title: Treg therapy in transplantation: a general overview.
abstract: Solid organ transplantation remains the treatment of choice for end-stage organ failure. Whilst the short-term outcomes post-transplant have improved in the last decades, chronic rejection and immunosuppressant side effects remain an ongoing concern. Hematopoietic stem cell transplantation is a well-established procedure for the treatment of patients with haematological disorders. However, donor T cells are continually primed and activated to react against the host causing graft-versus-host disease (GvHD) that leads to tissue damages and death. Regulatory T cells (Tregs) play an essential role in maintaining tolerance to self-antigens, preventing excessive immune responses and abrogating autoimmunity. Due to their suppressive properties, Tregs have been extensively studied for their use as a cellular therapy aiming to treat GvHD and limit immune responses responsible for graft rejection. Several clinical trials have been conducted or are currently ongoing to investigate safety and feasibility of Treg-based therapy. This review summarizes the general understanding of Treg biology and presents the methods used to isolate and expand Tregs. Furthermore, we describe data from the first clinical trials using Tregs, explaining the limitations and future application of these cells.
authors.affiliation: Immunoregulation Laboratory, Division of Transplantation Immunology & Mucosal Biology, MRC Centre for Transplantation, King's College London, Guy's Hospital, London, UK.
authors.forename: Marco
authors.initials: M
authors.lastname: Romano
authors.affiliation: Immunoregulation Laboratory, Division of Transplantation Immunology & Mucosal Biology, MRC Centre for Transplantation, King's College London, Guy's Hospital, London, UK.
authors.forename: Sim Lai
authors.initials: SL
authors.lastname: Tung
authors.affiliation: Immunoregulation Laboratory, Division of Transplantation Immunology & Mucosal Biology, MRC Centre for Transplantation, King's College London, Guy's Hospital, London, UK.|School of Health Sport and Bioscience, University of East London, London, UK.
authors.forename: Lesley Ann
authors.initials: LA
authors.lastname: Smyth
authors.affiliation: Immunoregulation Laboratory, Division of Transplantation Immunology & Mucosal Biology, MRC Centre for Transplantation, King's College London, Guy's Hospital, London, UK.
authors.forename: Giovanna
authors.initials: G
authors.lastname: Lombardi
mesh_terms: D000818:Animals; D017690:Cell Transplantation / Q000379:methods; D064987:Cell- and Tissue-Based Therapy / Q000379:methods; D002986:Clinical Trials as Topic; D006084:Graft Rejection / Q000276:immunology / Q000517:prevention & control; D006086:Graft vs Host Disease / Q000276:immunology / Q000517:prevention & control; D006801:Humans; D007165:Immunosuppression Therapy / Q000379:methods; D007167:Immunotherapy / Q000379:methods; D050378:T-Lymphocytes, Regulatory / Q000276:immunology* / Q000637:transplantation*; D023001:Transplantation Tolerance
keywords: clinical trials; good manufacturing practice; regulatory T cells; transplantation