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Zhu C, Su Y, Juriasingani S, Zheng H, Veramkovich V, Jiang J, Sener A, Whiteman M, Lacefield J, Nagpal D, Alotaibi F, Liu K, Zheng X. Supplementing preservation solution with mitochondria-targeted H 2 S donor AP39 protects cardiac grafts from prolonged cold ischemia-reperfusion injury in heart transplantation. Am J Transplant 2019; 19:3139-3148. [PMID: 31338943 DOI: 10.1111/ajt.15539] [Citation(s) in RCA: 42] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/13/2019] [Revised: 07/01/2019] [Accepted: 07/14/2019] [Indexed: 01/25/2023]
Abstract
Heart transplant has been accepted as the standard treatment for end-stage heart failure. Because of its susceptibility to ischemia-reperfusion injury, the heart can be preserved for only 4 to 6 hours in cold static preservation solutions. Prolonged ischemia time is adversely associated with primary graft function and long-term survival. New strategies to preserve donor hearts are urgently needed. We demonstrate that AP39, a mitochondria-targeting hydrogen sulfide donor, significantly increases cardiomyocyte viability and reduces cell apoptosis/death after cold hypoxia/reoxygenation in vitro. It also decreases gene expression of proinflammatory cytokines and preserves mitochondria function. Using an in vivo murine heart transplant model, we show that preserving donor hearts with AP39-supplemented University of Wisconsin solution (n = 7) significantly protects heart graft function, measured by quantitative ultrasound scan, against prolonged cold ischemia-reperfusion injury (24 hours at 4°C), along with reducing tissue injury and fibrosis. Our study demonstrates that supplementing preservation solution with AP39 protects cardiac grafts from prolonged ischemia, highlighting its therapeutic potential in preventing ischemia-reperfusion injury in heart transplant.
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Affiliation(s)
- Cuilin Zhu
- Department of Cardiovascular Surgery, The Second Hospital of Jilin University, Changchun, China.,Department of Pathology, Western University, Ontario, Canada.,Matthew Mailing Centre for Translational Transplant Studies, London Health Sciences Center, Ontario, Canada
| | - Yale Su
- Department of Cardiovascular Surgery, The Second Hospital of Jilin University, Changchun, China.,Department of Pathology, Western University, Ontario, Canada.,Matthew Mailing Centre for Translational Transplant Studies, London Health Sciences Center, Ontario, Canada
| | - Smriti Juriasingani
- Matthew Mailing Centre for Translational Transplant Studies, London Health Sciences Center, Ontario, Canada
| | - Hao Zheng
- Department of Pathology, Western University, Ontario, Canada.,Matthew Mailing Centre for Translational Transplant Studies, London Health Sciences Center, Ontario, Canada
| | - Vitali Veramkovich
- Department of Pathology, Western University, Ontario, Canada.,Matthew Mailing Centre for Translational Transplant Studies, London Health Sciences Center, Ontario, Canada
| | - Jifu Jiang
- Matthew Mailing Centre for Translational Transplant Studies, London Health Sciences Center, Ontario, Canada
| | - Alp Sener
- Matthew Mailing Centre for Translational Transplant Studies, London Health Sciences Center, Ontario, Canada.,Department of Surgery, Western University, Ontario, Canada.,Lawson Health Research Institute, Ontario, Canada.,Department of Oncology, Western University, Ontario, Canada
| | - Matthew Whiteman
- University of Exeter Medical School, St. Luke's Campus, Exeter, UK
| | - James Lacefield
- Department of Medical Biophysics, Western University, Ontario, Canada.,Department of Electrical & Computer Engineering, Western University, Ontario, Canada.,Robarts Research Institute, Western University, Ontario, Canada
| | - Dave Nagpal
- Department of Surgery, Western University, Ontario, Canada
| | - Faizah Alotaibi
- Department of Pathology, Western University, Ontario, Canada
| | - Kexiang Liu
- Department of Cardiovascular Surgery, The Second Hospital of Jilin University, Changchun, China
| | - Xiufen Zheng
- Department of Pathology, Western University, Ontario, Canada.,Matthew Mailing Centre for Translational Transplant Studies, London Health Sciences Center, Ontario, Canada.,Department of Surgery, Western University, Ontario, Canada.,Lawson Health Research Institute, Ontario, Canada.,Department of Oncology, Western University, Ontario, Canada
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Wang S, Xu X, Xie A, Li J, Ye P, Liu Z, Wu J, Rui L, Xia J. Anti-interleukin-12/23p40 antibody attenuates chronic rejection of cardiac allografts partly via inhibition γδT cells. Clin Exp Immunol 2012; 169:320-9. [PMID: 22861372 DOI: 10.1111/j.1365-2249.2012.04612.x] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/13/2023] Open
Abstract
In our previous study, we showed that treatment with an anti-interleukin (IL)-12/23p40 antibody inhibits acute cardiac allograft rejection via inhibiting production of interferon (IFN)-γ and IL-17a. However, the impact of this antagonistic anti-p40 antibody on chronic cardiac rejection was unclear. Hearts of B6.C-H2bm12/KhEg mice were transplanted into major histocompatibility complex (MHC) class II-mismatched C57Bl/6J mice (wild-type, γδTCR (-/-) and IL-17(-/-) ), which is an established murine model of chronic allograft rejection without immunosuppression. The mice were treated with control immunoglobulin (Ig)G or 200 µg anti-p40 monoclonal antibody on post-operative days, respectively. Abdominal palpation and echocardiography were used to monitor graft survival. The mice administered with anti-p40 antibody showed a significant promotion in graft survival (median survival time >100 days), and histological analyses revealed that cardiac allograft rejection was attenuated. Quantitative real-time polymerase chain reaction (qRT-PCR) and immunofluorescence analyses demonstrated that anti-p40 antibody down-regulated the level of ingraft cytokine and chemokine expression (IL-6, IFN-γ, IL-17a, CCL2 and CCL20). Flow cytometry analyses showed that γδ T cells are an important ingraft source of IFN-γ and IL-17a and inhibit the production of inflammation cytokine by anti-p40 antibody. Compared with the wild-type group, the graft survival time in the γδ T cell receptor(-/-) and IL-17(-/-) mice was prolonged significantly. Therefore we propose that, in the chronic allograft rejection model, treatment with anti-p40 antibody prolongs graft survival possibly by reducing the amount of reactive inflammatory cells, especially γδ T cells.
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Affiliation(s)
- S Wang
- Department of Cardiovascular Surgery, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan Institute of Cardiovascular Surgery, Xijing Hospital, The 4th Military Medical University, Xi'an, Shaanxi Province Department of Cardiovascular Surgery, Fu Wai Hospital, Beijing, China
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Ionova IA, Vásquez-Vivar J, Cooley BC, Khanna AK, Whitsett J, Herrnreiter A, Migrino RQ, Ge ZD, Regner KR, Channon KM, Alp NJ, Pieper GM. Cardiac myocyte-specific overexpression of human GTP cyclohydrolase I protects against acute cardiac allograft rejection. Am J Physiol Heart Circ Physiol 2010; 299:H88-96. [PMID: 20418482 PMCID: PMC2904123 DOI: 10.1152/ajpheart.00203.2010] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/26/2010] [Accepted: 04/20/2010] [Indexed: 12/31/2022]
Abstract
GTP cyclohydrolase I (GTPCH) is the rate-limiting enzyme for tetrahydrobiopterin (BH(4)) synthesis. Decreases in GTPCH activity and expression have been shown in late stages of acute cardiac rejection, suggesting a deficit in BH(4). We hypothesized that increasing intracellular levels of BH(4) by cardiac myocyte-targeted overexpression of GTPCH would diminish acute cardiac allograft rejection. Transgenic mice overexpressing GTPCH in the heart were generated and crossed on C57BL6 background. Wild-type and transgenic mouse donor hearts were transplanted into BALB/c recipient mice. Left ventricular (LV) function, histological rejection, BH(4) levels, and inflammatory cytokine gene expression (mRNA) were examined. Expression of human GTPCH was documented by PCR, Western analysis, and function by a significant (P < 0.001) increase in cardiac BH(4) levels. GTPCH transgene decreased histological rejection (46%; P < 0.003) and cardiac myocyte injury (eosin autofluorescence; 56%; P < 0.0001) independent of changes in inflammatory cytokine expression or nitric oxide content. GTPCH transgene decreased IL-2 (88%; P < 0.002), IL-1R2 (42%; P < 0.0001), and programmed cell death-1 (67%; P < 0.0001) expression, whereas it increased fms-like tyrosine kinase 3 (156%; P < 0.0001) and stromal-derived factor-1 (2; 190%; P < 0.0001) expression. There was no difference in ejection fraction or fractional shortening; however, LV mass was significantly increased (P < 0.05) only in wild-type grafts. The decreases in LV mass, cardiac injury, and histological rejection support a protective role of cardiac GTPCH overexpression and increased BH(4) synthesis in cardiac allografts. The mechanism of the decreased rejection appears related to decreased T cell proliferation and modulation of immune function by higher expression of genes involved in hematopoietic/stromal cell development and recruitment.
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Affiliation(s)
- Irina A Ionova
- Department of Surgery, Division of Transplant Surgery, Medical College of Wisconsin, 9200 West Wisconsin Ave., Milwaukee, WI 53226, USA
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Baerwald A, Dauk S, Kanthan R, Singh J. Use of ultrasound biomicroscopy to image human ovaries in vitro. ULTRASOUND IN OBSTETRICS & GYNECOLOGY : THE OFFICIAL JOURNAL OF THE INTERNATIONAL SOCIETY OF ULTRASOUND IN OBSTETRICS AND GYNECOLOGY 2009; 34:201-207. [PMID: 19606428 DOI: 10.1002/uog.6438] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/28/2023]
Abstract
OBJECTIVES To test the hypothesis that ultrasound biomicroscopy is an effective tool for imaging human ovaries in vitro. METHODS This was a prospective, observational study of 11 women (mean age, 48.9 +/- 2.3 years; range, 40-65 years) undergoing unilateral or bilateral oophorectomy. Ovaries were obtained in the operating room and imaged in a cooled saline bath using conventional two-dimensional (2D) ultrasound. Follicles identified using conventional 2D ultrasound were then imaged in a cooled saline bath using ultrasound biomicroscopy. Ovaries were then placed in 10% neutral-buffered formaldehyde and transported to the Pathology Department for histological evaluation. Digital images of individually identified ovarian follicles using conventional ultrasound, ultrasound biomicroscopy and histology were obtained (n = 22). Thicknesses of the follicle wall, granulosa layer and theca interna layer were measured using standardized techniques. RESULTS The imaging sensitivity, defined as the smallest follicle visualized, was greater using ultrasound biomicroscopy (0.33 +/- 0.07 mm) than it was using conventional ultrasound (1.5 +/- 0.21 mm; P < 0.0001). The mean follicle wall thickness was greater using conventional ultrasound (0.675 +/- 0.039 mm) compared with ultrasound biomicroscopy (0.254 +/- 0.017 mm), which in turn, was greater than that measured by histology (0.160 +/- 0.009 mm) (P < 0.0001). The mean granulosa and theca layer thickness measurements, respectively, were greater using ultrasound biomicroscopy (0.067 +/- 0.004 mm; 0.186 +/- 0.014 mm) compared with histology (0.034 +/- 0.002 mm; 0.126 +/- 0.008 mm) (P < or = 0.001). Protrusions from the follicle wall into the antrum, believed to represent cumulus-oocyte complexes, were visualized in five of 22 follicles using ultrasound biomicroscopy. CONCLUSIONS The ultrasound biomicroscope was an effective tool to image human ovaries in vitro. Ultrasound biomicroscopy provided greater sensitivity and resolution for imaging ovarian follicles compared with conventional 2D ultrasonographic techniques.
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Affiliation(s)
- A Baerwald
- Department of Obstetrics, Gynecology and Reproductive Sciences, Royal University Hospital, College of Medicine, University of Saskatchewan, Saskatoon, Saskatchewan, Canada.
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Diaz JA, Booth AJ, Lu G, Wood SC, Pinsky DJ, Bishop DK. Critical role for IL-6 in hypertrophy and fibrosis in chronic cardiac allograft rejection. Am J Transplant 2009; 9:1773-83. [PMID: 19538487 PMCID: PMC2756490 DOI: 10.1111/j.1600-6143.2009.02706.x] [Citation(s) in RCA: 85] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/25/2023]
Abstract
Chronic cardiac allograft rejection is the major barrier to long term graft survival. There is currently no effective treatment for chronic rejection except re-transplantation. Though neointimal development, fibrosis, and progressive deterioration of graft function are hallmarks of chronic rejection, the immunologic mechanisms driving this process are poorly understood. These experiments tested a functional role for IL-6 in chronic rejection by utilizing serial echocardiography to assess the progression of chronic rejection in vascularized mouse cardiac allografts. Cardiac allografts in mice transiently depleted of CD4+ cells that develop chronic rejection were compared with those receiving anti-CD40L therapy that do not develop chronic rejection. Echocardiography revealed the development of hypertrophy in grafts undergoing chronic rejection. Histologic analysis confirmed hypertrophy that coincided with graft fibrosis and elevated intragraft expression of IL-6. To elucidate the role of IL-6 in chronic rejection, cardiac allograft recipients depleted of CD4+ cells were treated with neutralizing anti-IL-6 mAb. IL-6 neutralization ameliorated cardiomyocyte hypertrophy, graft fibrosis, and prevented deterioration of graft contractility associated with chronic rejection. These observations reveal a new paradigm in which IL-6 drives development of pathologic hypertrophy and fibrosis in chronic cardiac allograft rejection and suggest that IL-6 could be a therapeutic target to prevent this disease.
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Affiliation(s)
- J A Diaz
- Department of Surgery, Division of Cardiovascular Medicine, University of Michigan Medical Center, Ann Arbor, MI, USA.
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Pieper GM, Ionova IA, Cooley BC, Migrino RQ, Khanna AK, Whitsett J, Vásquez-Vivar J. Sepiapterin decreases acute rejection and apoptosis in cardiac transplants independently of changes in nitric oxide and inducible nitric-oxide synthase dimerization. J Pharmacol Exp Ther 2009; 329:890-9. [PMID: 19307452 PMCID: PMC2683770 DOI: 10.1124/jpet.108.148569] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/17/2008] [Accepted: 03/18/2009] [Indexed: 12/30/2022] Open
Abstract
Tetrahydrobiopterin (BH(4)), a cofactor of inducible nitric-oxide synthase (iNOS), is an important post-translational regulator of NO bioactivity. We examined whether treatment of cardiac allograft recipients with sepiapterin [S-(-)-2-amino-7,8-dihydro-6-(2-hydroxy-1-oxopropyl)-4-(1H)-pteridinone], a precursor of BH(4), inhibited acute rejection and apoptosis in cardiac transplants. Heterotopic cardiac transplantation was performed in Wistar-Furth donor to Lewis recipient strain rats. Recipients were treated daily after transplantation with 10 mg/kg sepiapterin. Grafts were harvested on post-transplant day 6 for analysis of BH(4) (high-performance liquid chromatography), expression of inflammatory cytokines (reverse transcription- and real-time polymerase chain reaction), iNOS (Western blots), and NO (Griess reaction and NO analyzer). Histological rejection grade was scored, and graft function was determined by echocardiography. Apoptosis, protein nitration, and oxidative stress were determined by immunohistochemistry. Treatment of allografts with sepiapterin increased cardiac BH(4) levels by 3-fold without changing protein levels of GTP cyclohydrolase, the enzyme that regulates de novo BH(4) synthesis. Sepiapterin decreased inflammatory cell infiltrate and significantly inhibited histological rejection scores and apoptosis similar in magnitude to cyclosporine. Sepiapterin also decreased nitrative and oxidative stress. Sepiapterin caused a smaller increase in left ventricular mass versus untreated allografts but without improving fractional shortening. Sepiapterin did not alter tumor necrosis factor-alpha and interferon-gamma expression, whereas it decreased interleukin (IL)-2 expression. Sepiapterin did not change total iNOS protein or monomer levels, or plasma and tissue NO metabolites levels. It is concluded that the mechanism(s) of antirejection are due in part to decreased apoptosis, protein nitration, and oxidation of cardiomyocytes, which seems to be mediated at the immune level by limiting inflammatory cell infiltration via decreased IL-2-mediated T-lymphocyte expansion.
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Affiliation(s)
- Galen M Pieper
- Division of Transplant Surgery, Medical College of Wisconsin, 9200 West Wisconsin Ave., Milwaukee, WI 53226, USA.
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