Skip to main content

Commentary on Section II

  • Chapter
Immunology for Surgeons
  • 144 Accesses

Abstract

In Chapter 5, Morrissey and colleagues fully discuss the immunologic basis of tissue typing in solid organ transplantation. This area along with the other chapters in this section combines an understanding of the clinical practice of transplantation with that of immune regulation and tolerance. As indicated by the authors, new advances in immunotherapy offer promise whereby donor-specific unresponsiveness or “tolerance” to solid organ transplantation may be realized in the near future. This elusive goal of tolerance has as its raison d’être the creation of a microenvironment or milieu in which the recipient may accept an allograft without immunosuppression, but remains immunocompetent to the ravenous infiltrations of infectious organisms and neoplastic transformation. Several animal models are in evolution whereby the limited exposure to immunosuppression within the period of engraftment provides donor-specific hyporesponsiveness (tolerance).

This is a preview of subscription content, log in via an institution to check access.

Access this chapter

eBook
USD 16.99
Price excludes VAT (USA)
  • Available as EPUB and PDF
  • Read on any device
  • Instant download
  • Own it forever
Softcover Book
USD 54.99
Price excludes VAT (USA)
  • Compact, lightweight edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info

Tax calculation will be finalised at checkout

Purchases are for personal use only

Institutional subscriptions

Preview

Unable to display preview. Download preview PDF.

Unable to display preview. Download preview PDF.

References

  1. Burlingham WI, Grailer AP, Fechner JH Jr, Kusaka S, Trucco M, Kocova M, et al. Microchimerism linked to cytotoxic T lymphocyte functional unresponsiveness (clonal anergy) in a tolerant renal transplant recipient. Transplantation 1995;59:1147–55.

    Article  CAS  PubMed  Google Scholar 

  2. Billingham R, Brent L, Medawar P. Actively acquired tolerance of foreign cells. Nature 1953, 172:603–6.

    Article  CAS  PubMed  Google Scholar 

  3. Starzl TE, Demetris AJ, Murase AJ et al. Cell migration, chimerism and graft acceptance. Lancet 1992;339:1579–82.

    Article  CAS  PubMed Central  PubMed  Google Scholar 

  4. Armstrong N, Buckley P, Oberley T et al. Analysis of primate renal allografts after T-cell depletion with anti-CD-CRM9. Transplantation 1998;66:5–13.

    Article  CAS  PubMed  Google Scholar 

  5. Kirk AD, Harlan DM, Armstrong NN et al. CTLA4-Ig and anti-CD40 ligand prevent renal allograft rejection in primates. Proc Natl Acad Sci USA 1997;94:8789–94.

    Article  CAS  PubMed Central  PubMed  Google Scholar 

  6. Kirk AD, Burkly LC, Batty DS, Baumgartner RE, Berning JD, Buchanan K, Fechner JH Jr, Germond RL, Kampen RL, Patterson NB. Treatment with humanized monoclonal antibody against CD 154 prevents acute renal allograft rejection in nonhuman primates. Nat Med 1999;5:686–93.

    Article  CAS  PubMed  Google Scholar 

  7. Thomas JM, Contreras JL, Jiang XL, et al. Peritransplant tolerance induction in macaques: early events reflecting the unique synergy between immunotoxin and deoxyspergualin. Transplantation 1999;68(11):1660–73.

    Article  CAS  PubMed  Google Scholar 

  8. Thomas JM, Eckhoff DE, Contreras JL et al. Durable donor-specific T and B cell tolerance in rhesus macaques induced with peritransplantation anti-CD3 immunotoxin and deoxyspergualin: Absence of chronic allograft nephropathy. Transplantation 2000;69(12):2497–2503.

    Article  CAS  PubMed  Google Scholar 

  9. Geluk A, Elferink DG, Slierendregt BL, Van Meijgaarden KE, de Vries RR, Ottenhoff TH, et al. Evolutionary conservation of major histocompatibility complex-DR/peptide/T cell interactions in primates. J Exp Med 1993;177:979–87.

    Article  CAS  PubMed  Google Scholar 

  10. Kimikawa M, Sachs DR, Colvin RB, Bartholomew A, Kawai T, Cosimi AB. Modifications of the conditioning regimen for achieving mixed chimerism and donor-specific tolerance in cynomolgus monkeys. Transplantation 1997;64:709–16.

    Article  CAS  PubMed  Google Scholar 

  11. Spitzer TR, Delmonico F, Tolkoff-Rubin N, McAfee S, Sackstein R, Saidman S, et al. Combined histocompatibility leukocyte antigen-matched donor bone marrow and renal transplantation for multiple myeloma with end stage renal disease: the induction of allograft tolerance through mixed lymphohematopoietic chimerism. Transplantation 1999;68:480–4.

    Article  CAS  PubMed  Google Scholar 

  12. Waaga AM, Rocha AM, Tilney NL. Early risk factors contributing to the evolution of long-term allograft dysfunction. Transplant Rev 1997;11:208–16.

    Article  Google Scholar 

  13. Tullius SG, Tilney NL. Both alloantigen-dependent and independent factors influence chronic allograft rejection. Transplantation 1995;59:313–8.

    Article  CAS  PubMed  Google Scholar 

  14. Cho YW, Terasaki PI, Cecka JM. High kidney graft survival rates using non-heart-beating trauma donors. Transpl Proc 1998;30:3795–6.

    Article  CAS  Google Scholar 

  15. Brenner BM, Milford EL. Nephron underdosing: a programmed cause of chronic renal allograft failure. Am J Kid Dis 1993;21:66–72.

    CAS  PubMed  Google Scholar 

  16. Halloran P, Melk A, Barth C. Rethinking chronic allograft nephropathy: the concept of accelerated senescence. Am Soc Nephrol 1999;10:167–81.

    CAS  Google Scholar 

  17. Takada M, Nadeau KC, Hancock WW, Mackenzie HS, Shaw GD, Waaga AM, et al. Effects of explosive brain death on cytokine activation of peripheral organs in the rat. Transpantation 1998;65:1533–42.

    Article  CAS  Google Scholar 

  18. Zwacka RM, Zhang Y, Halldorson J, Schlossberg H, Dudus L, Engelhardt JF. CD4(+) T-lymphocytes mediate ischemia/reperfusion-induced inflammatory responses in mouse liver. J Clin Invest 1997;100:279–89.

    Article  CAS  PubMed Central  PubMed  Google Scholar 

  19. Judge TA, Tang A, Spain LM, Deans-Gratiot J, Sayegh MH, Turka LA. The in vivo mechanism of action of CTLA4Ig. J Immunol 1996;156:2294–9.

    CAS  PubMed Central  PubMed  Google Scholar 

  20. Azuma H, Chandraker A, Nadeau K, Hancock WW, Carpenter CB, Tilney NL, et al. Blockade of Tcell costimulation prevents development of experimental chronic renal allograft rejection. Proc Natl Acad Sci USA 1996;93:12439–44.

    Article  CAS  PubMed Central  PubMed  Google Scholar 

  21. Dambrin C, Klupp J, Morris RE. Pharmacodynamics of immunosuppressive drugs. Curr Opin Immunol 2000;12:557–62.

    Article  CAS  PubMed  Google Scholar 

  22. Yatscoff RW, Aspeslet LJ. The monitoring of immunosuppressive drugs: a pharmacodynamic approach. Ther Drug Monit 1998;20:459–63.

    Article  CAS  PubMed  Google Scholar 

  23. van den Berg AP, Twilhaar WN, van Son WJ, van der Bij W, Klompmaker U, Slooff MJ, et al. Quantitation of immunosuppression flow cytometric measurement of intacellular cytokine synthesis. Transplant Int 1998;11(Suppl 1):S318–21.

    Article  Google Scholar 

  24. Klupp J, van Gelder T, Dambrin C, Regieli J, Boecke K, Billingham ME, et al. Mycophenolate mofetil pharmacodynamics and pharmacokinetics correlate with rejection score in a BN to LEW heterotopic heart transplant model. Transplant Proc 2001;33:2170–1

    Article  CAS  PubMed  Google Scholar 

  25. Gallant HL, Yatscoff RW. P70 S6 kinase assay: a pharmacodynamic monitoring strategy for rapamycin: assay development. Transplant Proc 1996;28:3058–61.

    CAS  PubMed  Google Scholar 

  26. Horowitz M, Gale RP, Sondel PM, Goldman JM, Kersey J, Kolb HJ, et al. Graft-versus-leukemia reactions after bone marrow transplantation. Blood 1990;75:555–62.

    CAS  PubMed  Google Scholar 

  27. Slavin S, Naparstek E, Ackerstein A, Kapelushnik Y, Or R. Allogeneic cell therapy for relapsed leukemia following bone marrow transplantation with donor peripheral blood lymphocytes. Exp Hematol 1995;23:1553–62.

    CAS  PubMed  Google Scholar 

  28. Eibl B, Schwaighofer H, Nachbaur C, Marth C, Gachter A, Knapp R, et al. Evidence for a graft-vstumor effect in a patient treated with marrow ablative chemotherapy and allogeneic bone marrow transplantation for breast cancer. Blood 1996;88:1501–8.

    CAS  PubMed  Google Scholar 

  29. Or R, Ackerstein A, Nagler A, Kapelushnik J, Naparstek E, Samuel S, et al. Allogeneic cell mediated immunotherapy for breast cancer after autologous stem cell transplantation: a clinical pilot study. Cytokines Cell Mol Ther 1998;4:1–6.

    CAS  PubMed  Google Scholar 

  30. Childs R, Clave E, Plante M, Tisdale J, Barrett AJ. Successful treatment of metastatic renal-cell carcinoma with a non-myeloablative allogeneic peripheral blood progenitor cell transplant:evidence for a graft-versus-host tumor effect. J Clin Oncol 1999;17:2044–9.

    CAS  PubMed  Google Scholar 

Download references

Authors

Editor information

Editors and Affiliations

Rights and permissions

Reprints and permissions

Copyright information

© 2002 Springer-Verlag London

About this chapter

Cite this chapter

Bland, K.I. (2002). Commentary on Section II. In: Zbar, A.P., Guillou, P.J., Bland, K.I., Syrigos, K.N. (eds) Immunology for Surgeons. Springer, London. https://doi.org/10.1007/978-1-4471-0201-4_11

Download citation

  • DOI: https://doi.org/10.1007/978-1-4471-0201-4_11

  • Publisher Name: Springer, London

  • Print ISBN: 978-1-85233-482-6

  • Online ISBN: 978-1-4471-0201-4

  • eBook Packages: Springer Book Archive

Publish with us

Policies and ethics