Cargando…

HLA Desensitization in Solid Organ Transplantation: Anti-CD38 to Across the Immunological Barriers

The presence of anti-human leucocyte antigen (HLA) antibodies in the potential solid organ transplant recipient’s blood is one of the main barriers to access to a transplantation. The HLA sensitization is associated with longer waitlist time, antibody mediated rejection and transplant lost leading t...

Descripción completa

Detalles Bibliográficos
Autores principales: Joher, Nizar, Matignon, Marie, Grimbert, Philippe
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Frontiers Media S.A. 2021
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8173048/
https://www.ncbi.nlm.nih.gov/pubmed/34093594
http://dx.doi.org/10.3389/fimmu.2021.688301
_version_ 1783702641709154304
author Joher, Nizar
Matignon, Marie
Grimbert, Philippe
author_facet Joher, Nizar
Matignon, Marie
Grimbert, Philippe
author_sort Joher, Nizar
collection PubMed
description The presence of anti-human leucocyte antigen (HLA) antibodies in the potential solid organ transplant recipient’s blood is one of the main barriers to access to a transplantation. The HLA sensitization is associated with longer waitlist time, antibody mediated rejection and transplant lost leading to increased recipient’s morbidity and mortality. However, solid organ transplantation across the HLA immunological barriers have been reported in recipients who were highly sensitized to HLA using desensitization protocols. These desensitization regimens are focused on the reduction of circulating HLA antibodies. Despite those strategies improve rates of transplantation, it remains several limitations including persistent high rejection rate and worse long-term outcomes when compare with non-sensitized recipient population. Currently, interest is growing in the development of new desensitization approaches which, beyond targeting antibodies, would be based on the modulation of alloimmune pathways. Plasma cells appears as an interesting target given their critical role in antibody production. In the last decade, CD38-targeting immunotherapies, such as daratumumab, have been recognized as a key component in the treatment of myeloma by inducing an important plasma cell depletion. This review focuses on an emerging concept based on targeting CD38 to desensitize in the field of transplantation.
format Online
Article
Text
id pubmed-8173048
institution National Center for Biotechnology Information
language English
publishDate 2021
publisher Frontiers Media S.A.
record_format MEDLINE/PubMed
spelling pubmed-81730482021-06-04 HLA Desensitization in Solid Organ Transplantation: Anti-CD38 to Across the Immunological Barriers Joher, Nizar Matignon, Marie Grimbert, Philippe Front Immunol Immunology The presence of anti-human leucocyte antigen (HLA) antibodies in the potential solid organ transplant recipient’s blood is one of the main barriers to access to a transplantation. The HLA sensitization is associated with longer waitlist time, antibody mediated rejection and transplant lost leading to increased recipient’s morbidity and mortality. However, solid organ transplantation across the HLA immunological barriers have been reported in recipients who were highly sensitized to HLA using desensitization protocols. These desensitization regimens are focused on the reduction of circulating HLA antibodies. Despite those strategies improve rates of transplantation, it remains several limitations including persistent high rejection rate and worse long-term outcomes when compare with non-sensitized recipient population. Currently, interest is growing in the development of new desensitization approaches which, beyond targeting antibodies, would be based on the modulation of alloimmune pathways. Plasma cells appears as an interesting target given their critical role in antibody production. In the last decade, CD38-targeting immunotherapies, such as daratumumab, have been recognized as a key component in the treatment of myeloma by inducing an important plasma cell depletion. This review focuses on an emerging concept based on targeting CD38 to desensitize in the field of transplantation. Frontiers Media S.A. 2021-05-20 /pmc/articles/PMC8173048/ /pubmed/34093594 http://dx.doi.org/10.3389/fimmu.2021.688301 Text en Copyright © 2021 Joher, Matignon and Grimbert https://creativecommons.org/licenses/by/4.0/This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) and the copyright owner(s) are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
spellingShingle Immunology
Joher, Nizar
Matignon, Marie
Grimbert, Philippe
HLA Desensitization in Solid Organ Transplantation: Anti-CD38 to Across the Immunological Barriers
title HLA Desensitization in Solid Organ Transplantation: Anti-CD38 to Across the Immunological Barriers
title_full HLA Desensitization in Solid Organ Transplantation: Anti-CD38 to Across the Immunological Barriers
title_fullStr HLA Desensitization in Solid Organ Transplantation: Anti-CD38 to Across the Immunological Barriers
title_full_unstemmed HLA Desensitization in Solid Organ Transplantation: Anti-CD38 to Across the Immunological Barriers
title_short HLA Desensitization in Solid Organ Transplantation: Anti-CD38 to Across the Immunological Barriers
title_sort hla desensitization in solid organ transplantation: anti-cd38 to across the immunological barriers
topic Immunology
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8173048/
https://www.ncbi.nlm.nih.gov/pubmed/34093594
http://dx.doi.org/10.3389/fimmu.2021.688301
work_keys_str_mv AT johernizar hladesensitizationinsolidorgantransplantationanticd38toacrosstheimmunologicalbarriers
AT matignonmarie hladesensitizationinsolidorgantransplantationanticd38toacrosstheimmunologicalbarriers
AT grimbertphilippe hladesensitizationinsolidorgantransplantationanticd38toacrosstheimmunologicalbarriers