In principle, IL-10 has been used in experimental transplantation in three different ways: • donor pretreatment with recombinant IL-10 or systemic gene therapy with the aim to reduce the ischemia/reperfusion injury and the graft immunogenicity by deactivating donor intragraft macrophages and antigen-presenting cells.
• recipient treatment with recombinant IL-10 or systemic gene therapy with the aim to prevent acute graft rejection by deactivating inflammatory reactions and inducing regulatory T cells.
• gene therapy resulting in intragraft over-expression of IL-10 with the aim to combat both ischemia/reperfusion injury and T-cell mediated graft rejection by combination of the effects described above.
Protective IL-10 can also be induced indirectly, e.g., by application of cAMP elevating drugs like prostaglandins or 15-deoxyspergualin5 but these approaches will not be discussed in this review.
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