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Garry DJ, Weiner JI, Greising SM, Garry MG, Sachs DH. Mechanisms and strategies to promote cardiac xenotransplantation. J Mol Cell Cardiol 2022; 172:109-119. [PMID: 36030840 DOI: 10.1016/j.yjmcc.2022.07.013] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/19/2022] [Revised: 06/21/2022] [Accepted: 07/31/2022] [Indexed: 12/14/2022]
Abstract
End stage heart failure is a terminal disease, and the only curative therapy is orthotopic heart transplantation. Due to limited organ availability, alternative strategies have received intense interest for treatment of patients with advanced heart failure. Recent studies using gene-edited porcine organs suggest that cardiac xenotransplantation may provide a future source of organs. In this review, we highlight the historical milestones for cardiac xenotransplantation and the gene editing strategies designed to overcome immunological barriers, which have culminated in a recent cardiac pig-to-human xenotransplant. We also discuss recent results of studies on the engineering of human-porcine chimeric organs that may provide an alternative and complementary strategy to overcome some of the major immunological barriers to producing a new source of transplantable organs.
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Affiliation(s)
- Daniel J Garry
- Cardiovascular Division, Department of Medicine, University of Minnesota, Minneapolis, MN 55455, United States of America; Stem Cell Institute, University of Minnesota, Minneapolis, MN 55455, United States of America; Lillehei Heart Institute, University of Minnesota, Minneapolis, MN 55455, United States of America; NorthStar Genomics, Eagan, MN, United States of America.
| | - Joshua I Weiner
- Departments of Surgery, Columbia Center for Translational Immunology, Vagelos College of Physicians and Surgeons, Columbia University, New York, NY, United States of America
| | - Sarah M Greising
- School of Kinesiology, University of Minnesota, Minneapolis, MN 55455, United States of America
| | - Mary G Garry
- Cardiovascular Division, Department of Medicine, University of Minnesota, Minneapolis, MN 55455, United States of America; Stem Cell Institute, University of Minnesota, Minneapolis, MN 55455, United States of America; Lillehei Heart Institute, University of Minnesota, Minneapolis, MN 55455, United States of America; NorthStar Genomics, Eagan, MN, United States of America
| | - David H Sachs
- Departments of Surgery, Columbia Center for Translational Immunology, Vagelos College of Physicians and Surgeons, Columbia University, New York, NY, United States of America; Department of Surgery, Massachusetts General Hospital, Boston, MA, United States of America
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Condello I, Condello S. The relationship between the xenotransplantation limitations and Charles Darwin theory on human evolution. ACTA BIO-MEDICA : ATENEI PARMENSIS 2020; 92:e2021004. [PMID: 33682845 PMCID: PMC7975927 DOI: 10.23750/abm.v92i1.10215] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Download PDF] [Subscribe] [Scholar Register] [Received: 07/13/2020] [Accepted: 07/14/2020] [Indexed: 11/23/2022]
Affiliation(s)
- Ignazio Condello
- Department of Cardiac Surgery, Anthea Hospital, GVM Care and Research, Bari, Italy.
| | - Salvatore Condello
- Neuromotor Rehabilitation Unit, Istituti Clinici Scientifici, Maugeri SPA, Ribera, Italy..
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Feng Y, Wang W. In vivo confocal microscopic observation of lamellar corneal transplantation in the rabbit using xenogenic acellular corneal scaffolds as a substitute. Chin Med J (Engl) 2015; 128:933-40. [PMID: 25836615 PMCID: PMC4834011 DOI: 10.4103/0366-6999.154301] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/26/2023] Open
Abstract
BACKGROUND The limiting factor to corneal transplantation is the availability of donors. Research has suggested that xenogenic acellular corneal scaffolds (XACS) may be a possible alternative to transplantation. This study aimed to investigate the viability of performing lamellar corneal transplantation (LCT) in rabbits using canine XACS. METHODS Fresh dog corneas were decellularized by serial digestion, and LCT was performed on rabbit eyes using xenogeneic decellularized corneal matrix. Cellular and morphological changes were observed by slit-lamp, light, and scanning electron microscopy at 7, 30 and 90 days postoperatively. Immunocytochemical staining for specific markers such as keratin 3, vimentin and MUC5AC, was used to identify cells in the graft. RESULTS Decellularized xenogenic corneal matrix remained transparent for about 1-month after LCT. The recipient cells were able to survive and proliferate into the grafts. Three months after transplantation, grafts had merged with host tissue, and graft epithelialization and vascularization had occurred. Corneal nerve fibers were able to grow into the graft in rabbits transplanted with XACS. CONCLUSIONS Xenogenic acellular corneal scaffolds can maintain the transparency of corneal grafts about 1-month and permit growth of cells and nerve fibers, and is, therefore, a potential substitute or carrier for a replacement cornea.
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Affiliation(s)
| | - Wei Wang
- Department of Ophthalmology, Peking University Third Hospital, Peking University Eye Center, Beijing 100191, China
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Nishimura T, Onda M, Takao S. CD4+ CD25+ regulatory T cells suppressed the indirect xenogeneic immune response mediated by porcine epithelial cell pulsed dendritic cells. Xenotransplantation 2010; 17:313-23. [PMID: 20723203 DOI: 10.1111/j.1399-3089.2010.00599.x] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022]
Abstract
BACKGROUND CD4(+) CD25(+) regulatory T cells have been reported to suppress T cell-mediated xenogeneic immune responses. Although the direct T cell response to xenogeneic cells is important, the indirect xenogeneic immune response mediated by dendritic cells (DCs) is also likely involved in rejection. We have generated an in vitro indirect immune reaction model and evaluated the effect of CD4(+) CD25(+) regulatory T cells on this system. METHODS Human DCs were generated from peripheral blood and cultured with X-ray-irradiated porcine kidney epithelial cells. Porcine cell-pulsed DCs were mixed with autologous CD4(+) T cells, CD4(+) CD25(-) T cells and/or CD4(+) CD25(+) T cells. After 7 days of culture, T cell proliferation was measured. RESULTS The co-culture of human DCs and X-ray-irradiated porcine epithelial cells resulted in observable DC phagocytic activity within 2 days. These porcine cell-pulsed DCs stimulated CD4(+) T cell proliferation much more potently than unpulsed DCs or porcine cells. This proliferation was blocked by CTLA4-Ig or an anti-HLA-DR antibody. CD4(+) CD25(+) regulatory T cells also suppressed CD4(+) CD25(-) T cell proliferation in response to porcine cell-pulsed DCs. CONCLUSIONS An in vitro model of the indirect xenogeneic immune response was established. Porcine cell-pulsed DCs stimulated CD4(+) T cells, and CD4(+) CD25(+) regulatory T cells suppressed this response.
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Affiliation(s)
- Toshihide Nishimura
- Department of Immunology, Graduate School of Medical and Dental Sciences, Kagoshima University, Sakuragaoka, Kagoshima-shi, Kagoshima, Japan.
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Abstract
OBJECTIVES Streptozotocin (STZ) has been widely used to induce diabetes in rodents and nonhuman primates, but it has been found difficult to achieve a completely diabetic state in pigs in the absence of detrimental side effects. As a result, pancreatectomy has been advocated in this species. We have investigated the effects of 2 dosages of STZ to safely induce diabetes in pigs. METHODS Three pigs received Zanosar STZ at 150 mg/kg (group 1). Four pigs received Zanosar STZ at 200 mg/kg (group 2). The levels of glucose, insulin, and C-peptide when (a) fasting, (b) 30 minutes after eating, and (c) during intravenous glucose tolerance tests (IVGTTs) were measured in all pigs for 4 weeks after STZ injection. To confirm how long the diabetic state can be maintained after induction with STZ, levels were measured for 20 weeks in group 2. RESULTS One to 4 weeks after STZ administration, in group 1 (150 mg/kg) pigs, insulin and C-peptide levels were detected up to 7 microIU/mL and 0.4 ng/mL, respectively, both when fasting and after a meal test or IVGTT, indicating that the pigs had failed to become fully diabetic. In group 2 (200 mg/kg) pigs, insulin and C-peptide levels were less than the 2 microIU/mL and 0.25 ng/mL respective detection levels and did not increase after a meal test or IVGTT. Group 2 remained completely diabetic for the entire 20-week period of follow-up, without STZ-related hepatic or renal dysfunction. CONCLUSIONS High-dose (200 mg/kg) Zanosar STZ induces diabetes safely and completely in pigs without side effects. Pancreatectomy can, therefore, be avoided.
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Armstrong SR, Campbell GR, Campbell JH, Little MH. Establishment of Metanephros Transplantation in Mice Highlights Contributions by Both Nephrectomy and Pregnancy to Developmental Progression. ACTA ACUST UNITED AC 2005; 101:e155-64. [PMID: 16131810 DOI: 10.1159/000087939] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/22/2004] [Accepted: 06/08/2005] [Indexed: 11/19/2022]
Abstract
BACKGROUND It has been demonstrated that embryonic kidneys (metanephroi) xenotransplanted into the omentum of adult recipients continue to develop and display immune protection due to their more naïve immune presentation. To date, this has been achieved using rat, pig and human metanephroi, with unilateral nephrectomy (UNX) of recipient rats a requisite of renal development. The aim of this study was to adapt this approach for use in mice and examine the parameters affecting successful onward development in this species. METHODS Metanephroi at embryonic age (E) 13.5 were transplanted either onto the body wall, abdominal fat pads or omentum of recipient isogenic C57/Bl6 mice using either sutures or polyglycolic acid mesh. Having established greatest success with polyglycolic acid mesh on the body wall, E12.5 and 15.5 days metanephroi from C57/Bl6 mice were then transplanted onto the body wall of control (non-pregnant non-UNX), UNX or 12.5 days post-coitum pregnant isogenic recipients. After 7 days, implanted tissue was harvested and examined using histology and immunohistochemistry for markers of renal maturation. The mean number of S-shaped bodies and glomeruli per section were recorded and statistically analysed for significant differences between all recipient groups and untransplanted metanephroi. The degree of development was scored qualitatively. RESULTS Transplanted E12.5 metanephroi developed S-shaped bodies and glomeruli in all recipient groups, although there were statistically higher numbers of S-shaped bodies in UNX (n = 2) and pregnant recipients (n = 9) than in control recipients (n = 4). Continued development, as indicated by mature vascularized glomeruli, was only observed in those E15.5 metanephroi transplanted into pregnant recipients (n = 11) with a 15.5-fold increase in S-shaped bodies and 4-fold increase in glomeruli compared with control transplants (n = 12). CONCLUSIONS We have successfully established metanephros transplantation in mice and demonstrated enhancement of onward development of E12.5 metanephroi in response to both pregnancy and UNX. Using E15.5 metanephroi, continued development only occurred in pregnant recipients, implying pregnancy provides an environment conducive to continued organogenesis. This murine assay, when coupled with transgenically-tagged strains of mice, will allow the investigation of the relative contribution of donor and recipient cells to this process.
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Affiliation(s)
- Shannon R Armstrong
- Institute for Molecular Bioscience, The University of Queensland, St. Lucia, Australia
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Morgan BP, Berg CW, Harris CL. ''Homologous restriction'' in complement lysis: roles of membrane complement regulators. Xenotransplantation 2005; 12:258-65. [PMID: 15943774 DOI: 10.1111/j.1399-3089.2005.00237.x] [Citation(s) in RCA: 65] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Abstract
The complement system is a powerful bactericidal immune defence with the potential to damage self cells. Protection of self is provided by expression on cells of a battery of membrane regulators that inhibit activation of complement. Roles of complement in the rejection of transplanted organs have long been recognized, and are particularly relevant in xenotransplantation, where hyperacute rejection is complement-driven. Inhibiting complement was therefore considered early in the history of xenografting, and the use of membrane complement regulators to this end was proposed more than two decades ago. For each of the membrane regulators in humans, early studies implied a species-specificity of action, inhibiting human complement but not that from other species. The dogma of species-specificity dictated strategies for inhibiting complement in xenografts and drove the creation of donor transgenic pigs expressing human regulators. Here we critically evaluate the evidence for species-specificity in membrane complement regulators from humans and other animals. We challenge the dogma and show that there is considerable cross-species activity for each of the membrane regulators of complement. Acceptance of the fact that species selectivity is not a limitation will open new avenues for protection of the xenograft from complement damage.
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Affiliation(s)
- B Paul Morgan
- Complement Biology Group, Department of Medical Biochemistry and Immunology, School of Medicine, Cardiff University, Cardiff, UK.
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Koulmanda M, Laufer TM, Auchincloss H, Smith RN. Prolonged survival of fetal pig islet xenografts in mice lacking the capacity for an indirect response. Xenotransplantation 2004; 11:525-30. [PMID: 15479462 DOI: 10.1111/j.1399-3089.2004.00174.x] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
BACKGROUND Xenografts of islets from organ-cultured fetal pig pancreases transplanted into non-immunosuppressed mice are rejected within 10 days. Immunosuppression with anti-T cell (anti-CD4) monoclonal antibody alone delays rejection of these xenografts for about 28 days, but rejection eventually occurs despite marked depletion of T cells. To determine if the critical CD4+ T cells responsible for xenograft islet rejection function through the direct or indirect pathway, selective class II-deficient mice that express class II antigens only on their thymic epithelium (not on peripheral cells) with normal numbers of CD4+ T cells, (class II-, CD4+), were used as recipients of xenograft islets to test if rejection occurs in the absence of an indirect response. METHODS Control (C57BL/6) or class II-, CD4+ mice were transplanted under the kidney capsule with cultured fetal pig islets. Class II-, CD4+ mice have normal numbers of B cells, CD4+, gamma delta T cells, and slightly increased numbers of CD8+ T cells. Additional mice were thymectomized before receiving anti-CD4 or anti-CD8 monoclonal antibodies. Islet graft survival was determined histologically as fetal pig islets were too immature to secrete insulin. RESULTS Xenograft survival in control animals was 7 to 14 days. In contrast, graft survival in class II-, CD4+ mice was significantly prolonged to greater than 35 days. Depletion of CD8+ T cells in class II-, CD4+ mice prolonged graft survival to about 70 days. Depletion of CD4+ T cells from these mice further prolonged xenograft survival to about 100 days. CONCLUSIONS These results suggest that the rejection of pig islets by mice initially depends on a CD4 dependent indirect response. The CD4 direct response also contributes to graft destruction. CD8+ T cells also participate in graft destruction, albeit weakly.
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Affiliation(s)
- Maria Koulmanda
- Islet Transplantation Research Laboratory, Department of Surgery, Massachusetts General Hospital, Harvard Medical School, Boston, MA 02114, USA.
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Vetere A, Donati I, Campa C, Semeraro S, Gamini A, Paoletti S. Synthesis and characterization of a novel glycopolymer with protective activity toward human anti-alpha-Gal antibodies. Glycobiology 2002; 12:283-90. [PMID: 12042251 DOI: 10.1093/glycob/12.4.283] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/23/2022] Open
Abstract
An efficient and rapid synthesis of the derivative of the biocompatible polymer poly(styrene co-maleic acid) with Linear B disaccharide (Galili antigen) was achieved. The oligosaccharide portion was obtained by a transglycosylation reaction catalyzed by coffee bean alpha-D-galactosidase using p-nitrophenyl-alpha-D-galactopyranoside both as donor and as acceptor. The reaction was carried out in aqueous buffer without any organic cosolvent. The molar yield (30%) and the regioselectivity (82%) were significantly improved with respect to the data so far reported in the literature. The selective reduction of the p-nitrophenyl group afforded the p-aminophenyl derivative of Linear B disaccharide. Linkage of this derivative via an amidic bond to the poly(styrene co-maleic acid) was obtained by using N'-(3-dimethylaminopropyl)-N-ethylcarbodiimide hydrochloride and N-hydroxysuccinimide. The products were chemically characterized by ionspray mass spectrometry, infrared, (13)C- and (1)H-nuclear magnetic resonance. The glycopolymer specifically reacts with human serum containing antibodies and with a mixture of partially purified human IgG and IgM anti-Linear B. It efficiently protects pig kidney PK15 cells from cytotoxic effects of human serum.
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Affiliation(s)
- Amedeo Vetere
- Department of Biochemistry, Biophysics and Macromolecular Chemistry, University of Trieste, Via L. Giorgieri 1, I-34127 Trieste, Italy
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Affiliation(s)
- D Grant
- Departments of Immunology, Medicine, and Surgery, University of Toronto, Toronto, Ontario, Canada
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Cheng J, Ma Y, Li Y, Li S, He Q, Shen W. A novel model mimicking the immunoreactivity in pig-to-human xenotransplantation. Transplant Proc 2000; 32:1056-7. [PMID: 10936351 DOI: 10.1016/s0041-1345(00)01117-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
Affiliation(s)
- J Cheng
- Laboratory of Transplant Immunology, First University Hospital, West China University of Medical Sciences, Chengdu, People's Republic of China
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Bauer M, Ueffing M, Meitinger T, Gasser T. Somatic gene therapy in animal models of Parkinson's disease. JOURNAL OF NEURAL TRANSMISSION. SUPPLEMENTUM 1999; 55:131-47. [PMID: 10335499 DOI: 10.1007/978-3-7091-6369-6_12] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/12/2023]
Abstract
Gene therapy in Parkinson's disease (PD) emerged about 10 years ago but until now, no clinical trials are under way, because most approaches have failed to show long-term therapeutic effects in PD animal models and because safety concerns precluded the use in humans so far. This review tries to give an overview on the development of different strategies in gene therapy in PD animal models and point out new and possibly more successful directions, including the transplantation of neural precursor cells and pig tissue.
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Affiliation(s)
- M Bauer
- Department of Neurology, Klinikum Grosshadern, Ludwig-Maximilians-University, Munich, Federal Republic of Germany
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Affiliation(s)
- O Isacson
- Neuroregeneration Laboratory, McLean Hospital, Harvard Medical School, Belmont, Massachusetts 02178, USA
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Deacon T, Schumacher J, Dinsmore J, Thomas C, Palmer P, Kott S, Edge A, Penney D, Kassissieh S, Dempsey P, Isacson O. Histological evidence of fetal pig neural cell survival after transplantation into a patient with Parkinson's disease. Nat Med 1997; 3:350-3. [PMID: 9055867 DOI: 10.1038/nm0397-350] [Citation(s) in RCA: 355] [Impact Index Per Article: 13.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/03/2023]
Abstract
The movement disorder in Parkinson's disease results from the selective degeneration of a small group of dopaminergic neurons in the substantia nigra pars compacta region of the brain. A number of exploratory studies using human fetal tissue allografts have suggested that transplantation of dopaminergic neurons may become an effective treatment for patients with Parkinson's disease and the difficulty in obtaining human fetal tissue has generated interest in finding corresponding non-human donor cells. Here we report a post-mortem histological analysis of fetal pig neural cells that were placed unilaterally into the caudate-putamen brain region of a patient suffering from Parkinson's disease. Long-term (over seven months) graft survival was found and the presence of pig dopaminergic neurons and other pig neural and glial cells is documented. Pig neurons extended axons from the graft sites into the host brain. Furthermore, other graft derived cells were observed several millimeters from the implantation sites. Markers for human microglia and T-cells showed only low reactivity in direct proximity to the grafts. This is the first documentation of neural xenograft survival in the human brain and of appropriate growth of non-human dopaminergic neurons for a potential therapeutic response in Parkinson's disease.
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Affiliation(s)
- T Deacon
- Neuroregeneration Laboratory, Harvard Medical School, McLean Hospital MRC 119, Belmont, Massachusetts 02178, USA
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