We read with great interest the recent study by Wilson et al. (1), which demonstrated that B lymphocytes impair regulatory T cell (Treg) development and function, thereby eroding islet tolerance in the NOD islet allograft model. Their findings show that B-cell deficiency enables durable graft acceptance following short course anti-CD45RB treatment, accompanied by Helios+ Treg expansion, improved Treg-to-effector ratios, and increased expression of regulatory markers such as GARP and LAP. These results provide strong evidence that B cells can actively antagonize immune regulation in islet transplantation.
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