Michelle L Miller1, Anita S Chong2, Maria-Luisa Alegre1. 1. Department of Medicine, Section of Rheumatology, University of Chicago. 2. Department of Surgery, Section of Transplantation, University of Chicago.
Abstract
PURPOSE OF REVIEW: It has long been considered that tolerance in a transplant recipient is a binary all-or-none state: either the graft is accepted without immunosuppression identifying the recipient as tolerant, or the recipient rejects the graft and is not tolerant. This tolerance paradigm, however, does not accurately reflect data emerging from animal models and patients and requires revision. RECENT FINDINGS: It is becoming appreciated that there may be different gradations in the quality of tolerance based on underlying cellular mechanisms of immunological tolerance, and that individuals may enhance their tolerance by strengthening or combining different cellular mechanisms. Furthermore, evidence suggests that even if tolerance is lost, the loss may be only temporary, and in some circumstances tolerance can be restored. SUMMARY: Shifting our focus from an all-or-nothing tolerance paradigm to one with many shades may help us better understand how tolerance operates, and how this state may be tracked and enhanced for better patient outcomes.
PURPOSE OF REVIEW: It has long been considered that tolerance in a transplant recipient is a binary all-or-none state: either the graft is accepted without immunosuppression identifying the recipient as tolerant, or the recipient rejects the graft and is not tolerant. This tolerance paradigm, however, does not accurately reflect data emerging from animal models and patients and requires revision. RECENT FINDINGS: It is becoming appreciated that there may be different gradations in the quality of tolerance based on underlying cellular mechanisms of immunological tolerance, and that individuals may enhance their tolerance by strengthening or combining different cellular mechanisms. Furthermore, evidence suggests that even if tolerance is lost, the loss may be only temporary, and in some circumstances tolerance can be restored. SUMMARY: Shifting our focus from an all-or-nothing tolerance paradigm to one with many shades may help us better understand how tolerance operates, and how this state may be tracked and enhanced for better patient outcomes.
Authors: Luis Graca; Sara Thompson; Chun-Yen Lin; Elizabeth Adams; Stephen P Cobbold; Herman Waldmann Journal: J Immunol Date: 2002-06-01 Impact factor: 5.422
Authors: Katsunori Tanaka; Monica J Albin; Xueli Yuan; Kazuhiro Yamaura; Antje Habicht; Takaya Murayama; Martin Grimm; Ana Maria Waaga; Takuya Ueno; Robert F Padera; Hideo Yagita; Miyuki Azuma; Tahiro Shin; Bruce R Blazar; David M Rothstein; Mohamed H Sayegh; Nader Najafian Journal: J Immunol Date: 2007-10-15 Impact factor: 5.422
Authors: Sinda Bigenzahn; Peter Blaha; Zvonimir Koporc; Ines Pree; Edgar Selzer; Helga Bergmeister; Friedrich Wrba; Christoph Heusser; Kathrin Wagner; Ferdinand Muehlbacher; Thomas Wekerle Journal: Am J Transplant Date: 2005-06 Impact factor: 8.086
Authors: R M Welsh; T G Markees; B A Woda; K A Daniels; M A Brehm; J P Mordes; D L Greiner; A A Rossini Journal: J Virol Date: 2000-03 Impact factor: 5.103
Authors: Tatsuo Kawai; A Benedict Cosimi; Thomas R Spitzer; Nina Tolkoff-Rubin; Manikkam Suthanthiran; Susan L Saidman; Juanita Shaffer; Frederic I Preffer; Ruchuang Ding; Vijay Sharma; Jay A Fishman; Bimalangshu Dey; Dicken S C Ko; Martin Hertl; Nelson B Goes; Waichi Wong; Winfred W Williams; Robert B Colvin; Megan Sykes; David H Sachs Journal: N Engl J Med Date: 2008-01-24 Impact factor: 91.245
Authors: Shuangjin Yu; Anil Dangi; Melanie Burnette; Michael M Abecassis; Edward B Thorp; Xunrong Luo Journal: Am J Transplant Date: 2020-08-17 Impact factor: 8.086