Adaptive Immunotherapy for Opportunistic Infections

Infectious complications are a major cause of morbidity and mortality in patients undergoing solid organ or stem cell transplantation. Over the past years, advances in immunology and molecular biology have greatly contributed to a better understanding of the pathogenesis of opportunistic infections in the immunocompromised host. The lifelong immunosuppression required by the transplant recipients together with the limitations of the current anti-infective agents makes strategies able to stimulate immune response attractive aids to conventional treatment options. Among the immunotherapeutic strategies studied in transplant recipients aiming to enhance the adaptive immune response are the adoptive transfer of T lymphocytes and the use of cytokines such as granulocyte colony-stimulating factor (G-CSF), granulocyte-macrophage colony-stimulating factor (GM-CSF), macrophage colony-stimulating factor (M-CSF), or interferon-gamma (IFN-γ). While some encouraging results in in vitro and in vivo studies exist, currently available clinical evidence on the use of these approaches is limited to allow firm recommendations.