One of the biggest barriers to achieving allograft tolerance is the presence of immunological memory within the recipient, which confers a faster, more robust immune response that is in most cases more resistant to pharmacologic immunosuppression. This review will identify the mechanisms by which alloreactive T cells arise within hosts prior to transplantation, and explore the properties of immunological memory that contribute to allograft rejection. In doing so we will also illuminate how targeting pathways that induce memory T cell exhaustion can promote allograft tolerance. Recent studies demonstrating the impact of the allograft microenvironment on memory cell survival and activation, as well as new therapeutic strategies that are being explored to mitigate memory driven allograft rejection, will also be reviewed.

中文翻译：

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记忆性T细胞衰竭和移植耐受性。

获得同种异体移植耐受性的最大障碍之一是接受者体内存在免疫记忆，这赋予了更快，更强大的免疫反应，在大多数情况下，它们对药理学免疫抑制的抵抗力更强。这项审查将确定移植前宿主体内同种异体反应性T细胞产生的机制，并探讨有助于同种异体移植排斥的免疫记忆特性。通过这样做，我们还将阐明诱导记忆T细胞衰竭的靶向途径如何促进同种异体移植耐受性。最近的研究表明同种异体移植微环境对记忆细胞存活和激活的影响，以及正在探索减轻记忆驱动的同种异体移植排斥反应的新治疗策略，也将进行综述。