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Orchestration of transplantation tolerance by regulatory dendritic cell therapy or in-situ targeting of dendritic cells

Morelli, Adrian E.a,b; Thomson, Angus W.a,b

Current Opinion in Organ Transplantation: August 2014 - Volume 19 - Issue 4 - p 348–356
doi: 10.1097/MOT.0000000000000097
TOLERANCE INDUCTION: Edited by Herman Waldmann

Purpose of review Extensive research in murine transplant models over the past two decades has convincingly demonstrated the ability of regulatory dendritic cells (DCregs) to promote long-term allograft survival. We review important considerations regarding the source of therapeutic DCregs (donor or recipient) and their mode of action, in-situ targeting of DCregs, and optimal therapeutic regimens to promote DCreg function.

Recent findings Recent studies have defined protocols and mechanisms whereby ex-vivo-generated DCregs of donor or recipient origin subvert allogeneic T-cell responses and promote long-term organ transplant survival. Particular interest has focused on how donor antigen is acquired, processed and presented by autologous dendritic cells, on the stability of DCregs, and on in-situ targeting of dendritic cells to promote their tolerogenic function. New evidence of the therapeutic efficacy of DCregs in a clinically relevant nonhuman primate organ transplant model and production of clinical grade DCregs support early evaluation of DCreg therapy in human graft recipients.

Summary We discuss strategies currently used to promote dendritic cell tolerogenicity, including DCreg therapy and in-situ targeting of dendritic cells, with a view to improved understanding of underlying mechanisms and identification of the most promising strategies for therapeutic application.

aDepartment of Surgery, Starzl Transplantation Institute

bDepartment of Immunology, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania, USA

Correspondence to Angus W. Thomson, PhD, DSc, Department of Surgery, Thomas E. Starzl Transplantation Institute, University of Pittsburgh School of Medicine, 200 Lothrop Street, BST W1540, Pittsburgh, Pennsylvania 15235, USA. Tel: +1 412 624 6392; e-mail:

© 2014 Wolters Kluwer Health | Lippincott Williams & Wilkins