Cabello-Kindelan Cecilia, Mackey Shane, Bayer Allison L
Diabetes Research Institute, University of Miami Miller School of Medicine, Miami, FL 33136.
Department of Microbiology and Immunology, University of Miami Miller School of Medicine, Miami, FL 33136 ; Diabetes Research Institute, University of Miami Miller School of Medicine, Miami, FL 33136.
Curr Transplant Rep. 2015 Jun 1;2(2):191-201. doi: 10.1007/s40472-015-0058-5.
There is a clear need to develop strategies to induce tolerance without the need of chronic immunosuppression in transplant recipient and in patients with autoimmunity. Adoptive T regulatory cell (T) therapy offers the potential of long-lasting protection. However, based on results of clinical trials so far with expanded autologous T in type 1 diabetic (T1D) patients, it seems unlikely that single immunotherapy with T infusion without immunomodulation regimens that promote stable donor T engraftment and persistence would afford truly significant clinical benefit. Combination therapies could provide improved outcomes with consideration of the fundamental factors required for T generation, homeostasis, and function to promote long-term donor T persistence to provoke beneficial therapeutic outcomes.
显然需要制定策略,在移植受者和自身免疫性疾病患者中诱导耐受而无需长期免疫抑制。过继性调节性T细胞(Treg)疗法具有提供持久保护的潜力。然而,根据目前1型糖尿病(T1D)患者自体Treg扩增的临床试验结果,在没有促进稳定供体Treg植入和持续存在的免疫调节方案的情况下,单纯输注Treg进行单一免疫治疗似乎不太可能带来真正显著的临床益处。考虑到Treg产生、稳态和功能所需的基本因素以促进供体Treg长期持续存在从而引发有益的治疗结果,联合疗法可能会带来更好的疗效。