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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.
Financial & competing interests disclosure
Michael Cancro holds a sponsored research agreement with Human Genome Sciences (HGS). Thi-Sau Migone is an employee of HGS who has stock options from the company. This work was supported by the US NIH (grant numbers DK64603 and DK80286 to Hooman Noorchashm) and the Juvenile Diabetes Research Foundation (grant number 5-2008-276 to Ali Naji). The authors have no other relevant affiliations or financial involvement with any organization or entity with a financial interest in or financial conflict with the subject matter or materials discussed in the manuscript apart from those disclosed.
No writing assistance was utilized in the production of this manuscript.