Regulatory T cell therapy in lung transplantation: bridging the gap from bench to bedside

TL;DR

Regulatory T cells could improve lung transplant outcomes by modulating the immune system, but more research is needed to apply them effectively in this context.

Contribution

This paper reviews how Treg therapy can be adapted for lung transplantation, focusing on immune modulation and clinical implementation strategies.

Findings

Tregs can influence immune responses in lung allografts and affect rejection and tolerance.

Preclinical and clinical data suggest Treg therapy is safe and may reduce the need for conventional immunosuppression.

Key factors like administration timing and integration with current protocols are critical for successful clinical use.

Abstract

Lung transplant recipients face significantly poorer outcomes compared to other solid organ transplants, with median survival rates substantially lower despite current immunosuppressive regimens. Regulatory T cell (Treg) therapy has emerged as a promising approach for immune modulation, though its successful application in lung transplantation requires understanding of the unique pulmonary immune environment. This review examines how Tregs mediate immune responses in lung allografts and their role in rejection and tolerance pathways. We evaluate emerging evidence from preclinical studies of Treg therapy in lung transplantation, complemented by clinical experience from kidney and liver transplant trials that demonstrate safety and potential for reducing conventional immunosuppression. The analysis addresses key considerations for clinical implementation, including therapeutic strategies, timing of administration, and integration with existing protocols. This framework aims to guide the development of Treg-based therapies specifically tailored for lung transplant recipients.

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