Chronic allograft dysfunction (CAD) in solid organ transplantation is a principal cause of patient morbidity and late allograft loss. The pathogenesis of CAD is largely secondary to chronic damage by the adaptive immune system and long-term immunosuppression. Manipulating these factors may be possible with the use of regulatory T cells (Treg), which have the ability to suppress specific immune responses and therefore potentially remove the need for immunosuppressive drugs. Studies of CAD in experimental models have demonstrated the capacity for both mouse and human Treg cellular therapy to prevent the development of some manifestations of CAD. Furthermore, a role for Treg has been demonstrated in clinically tolerant transplant patients. Certain immunosuppressive therapies are also proving to be 'Treg friendly' and may be helpful in promoting Treg while maintaining other immunosuppressive activity. With this in mind, monitoring for biomarkers of operational tolerance with tailored immunosuppressive therapy or controlled weaning in conjunction with Treg cellular therapy may be a useful strategy to pursue.

中文翻译：

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调节性 T 细胞作为慢性同种异体移植功能障碍的调节剂。

实体器官移植中的慢性同种异体移植物功能障碍 (CAD) 是导致患者发病和晚期同种异体移植物丢失的主要原因。CAD 的发病机制很大程度上继发于适应性免疫系统和长期免疫抑制的慢性损伤。使用调节性 T 细胞 (Treg) 可以操纵这些因素，Treg 具有抑制特定免疫反应的能力，因此有可能消除对免疫抑制药物的需求。在实验模型中对 CAD 的研究已经证明了小鼠和人类 Treg 细胞疗法的能力，以防止 CAD 的某些表现的发展。此外，已在临床耐受移植患者中证明了 Treg 的作用。某些免疫抑制疗法也被证明是“Treg 友好的” 并且可能有助于促进 Treg，同时保持其他免疫抑制活性。考虑到这一点，通过量身定制的免疫抑制疗法或受控脱机结合 Treg 细胞疗法监测操作耐受性的生物标志物可能是一种有用的策略。