Development of tolerogenic strategies in the clinic.

Journal Article (Journal Article;Review)

The study of tolerance in the clinic can be divided into three areas: (i) focused evaluation of existing tolerant transplant recipients as to their mechanism of tolerance; (ii) prospective tolerance trials, such as combined bone marrow and kidney transplantation as well as T cell depletion followed by subsequent weaning of immunosuppression; and (iii) immunologic assays to assess the likelihood of rejection or tolerance. Frankly, a very small number of patients have been transplanted with the intention of removing all immunosuppressive therapy, but several clinical trials with this aim are currently in progress, largely sponsored by the Immune Tolerance Network, a joint venture between the National Institutes of Health and the Juvenile Diabetes Research Foundation. Similarly, a reliable assay to assess tolerance has not yet been developed but a variety of approaches towards assessing rejection, and in some cases tolerance, are being developed. It would be accurate to state that many of the experimental and preclinical approaches to the induction of tolerance have resulted in better immunosuppression for human transplantation, but reliable tolerance strategies in humans have not yet been achieved. Combined bone marrow and kidney transplantation may be considered as one exception to this, but such a strategy is not generally applicable to the vast majority of solid organ transplant recipients. This review will summarize efforts to date, particularly focusing on kidney transplantation.

Full Text

Duke Authors

Cited Authors

  • Knechtle, SJ

Published Date

  • September 29, 2005

Published In

Volume / Issue

  • 360 / 1461

Start / End Page

  • 1739 - 1746

PubMed ID

  • 16147538

Pubmed Central ID

  • PMC1569535

International Standard Serial Number (ISSN)

  • 0962-8436

Digital Object Identifier (DOI)

  • 10.1098/rstb.2005.1705


  • eng

Conference Location

  • England