The balance of immune responses: costimulation verse coinhibition

Many of the B7 superfamily members (e.g., B7-1, B7-2, ICOS-L, B7-H1, B7-DC) were initially characterized as T cell costimulatory molecules. However, more recently it has become clear they can also coinhibit T cell responses. We review many of the B7 family members, with a particular focus on B7-H1, and examine their role in autoimmunity, transplant rejection, and cancer pathogenesis. It is crucial to understand that many B7 family members have opposing effects on an immune response. This cautions against using clinical immunotherapeutic reagents targeted against these molecules until we gain a better understanding of the circumstances that regulate the outcomes of the T cell response.