{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,12]],"date-time":"2026-10-12T13:01:55Z","timestamp":1791810115254,"version":"4.3.4"},"reference-count":76,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2026,5,28]],"date-time":"2026-05-28T00:00:00Z","timestamp":1779926400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Immunol."],"abstract":"<jats:p>The CD40-CD154 costimulatory axis serves as a central hub bridging innate and adaptive immunity, regulating antigen presentation, T-cell priming, B-cell activation, germinal center formation, and antibody class switching. In transplantation, this pathway drives donor-reactive T-cell expansion, dendritic cell (DC) licensing, and donor-specific antibody generation, contributing to both acute and chronic allograft rejection. Recent discoveries have expanded the classical linear model into a multidimensional signaling network. This network encompasses canonical CD40-TNF receptor-associated factor (TRAF)-NF-\u03baB signaling, CD154 reverse signaling, and alternative receptor engagement\u2014particularly through integrins such as CD11b. These insights explain the differential efficacy of CD154 versus CD40 blockade and inform next-generation therapeutic design. Concurrently, renewed clinical interest has emerged following the development of fragment crystallizable (Fc)-engineered anti-CD154 antibodies that circumvent first-generation thromboembolic toxicity. Here, we synthesize current understanding of CD40-CD154 molecular architecture, upstream triggers, downstream signaling networks, crosstalk with other immune pathways, and cell type-specific outputs. We evaluate therapeutic candidates in clinical development, discuss unresolved questions regarding long-term safety and biomarker development, and highlight future directions including cell-targeted intervention and tolerance-inducing combination strategies.<\/jats:p>","DOI":"10.3389\/fimmu.2026.1825653","type":"journal-article","created":{"date-parts":[[2026,5,28]],"date-time":"2026-05-28T04:53:22Z","timestamp":1779944002000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":1,"title":["The CD40-CD154 axis in transplantation: from immunobiology to therapeutic targeting"],"prefix":"10.3389","volume":"17","author":[{"given":"Kunxiong","family":"Wang","sequence":"first","affiliation":[{"name":"Department of Kidney Transplantation, The Second Affiliated Hospital of Hainan Medical University","place":["Haikou, China"]},{"name":"The Transplantation Institute of Hainan Medical University","place":["Haikou, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tao","family":"Li","sequence":"additional","affiliation":[{"name":"Department of Kidney Transplantation, The Second Affiliated Hospital of Hainan Medical University","place":["Haikou, China"]},{"name":"The Transplantation Institute of Hainan Medical University","place":["Haikou, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ting","family":"Yan","sequence":"additional","affiliation":[{"name":"Department of Kidney Transplantation, The Second Affiliated Hospital of Hainan Medical University","place":["Haikou, China"]},{"name":"The Transplantation Institute of Hainan Medical University","place":["Haikou, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hidetaka","family":"Hara","sequence":"additional","affiliation":[{"name":"Department of Kidney Transplantation, The Second Affiliated Hospital of Hainan Medical University","place":["Haikou, China"]},{"name":"The Transplantation Institute of Hainan Medical University","place":["Haikou, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yi","family":"Wang","sequence":"additional","affiliation":[{"name":"Department of Kidney Transplantation, The Second Affiliated Hospital of Hainan Medical University","place":["Haikou, China"]},{"name":"The Transplantation Institute of Hainan Medical University","place":["Haikou, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1965","published-online":{"date-parts":[[2026,5,28]]},"reference":[{"key":"B1","doi-asserted-by":"publisher","first-page":"881","DOI":"10.1146\/annurev.iy.12.040194.004313","article-title":"The CD40 antigen and its ligand","volume":"12","author":"Banchereau","year":"1994","journal-title":"Annu Rev Immunol"},{"key":"B2","doi-asserted-by":"publisher","DOI":"10.1073\/pnas.94.5.1931","article-title":"Functional CD40 ligand is expressed on human vascular endothelial cells, smooth muscle cells, and macrophages: implications for CD40-CD40 ligand signaling in atherosclerosis","volume":"94","author":"Mach","year":"1997","journal-title":"Proc Natl Acad Sci USA"},{"key":"B3","doi-asserted-by":"publisher","first-page":"1747","DOI":"10.3390\/cells11111747","article-title":"Novel functions of integrins as receptors of CD154: their role in inflammation and apoptosis","volume":"11","author":"Hassan","year":"2022","journal-title":"Cells"},{"key":"B4","doi-asserted-by":"publisher","first-page":"e148652","DOI":"10.1172\/jci.insight.148652","article-title":"CD40L modulates transcriptional signatures of neutrophils in the bone marrow associated with development and trafficking","volume":"6","author":"Franca","year":"2021","journal-title":"JCI Insight"},{"key":"B5","doi-asserted-by":"publisher","first-page":"1926","DOI":"10.3390\/cells12151926","article-title":"Ectodomain shedding by ADAM17 increases the release of soluble CD40 from human endothelial cells under pro-inflammatory conditions","volume":"12","author":"Klersy","year":"2023","journal-title":"Cells"},{"key":"B6","doi-asserted-by":"publisher","DOI":"10.1074\/jbc.M113.506220","article-title":"CD154 is released from T-cells by a disintegrin and metalloproteinase domain-containing protein 10 (ADAM10) and ADAM17 in a CD40 protein-dependent manner","volume":"288","author":"Yacoub","year":"2013","journal-title":"J Biol Chem"},{"key":"B7","doi-asserted-by":"publisher","DOI":"10.1097\/tp.0000000000000042","article-title":"Increased soluble CD154 (CD40 ligand) levels in xenograft recipients correlate with the development of de novo anti-pig IgG antibodies","volume":"97","author":"Ezzelarab","year":"2014","journal-title":"Transplantation"},{"key":"B8","doi-asserted-by":"publisher","DOI":"10.4049\/jimmunol.160.5.2145","article-title":"CD40 ligand and appropriate cytokines induce switching to IgG, IgA, and IgE and coordinated germinal center and plasmacytoid phenotypic differentiation in a human monoclonal IgM+IgD+ B cell line","volume":"160","author":"Cerutti","year":"1998","journal-title":"J Immunol"},{"key":"B9","doi-asserted-by":"publisher","DOI":"10.1084\/jem.179.4.1109","article-title":"Efficient presentation of soluble antigen by cultured human dendritic cells is maintained by granulocyte\/macrophage colony-stimulating factor plus interleukin 4 and downregulated by tumor necrosis factor alpha","volume":"179","author":"Sallusto","year":"1994","journal-title":"J Exp Med"},{"key":"B10","doi-asserted-by":"publisher","DOI":"10.1097\/tp.0000000000004469","article-title":"CD40-CD40L blockade: update on novel investigational therapeutics for transplantation","volume":"107","author":"Singh","year":"2023","journal-title":"Transplantation"},{"key":"B11","doi-asserted-by":"publisher","DOI":"10.1016\/j.ajt.2026.01.024","article-title":"Inhibition of CD154:CD11b interactions using a novel nanotherapeutic improves allograft survival","volume":"2026","author":"Yao","year":"2026","journal-title":"Am J Transplant"},{"key":"B12","doi-asserted-by":"publisher","DOI":"10.3389\/fimmu.2022.861471","article-title":"The inhibition of CD40\/CD154 costimulatory signaling in the prevention of renal transplant rejection in nonhuman primates: a systematic review and meta analysis","volume":"13","author":"Perrin","year":"2022","journal-title":"Front Immunol"},{"key":"B13","doi-asserted-by":"publisher","DOI":"10.1016\/j.ajt.2024.03.033","article-title":"Differential induction of donor-reactive Foxp3(+) regulatory T cell via blockade of CD154 vs CD40","volume":"24","author":"Liu","year":"2024","journal-title":"Am J Transplant"},{"key":"B14","doi-asserted-by":"publisher","first-page":"75","DOI":"10.1016\/j.jneuroim.2014.03.009","article-title":"Defining a new biomarker for the autoimmune component of multiple sclerosis: Th40 cells","volume":"270","author":"Waid","year":"2014","journal-title":"J Neuroimmunol"},{"key":"B15","doi-asserted-by":"publisher","DOI":"10.1189\/jlb.1207857","article-title":"Disruption of the homeostatic balance between autoaggressive (CD4+CD40+) and regulatory (CD4+CD25+FoxP3+) T cells promotes diabetes","volume":"84","author":"Waid","year":"2008","journal-title":"J Leukoc Biol"},{"key":"B16","doi-asserted-by":"publisher","DOI":"10.1002\/art.10856","article-title":"A short course of BG9588 (anti-CD40 ligand antibody) improves serologic activity and decreases hematuria in patients with proliferative lupus glomerulonephritis","volume":"48","author":"Boumpas","year":"2003","journal-title":"Arthritis Rheum"},{"key":"B17","doi-asserted-by":"publisher","DOI":"10.1016\/j.ajt.2023.03.022","article-title":"TNX-1500, a crystallizable fragment-modified anti-CD154 antibody, prolongs nonhuman primate renal allograft survival","volume":"23","author":"Lassiter","year":"2023","journal-title":"Am J Transplant"},{"key":"B18","doi-asserted-by":"publisher","DOI":"10.1016\/j.ajt.2022.12.023","article-title":"Milestones on the path to clinical pig organ xenotransplantation","volume":"23","author":"Cooper","year":"2023","journal-title":"Am J Transplant"},{"key":"B19","doi-asserted-by":"publisher","DOI":"10.3389\/fimmu.2022.1060576","article-title":"Chronic CD40L blockade is required for long-term cardiac allograft survival with a clinically relevant CTLA4-Ig dosing regimen","volume":"13","author":"Unger","year":"2022","journal-title":"Front Immunol"},{"key":"B20","doi-asserted-by":"publisher","DOI":"10.4049\/jimmunol.151.5.2497","article-title":"The regulation of the expression of gp39, the CD40 ligand, on normal and cloned CD4+ T cells","volume":"151","author":"Roy","year":"1993","journal-title":"J Immunol"},{"key":"B21","doi-asserted-by":"publisher","DOI":"10.1182\/blood-2008-03-143305","article-title":"CD40: an upstream master switch for endothelial cell activation uncovered by RNAi-coupled transcriptional profiling","volume":"112","author":"Raquel","year":"2008","journal-title":"Blood"},{"key":"B22","doi-asserted-by":"publisher","DOI":"10.1002\/eji.201041143","article-title":"CD40 translocation to lipid rafts: signaling requirements and downstream biological events","volume":"41","author":"Amal","year":"2011","journal-title":"Eur J Immunol"},{"key":"B23","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pone.0043070","article-title":"Requirement of transmembrane domain for CD154 association to lipid rafts and subsequent biological events","volume":"7","author":"Nadir","year":"2012","journal-title":"PloS One"},{"key":"B24","doi-asserted-by":"publisher","DOI":"10.1038\/ki.2015.146","article-title":"CD154-CD40 T-cell co-stimulation pathway is a key mechanism in kidney ischemia-reperfusion injury","volume":"88","author":"de Ramon","year":"2015","journal-title":"Kidney Int"},{"key":"B25","doi-asserted-by":"publisher","DOI":"10.1074\/jbc.274.20.14246","article-title":"CD40 signaling through tumor necrosis factor receptor-associated factors (TRAFs). Binding site specificity and activation of downstream pathways by distinct TRAFs","volume":"274","author":"Pullen","year":"1999","journal-title":"J Biol Chem"},{"key":"B26","doi-asserted-by":"publisher","DOI":"10.1073\/pnas.0402629101","article-title":"Unique CD40-mediated biological program in B cell activation requires both type 1 and type 2 NF-kappaB activation pathways","volume":"101","author":"Zarnegar","year":"2004","journal-title":"Proc Natl Acad Sci USA"},{"key":"B27","doi-asserted-by":"publisher","DOI":"10.1097\/tp.0000000000004181","article-title":"Evolving understanding of T-cell cosignaling pathways","volume":"106","author":"Yang","year":"2022","journal-title":"Transplantation"},{"key":"B28","doi-asserted-by":"publisher","DOI":"10.1016\/s0014-5793(97)01306-9","article-title":"Evidence for a novel function of the CD40 ligand as a signaling molecule in T-lymphocytes","volume":"417","author":"Brenner","year":"1997","journal-title":"FEBS Lett"},{"key":"B29","doi-asserted-by":"publisher","DOI":"10.1111\/ajt.15835","article-title":"CD11b is a novel alternate receptor for CD154 during alloimmunity","volume":"20","author":"Liu","year":"2020","journal-title":"Am J Transplant"},{"key":"B30","doi-asserted-by":"publisher","DOI":"10.1002\/eji.201343644","article-title":"With(out) a little help from my friends: an IL-12\/CD40L-mediated feed-forward loop between CD8+ T cells and DCs","volume":"43","author":"Nolte","year":"2013","journal-title":"Eur J Immunol"},{"key":"B31","doi-asserted-by":"publisher","first-page":"79","DOI":"10.1007\/978-1-4615-1971-3_16","article-title":"Functional CD40 antigen on B cells, dendritic cells and fibroblasts","volume":"378","author":"Banchereau","year":"1995","journal-title":"Adv Exp Med Biol"},{"key":"B32","doi-asserted-by":"publisher","DOI":"10.1016\/j.ijpharm.2022.121667","article-title":"Dendritic cell activation by a micro particulate based system containing the influenza matrix-2 protein virus-like particle (M2e VLP)","volume":"622","author":"Gomes","year":"2022","journal-title":"Int J Pharm"},{"key":"B33","doi-asserted-by":"publisher","DOI":"10.1016\/j.healun.2021.08.008","article-title":"Gut microbes enlarged the protective effect of transplanted regulatory B cells on rejection of cardiac allografts","volume":"40","author":"Li","year":"2021","journal-title":"J Heart Lung Transplant"},{"key":"B34","doi-asserted-by":"publisher","DOI":"10.1007\/s00125-004-1645-7","article-title":"A functional CD40 receptor is expressed in pancreatic beta cells","volume":"48","author":"Klein","year":"2005","journal-title":"Diabetologia"},{"key":"B35","doi-asserted-by":"publisher","first-page":"77","DOI":"10.1016\/s0165-5728(99)00053-3","article-title":"Activation of microglial cells by the CD40 pathway: relevance to multiple sclerosis","volume":"97","author":"Tan","year":"1999","journal-title":"J Neuroimmunol"},{"key":"B36","doi-asserted-by":"publisher","DOI":"10.1016\/s0002-9440(10)64875-4","article-title":"CD40-CD40L interactions induce chemokine expression by human microglia: implications for human immunodeficiency virus encephalitis and multiple sclerosis","volume":"160","author":"D'Aversa","year":"2002","journal-title":"Am J Pathol"},{"key":"B37","doi-asserted-by":"publisher","first-page":"429","DOI":"10.3390\/cells13050429","article-title":"Advanced glycation end products upregulate CD40 in human retinal endothelial and Muller cells: relevance to diabetic retinopathy","volume":"13","author":"Portillo","year":"2024","journal-title":"Cells"},{"key":"B38","doi-asserted-by":"publisher","DOI":"10.1158\/1078-0432.Ccr-20-4001","article-title":"Fibroblast activation protein alpha-targeted CD40 agonism abrogates systemic toxicity and enables administration of high doses to induce effective antitumor immunity","volume":"27","author":"Sum","year":"2021","journal-title":"Clin Cancer Res"},{"key":"B39","doi-asserted-by":"publisher","DOI":"10.1038\/s44320-025-00124-2","article-title":"Synergy and antagonism in the integration of BCR and CD40 signals that control B-cell population expansion","volume":"21","author":"Huang","year":"2025","journal-title":"Mol Syst Biol"},{"key":"B40","doi-asserted-by":"publisher","DOI":"10.1126\/sciimmunol.add1823","article-title":"IL-21R signal reprogramming cooperates with CD40 and BCR signals to select and differentiate germinal center B cells","volume":"8","author":"Luo","year":"2023","journal-title":"Sci Immunol"},{"key":"B41","doi-asserted-by":"publisher","DOI":"10.1126\/sciadv.adl5815","article-title":"Mechanotransduction governs CD40 function and underlies X-linked hyper-IgM syndrome","volume":"10","author":"Choi","year":"2024","journal-title":"Sci Adv"},{"key":"B42","doi-asserted-by":"publisher","DOI":"10.1182\/blood.2020005627","article-title":"miR-29 modulates CD40 signaling in chronic lymphocytic leukemia by targeting TRAF4: an axis affected by BCR inhibitors","volume":"137","author":"Sharma","year":"2021","journal-title":"Blood"},{"key":"B43","doi-asserted-by":"publisher","first-page":"e20211336","DOI":"10.1084\/jem.20211336","article-title":"B cell-intrinsic TBK1 is essential for germinal center formation during infection and vaccination in mice","volume":"219","author":"Lee","year":"2022","journal-title":"J Exp Med"},{"key":"B44","doi-asserted-by":"publisher","DOI":"10.1038\/s41584-024-01179-5","article-title":"The essential roles of memory B cells in the pathogenesis of systemic lupus erythematosus","volume":"20","author":"Dorner","year":"2024","journal-title":"Nat Rev Rheumatol"},{"key":"B45","doi-asserted-by":"publisher","DOI":"10.1016\/j.joca.2023.03.017","article-title":"B-cell capacity for expansion and differentiation into plasma cells are altered in osteoarthritis","volume":"31","author":"Xie","year":"2023","journal-title":"Osteoarthritis Cartilage"},{"key":"B46","doi-asserted-by":"publisher","DOI":"10.3389\/fimmu.2022.882502","article-title":"Multimericity amplifies the synergy of BCR and TLR4 for B cell activation and antibody class switching","volume":"13","author":"Pone","year":"2022","journal-title":"Front Immunol"},{"key":"B47","doi-asserted-by":"publisher","DOI":"10.1038\/s41375-023-01898-w","article-title":"Ibrutinib sensitizes CLL cells to venetoclax by interrupting TLR9-induced CD40 upregulation and protein translation","volume":"37","author":"Kielbassa","year":"2023","journal-title":"Leukemia"},{"key":"B48","doi-asserted-by":"publisher","DOI":"10.1182\/blood.2020008040","article-title":"BAFF promotes heightened BCR responsiveness and manifestations of chronic GVHD after allogeneic stem cell transplantation","volume":"137","author":"Jia","year":"2021","journal-title":"Blood"},{"key":"B49","doi-asserted-by":"publisher","DOI":"10.3389\/fimmu.2023.1096019","article-title":"IgD shapes the pre-immune naive B cell compartment in humans","volume":"14","author":"Dirks","year":"2023","journal-title":"Front Immunol"},{"key":"B50","doi-asserted-by":"publisher","DOI":"10.3389\/fimmu.2021.663443","article-title":"How the signaling crosstalk of B cell receptor (BCR) and co-receptors regulates antibody class switch recombination: a new perspective of checkpoints of BCR signaling","volume":"12","author":"Chen","year":"2021","journal-title":"Front Immunol"},{"key":"B51","doi-asserted-by":"publisher","DOI":"10.1016\/j.ymthe.2025.03.025","article-title":"Interaction between stromal cells and tumor cells promotes GCB-DLBCL cell survival via the CD40\/RANK-KDM6B-NF-\u03baB axis","volume":"33","author":"Liu","year":"2025","journal-title":"Mol Ther"},{"key":"B52","doi-asserted-by":"publisher","first-page":"197","DOI":"10.1046\/j.0022-3042.2001.00691.x","article-title":"Regulation of tumor necrosis factor-alpha expression by CD40 ligation in BV-2 microglial cells","volume":"80","author":"Jana","year":"2002","journal-title":"J Neurochem"},{"key":"B53","doi-asserted-by":"publisher","DOI":"10.1084\/jem.189.2.441","article-title":"CD40 activation induces apoptosis in cultured human hepatocytes via induction of cell surface fas ligand expression and amplifies fas-mediated hepatocyte death during allograft rejection","volume":"189","author":"Afford","year":"1999","journal-title":"J Exp Med"},{"key":"B54","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pone.0147509","article-title":"Chimeric vaccine stimulation of human dendritic cell indoleamine 2, 3-dioxygenase occurs via the non-canonical NF-\u03baB pathway","volume":"11","author":"Kim","year":"2016","journal-title":"PloS One"},{"key":"B55","doi-asserted-by":"publisher","DOI":"10.1016\/j.bbadis.2025.167923","article-title":"Lactate inhibits T-cell activation in sepsis through CD40LG downregulation and SOCS3-mediated JAK1\/STAT3 pathway suppression","volume":"1871","author":"Zhang","year":"2025","journal-title":"Biochim Biophys Acta Mol Basis Dis"},{"key":"B56","doi-asserted-by":"publisher","DOI":"10.1182\/blood-2010-11-320259","article-title":"Tyrosine nitration limits stretch-induced CD40 expression and disconnects CD40 signaling in human endothelial cells","volume":"118","author":"Wagner","year":"2011","journal-title":"Blood"},{"key":"B57","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pone.0000159","article-title":"C4b binding protein binds to CD154 preventing CD40 mediated cholangiocyte apoptosis: a novel link between complement and epithelial cell survival","volume":"2","author":"Williams","year":"2007","journal-title":"PloS One"},{"key":"B58","doi-asserted-by":"publisher","DOI":"10.4049\/jimmunol.1001501","article-title":"T cell polarity at the immunological synapse is required for CD154-dependent IL-12 secretion by dendritic cells","volume":"185","author":"Tourret","year":"2010","journal-title":"J Immunol"},{"key":"B59","doi-asserted-by":"publisher","DOI":"10.1126\/scitranslmed.adf6376","article-title":"The anti-CD40L monoclonal antibody AT-1501 promotes islet and kidney allograft survival and function in nonhuman primates","volume":"15","author":"Anwar","year":"2023","journal-title":"Sci Transl Med"},{"key":"B60","doi-asserted-by":"publisher","first-page":"e146314","DOI":"10.1172\/jci.insight.146314","article-title":"TNF blockade uncouples toxicity from antitumor efficacy induced with CD40 chemoimmunotherapy","volume":"6","author":"Stone","year":"2021","journal-title":"JCI Insight"},{"key":"B61","doi-asserted-by":"publisher","first-page":"40","DOI":"10.1016\/j.cytogfr.2023.11.002","article-title":"Harnessing the potential of CD40 agonism in cancer therapy","volume":"75","author":"Zhou","year":"2024","journal-title":"Cytokine Growth Factor Rev"},{"key":"B62","doi-asserted-by":"publisher","DOI":"10.1038\/s41591-024-03429-1","article-title":"Transplantation of a genetically modified porcine heart into a live human","volume":"31","author":"Griffith","year":"2025","journal-title":"Nat Med"},{"key":"B63","doi-asserted-by":"publisher","DOI":"10.1097\/tp.0000000000003622","article-title":"What therapeutic regimen will be optimal for initial clinical trials of pig organ transplantation","volume":"105","author":"Bikhet","year":"2021","journal-title":"Transplantation"},{"key":"B64","doi-asserted-by":"publisher","DOI":"10.1016\/j.xcrm.2024.101744","article-title":"Pig-to-human kidney xenotransplants using genetically modified minipigs","volume":"5","author":"Wang","year":"2024","journal-title":"Cell Rep Med"},{"key":"B65","doi-asserted-by":"publisher","DOI":"10.1016\/j.ajt.2025.12.017","article-title":"Gene-edited pig cardiac xenotransplantation as a bridge to allotransplantation in infants: Progress in a pig-to-baboon model","volume":"26","author":"Cleveland","year":"2025","journal-title":"Am J Transplant"},{"key":"B66","doi-asserted-by":"publisher","DOI":"10.3389\/fimmu.2024.1484425","article-title":"Small-molecule inhibitors of the CD40-CD40L costimulatory interaction are effective in pancreatic islet transplantation and prevention of type 1 diabetes models","volume":"15","author":"Chuang","year":"2024","journal-title":"Front Immunol"},{"key":"B67","doi-asserted-by":"publisher","DOI":"10.3389\/fimmu.2022.979277","article-title":"Detection of rare autoreactive T cell subsets in patients with pemphigus vulgaris","volume":"13","author":"Polakova","year":"2022","journal-title":"Front Immunol"},{"key":"B68","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pmed.1004469","article-title":"Safety and tolerability of tegoprubart in patients with amyotrophic lateral sclerosis: A Phase 2A clinical trial","volume":"21","author":"Perrin","year":"2024","journal-title":"PloS Med"},{"key":"B69","doi-asserted-by":"publisher","DOI":"10.1177\/15209156251396115","article-title":"A Phase 2 (2a) randomized trial of iscalimab in adolescents and young adults with new-onset type 1 diabetes","author":"Mathieu","year":"2025","journal-title":"Diabetes Technol Ther"},{"key":"B70","doi-asserted-by":"publisher","DOI":"10.3389\/fimmu.2022.854883","article-title":"Current topics of relevance to the xenotransplantation of free pig islets","volume":"13","author":"Mou","year":"2022","journal-title":"Front Immunol"},{"key":"B71","doi-asserted-by":"publisher","DOI":"10.1016\/j.ajt.2022.11.022","article-title":"Renin-angiotensin-aldosterone system function in the pig-to-baboon kidney xenotransplantation model","volume":"23","author":"Hansen-Estruch","year":"2023","journal-title":"Am J Transplant"},{"key":"B72","doi-asserted-by":"publisher","first-page":"3361","DOI":"10.1038\/s41467-024-47679-6","article-title":"Consistent survival in consecutive cases of life-supporting porcine kidney xenotransplantation using 10GE source pigs","volume":"15","author":"Eisenson","year":"2024","journal-title":"Nat Commun"},{"key":"B73","doi-asserted-by":"publisher","first-page":"e184843","DOI":"10.1172\/jci.insight.184843","article-title":"CD154:CD11b blockade enhances CD8+ T cell differentiation during infection but not transplantation","volume":"10","author":"Alexander","year":"2025","journal-title":"JCI Insight"},{"key":"B74","doi-asserted-by":"publisher","DOI":"10.1007\/s00125-014-3342-5","article-title":"A CD40-targeted peptide controls and reverses type 1 diabetes in NOD mice","volume":"57","author":"Vaitaitis","year":"2014","journal-title":"Diabetologia"},{"key":"B75","doi-asserted-by":"publisher","DOI":"10.1111\/ajt.14910","article-title":"De novo belatacept in clinical vascularized composite allotransplantation","volume":"18","author":"Cendales","year":"2018","journal-title":"Am J Transplant"},{"key":"B76","doi-asserted-by":"publisher","DOI":"10.3389\/fimmu.2020.544186","article-title":"Costimulation blockade in vascularized composite allotransplantation","volume":"11","author":"Giannis","year":"2020","journal-title":"Front Immunol"}],"container-title":["Frontiers in Immunology"],"original-title":[],"link":[{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fimmu.2026.1825653\/full","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,5,28]],"date-time":"2026-05-28T04:53:27Z","timestamp":1779944007000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fimmu.2026.1825653\/full"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,5,28]]},"references-count":76,"alternative-id":["10.3389\/fimmu.2026.1825653"],"URL":"https:\/\/doi.org\/10.3389\/fimmu.2026.1825653","relation":{},"ISSN":["1664-3224"],"issn-type":[{"value":"1664-3224","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,5,28]]},"article-number":"1825653"}}