If you tell an organ transplant patient there will be no need for immunosuppressant drugs anymore without a risk for rejection, what would be the reaction?  I think there would be a suspicious reaction at first and then a big sigh of relief.  Nobody else is better informed than these patients regarding the risks and side effects of anti-rejection therapy.  This is the only way known to transplant specialists to keep the graft working and the patient alive.  Hope is on the way.  Not one, not two but three studies came out this week in the Science Translational Medicine suggesting that one day it could be possible.

One of the study is led by Britains Oxford University Andrew Bushell and calls for retraining or reprogramming  the patient owns Treg-cells (regulatory T-cells: those white blood cells” role is to suppress our own immune system response as needed).  The goal would be for those T-cells to recognize the transplanted organ as friendly instead of an intruder like it is now.  If that can successfully be done in human (it has been accomplish with mice in the research), the regulatory T-cells would do the current job of the anti-rejection drugs.  The patients” own regulatory (AKA suppressor) T-cells would prevent the body’s immune system from attacking the transplanted organ and as a result will decrease the risk of rejection.

Basically, those T-cells are like the police of the immune system; they keep the other kind of white blood cells under control so they don’t attack continuously the body.  They regularize the immune system just like the name defines it.  That would potentially eliminate the need for powerful drugs like neoral, prograf, rapamune and cellcept to name a few in the long run.  In the immediate transplant phase, those drugs are still expected to be given as the T-cells are reprogrammed in a lab.

That study was conducted on mice in a lab we are years away from testing that on humans but it is a promising start.  This would be a major breakthrough in improving graft and patient survival.   By having less rejection and longer graft survival, more people could be transplanted with the same number of organs available.  The reason being less people needing a second transplant.  Also, there should be less complications caused by the current drugs like kidney failure and skin cancer by example.  Those two complications are very common and debilitating.  Their respective treatments, dialysis and chemotherapy,  can be very expensive too.

Another important point in the study was the fact that the regulatory T-cells would still be able to recognize infections and cancer as a threat to the body.  Therefore, they will get out of the way of the attacking white blood cells.  The other good news is it could also benefits the patients with autoimmune disease who are taking medications similar to the transplant patients to weaken their immune system.

In short, this could be a major breakthrough for the transplant community and their patients if it ever becomes available at the bedside to treat real people.




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