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Alloreactive cytotoxic T lymphocytes are a subset of CD8+ cytotoxic T cells that recognize foreign major histocompatibility complex (MHC) class I molecules or allogeneic peptides presented by shared MHC on donor cells, leading to direct killing via cytolytic mechanisms. They contribute to acute transplant rejection and graft-versus-host disease through high precursor frequencies and potent alloresponses, distinct from conventional antigen-specific cytotoxic T cells activated against pathogens or tumors.[1][2][3][4][5] This is not a single molecular entity like a receptor or enzyme but a functional population of immune cells, making it unsuitable as a traditional therapeutic target.[5]
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