Over the past few years, hundreds of heart transplants have taken place in the UK, saving hundreds of lives.
Advances in medicine have dramatically increased the success rates of transplant operations since their early days in the late 1960s, but one of the major challenges facing researchers remains transplant rejection. This occurs when the immune system recognises a new heart as a foreign object and responds by attacking it, just as it would an infection.
The number of people on the waiting list for a new heart in the UK has risen by 162 per cent since 2008 and around half the people accepted onto the heart transplant waiting list receive a transplant within three years. In 2016/17, 40 people died while on the heart transplant list in the UK.
A team at Queen Mary University of London, led by British Heart Foundation (BHF) Professor of Cardiovascular Immunology Federica Marelli-Berg, is working to combat organ transplant rejection by researching the role of the immune system.
Because the body rejects a transplanted organ as foreign, people need to take immunosuppressant drugs. These stop rejection but can also shut down other aspects of the immune system, increasing the risk of complications such as infection or cancer. Prof Marelli-Berg believes the answer is to develop drugs which selectively switch off the immune response only in the heart, or that activate the anti-inflammatory arm of the immune system.
The research conducted by Prof Marelli-Berg and her team focuses on T-cells, a type of white blood cell involved in activating the immune system and transplant rejection.
The team want to find a way to prevent T-cells from going to the heart, to stop rejection.
In a recent break-through they identified a specific molecular pathway which allows T-cells to just to go to the heart. This discovery could pave the way for drugs that could block this pathway, preventing rejection without affecting the rest of the immune system, which would reduce the risk of complications from immunosuppressants.
Additionally, they found that anti-inflammatory T-cells, called regulatory T-cells, which are a natural subset of white blood cells, can be induced to migrate to the transplant and reduce rejection. This was achieved by administering a ‘shelved’ drug previously developed for type 2 diabetes.
It is vital that this research continues. With your help Prof Marelli-Berg and her team may find a way of stopping transplant rejection altogether.
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