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“There are different potential strategies to expand Tregs, including manipulating specific costimulatory/coinhibitory pathways, administration of agents that promote Tregs (eg, low-dose IL-2) or adoptive transfer of ex vivo expanded Tregs. Promising results of targeting Tregs in bone marrow transplantation in humans have been shown: expansion of Tregs with low-dose IL-2 in refractory chronic GVHD was capable of controlling disease (Koreth et al, NEJM 2011). In human solid organ transplantation, operationally tolerant kidney and liver recipients have a significant expansion of Foxp3+ Tregs, in particular memory Tregs (Braza et al, JASN 2015; Martinez-Lloredella et al, AJT 2007). In the worse case scenario of not achieving tolerance, one of the greatest advantages of targeting Tregs is that patients will most likely be able to reduce the amount of immunosuppressive medication required in the long-term due to the increased immune modulation provided by those Tregs.” For more, please see the full post on Dr. Riella’s blog.
Leonardo V. Riella, MD, PhD, is an Assistant Professor of Medicine at Harvard Medical School, Associate Director of Kidney Transplantation and Medical Director of the Vascularized Composite Allotransplantation Program at the Brigham and Women’s Hospital (BWH). His research is focused on understanding the mechanisms of immune regulation and on the development of novel therapies to promote organ tolerance. He is also involved in translational/clinical trials that are attempting to identify earlier non-invasive markers of rejection and develop novel assays to measure the immune function in transplant recipients. He has received multiple awards, including the Young Innovator Award of the American Society of Transplantation (AST) and the 2016 Basic Science Career Development Award from the AST. Dr. Riella is author of the Kidney Transplant iBook, an interactive education tool for students and fellows with over 250 original figures, videos, review questions, problem-based cases and hyperlinks. He is Associate Editor of the American Journal of Transplantation and is currently funded by the American Heart Association, Department of Defense and Industry grants.