Novel Applications of Epitope Biology to Improve Outcomes in Transplantation

HLA compatibility between graft donor and recipient is associated with superior transplant outcomes but the enormous polymorphisms of the HLA genes, now comprising over 34,000 alleles, make extensive matching impractical. Advances in genome and proteome sciences have defined unique epitopes, regions of the HLA molecules defined by structure or charge, that are recognized by T-cells and antibodies and determine graft immunogenicity and antigenicity. Retrospective studies indicate that the degree of epitope mismatch between donor and recipient is associated with post-transplant graft rejection and survival. While this measure does not improve matching, it may be leveraged to guide the use of immunosuppressive medications and post-transplant immune monitoring. Other modeling studies suggest that the limited number of these epitopes, numbering only a few hundred, coupled with rapid sequence-level information on donor type may permit prospective allocation of donor organs to optimize epitope match and improve survival. Both hypotheses offer important new opportunities to improve transplant outcomes but require rigorous prospective evaluation, aided by emerging technologies that will permit real-time assessment of epitope compatibility, with the development of clear allocation policies.

The focus of this research topic is to present novel approaches, technologies, evaluation, and clinical implementation of applying epitope biology to improve outcomes in transplantation.

Original Research, Opinion, Perspective, Review, and Mini Review articles on topics related to the evaluation and application of epitope biology in transplantation including but not limited to:
solid organ transplantation; hematopoietic stem cell transplantation; transplant outcomes; graft immunogenicity; post-transplant monitoring; precision medicine; rapid sequencing technologies; epitope compatibility assessment; transplant allocation policy.

Manuscripts covering pure bioinformatic analyses are not in scope of the Immunogenetics section of Frontiers in Genetics. Experimental (wet lab) validation of the in silico obtained results is a prerequisite for peer-review. Further, reports oriented towards the application of genetic analyses in oncological disease are not to be primarily targeted to the Immunogenetics unless they evolve in detail around the MHC (HLA) or other major immunogenetic systems and how those affect immune response and or therapy documented by real laboratory and/or clinical data, not solely bioinformatic analyses.