4.8 Review

Costimulation blockade and Tregs in solid organ transplantation

Journal

FRONTIERS IN IMMUNOLOGY
Volume 13, Issue -, Pages -

Publisher

FRONTIERS MEDIA SA
DOI: 10.3389/fimmu.2022.969633

Keywords

Treg; regulatory T cell; transplantation; costimulation blockade; CTLA4 Ig; IL-2; immunosuppressant; costimulation

Categories

Funding

  1. Medical-Scientific Fund of the Major of Vienna [21050]
  2. Vienna Science and Technology Fund [LS18-031]
  3. Country of Lower Austria Danube Allergy Research Cluster (DARC)

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Regulatory T cells (Tregs) play a critical role in transplantation, and the use of pharmaceutical costimulation blockers may have an impact on these cells. This review provides an overview of the effects of costimulation therapy on Treg function.
Regulatory T cells (Tregs) play a critical role in maintaining self-tolerance and in containing allo-immune responses in the context of transplantation. Recent advances yielded the approval of the first pharmaceutical costimulation blockers (abatacept and belatacept), with more of them in the pipeline. These costimulation blockers inhibit effector cells with high clinical efficacy to control disease activity, but might inadvertently also affect Tregs. Treg homeostasis is controlled by a complex network of costimulatory and coinhibitory signals, including CD28, the main target of abatacept/belatacept, and CTLA4, PD-1 and ICOS. This review shall give an overview on what effects the therapeutic manipulation of costimulation has on Treg function in transplantation.

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