Trained immunity in organ transplantation

Area of Science:

• Immunology
• Transplantation Science

Background:

• Achieving lasting donor-specific unresponsiveness without continuous immunosuppression is a major challenge in organ transplantation.
• Current strategies targeting adaptive immunity show suboptimal long-term graft survival, indicating other rejection mechanisms exist.

Purpose of the Study:

• To explore the role of trained immunity pathways in mediating allograft rejection.
• To summarize the negative impacts of trained immunity in organ transplantation and identify pathways inducing macrophage training.

Main Methods:

• Review of existing literature on trained immunity and its components.
• Analysis of macrophage reprogramming (epigenetic and metabolic) in the context of transplantation.

Main Results:

• Trained immunity, involving epigenetic and metabolic reprogramming of macrophages, contributes to graft rejection.
• Trained macrophages enhance immune responses by upregulating costimulatory molecules and producing pro-inflammatory cytokines.

Conclusions:

• Trained immunity pathways represent a critical, yet often unrecognized, mechanism contributing to organ transplant rejection.
• Targeting trained immunity in macrophages may offer novel therapeutic strategies to improve graft survival and reduce reliance on immunosuppression.