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2014 ; 258
(1
): 167-82
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Recollective homeostasis and the immune consequences of peritransplant
depletional induction therapy
#MMPMID24517433
Rosenblum JM
; Kirk AD
Immunol Rev
2014[Mar]; 258
(1
): 167-82
PMID24517433
show ga
One's cellular immune repertoire is composed of lymphocytes in multiple stages of
maturation - the dynamic product of their responses to antigenic challenges and
the homeostatic contractions necessary to accommodate immune expansions within
physiologic norms. Given that alloreactivity is predominantly a cross-reactive
phenomenon that is stochastically distributed throughout the overall T-cell
repertoire, one's allospecific repertoire is similarly made up of cells in a
variety of differentiation states. As such, the continuous expansion and
elimination of activated memory populations, producing a 'recollective
homeostasis' of sorts, has the potential over time to alter the maturation state
and effector composition of both ones protective and alloreactive T-cell
repertoire. Importantly, a T cell's maturation state significantly influences its
response to numerous immunomodulatory therapies used in organ transplantation,
including depletional antibody induction. In this review, we discuss clinically
utilized depletional induction strategies, how their use alters a transplant
recipient's cellular immune repertoire, and how a recipient's repertoire
influences the clinical effects of induction therapy.
|Animals
[MESH]
|Antibodies/adverse effects/*therapeutic use
[MESH]
|Graft Rejection/immunology/prevention & control
[MESH]
|Homeostasis
[MESH]
|Humans
[MESH]
|Immunity, Cellular/*drug effects
[MESH]
|Immunologic Memory/drug effects
[MESH]
|Immunosuppressive Agents/adverse effects/*therapeutic use
[MESH]