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 articlepeer-review

12 Scopus citations

Abstract

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
Volume5
Issue number6
DOIs
StatePublished - Nov 2009
Externally publishedYes

Keywords

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

ASJC Scopus subject areas

  • Immunology and Allergy
  • Immunology

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