Fig. 3: Strategies targeting adaptive immunity.

In general, allogeneic transplantation using mDA cells derived from hESCs still necessitates immunosuppression, whereas autologous transplantation with mDA cells from hiPSCs is characterized by immune tolerance, eliminating the need for immunosuppressants. An alternative strategy, distinct from utilizing autologous cells, involves the application of HLA-matched hiPSCs to reduce the risk of graft rejection, with ongoing efforts to establish an HLA-matched iPSC bank encompassing a diverse array of donors. Another approach focuses on the development of "universal donor stem cells," incorporating genetic modifications, such as CRISPR/Cas9-mediated knockout of HLA class I and II components, along with lentiviral overexpression of the immune receptor CD47 or HLA-E/G transgene.