B-cell tolerance in transplantation: Is repertoire remodeling the answer?

Ronald F. Parsons, Kumar Vivek, Robert R. Redfield, Thi Sau Migone, Michael P. Cancro, Ali Naji, Hooman Noorchashm

Research output: Contribution to journalReview article

12 Scopus citations


T lymphocytes are the primary targets of immunotherapy in clinical transplantation; however, B-lymphocytes and their secreted alloantibodies are also highly detrimental to the allograft. Therefore, the achievement of sustained organ transplant survival will likely require the induction of B-lymphocyte tolerance. During development, acquisition of B-cell tolerance to self-antigens relies on clonal deletion in the early stages of B-cell compartment ontogeny. We contend that this mechanism should be recapitulated in the setting of alloantigens and organ transplantation to eliminate the alloreactive B-cell subset from the recipient. Clinically feasible targets of B-cell-directed immunotherapy, such as CD20 and B-lymphocyte stimulator (BLyS), should drive upcoming clinical trials aimed at remodeling the recipient B-cell repertoire.

Original languageEnglish (US)
Pages (from-to)703-723
Number of pages21
JournalExpert Review of Clinical Immunology
Issue number6
StatePublished - Nov 1 2009
Externally publishedYes


  • Allograft
  • B cell
  • BLyS
  • Homeostasis
  • Rejection
  • Selection
  • Tolerance

ASJC Scopus subject areas

  • Immunology and Allergy
  • Immunology

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  • Cite this

    Parsons, R. F., Vivek, K., Redfield, R. R., Migone, T. S., Cancro, M. P., Naji, A., & Noorchashm, H. (2009). B-cell tolerance in transplantation: Is repertoire remodeling the answer? Expert Review of Clinical Immunology, 5(6), 703-723. https://doi.org/10.1586/eci.09.63