Molecular biology of the allograft response

Intensive basic research in immunology has provided us with a detailed understanding of the molecular events and interactions of the immune response that would have seemed incredible only a decade ago. An in-depth knowledge of the factors that initiate and control the immune response is, however, just the first step in learning how to manipulate this complex process for human benefit. One goal that seems quite attainable over the near term is a significant improvement in our ability to alleviate many of the problems resulting from allograft rejection--with newer drugs that not only are more effective, but are also much less hazardous or debilitating to transplant patients. Clearly the goal for the long term is the induction of allograft tolerance, rather than simply the modification of rejection. Genetic techniques will continue to serve as important tools in the research necessary to explore this new territory, and they are even now showing tremendous potential as sources of useful and effective immunotherapies.