Cell Therapy in Kidney Transplantation.
10.4285/jkstn.2014.28.3.121
- Author:
Hee Jung JEON
1
;
Jaeseok YANG
Author Information
1. Transplantation Center, Seoul National University Hospital, Seoul, Korea. jcyjs@dreamwiz.com
- Publication Type:Review
- Keywords:
Cell therapy;
Kidney transplantation
- MeSH:
Cell- and Tissue-Based Therapy*;
Dendritic Cells;
Humans;
Immune Tolerance;
Immunosuppressive Agents;
Immunotherapy;
Kidney;
Kidney Transplantation*;
Macrophages;
Major Histocompatibility Complex;
Mesenchymal Stromal Cells;
T-Lymphocytes, Regulatory;
Tissue Donors
- From:The Journal of the Korean Society for Transplantation
2014;28(3):121-134
- CountryRepublic of Korea
- Language:Korean
-
Abstract:
Current immunosuppressants have nonspecific immuosuppressive effects, and are not helpful for tolerance induction. Consequently, transplant patients cannot discontinue using them, and their nonspecific immunosuppressive effects result in many side effects, including infection and malignancy. However, most of cellular immunotherapy can have donor antigen-specific immunsuppressive effects. Therefore, cell therapy could be an alternative or adjunctive to nonspecific immunosuppressants. Polyclonal or antigen-specific Foxp3+ regulatory T cells have been actively tried for prevention of acute rejection, treatment of chronic rejection, or tolerance induction in clinical trials. Regulatory macrophages are also under clinical trials for kidney transplant patients. IL-10-secreting type 1 regulatory T cells and donor- or recipient-derived tolerogenic dendritic cells will also be used for immunoregulation in clinical trials of kidney transplantation. These cells have antigen-specific immunoregulatory effects. Mesenchymal stromal cells (MSCs) have good proliferative capacity and immunosuppressive actions independently of major histocompatibility complex; therefore, even third-party MSCs can be stored and used for many patients. Cell therapy using various immunoregulatory cells is now promising for not only reducing side effects of nonspecific immunosuppressants but also induction of immune tolerance, and is expected to contribute to better outcomes in transplant patients.