Chemokines and their receptors as markers of allograft rejection and targets for immunosuppression

Although almost every known chemokine and chemokine receptor is expressed at some stage during development of allograft rejection, mechanistic studies indicate that the actual key effector mechanisms are rather few. Thus, in vivo studies have alleviated concerns regarding possible biological redundancy and the pleiotropic effects of these molecules, and have resulted in a focus on CXCR3, CCR5 and their respective ligands as key mediators of host alloresponses, especially in acute rejection. Data are also accruing regarding the importance of chemokine/chemokine receptor pathways in ischemia/reperfusion, chronic rejection and tolerance induction following co-stimulation blockade, providing new targets for immune monitoring and therapeutic intervention.