Hutchinson, James A. and Geissler, Edward K. (2015) Now or never? The case for cell-based immunosuppression in kidney transplantation. KIDNEY INTERNATIONAL, 87 (6). pp. 1116-1124. ISSN 0085-2538, 1523-1755
Full text not available from this repository. (Request a copy)Abstract
By exploiting mechanisms of immunological regulation against donor alloantigen, it may be possible to reduce the dependence of kidney transplant recipients upon calcineurin inhibitor-based maintenance immunosuppression. One means to strengthen regulatory responses is treating recipients with preparations of regulatory cells obtained by ex vivo manipulation. This strategy, which is a well-established experimental method, has been developed to the point that early-phase clinical trials in kidney transplantation are now feasible. Cell-based therapies represent a radical departure from conventional treatment, so what grounds are there for this new approach? This article offers a three-part justification for trialing cell-based therapies in kidney transplantation: first, a clinical need for alternatives to standard immunosuppression is identified, based on the inadequacies of calcineurin inhibitor-based regimens in preventing late allograft loss; second, a mechanistic explanation of how cell-based therapies might address this clinical need is given; and third, the possible benefit to patients is weighed against the potential risks of cell-based immunosuppressive therapy. It is concluded that the safety of cell-based immunosuppressive therapy will not be greatly improved by further basic scientific and preclinical development. Only trials in humans can now tell us whether cell-based therapy is likely to benefit kidney transplant recipients, but these should be conservative in design to minimize any potential harm to patients.
| Item Type: | Article |
|---|---|
| Uncontrolled Keywords: | REGULATORY T-CELLS; ACCEPTANCE-INDUCING-CELLS; SOLID-ORGAN TRANSPLANTATION; TOLEROGENIC DENDRITIC CELLS; RENAL-TRANSPLANTATION; CALCINEURIN INHIBITORS; SUPPRESSOR-CELLS; ALLOGRAFT-REJECTION; MAINTENANCE IMMUNOSUPPRESSION; CYCLOSPORINE WITHDRAWAL; cell therapy; Mreg; Mreg_UKR; The ONE Study |
| Subjects: | 600 Technology > 610 Medical sciences Medicine |
| Divisions: | Medicine > Lehrstuhl für Chirurgie |
| Depositing User: | Petra Gürster |
| Date Deposited: | 21 Aug 2020 06:38 |
| Last Modified: | 21 Aug 2020 06:38 |
| URI: | https://pred.uni-regensburg.de/id/eprint/5415 |
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