Transplantation is limited by the need for life-long pharmacological immunosuppression, which carries significant morbidity and mortality. Regulatory T cell (Treg) therapy holds significant promise as a strategy to facilitate immunosuppression minimization. Polyclonal Treg therapy has been assessed in a number of Phase I/II clinical trials in both solid organ and hematopoietic transplantation. Attention is now shifting towards the production of alloantigen-reactive Tregs (arTregs) through co-culture with donor antigen. These allospecific cells harbour potent suppressive function and yet their specificity implies a theoretical reduction in off-target effects. This review will cover the progress in the development of arTregs including their potential application for clinical use in transplantation, the knowledge gained so far from clinical trials of Tregs in transplant patients, and future directions for Treg therapy.

移植受到终生药物免疫抑制需求的限制，这会带来显着的发病率和死亡率。调节性 T 细胞 (Treg) 疗法作为促进免疫抑制最小化的策略具有重要前景。多克隆 Treg 疗法已在实体器官和造血移植的多项 I/II 期临床试验中得到评估。现在注意力正转向通过与供体抗原共培养来生产同种异体抗原反应性 Tregs (arTregs)。这些同种异体细胞具有强大的抑制功能，但它们的特异性意味着理论上减少了脱靶效应。这篇综述将涵盖 arTregs 的开发进展，包括它们在移植临床应用中的潜在应用，