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Rejection-Free Organ Transplants
| Article
# : |
20010 |
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Section : |
NATURAL SCIENCE
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| Issue
Date : |
8 / 1992 |
2,282 Words |
| Author
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Mitsuaki Isobe
Mitsuaki Isobe is a research and clinical cardiologist in the
Third Department of Internal Medicine at the University of
Tokyo. |
The success came as an unexpected surprise. The brown mouse had already attracted attention around the laboratory by tolerating a new heart from a white mouse without rejection-suppressing drugs for two months. This same mouse had also been given two skin grafts 10 days before: one from another white mouse, another from an unrelated black mouse. When I took off the bandages that covered the grafts, I found acceptance of the white skin and rejection of the black. I was so excited that I ran down to my laboratory and showed the mouse to every colleague on the room. That was the moment I became convinced that the transplant regimen we had developed could induce antigen-specific tolerance within the body's immune system. The experiment was conducted in mid-1991 at the Cardiac Research Laboratory of the Massachusetts General Hospital and the Harvard Medical School, where I had worked as a research fellow since 1987.
The immune system's defense
The fundamental principle of the immune system is that the body can discriminate itself from others. The immune system accepts self and keeps out non-self. It is well known that tissues transplanted from other individuals are rejected, and that is the most serious problem in patients who undergo organ transplantation. The history of clinical transplantation has been a history of struggle over rejection. The ultimate goal of transplantation immunology, therefore, is to develop a method that prevents rejection without impairing the immune function.
There are many immuno-suppressants that are clinically useful for suppressing rejection. The emergence of cyclosporine in the early 1980s, above all, made history. The number of organ transplants increased dramatically around the world because of its superb effects on suppressing rejection. Nevertheless, all immunosuppressive drugs, including cyclosporine, considerably impair the immune function and increase the susceptibility of patients to serious infection. Furthermore, patients must take these medicines as long as they live. Long-term use of these drugs impairs kidney and liver functions and increases the incidence of cancer.
The ideal way to manage rejection would be to develop a method whereby the body accepts transplanted organs as its own, without lifelong administration of drugs. Is that possible? Many studies now suggest that the dream will become a reality.
Our immune system normally recognizes our own tissues and does not attack them.
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