Immunologic monitoring

Abstract

The development of reliable in vitro assays that could allow the quantitation and characterization of anti-donor alloimmune responses has always been a goal in clinical transplantation, both to predict presensitization to the transplanted tissue and to be able to identify rejection without resorting to more invasive tests. With recent development in our understanding of transplantation biology and therapeutics, there is a real expectation that these tests may be used to identify tolerance as much as to predict rejection. The traditional limiting dilution assays still have a contribution to make and are being complemented by an array of tools, such as ELISpot, flow cytometry-based techniques, and microarray analysis. The assays that have been informative, to date, are discussed in this review. This information will lead, at least, to a better understanding of how and when the rejection process occurs. More interestingly, the objective is to apply this information to evaluate tolerance-inducing strategies or to identify patients that have become tolerant to their graft and can be weaned of immunosuppression. Of course sensitive, accurate and specific immunologic monitoring has applications well beyond the field of transplantation.

Potent Phagocytic Activity with Impaired Antigen Presentation Identifying Lipopolysaccharide-Tolerant Human Monocytes: Demonstration in Isolated Monocytes from Cystic Fibrosis Patients

“…7C). Finally, we have verified the functional impact of CIITA/MHC class II down-regulation via a standard lymphocyte proliferation assay (33,34). In full agreement with the findings presented above, Ag presentation is significantly impaired in tolerant human monocytes (Fig.…”

“…We followed a protocol previously described by Hernandez-Fuentes and coworkers (33) and Adam and coworkers (34).…”

Chronic Lymphocytic Leukemia: A Paradigm of Innate Immune Cross-Tolerance

“…3A, 3B). Finally, we verified the functional impact of MHC class II downregulation via a lymphocyte-proliferation assay (15,24,32). In full agreement with the findings presented above, Ag presentation was significantly impaired in CLL monocytes (Fig.…”

Harnessing the diversity of the human T‐cell repertoire: A monitoring tool for transplantation tolerance?

“…Antigen-specific assays include the cytotoxic T lymphocyte (CTL) assays, the mixed leukocyte reaction (MLR), and the limiting dilution assays (LDA), which are not used in large clinical studies because these techniques are time-consuming. In the past decade, the faster and more reproducible ELISPOT assay, used to measure antigenspecific T-cell responses, is gaining a lot of attention and appears to be promising for routine clinical practice [9]. Non-antigenspecific assays include techniques to quantify T-cell genes or genesets by qPCR or DNA microarrays [10], protein microarrays [11], methods to measure general T-cell activation (e.g.…”