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Regulatory B cells and transplantation

almost prime time?

Mohib, Kanishka*; Cherukuri, Aravind*; Rothstein, David M.

Current Opinion in Organ Transplantation: October 2018 - Volume 23 - Issue 5 - p 524–532
doi: 10.1097/MOT.0000000000000559
REGULATORY IMMUNE CELLS IN ORGAN TRANSPLANTATION AND THEIR THERAPEUTIC APPLICATION: Edited by Angus W. Thomson
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Purpose of review Regulatory B cells (Bregs) are potent inhibitors of the immune system with the capacity to suppress autoimmune and alloimmune responses. Murine transplant models showing that Bregs can promote allograft tolerance are now supported by clinical data showing that patients who develop operational tolerance have higher frequency of Bregs. Breg function has been widely studied resulting in improved understanding of their biology and effector mechanisms. However, our overall understanding of Bregs remains poor due the lack of specific marker, limited knowledge of how and where they act in vivo, and whether different Breg subpopulations exhibit different functions.

Recent findings In this review we detail murine and human phenotypic markers used to identify Bregs, their induction, maintenance, and mechanisms of immune suppression. We highlight recent advances in the field including their use as biomarkers to predict allograft rejection, in-vitro expansion of Bregs, and the effects of commonly used immunosuppressive drugs on their induction and frequency.

Summary Clinical data continue to emerge in support of Bregs playing an important role in preventing transplant rejection. Hence, it is necessary for the transplant field to better comprehend the mechanisms of Breg induction and approaches to preserve or even enhance their activity to improve long-term transplant outcomes.

Department of Surgery, Thomas E. Starzl Transplantation Institute, University of Pittsburgh Medical School, Pittsburgh, Pennsylvania, USA

Correspondence to David M. Rothstein, MD, 200 Lothrop Street Biomedical Science Tower, W1542, Pittsburgh, PA 15261, USA. Tel: +1 412 648 7154; e-mail: rothsteind@upmc.edu

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