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As our attention was very busy in 2020, a few key developments, particularly in the field of transplantation, remained under the radar. The generation of immune tolerance continues to be the Holy Grail in transplantation medicine. Since the discovery of tolerance in Freemartin cattle in 1945, various strategies to induce tolerance have been attempted without clinically feasible success and often associated with the development of graft-versus-host disease (GVHD). In 2020, a phase 1 study (n = 10) succeeded in demonstrating not only the safety but also the efficacy of this therapy by injecting modified immune cells (leukapheresis-derived donor monocytes treated with mitomycin C). These cells developed characteristics of immature dendritic cells and led to a strong suppression of the T-cell response with subsequent development of permanent immune tolerance. It remains to be seen how the phase 2 trials (n = 200) of this strategy will fare, but one thing is certain: the search for the Holy Grail may be drawing closer.
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As our attention has been busy in 2020, a few crucial developments have remained under the radar, especially in the field of transplantation. The generation of immune tolerance continues to be the Holy Grail in transplant medicine. Since the discovery of tolerance in freemartin cattle in 1945, various strategies for tolerance induction have been attempted without clinically feasible success and often associated with the development of graft-versus-host disease (GVHD). In 2020, a phase 1 study (n = 10) succeeded in demonstrating not only the safety but also the efficacy of this therapy with the injection of modified immune cells (donor monocytes obtained with leukapheresis and treated with mitomycin C). These cells developed properties of immature dendritic cells and resulted in a strong suppression of the T-cell response with subsequent development of permanent immune tolerance. It remains to be seen how the phase 2 trials (n = 200) of this strategy will go, but one thing is certain: the search for the Holy Grail may be drawing closer.