Introduction: For late stage organ failure patients, transplantation is the best option to increase life expectancy with a superior quality of life. Unfortunately, after transplantation many patients are at risk of cellular and antibody-mediated rejection (ABMR). The latter is initiated by donor specific antibodies (DSA) which depend on the actions of B cells, T follicular helper (Tfh) cells and T follicular regulatory (Tfr) cells that are present in the germinal center of lymphoid organs.

Areas covered: In this overview paper, we discuss the biology and function of Tfh and Tfr cells in lymphoid tissues, transplanted organs and their circulating counterparts. We report on their relevance to alloimmunity and on the effects of immunosuppressive drugs on these immunocompetent cell populations.

Expert opinion: Growing knowledge about the actions of Tfh and Tfr allows for a better understanding of the immunological mechanisms of ABMR after organ transplantation. This understanding feeds the hypothesis that immunosuppressive drugs targeting the actions of Tfh cells have huge therapeutic potential. This new concept in the treatment of the humoral rejection response will improve graft and patient survival after organ transplantation.

简介：对于晚期器官衰竭患者，移植是提高预期寿命和提高生活质量的最佳选择。不幸的是，移植后许多患者处于细胞和抗体介导的排斥反应（ABMR）的风险中。后者由供体特异性抗体（DSA）引发，该抗体取决于存在于淋巴器官生发中心的B细胞，T卵泡辅助细胞（Tfh）和T卵泡调节（Tfr）细胞的作用。

涵盖的领域：在本概述文件中，我们讨论了淋巴组织，移植器官及其循环对应物中Tfh和Tfr细胞的生物学和功能。我们报告了它们与同种免疫的相关性以及免疫抑制药物对这些具有免疫能力的细胞群的影响。

专家意见：对Tfh和Tfr的作用的了解不断增加，可以更好地了解器官移植后ABMR的免疫机制。这种理解提供了这样的假设，即针对Tfh细胞作用的免疫抑制药物具有巨大的治疗潜力。这种治疗体液排斥反应的新概念将改善器官移植后的移植物和患者存活率。