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Clinical and Developmental Immunology
Volume 2013, Article ID 852395, 7 pages
http://dx.doi.org/10.1155/2013/852395
Review Article

Regulatory T Cells in the Immunodiagnosis and Outcome of Kidney Allograft Rejection

1Division of Pharmacology, Department of Medicine of the Systems, University of Rome “Tor Vergata” Rome, Italy
2Division of Nephrology, Department of Medicine of the Systems, University of Rome “Tor Vergata” Rome, Italy
3Division of Internal Medicine, Department of Medicine of the Systems, University of Rome “Tor Vergata” Rome, Italy

Received 1 February 2013; Revised 2 May 2013; Accepted 2 June 2013

Academic Editor: Anne M. Stevens

Copyright © 2013 O. Franzese et al. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

Acute rejection (AR) is responsible for up to 12% of graft loss with the highest risk generally occurring during the first six months after transplantation. AR may be broadly classified into humoral as well as cellular rejection. Cellular rejection develops when donor alloantigens, presented by antigen-presenting cells (APCs) through class I or class II HLA molecules, activate the immune response against the allograft, resulting in activation of naive T cells that differentiate into subsets including cytotoxic CD8+ and helper CD4+ T cells type 1 (TH1) and TH2 cells or into cytoprotective immunoregulatory T cells (Tregs). The immune reaction directed against a renal allograft has been suggested to be characterized by two major components: a destructive one, mediated by CD4+ helper and CD8+ cytotoxic T cells, and a protective response, mediated by Tregs. The balance between these two opposite immune responses can significantly affect the graft survival. Many studies have been performed in order to define the role of Tregs either in the immunodiagnosis of transplant rejection or as predictor of the clinical outcome. However, information available from the literature shows a contradictory picture that deserves further investigation.