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Semin Immunol. 2011 Jun;23(3):157-64. doi: 10.1016/j.smim.2011.07.002. Epub 2011 Aug 19.

Challenges and opportunities in targeting the costimulation pathway in solid organ transplantation.

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  • 1University of California, San Francisco, Kidney Transplant Service, CA 94143-0780, United States. david.wojciechowski@ucsf.edu

Abstract

Signaling through the costimulatory pathway is critical in the regulation of T cell activation. Abatacept, a selective costimulatory antagonist FDA approved for the treatment of moderate to severe rheumatoid arthritis, binds to CD80 and CD86 on antigen presenting cells, blocking the interaction with CD28 on T cells. Belatacept, a second generation CTLA4-Ig with 2 amino acid substitutions, has shown considerable promise in clinical transplantation as part of a maintenance immunosuppression regimen. This review will summarize the role of costimulation in T cell activation, detail the development of costimulation antagonists and highlight the pertinent clinical trials completed and ongoing utilizing belatacept as part of an immunosuppressive regimen in organ transplantation.

Copyright © 2011 Elsevier Ltd. All rights reserved.

PMID:
21856169
[PubMed - indexed for MEDLINE]
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