Minireviews
Copyright ©The Author(s) 2016. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Transplant. Sep 24, 2016; 6(3): 556-563
Published online Sep 24, 2016. doi: 10.5500/wjt.v6.i3.556
Tregs and kidney: From diabetic nephropathy to renal transplantation
Periklis Dousdampanis, Kostantina Trigka, Athanasia Mouzaki
Periklis Dousdampanis, Kostantina Trigka, Hemodialysis Unit, Kyanos Stavros, 26225 Patras, Greece
Athanasia Mouzaki, Laboratory of Immunohematology, Division of Hematology, Department of Internal Medicine, Medical School, University of Patras, 26504 Patras, Greece
Author contributions: Dousdampanis P, Trigka K and Mouzaki A wrote the paper.
Conflict-of-interest statement: None.
Open-Access: This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
Correspondence to: Periklis Dousdampanis, MD, PhD, Consultant Nephrologist, Hemodialysis Unit, Kyanos Stavros, Germanou 115, 26225 Patras, Greece. dousdampanis@yahoo.gr
Telephone: +30-26-10243110 Fax: +30-26-10243139
Received: May 25, 2016
Peer-review started: May 26, 2016
First decision: July 6, 2016
Revised: July 14, 2016
Accepted: July 29, 2016
Article in press: August 1, 2016
Published online: September 24, 2016
Processing time: 120 Days and 16.7 Hours
Abstract

Kidney transplantation is recognised as the most effective treatment for patients with end-stage renal disease (ESRD). Kidney transplantation continues to face several challenges including long-term graft and patient survival, and the side effects of immunosuppressive therapy. The tendency in kidney transplantation is to avoid the side effects of immunosuppresants and induce immune tolerance. Regulatory T-cells (Tregs) contribute to self-tolerance, tolerance to alloantigen and transplant tolerance, mainly by suppressing the activation and function of reactive effector T-cells. Additionally, Tregs are implicated in the pathogenesis of diabetes, which is the leading cause of ESRD, suggesting that these cells play a role both in the pathogenesis of chronic kidney disease and the induction of transplant tolerance. Several strategies to achieve immunological tolerance to grafts have been tested experimentally, and include combinations of co-stimulatory blockade pathways, T-cell depletion, in vivo Treg-induction and/or infusion of ex-vivo expanded Tregs. However, a successful regimen that induces transplant tolerance is not yet available for clinical application. This review brings together certain key studies on the role of Tregs in ESRD, diabetes and kidney transplantation, only to emphasize that many more studies are needed to elucidate the clinical significance and the therapeutic applications of Tregs.

Keywords: Diabetes; Foxp3; Kidney transplantation; Regulatory T-cells

Core tip: This review brings together certain key studies on the role of regulatory T-cells (Tregs) in end-stage renal disease, diabetes and kidney transplantation, only to emphasize that many more studies are needed to elucidate the clinical significance and the therapeutic applications of Tregs.