Tolerogenic therapies in transplantation

Area of Science:

• Immunology
• Transplantation Science
• Pharmacology

Background:

• The concept of immunologic tolerance emerged in the 1940s, driving advancements in transplantation medicine.
• While short-term graft survival is high, achieving operational tolerance and withdrawing immunosuppression is rare, except in liver transplants.
• Consortia like the Immune Tolerance Network and Reprogramming the Immune System for Establishment of Tolerance have spurred research.

Purpose of the Study:

• To review traditional and novel strategies for inducing immunologic tolerance in organ transplantation.
• To emphasize the translation of these strategies into clinical trials.
• To explore the evaluation of safety and efficacy of tolerogenic approaches.

Main Methods:

• Review of existing literature on immunologic tolerance induction in transplantation.
• Analysis of data from collaborative research networks (NIH, European Commission).
• Focus on clinical trial translation of tolerogenic strategies.

Main Results:

• Significant development of pharmacologic and biologic agents for tolerance induction.
• High short-term graft survival rates achieved.
• Limited success in achieving operational tolerance and immunosuppression withdrawal outside liver transplantation.

Conclusions:

• Despite advances, achieving sustained operational tolerance in organ transplantation remains a significant hurdle.
• Ongoing research and clinical trials are crucial for developing effective tolerogenic strategies.
• Identifying biomarkers for tolerance is key to advancing the field.