1
|
Wang R, Moura LAZ, Lopes SV, Costa FDAD, Souza Filho NFS, Fernandes TL, Salvatti NB, Faria-Neto JR. Reduced progression of cardiac allograft vasculopathy with routine use of induction therapy with basiliximab. Arq Bras Cardiol 2015; 105:176-83. [PMID: 26107815 PMCID: PMC4559127 DOI: 10.5935/abc.20150063] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
Abstract
Background Cardiac allograft vasculopathy (CAV) is a major limitation for long-term survival
of patients undergoing heart transplantation (HT). Some immunosuppressants can
reduce the risk of CAV. Objectives The primary objective was to evaluate the variation in the volumetric growth of
the intimal layer measured by intracoronary ultrasound (IVUS) after 1 year in
patients who received basiliximab compared with that in a control group. Methods Thirteen patients treated at a single center between 2007 and 2009 were analyzed
retrospectively. Evaluations were performed with IVUS, measuring the volume of a
coronary segment within the first 30 days and 1 year after HT. Vasculopathy was
characterized by the volume of the intima of the vessel. Results Thirteen patients included (7 in the basiliximab group and 6 in the control
group). On IVUS assessment, the control group was found to have greater vessel
volume (120–185.43 mm3 vs. 127.77–131.32 mm3; p = 0.051). Intimal layer
growth (i.e., CAV) was also higher in the control group (27.30–49.15
mm3 [∆80%] vs. 20.23–26.69 mm3 [∆33%]; p = 0.015).
Univariate regression analysis revealed that plaque volume and prior
atherosclerosis of the donor were not related to intima growth (r = 0.15, p =
0.96), whereas positive remodeling was directly proportional to the volumetric
growth of the intima (r = 0.85, p < 0.001). Conclusion Routine induction therapy with basiliximab was associated with reduced growth of
the intima of the vessel during the first year after HT.
Collapse
|
2
|
Mitchell RN. Graft Vascular Disease: Immune Response Meets the Vessel Wall. ANNUAL REVIEW OF PATHOLOGY-MECHANISMS OF DISEASE 2009; 4:19-47. [DOI: 10.1146/annurev.pathol.3.121806.151449] [Citation(s) in RCA: 123] [Impact Index Per Article: 8.2] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Affiliation(s)
- Richard N. Mitchell
- Department of Pathology, Brigham and Women's Hospital and Harvard Medical School Health Sciences and Technology, Boston, Massachusetts 02115;
| |
Collapse
|
3
|
Steger U, Ensminger S, Bushell A, Wood KJ. Investigation into the onset and progression of transplant arteriosclerosis in a mice aortic retransplantation model. Microsurgery 2008; 28:182-6. [PMID: 18253942 DOI: 10.1002/micr.20477] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
Long-term function of vascularized human organ grafts is often limited by transplant arteriosclerosis and can lead to graft failure. Here, we have analyzed the impact of an initial rejection episode on the later development of transplant arteriosclerosis. Following transplantation of allogeneic abdominal aortic segments in mice, aortic grafts were retransplanted into either immunodeficient or syngeneic recipients. Retransplantation of grafts from immunocompetent into immunodeficient mice as early as 2 days after the primary transplant resulted in intimal proliferation and obstruction of the graft lumen 30 days after the primary transplant. In contrast, retransplantation of the grafts into donor syngeneic B10 recipients within 7 days did not result in the development of transplant arteriosclerosis. These data suggest that the adaptive immune system can induce intimal proliferation by an initial lethal hit that is sustained by the innate response. However our data demonstrate that development of chronic rejection can be inhibited, in this case by retransplantation into a syngeneic host.
Collapse
Affiliation(s)
- Ulrich Steger
- Transplantation Research Immunology Group, Nuffield Department of Surgery, University of Oxford, John Radcliffe Hospital, Headington, Oxford, UK.
| | | | | | | |
Collapse
|
4
|
Hagemeijer MC, van Oosterhout MFM, van Wichen DF, van Kuik J, Siera-de Koning E, Gmelig Meyling FHJ, Schipper MEI, de Jonge N, de Weger RA. T cells in cardiac allograft vasculopathy are skewed to memory Th-1 cells in the presence of a distinct Th-2 population. Am J Transplant 2008; 8:1040-50. [PMID: 18416740 DOI: 10.1111/j.1600-6143.2008.02198.x] [Citation(s) in RCA: 22] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/25/2023]
Abstract
Cardiac allograft vasculopathy (CAV) in heart transplantation (HTx) patients remains the major complication for long-term survival, due to concentric neointima hyperplasia induced by infiltrating mononuclear cells (MNC). Previously, we showed that activated memory T-helper-1 (Th-1) cells are the major component of infiltrating MNC in coronary arteries with CAV. In this study, a more detailed characterization of the MNC in human coronary arteries with CAV (n = 5) was performed and compared to coronary arteries without CAV (n = 5), by investigating MNC markers (CD1a, DRC-1, CD3, CD20, CD27, CD28, CD56, CD68, CD69, FOXP3 and HLA-DR), cytokines (IL-1A, 2, 4, 10, 12B, IFN-gamma, and TGF-beta1), and chemokine receptors (CCR3, CCR4, CCR5, CCR7, CCR8, CXCR3 and CX3CR1) by immunohistochemical double-labeling and quantitative PCR on mRNA isolated from laser microdissected layers of coronary arteries. T cells in the neointima and adventitia of CAV were skewed toward an activated memory Th-1 phenotype, but in the presence of a distinct Th-2 population. FOXP3 positive T cells were not detected and production of most cytokines was low or absent, except for IFN-gamma, and TGF-beta. This typical composition of T-helper cells and especially production of IFN-gamma and TGF-beta may play an important role in the proliferative CAV reaction.
Collapse
Affiliation(s)
- M C Hagemeijer
- Department of Pathology, University Medical Center Utrecht, The Netherlands
| | | | | | | | | | | | | | | | | |
Collapse
|
5
|
Marui T, Iwata H, Shirahashi K, Matsumoto S, Mizuno Y, Matsui M, Takemura H. Histologic damage of lung allografts according to magnitude of acute rejection in the re-isotransplant model. J Heart Lung Transplant 2008; 27:642-8. [PMID: 18503964 DOI: 10.1016/j.healun.2008.03.012] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/31/2007] [Revised: 03/03/2008] [Accepted: 03/12/2008] [Indexed: 10/22/2022] Open
Abstract
BACKGROUND Graft damage due to acute rejection has been reported as one of the risk factors in the chronic stage of cardiac and renal allografts. This study was designed to elucidate the histologic changes of grafts after ongoing acute allograft rejection was discontinued in models of lung re-isotransplantation. METHODS WKAH rat lungs were orthotopically transplanted into F344 recipients. Three days (3A group) and 5 days (5A group) after the first allotransplantation, the grafts were re-isotransplanted back into the WKAH rats (3RA and 5RA groups, respectively). Five days (5I group) after the first isotransplantation, the grafts were re-isotransplanted back into the WKAH rats (5RI group). The grafts were removed 30 and 60 days after re-isotransplantation and assessed histologically. RESULTS Typical acute allograft rejection developed in the 3A and 5A groups, and the changes were reduced after re-isotransplantation, although they remained significantly greater in the 5RA group than in the 3RA and 5RI groups. For intimal hyperplasia, the graft score 60 days after re-isotransplantation in the 5RA group was significantly higher than in the 5RI and 3RA groups. The changes in airway inflammation were significantly greater in the 5RA group than in the 3RA and 5RI groups at 60 days. Peribronchiolar fibrosis was significantly more frequent in the 5RA and 3RA groups than in the 5RI group. CONCLUSIONS Acute rejection and airway inflammation corresponded to the magnitude of rejection before retransplantation. Significant intimal hyperplasia developed in severe acute rejection, and peribronchiolar fibrosis occurred after the first acute rejection.
Collapse
Affiliation(s)
- Tsutomu Marui
- Department of General and Cardiothoracic Surgery, Graduate School of Medicine, Gifu University, Gifu, Japan.
| | | | | | | | | | | | | |
Collapse
|
6
|
Ito T, Shimada K, Gang M, Uchikoshi F, Tori M, Komoda H, Fumimoto Y, Ohmori K, Kawamoto K, Tanemura M, Nozawa M. Pancreas transplantation using type I and type II spontaneously diabetic rats--our experimental experience. Microsurgery 2007; 27:305-11. [PMID: 17477403 DOI: 10.1002/micr.20361] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
Pancreas transplantation (PTx) is the only therapy that can cure type 1 diabetes mellitus. With the recent advance of surgical procedures and immunosuppression, the outcome of PTx has become better than it used to be before, but some problems still remain. It is rather difficult to induce tolerance and to reverse rejection once it occurred because pancreas graft itself has a strong immunogenicity. Another important issue is regarding the recurrence of autoimmune disease in the pancreatic graft, therefore, some animal models are necessary to delineate and regulate those immune responses specific for PTx. Recently, PTx is also clinically applicable for type 2 diabetic patients with end-stage renal disease. It has been shown that insulin resistance was improved by PTx in type 2 diabetic recipients. In the current study, we have introduced some useful type 1 and type 2 diabetic models mainly based on our experimental experiences.
Collapse
MESH Headings
- Age Factors
- Animals
- Diabetes Mellitus, Type 1/immunology
- Diabetes Mellitus, Type 1/pathology
- Diabetes Mellitus, Type 1/surgery
- Diabetes Mellitus, Type 2/immunology
- Diabetes Mellitus, Type 2/pathology
- Diabetes Mellitus, Type 2/surgery
- Disease Models, Animal
- Feasibility Studies
- Glucose/analysis
- Glucose Tolerance Test
- Graft Survival
- Islets of Langerhans/cytology
- Islets of Langerhans/physiology
- Pancreas Transplantation/immunology
- Pancreas Transplantation/methods
- Rats
- Rats, Inbred BB
- Rats, Mutant Strains
- Regeneration/physiology
- Transplantation, Isogeneic
Collapse
Affiliation(s)
- Toshinori Ito
- Department of Complementary and Alternative Medicine, Osaka University Graduate School of Medicine, Osaka, Japan.
| | | | | | | | | | | | | | | | | | | | | |
Collapse
|
7
|
Hirashima Y, Kitajima K, Sugi S, Kagawa K, Kumamoto T, Murakami K, Fujioka T, Noguchi T. [Successful bi-weekly paclitaxel treatment of an AFP-producing gastric cancer patient with peritoneal dissemination and multiple liver metastasis]. Gan To Kagaku Ryoho 2006; 33:517-9. [PMID: 16612165 DOI: 10.2217/14750708.3.4.517] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
Abstract
The patient was a 71-year-old man. Chemotherapy was conducted in two courses combining TS-1 (120 mg) and CDDP (80 mg) under the diagnosis of AFP-producing gastric cancer with multiple liver metastasis and peritoneal dissemination. Peritoneal dissemination disappeared, liver metastasis almost disappeared after completion of two courses, and the therapeutic efficacy was rated as PR. Then, the patient underwent distal gastrectomy and lymph node dissection. He received TS-1 monotherapy after surgery, but his condition gradually became worse. TS-1 and CDDP combination were given again, but an ileus resulted due to peritonitis carcinomatous. We therefore administered bi-weekly paclitaxel (80 mg/m(2)) intravenously. The ileus disappeared after one week, liver metastatic lesions and ascites were improved after completion of one course, and therapeutic efficacy was rated as PR. Grade 3 neutropenia and grade 1 alopecia occurred, but no other adverse reaction occurred. This therapy made it possible to eat foods, conduct chemotherapy safely while ambulatory. Paclitaxel can be expected to show good therapeutic efficacy and improve QOL of a peritonitis carcinomatosa patient with TS-1 resistant advanced gastric cancer.
Collapse
|
8
|
Memon IA, Sawa Y, Fukushima N, Matsumiya G, Miyagawa S, Taketani S, Sakakida SK, Kondoh H, Aleshin AN, Shimizu T, Okano T, Matsuda H. Repair of impaired myocardium by means of implantation of engineered autologous myoblast sheets. J Thorac Cardiovasc Surg 2005; 130:1333-41. [PMID: 16256786 DOI: 10.1016/j.jtcvs.2005.07.023] [Citation(s) in RCA: 270] [Impact Index Per Article: 14.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/10/2005] [Revised: 07/17/2005] [Accepted: 07/19/2005] [Indexed: 12/12/2022]
Abstract
OBJECTIVES Autologous skeletal myoblast cell transplantation by means of the injection method is subject to the loss of intercellular communication, extracellular matrix, and cell numbers. We hypothesize that the implantation of skeletal myoblast cell sheets might be more advantageous in repairing the impaired heart by providing uniform and stable cell delivery with less cell loss and without disrupting the cell-cell microenvironment. METHODS Left anterior descending coronary artery-ligated Lewis rat hearts (2 weeks, total n = 173) received 1 x 10(7) autologous skeletal myoblasts by means of cell transplantation either through myoblast injection or implantation of 2 monolayer-constructed myoblast sheets (5 x 10(6) cells per sheet) or through medium injection. Myoblast sheets were constructed with temperature-responsive, polymer-grafted cell-culture dishes, which release the confluent cells from the dish surface at less than 20 degrees C. RESULTS Echocardiographic results indicated higher improvement of cardiac performance in the myoblast sheet group than among the other groups until 8 weeks after cell transplantation. Histologic comparison revealed greater cellularity and abundant widespread neocapillaries within the noticeable uniform thickened wall in myoblast sheet group hearts only. Fibrosis was substantially reduced with skeletal myoblast sheet implantation compared with skeletal myoblast cell injection. Obviously higher numbers of hematopoietic stem cells (c-kit, stem cell antigen 1, and CD34) were observed in the myoblast sheet group infarct heart region. Reverse transcription-polymerase chain reaction results showed expression of stromal-derived factor 1, hepatocyte growth factor, and vascular endothelial growth factor as follows: myoblast sheets > myoblast injection > control. CONCLUSIONS Myoblast sheets repaired the impaired myocardium, reduced fibrosis, and prevented remodeling in association with recruitment of hematopoietic stem cells through the release of stromal-derived factor 1 and other growth factors. Our experiment indicates a therapy for patients with severe heart failure.
Collapse
Affiliation(s)
- Imran A Memon
- Division of Cardiovascular Surgery, Department of Surgery, Osaka University Graduate School of Medicine, Suita, Osaka, Japan.
| | | | | | | | | | | | | | | | | | | | | | | |
Collapse
|
9
|
Kitagawa-Sakakida S, Fukushima N, Sawa Y, Horiguchi K, Doi T, Shirakura R, Matsuda H. Microarray-based Gene Expression Profiling of Retransplanted Rat Cardiac Allografts That Develop Cardiac Allograft Vasculopathy. J Heart Lung Transplant 2005; 24:2068-74. [PMID: 16364851 DOI: 10.1016/j.healun.2005.06.004] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/23/2004] [Revised: 06/01/2005] [Accepted: 06/07/2005] [Indexed: 11/17/2022] Open
Abstract
We studied the expression of 9,906 genes in retransplanted rat cardiac allografts that developed cardiac allograft vasculopathy (CAV) with the use of DNA microarray and real-time reverse transcriptase-polymerase chain reaction. Although only a slight difference in the timing of the retransplantation induced the later development of CAV, 1,067 genes were differentially expressed in the allografts 1 day after retransplantation. Thus, the development of CAV was determined by a robust difference in gene expression soon after retransplantation, controlled by a slight difference in retransplantation timing. In contrast, only 26 genes showed significant upregulation in the later phase of CAV development, and the time-course of the induction of 16 genes was associated with CAV progression. Of these genes, 8 were induced in 2 different aortic allograft combinations, and the time-course of the induction was correlated with the development of transplant vasculopathy. Microarray-based gene expression profiling has the potential to elucidate the mechanism of experimental chronic cardiac allograft rejection.
Collapse
Affiliation(s)
- Satoru Kitagawa-Sakakida
- Department of Molecular Pharmacology, Osaka University Graduate School of Medicine, Suita, Osaka, Japan.
| | | | | | | | | | | | | |
Collapse
|
10
|
George JF, Pinderski LJ, Litovsky S, Kirklin JK. Of Mice and Men: Mouse Models and the Molecular Mechanisms of Post-transplant Coronary Artery Disease. J Heart Lung Transplant 2005; 24:2003-14. [PMID: 16364842 DOI: 10.1016/j.healun.2005.06.008] [Citation(s) in RCA: 17] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/14/2005] [Revised: 06/01/2005] [Accepted: 06/17/2005] [Indexed: 01/19/2023] Open
Affiliation(s)
- James F George
- Division of Cardiothoracic Surgery, Department of Surgery, The University of Alabama at Birmingham, Birmingham, Alabama 35294-0007, USA.
| | | | | | | |
Collapse
|
11
|
Kelemen SE, Autieri MV. Expression of allograft inflammatory factor-1 in T lymphocytes: a role in T-lymphocyte activation and proliferative arteriopathies. THE AMERICAN JOURNAL OF PATHOLOGY 2005; 167:619-26. [PMID: 16049345 PMCID: PMC1603575 DOI: 10.1016/s0002-9440(10)63003-9] [Citation(s) in RCA: 44] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/22/2022]
Abstract
Allograft inflammatory factor (AIF)-1 is a cytoplasmic, calcium-binding protein whose expression in transplanted human hearts correlates with rejection and development of coronary artery vasculopathy (CAV). AIF-1 is constitutively expressed in monocytes/macrophages, but its expression in human lymphocytes has not been described. After immunohistochemical analysis of human coronary arteries with CAV, we identified AIF-1 expression in CD3-positive lymphocytes. AIF-1 was differentially expressed in peripheral blood mononuclear cells and in the T-lymphoblastoid MOLT-4 cell line exposed to various cytokines, suggesting a role for AIF-1 in T-lymphocyte activation. To determine AIF-1 function, MOLT-4 cells were stably transduced by AIF-1 retrovirus. Overexpression of AIF-1 in these cells led to a 238% increase in cell number compared to empty vector controls. AIF-1 polymerized nonmuscle actin and MOLT-4 cells overexpressing AIF-1 migrated 95% more rapidly than empty vector controls. Primary human vascular smooth muscle cells cultured in conditioned media from AIF-1-transduced MOLT-4 cells proliferated 99% more rapidly than vascular smooth muscle cells cultured in conditioned media from empty vector-transduced MOLT-4 cells. These data indicate that AIF-1 is expressed in activated T lymphocytes, that its expression enhances activation of lymphocytes, and that AIF-1 expression in activated lymphocytes may have important ramifications for activation of adjacent arterial vascular smooth muscle cells and development of CAV.
Collapse
Affiliation(s)
- Sheri E Kelemen
- Department of Cardiology, Cardiovascular Research Center, Temple University School of Medicine, Philadelphia PA 19140, USA
| | | |
Collapse
|
12
|
Lai JCK, Tranfield EM, Walker DC, Dyck J, Kerjner A, Loo S, English D, Wong D, McDonald PC, Moghadasian MH, Wilson JE, McManus BM. Ultrastructural evidence of early endothelial damage in coronary arteries of rat cardiac allografts. J Heart Lung Transplant 2003; 22:993-1004. [PMID: 12957609 DOI: 10.1016/s1053-2498(02)01163-4] [Citation(s) in RCA: 25] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022] Open
Abstract
BACKGROUND Events that occur early after transplantation, particularly immune recognition of allo-endothelium, initiate transplant vascular disease (TVD). Previous work suggests an important compromise of endothelial integrity as the allo-immune milieu evolves, although mechanisms by which integrity is altered remain unclear. Increased vascular permeability caused by endothelial damage may allow inflammatory cells, lipoproteins, other proteins, and plasma fluid to enter the sub-endothelial space, thereby contributing to the initiation of atherosclerosis. In this study, we examined endothelial integrity in coronary arteries and the proximal aorta after cardiac transplantation in rats. METHODS We used Lewis-to-Lewis and Lewis-to-F344 rat heterotopic cardiac transplant models. We studied the effects of cyclosporine (5mg/kg/day) therapy compared with saline-treated controls. En face silver nitrate staining was performed to demonstrate endothelial cell borders and gaps. We used scanning electron microscopy to extend silver nitrate findings and to further define the presence and nature of endothelial disruptions. We used transmission electron microscopy to further characterize immune cell identity and interaction with endothelium. RESULTS Syngrafts and cyclosporine-treated allografts showed normal-looking endothelium similar to that observed in arteries from native hearts. However, saline-treated allografts displayed progressive endothelial destruction, including large intercellular gaps, missing cells, and areas of bare extracellular matrix. Exfoliated surfaces were covered by platelets at various stages of adhesion, activation, and spreading. Similarly, we observed numerous leukocytes as either adherent to the endothelial lining or transmigrating into the sub-endothelial space. Cessation of cyclosporine therapy was associated with the development of similar abnormalities. CONCLUSIONS Our findings indicate that, especially when immunosuppression is insufficient, early endothelial damage may promote vascular permeability and thereby initiate TVD.
Collapse
Affiliation(s)
- John C K Lai
- University of British Columbia McDonald Research Laboratories, iCAPTUR4E Centre, Department of Pathology and Laboratory Medicine, St. Paul's Hospital, Providence Health Care, Vancouver, British Columbia, Canada
| | | | | | | | | | | | | | | | | | | | | | | |
Collapse
|
13
|
Ito T, Uchikoshi F, Tori M, Miao G, Tanaka S, Maeda A, Akamaru Y, Matsuda H, Nozawa M. Immunological characteristics of pancreas transplantation: review and our experimental experience. Pancreas 2003; 27:31-7. [PMID: 12826903 DOI: 10.1097/00006676-200307000-00005] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/10/2022]
Abstract
Pancreas and islet transplantation is the only treatment that can cure type 1 diabetes mellitus (DM). With the recent advances of operative procedure and immunosuppression, pancreas graft survivals have become better than before, but some problems still remain. It is extremely difficult to establish tolerance and to reverse rejection once it has been initiated because the pancreas graft itself has a strong immunogenicity. It is also known that pancreatic graft failure is sometimes due to autoimmune recurrence. In the clinical situation, however, these immunologic events actually coexist within the pancreatic graft. Thus, it is rather difficult to analyze each of them independently, but possible to delineate each of these immunologic mechanisms with using animal models of type 1 DM such as BB (BioBreeding) rats or NOD (nonobese diabetic) mice. In the current study, we reviewed the immunological characteristics in pancreas transplantation (PTx) based on our experimental experiences together with that of others and investigated the possibility of tolerance induction in PTx.
Collapse
Affiliation(s)
- Toshinori Ito
- Department of Surgery (E1), Osaka University Graduate School of Medicine, Osaka, Suita, Japan.
| | | | | | | | | | | | | | | | | |
Collapse
|
14
|
Horiguchi K, Kitagawa-Sakakida S, Sawa Y, Li ZZ, Fukushima N, Shirakura R, Matsuda H. Selective chemokine and receptor gene expressions in allografts that develop transplant vasculopathy. J Heart Lung Transplant 2002; 21:1090-100. [PMID: 12398874 DOI: 10.1016/s1053-2498(02)00443-6] [Citation(s) in RCA: 42] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022] Open
Abstract
BACKGROUND Chemokine systems probably play a role in transplant vasculopathy; however, a comprehensive study of the expression of chemokines and their receptors in this disease has not been performed. METHODS The expression of all the rat chemokines and chemokine receptor genes for which the nucleotide sequences are known were quantitatively monitored using the fluorescence-based real-time reverse-transcriptase polymerase chain reaction technique, and selected cytokine-receptor pairs were determined using immunohistochemical staining. The analysis covered the whole time course of transplant vasculopathy in 2 different graft models (cardiac and aortic grafts) with 4 different strain combinations of rats. RESULTS Among the 13 receptor genes examined, the CXCR3, CCR5, and CCR2 genes and those of their corresponding ligands were selectively and strongly induced in grafts that develop transplant vasculopathy. The expression patterns of the receptors were similar in both cardiac and aortic allografts, although their induction and their absolute levels of expression were amplified several fold in the grafted aorta compared with heart grafts. The genes were induced before morphologic changes became apparent and expression was sustained during the whole period of neointimal formation. Interestingly, immunohistochemical staining for CXCR3 showed a unique pattern of expression: we found weak expression on cells in the outer layer of the neointima and adventitia and found the strongest staining in the innermost layer of the neointima. CONCLUSIONS This study suggested diagnostic as well as potential functional roles of the chemokine-receptor pairs IP10-CXCR3, RANTES-CCR5, and MCP1-CCR2 in rat models of transplant vasculopathy.
Collapse
Affiliation(s)
- Kei Horiguchi
- Department of Surgery, Osaka University Graduate School of Medicine, Yamadaoka, Suita, Japan
| | | | | | | | | | | | | |
Collapse
|
15
|
Hadidi S, Chen Z, Phillips J, Yu K, Gorczynski RM. Antisense deoxyoligonucleotides or antibodies to murine MD-1 inhibit rejection of allogeneic and xenogeneic skin grafts in C3H mice. Transplantation 2002; 73:1771-9. [PMID: 12085000 DOI: 10.1097/00007890-200206150-00013] [Citation(s) in RCA: 14] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
BACKGROUND Altered expression of murine MD-1, a molecule controlling expression of members of the interleukin (IL)-1 receptor family of signaling proteins, regulates antigen-presenting cell-induced alloreactions. We investigated the effect of treatment with antisense deoxyoligonucleotides or antibodies to MD-1 in vivo on allogeneic and xenogeneic skin graft survival and the immune responses in transplanted mice. METHODS C3H mice received C57BL/6 or Lewis rat skin grafts, followed by i.v. injections of anti-MD-1 antibody or antisense oligonucleotides or control reagents at 48-hr intervals. Survival was monitored. In separate studies, mice were sacrificed at 5-day intervals. Serum was analyzed for circulating MD-1 antigen, and peritoneal cells for surface expression of MD-1. The proliferative and cytolytic response of lymphocytes harvested from treated animals and restimulated in vitro with allo- or xenogeneic cells, and the cytokines produced, was measured. Graft histology was assessed at 11 days after transplantation. RESULTS Treatment with anti-MD-1 oligonucleotides or antibodies suppressed rejection of both xeno- and allogeneic grafts, decreased induction of graft-specific cytotoxic T cells, increased production of type-2 cytokines (IL-4 and IL-10), and decreased production of type-1 cytokines (IL-2 and interferon-gamma). Serum levels of MD-1 were suppressed, as was expression of MD-1 on the surface of antigen-presenting cells. Grafts from MD-1-treated mice showed little lymphocyte infiltration, and no signs of graft necrosis. CONCLUSION Our data suggest a critical in vivo role for MD-1 expression in regulating graft rejection, as well as in the concomitant sensitization of T cells and their cytokine production profile, which parallels the rejection response.
Collapse
MESH Headings
- Animals
- Antibodies, Monoclonal/pharmacology
- Antigens, Surface/blood
- Antigens, Surface/genetics
- Antigens, Surface/immunology
- Cell Division/immunology
- Gene Expression/immunology
- Graft Rejection/immunology
- Graft Rejection/prevention & control
- Graft Rejection/therapy
- Graft Survival/immunology
- Interferon-gamma/biosynthesis
- Interleukin-4/biosynthesis
- Macrophages, Peritoneal/immunology
- Male
- Membrane Glycoproteins
- Mice
- Mice, Inbred BALB C
- Mice, Inbred C3H
- Mice, Inbred C57BL
- Oligodeoxyribonucleotides, Antisense/pharmacology
- RNA, Messenger/analysis
- Skin Transplantation/immunology
- Spleen/cytology
- T-Lymphocytes/immunology
- T-Lymphocytes/metabolism
- Transplantation, Heterologous
- Transplantation, Homologous
Collapse
Affiliation(s)
- Sima Hadidi
- Toronto General Hospital, Transplant Research Division, 200 Elizabeth Street, Toronto, M5G 2C4 Ontario, Canada
| | | | | | | | | |
Collapse
|
16
|
Abstract
Chronic allograft nephropathy remains the main cause of renal graft failure. Immunologic mechanisms seem mostly responsible for the injury and subsequent fibrogenic tissue response while nonimmune mechanisms act mostly as progression factors. In this article, these factors are reviewed along with the changes that take place in the graft and new insights into possible therapeutic strategies.
Collapse
Affiliation(s)
- Leendert C Paul
- Department of Nephrology, Leiden University Medical Center, Leiden, The Netherlands.
| |
Collapse
|
17
|
Cantin B, Wen P, Zhu D, Dai M, Panchal SN, Billingham ME, Gwathmey JK, Valantine HA. Transplant coronary artery disease: a novel model independent of cellular alloimmune response. Circulation 2001; 104:2615-9. [PMID: 11714659 DOI: 10.1161/hc4601.099398] [Citation(s) in RCA: 17] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
BACKGROUND Allograft coronary atherosclerosis (TxCAD) is the leading cause of death after the first year after transplantation. TxCAD is believed to be a form of chronic rejection of the cardiac allografts. This study was undertaken to determine whether TxCAD could develop in the absence of a cellular alloimmune response. METHODS AND RESULTS Inbred lean Zucker rats (>26 generations) served as donors and recipients of the cardiac grafts. Donor hearts were explanted at 60 or 90 days. Explanted hearts were processed for coronary artery histological analysis. Cytokine expression was determined by reverse transcription-polymerase chain reaction, and the presence of T cells within the explanted hearts was evaluated by immunohistochemistry. Forty-six transplantations were made, and TxCAD developed in all but one of the transplanted hearts. Overall, one third of the vessels examined were affected by TxCAD, and in roughly half of these vessels, the disease was severe. Native hearts were free of atherosclerosis. Interleukin-2 was absent from the transplanted hearts, and T cells were present in minimal amounts (<1 per low-power field). CONCLUSIONS TxCAD developed in the absence of a cellular alloimmune response in these genetically similar donors and recipients. The observed TxCAD was significant and comparable to what is found in rat allografting models.
Collapse
Affiliation(s)
- B Cantin
- Division of Cardiovascular Medicine, Department of Pathology, Stanford University School of Medicine, Stanford, California, USA
| | | | | | | | | | | | | | | |
Collapse
|
18
|
Nikolova Z, Hof A, Baumlin Y, Hof RP. Combined FTY720/cyclosporine A treatment promotes graft survival and lowers the peripheral lymphocyte count in DA to lewis heart and skin transplantation models. Transpl Immunol 2001; 8:267-77. [PMID: 11316070 DOI: 10.1016/s0966-3274(01)00031-4] [Citation(s) in RCA: 22] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/01/2023]
Abstract
OBJECTIVE The immunomodulator, FTY720, lowers the peripheral lymphocyte count (PLC) by inducing migration of circulating lymphocytes to secondary lymphoid organs. We investigated the efficacy of mono- vs. combined-FTY720/CsA therapy on graft survival (GS) and on lowering the PLC in a solid organ and a skin graft model, using strains with strong MHC disparity. METHODS Heterotopic cardiac or tail skin grafting was performed using the DA (RT1a) to Lewis (RT1(1)) rat strain combination. FTY720 was administered as a single daily dose by gavage alone or in combination with subcutaneously delivered CsA. PLC, body weight and drug concentrations were determined on day 7, 28, or the day of rejection. MAIN FINDINGS In placebo-treated animals the heart and skin allografts rejected after 6 and 8 days. FTY720 delayed rejection of both the solid organ and skin grafts. The maximal effect was achieved at 1 mg x kg(-l) x day(-1) FTY720, resulting in a median survival time (MST) of 14 days for both allotransplants comparable to the effect achieved by 1 mg x kg x day(-1) CsA in both models. In the cardiac graft experiment with CsA co-administration, doses of 0.3 and 1 mg/kg were used. Under these conditions very small doses of FTY720 were effective in maintaining grafts throughout the treatment period. Adding higher FTY720 doses to the 1 mg x kg(-1) x day(-1) CsA was needed to effectively extend the skin GS, e.g. 0.3 mg x kg(-l) x day(-1) FTY720 prolonged GS from 13 to 47.5 days MST, i.e. well beyond the 28 day-treatment period. CsA did not influence the PLC at clinically relevant doses. FTY720 lowered the PLC significantly and dose-dependently, at doses lower than those needed for the prolongation of both cardiac and skin GS with FTY720 monotherapy. In rats with skin grafts the PLC was markedly lowered up to 1 mg x kg(-1) x day(-1) FTY720, whereas, in the heart model, it was lowered up to 0.1 mg x kg(-1) x day(-1). Independently of the graft type, within the combination regimens 0.3 mg x kg(-1) x day(-1) FTY720 achieved a maximal PLC depletion. CONCLUSIONS Combining FTY720 and CsA was very well tolerated with respect to weight gain and lack of any clinically detectable infections. In the strain combination used FTY720 monotherapy was less effective than previously reported in maintaining grafts. The two-drug regimens extended strikingly the GS for both models. However, the prolongation of the heart GS was smoothly dose-related with FTY720 doses ranging from 0.01 to 1 mg x kg(-1) x day(-1) , whereas, the skin graft prolongation was modest at doses up to 0.1 mg x kg(-1) x day(-1) and remarkably enhanced at 0.3 and 1 mg x kg(-1) x day(-1) FTY720.
Collapse
MESH Headings
- Adjuvants, Immunologic/administration & dosage
- Adjuvants, Immunologic/blood
- Adjuvants, Immunologic/pharmacology
- Adjuvants, Immunologic/therapeutic use
- Animals
- Body Weight/drug effects
- Cyclosporine/administration & dosage
- Cyclosporine/blood
- Cyclosporine/pharmacology
- Cyclosporine/therapeutic use
- Dose-Response Relationship, Drug
- Drug Evaluation, Preclinical
- Drug Synergism
- Drug Therapy, Combination
- Fingolimod Hydrochloride
- Graft Rejection/prevention & control
- Graft Survival/drug effects
- Heart Transplantation/immunology
- Histocompatibility Antigens/immunology
- Immunosuppressive Agents/administration & dosage
- Immunosuppressive Agents/blood
- Immunosuppressive Agents/pharmacology
- Immunosuppressive Agents/therapeutic use
- Lymphocyte Count
- Male
- Models, Animal
- Propylene Glycols/administration & dosage
- Propylene Glycols/blood
- Propylene Glycols/pharmacology
- Propylene Glycols/therapeutic use
- Rats
- Rats, Inbred Lew
- Rats, Inbred Strains
- Skin Transplantation/immunology
- Sphingosine/analogs & derivatives
Collapse
Affiliation(s)
- Z Nikolova
- Novartis Pharma Research, Nocartis Pharma AG, Basel, Switzerland
| | | | | | | |
Collapse
|