Abstract
Objective. To dissect the efficacy of Tol-DC therapy with or without IS in multiple animal models of transplantation. Methods and Results. PubMed, Medline, Embase, and the Cochrane Library were searched for reviews published up to April 2015. Six systematic reviews and a total of 61 articles were finally included. Data were grouped by organ transplantation models and applied to meta-analysis. Our meta-analysis shows that Tol-DC therapy successfully prolonged allograft survival to varying extents in all except the islet transplantation models and with IS drugs further prolonged the survival of heart, skin, and islet allografts in mice, but not of heart allografts in rats. Compared with IS drugs alone, Tol-DC therapy with IS extended islet allograft survival in rats but failed to influence the survival of skin, small intestine, and heart allografts in rats or of heart and skin allografts in mice. Conclusion. Tol-DC therapy significantly prolonged multiple allograft survival and further prolonged survival with IS. However, standardized protocols for modification of Tol-DC should be established before its application in clinic.
Highlights
Transplantation is one of the most effective methods of extending life for patients with end-stage organ failure
1 systematic review was excluded for irrelevant theme and 6 systematic reviews assessing the efficacy of Tol-Dendritic cells (DCs) treatment in animal models of heart, liver, kidney, small intestine, skin, and islet transplantation satisfied our inclusion and exclusion criteria and were further evaluated (Figure 1) [10,11,12,13,14,15]
The current overview included a total of 61 articles (47 studies from six systematic reviews and 14 primary studies) dissecting the efficacy of adoptive transfusion of tolerogenic DCs (Tol-DCs) with or without IS drugs in promoting the survival of heart, liver, kidney, small intestine, skin, and islet allografts in animals
Summary
Transplantation is one of the most effective methods of extending life for patients with end-stage organ failure. The immunosuppressive (IS) agents commonly used to prevent graft-versus-host disease and host-versus-graft disease compromise the recipient’s immune system and are associated with side effects such as infection and recurrence of disease, decreasing the patient’s quality of life. For this reason, induction of donor-specific tolerance without impairment of immune defense remains the holy grail of transplantation research. Negative vaccines based on Tol-DCs have great potential to prevent transplant rejection. Whether Tol-DCs can effectively prolong allograft survival and show superiority to other forms of IS therapy remains controversial. We evaluated allograft survival time after treatment with Tol-DCs alone, compared the relative superiority of single therapy with Tol-DCs or IS, and looked for evidence of synergy between Tol-DC and IS therapy in promoting allograft survival
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