New perspectives on the Th1/Th2 paradigm

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Abstract
Over the past decade the fortunes of the Th1/Th2 paradigm have fluctuated. A substantial body of work from two groups, in several animal models, has demonstrated that allograft rejection is associated with Th1 activity, and acceptance with that of Th2s. Other studies have not obtained the same kind of associations, notably in human organ transplants, for reasons which are presently unclear. The procedures which have been used with success, for instance treatment with anti-CD4 monoclonal antibody, are likely to reduce signal strength within the responding T cells; experience with other (non-transplantation) systems indicates that this is indeed likely to drive-Th2 differentiation. Oral and nasal tolerance offer another possible means of modulating Th1/Th2 balance, although clinical trials have been disappointing. The genetics and pharmacology of the balance are surveyed for clues to mechanism.

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