In a recently published review in the American Journal of Transplantation, ITN authors Nadia Tchao, MD and Laurence Turka, MD discuss the biology of lymphocyte depletion and considerations for strategies that aim to promote pro-tolerogenic reconstitution in transplant settings. The depletion of lymphocytes (T cells and B cells) is a strategy increasingly being used to help prevent rejection in transplant settings by reducing the pool of alloreactive cells. However, as lymphocytes begin to grow back they can adopt a phenotype that favors rejection which poses a challenge to long-term tolerance induction. For depletion to be an effective therapy for alloimmunity, clinical approaches should aim to shift re-expansion of T and B cells away from alloreactive subtypes.
