I. Raul Badell Receives 2018 ASTS Vanguard Prize

January 2018

The American Society of Transplant Surgeons' (ASTS) Vanguard Prize recognizes and honors ASTS junior members for authoring the previous year's best clinical and basic research manuscripts from young investigators. Emory kidney transplant surgeon I. Raul Badell, MD, won the 2018 edition of the award for his paper "Selective CD28 Blockade Results in Superior Inhibition of Donor-Specific T Follicular Helper Cell and Antibody Responses Relative to CTLA4-Ig," which was first published electronically in August 2017 by the American Journal of Transplantation.

Vanguard Prize recipients attend the ASTS Winter Symposium, are recognized during the Awards Ceremony, and will present their research during the Oral Abstract Session.

Dr. Badell's co-authors included senior author Mandy Ford, PhD, scientific director of the Emory Transplant Center, who is advising Dr. Badell as he builds his research career.

The study was concerned with the role of T folliculary helper (Tfh) cells in the development of donor-specific antibodies (DSAs) that clinically lead to chronic renal allograft rejection and fibrosis, and focused on a new generation of costimulation blockade that selectively targets the costimulatory molecule CD28. Costimulaton blockade is an immunosuppressive strategy that interferes with the ability of T cells to become fully activated and mediate rejection. Dr. Badell and his co-authors found that selective CD28 blockade was superior to current costimulation blockade with CTLA4-Ig in inhibiting the Tfh cell-mediated DSA responses in a mouse transplant model.

The study team reported that selective CD28 blockade provided greater inhibition of donor-specific Tfh cells, graft-elicited germinal center B cells, and donor-specific antibodies; and that increased expression of CTLA4 on graft-reactive Tfh cells may be an important mechanism of the observed differences between selective CD28 blockade and CTLA4-Ig. Dr. Badell and his colleagues concluded that their findings support further study of selective CD28 costimulation blockade-based strategies to target Tfh cells as a means of combating harmful donor-specific antibodies in kidney transplantation.

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