Costimulatory blockade with belatacept in clinical and experimental transplantation - a review

Emamaullee, Juliet; Toso, Christian; Merani, Shaheed; Shapiro, A M James

doi:10.1517/14712590902942284

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Title		Costimulatory blockade with belatacept in clinical and experimental transplantation - a review
Authors		Emamaullee, Juliet Toso, Christian Merani, Shaheed Shapiro, A M James
Published in		Expert Opinion on Biological Therapy. 2009, vol. 9, no. 6, p. 789-796
Abstract		BACKGROUND: Current maintenance immunosuppression agents have been critical to the improved graft and patient survival rates in solid organ transplantation observed over the past decade. However, long-term follow-up has revealed that these agents are associated with troublesome side effects and chronic toxicity, contributing to graft loss and death. OBJECTIVES: Costimulation blockade has long been recognized as an important target for immunomodulation in solid organ transplantation. Belatacept, a high-affinity chimeric fusion protein that binds to CD80/CD86 on antigen-presenting cells, has shown great promise in renal transplantation and is now in Phase III trials. METHODS: This review explores the development and efficacy of belatacept, compared with currently approved immunosuppressive agents used in transplantation. RESULTS: Belatacept seems to be an effective alternative to current maintenance immunosuppressive therapies, with no apparent end organ toxicity and a minimal side-effect profile. This agent works best when used in combination with therapies that target different pathways of T-cell activation, but the optimal regimen has not yet been identified. Data generated in ongoing clinical trials will be essential in validating previous studies and for further development of belatacept-based combinatorial strategies.
Keywords		Animals — Humans — Immunoconjugates/adverse effects/contraindications/therapeutic use — Immunosuppressive Agents/adverse effects/contraindications/therapeutic use — *Transplantation
Identifiers		DOI: 10.1517/14712590902942284 PMID: 19426116
Full text		Article - Limited access to UNIGE
Structures		Faculté de médecine / Section de médecine clinique / Département de chirurgie
Research group		Transplantation et hépatologie (905)
Citation (ISO format)		EMAMAULLEE, Juliet et al. Costimulatory blockade with belatacept in clinical and experimental transplantation - a review. In: Expert Opinion on Biological Therapy, 2009, vol. 9, n° 6, p. 789-796. doi: 10.1517/14712590902942284 https://archive-ouverte.unige.ch/unige:19795