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Induction of Allograft Tolerance

An End to Immunosuppressive Therapy in Transplantation?

  • Review Article
  • Immunology-Based Agents
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Summary

Organ transplantation can be one of the therapeutic modalities for various terminal diseases. However, the morbidity and mortality associated with this procedure are still major problems. Discontinuation of immunosuppression or induction of allograft tolerance is the ideal goal in organ transplantation. In fact, there are reports of patients who have been able to stop all conventional immunosuppression and remain clinically stable and drug free over long periods. The mechanism underlying this phenomenon has not yet been clarified.

Recent advances in molecular biology shed light on the molecular mechanisms involved in allograft rejection. Depletion of passenger leucocytes and the reduction of immunogenicity of the allografted tissue lead to significant prolongation of graft survival. Some of the new immunosuppressive drugs have the potential for inducing unresponsiveness when combined with appropriate antigen presentation. Adhesion molecules participating in the interactions of lymphocytes and endothelial cells, and of antigen-presenting cells and T cells, have been identified, and monoclonal antibodies against each molecule have been shown to block full T cell activation, leading to antigen-specific unresponsiveness in certain situations. Some of these modalities are applicable to a large animal model, which could lead to an end to immunosuppressive treatment in clinical organ transplantation.

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Authors and Affiliations

  1. Division of Bioregulation, Biomedical Research Center, Osaka University Medical School, 2-2 Yamadaoka, Osaka, 565, Japan

    Mitsukazu Gotoh & Masayuki Miyasaka

  2. Department of Surgery II, Osaka University Medical School, Osaka, Japan

    Hiroki Ohzato, Keizo Dono, Koji Umeshita, Masato Sakon & Morito Monden

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  1. Mitsukazu Gotoh
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  2. Masayuki Miyasaka
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  3. Hiroki Ohzato
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  4. Keizo Dono
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  5. Koji Umeshita
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  6. Masato Sakon
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  7. Morito Monden
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Gotoh, M., Miyasaka, M., Ohzato, H. et al. Induction of Allograft Tolerance. BioDrugs 8, 56–67 (1997). https://doi.org/10.2165/00063030-199708010-00007

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