal; D053264:B-Cell Activating Factor; D001688:Biological Products; D018106:CD28 Antigens; D016207:Cytokines; D007155:Immunologic Factors; D007166:Immunosuppressive Agents; D053645:Interleukin-2 Receptor alpha Subunit; D013256:Steroids; C505719:TNFSF13B protein, human; D003165:Complement System Proteins; D019703:Calcineurin