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Current Transplantation Reports

, Volume 6, Issue 1, pp 60–68 | Cite as

High-Dimensional Renal Profiling: Towards a Better Understanding of Renal Transplant Immune Suppression

  • Cyd M. Castro-Rojas
  • Rita R. Alloway
  • E. Steve Woodle
  • David A. HildemanEmail author
Immunology (R Fairchild, Section Editor)
  • 67 Downloads
Part of the following topical collections:
  1. Topical Collection on Immunology

Abstract

Purpose of Review

The goal of this review is to discuss new approaches to avoid calcineurin inhibitor (CNI)/corticosteroids (CCS) toxicities with a focus on new biologics and new methods to understand transplant rejection at the single-cell level.

Recent Findings

Recently developed biologics hold significant promise as the next wave of therapeutics designed to promote CNI/CCS-free long-term allograft acceptance. Indeed, belatacept, soluble CTLA4-Ig, is largely devoid of CNI-like toxicities, although it is accompanied by an increased frequency of acute rejection. Besides belatacept, other biologics hold promise as CNI-free immune suppressive approaches. Finally, powerful new single-cell approaches can enable characterization of cellular populations that drive rejection within the rejecting allograft.

Summary

We propose that the incorporated single-cell profiling into studies investigating new biologics in transplantation could be tailored to each patient, correlated with potential biomarkers in the blood and urine, and provide a platform where therapeutic targets can be rationally defined, mechanistically based, and exploited.

Keywords

Kidney allograft rejection Calcineurin inhibitor Immunosuppression Toxicity Belatacept mTOR inhibitor High-dimension profiling Single-cell RNA sequencing 

Notes

Compliance with Ethical Standards

Conflict of Interest

David Hildeman reports grants from University of Cincinnati Center for Clinical & Translational Science & Training. David. A. Hildeman, Cyd Castro-Rojas, Rita R. Alloway, and E. Steve Woodle declare no conflict of interest.

Human and Animal Rights and Informed Consent

This article does not contain any studies with human or animal subjects performed by any of the authors.

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Copyright information

© Springer Nature Switzerland AG 2019

Authors and Affiliations

  • Cyd M. Castro-Rojas
    • 1
  • Rita R. Alloway
    • 2
  • E. Steve Woodle
    • 3
  • David A. Hildeman
    • 1
    • 4
    Email author
  1. 1.Division of ImmunobiologyCincinnati Children’s Hospital Medical CenterCincinnatiUSA
  2. 2.Division of Nephrology, Department of Internal MedicineUniversity of Cincinnati College of MedicineCincinnatiUSA
  3. 3.Division of Transplantation, Department of SurgeryUniversity of Cincinnati College of MedicineCincinnatiUSA
  4. 4.Department of PediatricsUniversity of Cincinnati College of MedicineCincinnatiUSA

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