Transplantation has therapeutic applications not only for patients experiencing end-stage organ failure, but also in other clinical settings, such as cancer and autoimmunity. However, a major barrier to a successful transplant outcome is that the immune system of the recipient will recognize a donor allograft as 'foreign' and seek to remove it. Consequently, an important goal for the transplant immunology field is to understand how to induce tolerogenic immune responses against a foreign allograft.
The Review articles in this Focus issue describe our current understanding of the immune mechanisms involved in allograft rejection and graft-versus-host disease. Importantly, the articles discuss how the immune system of transplant recipients can be manipulated (for example, through induction of graft-specific regulatory T cells) in order to promote long-term allograft acceptance and other clinical benefits, such as graft-versus-tumour effects.
All of the articles can be accessed for free by registered users until July 2012.
Research Highlights
Transplant immunology: Gut bugs and grafts
doi:10.1038/nri3236
Nature Reviews Immunology, 12, 399 (2012)
Composition of the intestinal flora influences the severity of graft-versus-host disease.
In brief
Transplantation: Handling complement for transplant success | PDF (100 KB)
p401 | doi:10.1038/nri3241
Nature Reviews Immunology, 12, 401 (2012)
Reviews
Emerging concepts in haematopoietic cell transplantation
Hao Wei Li & Megan Sykes
doi:10.1038/nri3226
Nature Reviews Immunology 12, 403-416 (2012)
Haematopoietic cell transplantation (HCT) is most frequently performed as a cancer therapy. However, more recently HCT has been used to treat patients with autoimmune diseases and to promote tolerance to other allografts. Here, the authors discuss the latest advances in HCT and the challenges still faced by researchers in the field.
Regulatory immune cells in transplantation
Kathryn J. Wood, Andrew Bushell & Joanna Hester
doi:10.1038/nri3227
Nature Reviews Immunology 12, 417-430 (2012)
Establishing immune tolerance in transplant recipients is essential for promoting the long-term survival of an allograft and for preventing the development of harmful graft-versus-host responses. This Review considers the clinical potential of manipulating different immunosuppressive cell populations, including regulatory T cells, B cells and macrophages, in the setting of transplantation.
The role of complement in the early immune response to transplantation
Steven H. Sacks & Wuding Zhou
doi:10.1038/nri3225
Nature Reviews Immunology 12, 431-442 (2012)
In this article, the importance of the peripheral production of complement in driving the immediate response of a transplanted organ to tissue stress and in the activation of alloreactive T cells is discussed, as well as the role of complement in antibody-mediated rejection. The authors also focus on new complement-targeted treatments for the prevention of transplant rejection.
Advances in graft-versus-host disease biology and therapy
Bruce R. Blazar, William J. Murphy & Mehrdad Abedi
doi:10.1038/nri3212
Nature Reviews Immunology 12, 443-458 (2012)
Here, the authors review the most promising strategies for preventing or treating graft-versus-host disease after allogeneic haematopoietic stem cell transplantation. Approaches that target alloreactive T cells are often favoured, but those that exploit regulatory cell populations are now showing increasing success.
The impact of infection and tissue damage in solid-organ transplantation
Anita S. Chong & Maria-Luisa Alegre
doi:10.1038/nri3215
Nature Reviews Immunology 12, 459-471 (2012)
It has long been known that infections and tissue damage can be detrimental for the survival of transplanted allografts but the underlying mechanisms that trigger both innate and adaptive immunity are only beginning to be understood and are reviewed here.
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