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Nat Rev Immunol. 2003 Oct;3(10):831-8.

Individuality: the barrier to optimal immunosuppression.

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Division of Immunology and Organ Transplantation, Department of Surgery, University of Texas Medical School at Houston, Suite 6.240, 6431 Fannin, Houston, Texas 77030, USA.


Immunosuppressive therapy aims to protect transplanted organs from host responses. Individuals have unique repertoires of responses to foreign antigens and toxic reactions to immunosuppressants; the former determining the type or intensity of rejection reactions and the latter influencing the severity of iatrogenic effects. Because existing agents target molecules that are widely distributed in tissues, new strategies must selectively block lymphoid cells only, disrupt alloresponses but not innate immune responses, interact synergistically with other agents, facilitate the homeostatic process that naturally leads to graft acceptance and ideally only interrupt donor-specific responses. Approaches presently under investigation aim to alter cell trafficking, or selectively deviate the maturation of antigen-presenting cells or inhibit lymphocyte-activation cascades - events that are crucial to rejection responses.

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