Regulatory CD4+CD25+ T cells in the peripheral blood of lung transplant recipients: correlation with transplant outcome

Meloni, Federica; Vitulo, Patrizio; Bianco, A. Marone; Paschetto, Enrica; Morosini, Monica; Cascina, Alessandro; Mazzucchelli, Iolanda; Ciardelli, Laura; Oggionni, Tiberio; Fietta, A.; Pozzi, Ernesto; Viganò, Mario

doi:10.1097/01.tp.0000116565.86752.6b

Cited by 123 publications

(92 citation statements)

References 9 publications

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“…32 Lung transplant patients affected with BOS have a lower level of circulating CD4 þ CD25 þ T reg than patients in a stable clinical condition. 34 In line with this, an animal model of BOS has shown increased local IL-17 production, with decreased peripheral blood levels of T regs . 35 IL-17 has been shown to induce IL-8 secretion, 36,37 which in turn is related to airway neutrophilia.…”

Section: Pathogenesismentioning

confidence: 68%

Bronchiolitis obliterans after allo-SCT: clinical criteria and treatment options

Uhlving

Buchvald

Heilmann

et al. 2011

Bone Marrow Transplant

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Bronchiolitis obliterans (BO) following allogeneic haematopoietic SCT (HSCT) is a serious complication affecting 1.7-26% of the patients, with a reported mortality rate of 21-100%. It is considered a manifestation of chronic graftversus-host disease, but our knowledge of aetiology and pathogenesis is still limited. Diagnostic criteria are being developed, and will allow more uniform and comparable research activities between centres. At present, no randomised controlled trials have been completed that could demonstrate an effective treatment. Steroids in combination with other immunosuppressive drugs still constitute the backbone of the treatment strategy, and results from our and other centres suggest that monthly infusions of high-dose pulse i.v. methylprednisolone (HDPM) might stabilise the disease and hinder progression. This article provides an overview of the current evidence regarding treatment options for BO and presents the treatment results with HDPM in a paediatric national HSCT-cohort.

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Section: Pathogenesismentioning

confidence: 68%

Bronchiolitis obliterans after allo-SCT: clinical criteria and treatment options

Uhlving

Buchvald

Heilmann

et al. 2011

Bone Marrow Transplant

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“…Data are limited regarding the role of Tregs in lung transplant rejection. One report in humans indicates that the rejection response and OB were associated with fewer numbers of CD4 ϩ CD25 ϩ T cells (89). These cells are believed to mediate immune suppression in a contact-dependent manner by membrane-associated transforming growth factor ␤ (TGF-␤).…”

Section: Autoimmunity Regulatory T Cells and Tolerancementioning

confidence: 99%

Lung Transplantation: Opportunities for Research and Clinical Advancement

Wilkes¹

2006

Am J Respir Crit Care Med

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Lung transplantation is the only definitive therapy for many forms of end-stage lung diseases. However, the success of lung transplantation is limited by many factors: (1 ) Too few lungs available for transplantation due to limited donors or injury to the donor lung; (2 ) current methods of preservation of excised lungs do not allow extended periods of time between procurement and implantation; (3 ) acute graft failure is more common with lungs than other solid organs, thus contributing to poorer short-term survival after lung transplant compared with that for recipients of other organs; (4 ) lung transplant recipients are particularly vulnerable to pulmonary infections; and (5 ) chronic allograft dysfunction, manifest by bronchiolitis obliterans syndrome, is frequent and limits long-term survival. Scientific advances may provide significant improvements in the outcome of lung transplantation. The National Heart, Lung, and Blood Institute convened a working group of investigators on June 14-15, 2004, in Bethesda, Maryland, to identify opportunities for scientific advancement in lung transplantation, including basic and clinical research. This workshop provides a framework to identify critical issues related to clinical lung transplantation, and to delineate important areas for productive scientific investigation. Keywords: allograft dysfunction; infection; ischemia-reperfusion injury; lung transplantation; obliterative bronchiolitis; rejectionThe transplantation of organs offers the promise of life-saving and life-enhancing therapy for a variety of ailments. Lung transplantation (LTx) has become an acceptable therapy to palliate patients with a variety of end-stage lung diseases. However, lung transplantation has not turned out to be a panacea for chronic lung disease because of significant limitations in the entire transplant process (Figure 1). First, there are not nearly enough suitable donor lungs to meet the needs of all patients with end-stage lung disease. As a result, more patients die waiting for transplants than from mortality associated with a lung transplant. Second, early graft survival after LTx is worse than for other types of organs transplanted (1). Finally, late survival after successful LTx is hampered by the development of chronic allograft dysfunction and by the life-limiting complications associated with conventional immunosuppressive medications. Two factors impede progress to address these problems: (1 ) lung transplant centers lack the infrastructure to facilitate prospective, multicenter clinical studies of sufficient power to address clinical questions and (2 ) there are too few investigators studying the biology of lung transplantation.The NHLBI convened a workshop on June 14-15, 2004, to better understand these complex problems and to identify strategies to address these and prioritize them. The topics addressed by participants were wide-ranging. They included the following: lung use rates from conventional brain-dead organ donors; safe limits for donor lung function; consideration o...

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“…Despite this low quantity, these cells can induce immune tolerance and are potent in inhibiting alloimmunity responses in an antigen-specific manner mediated by their Fas/FasL-dependent cytolysis. 10 There are growing reports demonstrating that kidney-, 4 liver-, 21 lung-, 22 heart-, 23 and skintransplanted patients 24 with chronic (and sometimes acute) rejection, have a diminished T-reg phenotype/function compared with tolerant or stable patients. Increased T-regs in some cases of acute rejection may be a response to high donor-activated effector T-cell activity.…”

Section: Reviewmentioning

confidence: 99%

Regulatory T Cells as a Therapeutic Tool To Induce Solid-Organ Transplant Tolerance: Current Clinical Experiences

Nikoueinejad¹,

Sharif²,

Amirzargar³

et al. 2013

Exp Clin Transplant

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Long-term tolerance is potentially an ideal in organ transplant. Achieving this leads us to eliminate immunosuppressive therapies and their associated side effects. Although most succession in this field belongs to mixed chimerism methods of tolerance induction, regulatory T cells and (T-reg)-based methods also have been demonstrated to prevent organ rejection and lead to transplant tolerance through different mechanisms. In contrast to chimeric protocols (which require bone marrow transplant), T-reg-mediated protocols do not aggressively manipulate blood and the immune system. Most treatment has been done for graft-versus-host disease after hematopoietic stem cell transplant. This review describes different types and mechanisms of action and clinical strategies using T-regs to induce transplant tolerance.

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Regulatory CD4+CD25+ T cells in the peripheral blood of lung transplant recipients: correlation with transplant outcome

Abstract: These results provide in vivo evidence that peripheral CD4+CD25+ T cells may represent an important regulatory subset in lung transplantation.

Cited by 123 publications

References 9 publications

Bronchiolitis obliterans after allo-SCT: clinical criteria and treatment options

Bronchiolitis obliterans after allo-SCT: clinical criteria and treatment options

Lung Transplantation: Opportunities for Research and Clinical Advancement

Regulatory T Cells as a Therapeutic Tool To Induce Solid-Organ Transplant Tolerance: Current Clinical Experiences

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