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Crosstalk Between T and B Cells in the Germinal Center After Transplantation

Kwun, Jean PhD; Manook, Miriam MD; Page, Eugenia; Burghuber, Christopher; Hong, Jungjoo; Knechtle, Stuart J. MD

doi: 10.1097/TP.0000000000001588
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Crosstalk between B and T cells in transplantation is increasingly recognized as being important in the alloimmune response. T cell activation of B cells occurs by a 3-stage pathway, culminating with costimulation signals. We review the distinct T cell subtypes required for B-cell activation and discuss the formation of the germinal center (GC) after transplantation, with particular reference to the repopulation of the GC after depletional induction, and the subsequent effect of immunosuppressive manipulation of T cell-B cell interactions. In addition, ectopic GCs are seen in transplantation, but their role is not fully understood. Therapeutic options to target T cell-B cell interactions are of considerable interest, both as immunosuppressive tools, and to aid in the further understanding of these important alloimmune mechanisms.

Kwun et al provide an in-depth review on the T cell subtypes, cytokines and molecules regulating B cell activation and germinal center development, and therapeutic options to control donor-specific B cell responses and antibody production.

1 Duke Transplant Center, Department of Surgery, Duke University Medical Center, Durham, NC.

2 Emory Transplant Center, Department of Surgery, Emory University, Atlanta, GA.

3 Division of Transplantation, Department of Surgery, Medical University of Vienna, Vienna, Austria.

4 National Primate Research Center (NPRC), Korea Research Institute of Bioscience and Biotechnology (KRIBB), Cheongju, Korea.

Received 8 August 2016. Revision received 9 October 2016.

Accepted 31 October 2016.

This work is supported in part by grants: NIH U01 AI074635 (S.J.K.), NIH U19 AI051731 (S.J.K.), and AHA Enduring Hearts Foundation Research Award 15SDG25710165 (J.K.).

The authors declare no conflicts of interest.

S.J.K. and J.K. share the corresponding authorship for this work.

J.K. participated in the concept, article writing, figures drawing. M.M. participated in the concept, article cowriting. E.P, C.B., and J.H. participated in article cowriting. S.J.K. participated in the concept and article writing.

Correspondence: Stuart J Knechtle, MD, Duke Transplant Center, 207 Research Dr., Jones 365, Durham, NC 27710. (; Jean Kwun, PhD, Duke Transplant Center, 207 Research Dr., Jones 365, Durham, NC 27710. (

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