Year: 2026
Type: review
Abstract: Background: Antigen-specific regulatory T-cell therapies seek to control donor-reactive immunity while preserving broader immune protection. The available platforms differ substantially in cellular composition, mode of antigen recognition, manufacturing requirements, and maturity of clinical evidence. Scope: , human non-kidney, kidney feasibility and safety, or suggestive of clinical activity. Key insights: No platform is likely to suit every transplant setting. Donor-cell approaches provide broad antigenic coverage but require individualized donor material. Peptide and receptor-defined approaches offer precision and donor-independent manufacture but are constrained by antigen processing, HLA restriction, or incomplete coverage. Early CAR-Treg studies provide preliminary safety and proof-of-mechanism observations, not evidence of operational tolerance. Culture conditions, accompanying immunosuppression, and product-specific safety risks must be considered together. Conclusions: Progress will require consistent nomenclature, mechanism-linked potency assays, quantitative reporting of clinical studies, and operational measures of persistence, regulatory stability, donor-specific function, graft engagement, and clinical durability. The near-term goal is safe and sustained immunosuppression minimization. Operational tolerance must be demonstrated rather than inferred.
Source: Frontiers in Immunology
Authors: Sudipta Tripathi, Anil Chandraker
Institution: University of Massachusetts Chan Medical School
Language: English
Subfield: Transplantation
Field: Medicine
Domain: Health Sciences
Open Access status: gold
Estimated APC paid: $3,801
OpenAlex ID: W7223154641