Cell therapeutic approaches to immunosuppression after clinical kidney transplantation

Pediatr Nephrol. 2018 Feb;33(2):199-213. doi: 10.1007/s00467-017-3599-2. Epub 2017 Feb 23.

Abstract

Refinement of immunosuppressive strategies has led to further improvement of kidney graft survival in recent years. Currently, the main limitations to long-term graft survival are life-threatening side effects of immunosuppression and chronic allograft injury, emphasizing the need for innovative immunosuppressive regimens that resolve this therapeutic dilemma. Several cell therapeutic approaches to immunosuppression and donor-specific unresponsiveness have been tested in early phase I and phase II clinical trials in kidney transplantation. The aim of this overview is to summarize current cell therapeutic approaches to immunosuppression in clinical kidney transplantation with a focus on myeloid suppressor cell therapy by mitomycin C-induced cells (MICs). MICs show great promise as a therapeutic agent to achieve the rapid and durable establishment of donor-unresponsiveness in living-donor kidney transplantation. Cell-based therapeutic approaches may eventually revolutionize immunosuppression in kidney transplantation in the near future.

Keywords: Immunosuppression; Mitomycin C-induced cells; Myeloid suppressor cells; Regulatory T cells; Tolerance; Transplantation.

Publication types

  • Research Support, Non-U.S. Gov't
  • Review

MeSH terms

  • Humans
  • Immunosuppression Therapy / methods*
  • Kidney Transplantation / methods*
  • Mitomycin / pharmacology
  • Myeloid-Derived Suppressor Cells / immunology
  • Nucleic Acid Synthesis Inhibitors / pharmacology
  • Transplantation Tolerance / drug effects
  • Transplantation Tolerance / immunology*

Substances

  • Nucleic Acid Synthesis Inhibitors
  • Mitomycin