Meet the editor

Dr. Xuehui He received her PhD at Tuebingen University, Germany, in the field of molecular biology. Thereafter, she moved to Nijmegen, The Netherlands, and started her adventure in the field of immunology. Over the years, the regulation of the immune system in relation to autoimmune diseases has been her main topic of research including the basics of T cell activation, the induction of immune tolerance, and the modulatory effect of

various immune suppressants. Identification of biomarkers for personalized therapy and using the biomarker profile as a co-diagnostic tool is her recent research focus. Her final aim is to capture disease severity in validated outcome measures and assess side effects of treatments in real clinical practice.

Contents

to Immunoactivation

*and Hiroko Shike*

*by Xining Yang and Mark D. Scott*

Rejections in Heart Transplantation

*by Takuya Watanabe and Norihide Fukushima*

Immunosuppression and Viral Infections

**Preface III**

**Chapter 1 1**

**Chapter 2 15**

**Chapter 3 33**

**Chapter 4 51**

**Chapter 5 65**

**Chapter 6 77**

*by Evgeny Grigoryev, Vera Matveeva, Artem Ivkin and Maryam Khanova*

Biological Modulation of the Treg: Teff Ratio: From Immunosuppression

Novel Diagnostic and Therapeutic Approach to Antibody-Mediated

*by Seema Naik, Kevin Rakszawski, Joseph Cioccio, Hong Zheng* 

Role of Hybrid Operating Room: Present and Future

*by Evan Qize Yuan and Calvin Sze Hang Ng*

The New Era of Immunotherapy in Bile Duct Cancer Management *by Cosmas Rinaldi Adithya Lesmana and Baiq Kirana D. Mandasari*

Induced Immunosuppression in Critical Care

## Contents


Preface

To safeguard ourselves, our immune system is equipped with a series of defence mechanisms to recognise and respond to non-self molecules. Although essential for fighting off infections and preventing cancers, destructive immune responses pose a considerable challenge in autoinflammation and transplantation. Currently available immunosuppressants help to control destructive immune responses. However, management of side-effects of lifelong immunosuppression, including cancer development and reduced survival, remain major problems. For this reason, an increasing amount of interest is directed towards the natural specific regulatory mechanism of the immune system. A better understanding of these mechanisms

One approach that the immune system employs to induce self-tolerance is via regulatory T cells (Treg). Treg are well known for their immune regulatory potential and are essential for maintaining immune homeostasis. Impaired Treg-mediated immune regulation has been observed in various autoimmune diseases as well as in cancers. Therefore, Treg might provide an ideal therapeutic target for diseases where the immune balance is impaired and could benefit from the regulation of Treg properties. The rationale of Treg-based immunotherapy for treating autoimmunity and transplant rejection is to tip the immune balance of effector T cell-mediated immune activation and Treg-mediated immune inhibition in favour of Treg cells, either through endogenous Treg expansion strategies or adoptive transfer of ex vivo expanded Treg. Human Treg are currently intensively studied for the induction of immunotolerance both in transplantation and autoimmunity. The tumour microenvironment preferably recruits immune cells, which possess a highly immunosuppressive capacity, thus inducing peripheral immune tolerance and facilitating tumour immune escape. Immune checkpoint inhibitors take the brakes off an immune response that has begun thus reactivating the anti-cancer effect.

In this book on immunosuppression, researchers in this area discuss their recent findings in the context of autoimmune diseases as well as cancers. Topics include biological modulation of Treg, monitoring of the complement pathway in the occurrence of antibody-mediated organ rejection, immunotherapy for bile duct cancer, immunosuppression in viral infections, and the management of biliary diseases using endoscopic ultrasound. These reviews are representative of a current active research field that continues to grow and enlighten. We hope the reviews

**Dr. Xuehui He**

Radboud University, Nijmegen, Netherlands

Department of Laboratory Medicine, Medical Immunology Section,

will be of use to experts in the field and new entrants alike.

holds the key.
