1
|
Dick JK, Sangala JA, Krishna VD, Khaimraj A, Hamel L, Erickson SM, Hicks D, Soigner Y, Covill LE, Johnson A, Ehrhardt MJ, Ernste K, Brodin P, Koup RA, Khaitan A, Baehr C, Thielen BK, Henzler CM, Skipper C, Miller JS, Bryceson YT, Wu J, John CC, Panoskaltsis-Mortari A, Orioles A, Steiner ME, Cheeran MCJ, Pravetoni M, Hart GT. Antibody-mediated cellular responses are dysregulated in Multisystem Inflammatory Syndrome in Children (MIS-C). bioRxiv 2024:2024.04.16.589585. [PMID: 38659969 PMCID: PMC11042288 DOI: 10.1101/2024.04.16.589585] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 04/26/2024]
Abstract
Multisystem Inflammatory Syndrome in Children (MIS-C) is a severe complication of SARS-CoV-2 infection characterized by multi-organ involvement and inflammation. Testing of cellular function ex vivo to understand the aberrant immune response in MIS-C is limited. Despite strong antibody production in MIS-C, SARS-CoV-2 nucleic acid testing can remain positive for 4-6 weeks after infection. Therefore, we hypothesized that dysfunctional cell-mediated antibody responses downstream of antibody production may be responsible for delayed clearance of viral products in MIS-C. In MIS-C, monocytes were hyperfunctional for phagocytosis and cytokine production, while natural killer (NK) cells were hypofunctional for both killing and cytokine production. The decreased NK cell cytotoxicity correlated with an NK exhaustion marker signature and systemic IL-6 levels. Potentially providing a therapeutic option, cellular engagers of CD16 and SARS-CoV-2 proteins were found to rescue NK cell function in vitro. Together, our results reveal dysregulation in antibody-mediated cellular responses unique to MIS-C that likely contribute to the immune pathology of this disease.
Collapse
|
2
|
Akinnola I, Rossi DR, Meyer C, Lindsey A, Haase DR, Fogas S, Ehrhardt MJ, Blue RE, Price AP, Johnson M, Alvarez DF, Taylor DA, Panoskaltsis-Mortari A. Engineering Functional Vasculature in Decellularized Lungs Depends on Comprehensive Endothelial Cell Tropism. Front Bioeng Biotechnol 2021; 9:727869. [PMID: 34485262 PMCID: PMC8415401 DOI: 10.3389/fbioe.2021.727869] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/20/2021] [Accepted: 08/02/2021] [Indexed: 11/13/2022] Open
Abstract
Tissue engineering using decellularized whole lungs as matrix scaffolds began as a promise for creating autologous transplantable lungs for patients with end-stage lung disease and can also be used to study strategies for lung regeneration. Vascularization remains a critical component for all solid organ bioengineering, yet there has been limited success in generating functional re-endothelialization of most pulmonary vascular segments. We evaluated recellularization of the blood vessel conduits of acellular mouse scaffolds with highly proliferating, rat pulmonary microvascular endothelial progenitor cells (RMEPCs), pulmonary arterial endothelial cells (PAECs) or microvascular endothelial cells (MVECs). After 8 days of pulsatile perfusion, histological analysis showed that PAECs and MVECs possessed selective tropism for larger vessels or microvasculature, respectively. In contrast, RMEPCs lacked site preference and repopulated all vascular segments. RMEPC-derived endothelium exhibited thrombomodulin activity, expression of junctional genes, ability to synthesize endothelial signaling molecules, and formation of a restrictive barrier. The RMEPC phenotype described here could be useful for identifying endothelial progenitors suitable for efficient vascular organ and tissue engineering, regeneration and repair.
Collapse
Affiliation(s)
- Ifeolu Akinnola
- MSTP, University of Minnesota Medical School, Minneapolis, MN, United States
| | - Daniel R Rossi
- Pediatric Blood and Marrow Transplantation and Cell Therapy, University of Minnesota, Minneapolis, MN, United States
| | - Carolyn Meyer
- Pediatric Blood and Marrow Transplantation and Cell Therapy, University of Minnesota, Minneapolis, MN, United States
| | - Ashley Lindsey
- Internal Medicine and Center for Lung Biology, College of Medicine, University of South Alabama, Mobile, AL, United States
| | - Douglas R Haase
- University of Minnesota Medical School, Minneapolis, MN, United States
| | - Samuel Fogas
- Pediatric Blood and Marrow Transplantation and Cell Therapy, University of Minnesota, Minneapolis, MN, United States
| | - Michael J Ehrhardt
- Pediatric Blood and Marrow Transplantation and Cell Therapy, University of Minnesota, Minneapolis, MN, United States
| | - Rachel E Blue
- University of Minnesota Medical School, Minneapolis, MN, United States
| | - Andrew P Price
- Pediatric Blood and Marrow Transplantation and Cell Therapy, University of Minnesota, Minneapolis, MN, United States
| | - Max Johnson
- Pediatric Blood and Marrow Transplantation and Cell Therapy, University of Minnesota, Minneapolis, MN, United States
| | - Diego F Alvarez
- Internal Medicine and Center for Lung Biology, College of Medicine, University of South Alabama, Mobile, AL, United States
| | | | - Angela Panoskaltsis-Mortari
- Pediatric Blood and Marrow Transplantation and Cell Therapy, University of Minnesota, Minneapolis, MN, United States.,Pulmonary, Allergy, Critical Care and Sleep Medicine, University of Minnesota, Minneapolis, MN, United States
| |
Collapse
|
3
|
Byiers BJ, Payen A, Feyma T, Panoskaltsis-Mortari A, Ehrhardt MJ, Symons FJ. Associations Among Diurnal Salivary Cortisol Patterns, Medication Use, and Behavioral Phenotype Features in a Community Sample of Rett Syndrome. Am J Intellect Dev Disabil 2020; 125:353-368. [PMID: 32936892 PMCID: PMC10699094 DOI: 10.1352/1944-7558-125.5.353] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/26/2019] [Accepted: 02/10/2020] [Indexed: 06/11/2023]
Abstract
Rett syndrome (RTT) is a severe neurodevelopmental disorder resulting from mutations of the MECP2 gene. Hyperactivity of the hypothalamic-pituitary-adrenal (HPA) axis and abnormal stress responses have been observed in animal models of RTT, but little is known about HPA axis function among individuals with RTT. Diurnal salivary cortisol patterns from 30 females with RTT were examined in relation to mutation type, medication use, and features of the RTT behavioral phenotype. Cortisol patterns were significantly related to mutation severity, anticonvulsant medication status, and bruxism (tooth grinding). This study provides preliminary support for the hypothesis that RTT may be at risk for outcomes associated with aberrant HPA axis function, and that this risk may be mediated by mutation type.
Collapse
Affiliation(s)
| | - Ameante Payen
- Breanne J. Byiers and Ameante Payen, University of Minnesota
| | - Timothy Feyma
- Timothy Feyma, Gillette Children's Specialty Healthcare, St. Paul, Minnesota
| | | | - Michael J Ehrhardt
- Angela Panoskaltsis-Mortari, Michael J. Ehrhardt, and Frank J. Symons, University of Minnesota
| | - Frank J Symons
- Angela Panoskaltsis-Mortari, Michael J. Ehrhardt, and Frank J. Symons, University of Minnesota
| |
Collapse
|
4
|
Lubas MM, Mandrell BN, Ehrhardt MJ, Ness KK, Srivastava D, Robison LL, Hudson MM, Krull KR, Brinkman TM. 1015 Sleep Duration and Physical and Mental Health Among Adult Survivors of Childhood Cancer: Results from the St. Jude Lifetime Cohort. Sleep 2020. [DOI: 10.1093/sleep/zsaa056.1011] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
Abstract
Introduction
Sleep disturbances are prevalent among adult survivors of childhood cancer, though little is known about associations between sleep and health in this vulnerable population.
Methods
Survivors recruited from the St. Jude Lifetime Cohort (n=911; 52% female; mean age 34 years; 26 years post-diagnosis) completed surveys assessing habitual sleep patterns and mental health and underwent comprehensive physical examinations. A subset of survivors (n=491) completed sleep actigraphy. Short sleep duration was defined as sleeping <7 hours per night, assessed via self-report or actigraphy. Clinically-assessed health outcomes were defined as grade ≥2 using modified CTCAE criteria for cardiac, pulmonary, and renal conditions. Anxiety and depression were defined as scores ≥90th percentile on the Brief Symptom Inventory-18. Covariates included childhood cancer treatment exposures, demographics, body mass index, and physical inactivity. Separate logistic or modified Poisson (common outcomes) regression models were computed for each health category to estimate odds ratios (OR) or relative risks (RR) and 95% confidence intervals (CI).
Results
Self-report and actigraphy-assessed short sleep was identified in 44% and 42% of survivors, respectively. However, these measures were weakly correlated (r=0.23). In adjusted multivariable models, self-reported short sleep was associated with higher risk of pulmonary conditions (RR=1.3, 95% CI=1.1-1.7), depression (OR=2.6, 95% CI=1.4-5.1) and anxiety (OR=3.4, 95% CI=1.6-6.8), while associations with cardiac (RR=1.10, 95% CI=0.94-1.30) and renal conditions (OR=1.30, 95% CI=0.79-2.13) were not significant. There were no significant associations between actigraphy-assessed short sleep and any of the health outcomes.
Conclusion
Habitual self-reported short sleep was associated with clinically ascertained adverse health outcomes. Although the temporality of these associations cannot be determined in this cross-sectional study, sleep is a modifiable health behavior and improving sleep may improve health in survivors. Measures of self-reported sleep may have unique value when assessing the relationship between sleep and health.
Support
CA225590, K. Krull Principal Investigator; CA195547, M. Hudson and L. Robison Principal Investigators; CA21765, C. Roberts, Principal Investigator
Collapse
Affiliation(s)
- M M Lubas
- St. Jude Children’s Research Hospital, Department of Epidemiology and Cancer Control, Memphis, TN
| | - B N Mandrell
- St. Jude Children’s Research Hospital, Department of Pediatric Medicine, Memphis, TN
| | - M J Ehrhardt
- St. Jude Children’s Research Hospital, Department of Epidemiology and Cancer Control, Memphis, TN
| | - K K Ness
- St. Jude Children’s Research Hospital, Department of Epidemiology and Cancer Control, Memphis, TN
| | - D Srivastava
- St. Jude Children’s Research Hospital, Department of Biostatistics, Memphis, TN
| | - L L Robison
- St. Jude Children’s Research Hospital, Department of Epidemiology and Cancer Control, Memphis, TN
| | - M M Hudson
- St. Jude Children’s Research Hospital, Department of Epidemiology and Cancer Control, Memphis, TN
| | - K R Krull
- St. Jude Children’s Research Hospital, Department of Epidemiology and Cancer Control, Memphis, TN
| | - T M Brinkman
- St. Jude Children’s Research Hospital, Department of Epidemiology and Cancer Control, Memphis, TN
| |
Collapse
|
5
|
Byiers BJ, Merbler AM, Barney CC, Frenn KA, Panoskaltsis-Mortari A, Ehrhardt MJ, Feyma TJ, Beisang AA, Symons F. Evidence of altered salivary cytokine concentrations in Rett syndrome and associations with clinical severity. Brain Behav Immun Health 2020; 1:100008. [PMID: 38377412 PMCID: PMC8474566 DOI: 10.1016/j.bbih.2019.100008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/16/2019] [Revised: 10/11/2019] [Accepted: 10/13/2019] [Indexed: 11/17/2022] Open
Abstract
Background Immune dysregulation may play a role in the development of Rett syndrome (RTT), a neurodevelopmental disorder caused by mutations of the MECP2 gene. Abnormal cytokine concentrations have been documented in the serum of individuals with RTT. Measurement of salivary cytokines has been investigated as a potential alternative approach to measurement in blood and serum, but it is unclear whether salivary cytokine concentrations can provide valid information about systemic immune function in neurodevelopmental disorders. The goal of this study was to evaluate the potential validity of salivary cytokines as biomarkers of immune dysregulation in RTT. Methods Saliva samples from 16 individuals with RTT (all female; age range 2-40 years) and 16 healthy control females (age range 2-40 years) were analyzed for concentrations of 12 cytokines. Between-group differences in concentrations, and correlations with clinical severity in the RTT group were evaluated. Results Concentrations of several salivary cytokines (IL-1β, IL-6, IL-8, IL-10, GM-CSF, TNF-α, and VEGF) were increased in RTT compared to controls. The same cytokines showed significant positive correlations with clinical severity scores. There were no differences in concentrations of IL-2, IL-4, IL-5, IL-12p70, and IFN-γ. Conclusion The results suggest that salivary cytokines may be a possible indicator of immune dysregulation in RTT. Future research should investigate whether these results can be applied to other neurodevelopmental disorders.
Collapse
Affiliation(s)
- Breanne J. Byiers
- Department of Educational Psychology, 56 E River Rd, University of Minnesota, Minneapolis, MN, 55455, USA
| | - Alyssa M. Merbler
- Department of Educational Psychology, 56 E River Rd, University of Minnesota, Minneapolis, MN, 55455, USA
| | - Chantel C. Barney
- Gillette Children’s Specialty Healthcare, 200 University Ave E, St. Paul, Minnesota, 55101, USA
| | - Kristin A. Frenn
- Gillette Children’s Specialty Healthcare, 200 University Ave E, St. Paul, Minnesota, 55101, USA
| | - Angela Panoskaltsis-Mortari
- Cancer Center and Department of Pediatrics, Division of Blood and Marrow Transplantation, 2450 Riverside Ave, University of Minnesota, Minneapolis, MN, 55454, USA
| | - Michael J. Ehrhardt
- Cancer Center and Department of Pediatrics, Division of Blood and Marrow Transplantation, 2450 Riverside Ave, University of Minnesota, Minneapolis, MN, 55454, USA
| | - Timothy J. Feyma
- Gillette Children’s Specialty Healthcare, 200 University Ave E, St. Paul, Minnesota, 55101, USA
| | - Arthur A. Beisang
- Gillette Children’s Specialty Healthcare, 200 University Ave E, St. Paul, Minnesota, 55101, USA
| | - Frank Symons
- Department of Educational Psychology, 56 E River Rd, University of Minnesota, Minneapolis, MN, 55455, USA
| |
Collapse
|
6
|
Raza K, Larsen T, Samaratunga N, Price AP, Meyer C, Matson A, Ehrhardt MJ, Fogas S, Tolar J, Hertz MI, Panoskaltsis-Mortari A. MSC therapy attenuates obliterative bronchiolitis after murine bone marrow transplant. PLoS One 2014; 9:e109034. [PMID: 25272285 PMCID: PMC4182803 DOI: 10.1371/journal.pone.0109034] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/11/2014] [Accepted: 09/03/2014] [Indexed: 12/18/2022] Open
Abstract
RATIONALE Obliterative bronchiolitis (OB) is a significant cause of morbidity and mortality after lung transplant and hematopoietic cell transplant. Mesenchymal stromal cells (MSCs) have been shown to possess immunomodulatory properties in chronic inflammatory disease. OBJECTIVE Administration of MSCs was evaluated for the ability to ameliorate OB in mice using our established allogeneic bone marrow transplant (BMT) model. METHODS Mice were lethally conditioned and received allogeneic bone marrow without (BM) or with spleen cells (BMS), as a source of OB-causing T-cells. Cell therapy was started at 2 weeks post-transplant, or delayed to 4 weeks when mice developed airway injury, defined as increased airway resistance measured by pulmonary function test (PFT). BM-derived MSC or control cells [mouse pulmonary vein endothelial cells (PVECs) or lung fibroblasts (LFs)] were administered. Route of administration [intratracheally (IT) and IV] and frequency (every 1, 2 or 3 weeks) were compared. Mice were evaluated at 3 months post-BMT. MEASUREMENTS AND MAIN RESULTS No ectopic tissue formation was identified in any mice. When compared to BMS mice receiving control cells or no cells, those receiving MSCs showed improved resistance, compliance and inspiratory capacity. Interim PFT analysis showed no difference in route of administration. Improvements in PFTs were found regardless of dose frequency; but once per week worked best even when administration began late. Mice given MSC also had decreased peribronchiolar inflammation, lower levels of hydroxyproline (collagen) and higher frequencies of macrophages staining for the alternatively activated macrophage (AAM) marker CD206. CONCLUSIONS These results warrant study of MSCs as a potential management option for OB in lung transplant and BMT recipients.
Collapse
Affiliation(s)
- Kashif Raza
- Pulmonary, Allergy, Critical Care and Sleep Medicine, University of Minnesota, Minneapolis, Minnesota, United States of America
| | - Trevor Larsen
- Breck High School, Edina, Minnesota, United States of America
| | | | - Andrew P Price
- Pediatric Blood and Bone Marrow Transplant Program, University of Minnesota Cancer Center, Minneapolis, Minnesota, United States of America
| | - Carolyn Meyer
- Pediatric Blood and Bone Marrow Transplant Program, University of Minnesota Cancer Center, Minneapolis, Minnesota, United States of America
| | - Amy Matson
- Pediatric Blood and Bone Marrow Transplant Program, University of Minnesota Cancer Center, Minneapolis, Minnesota, United States of America
| | - Michael J Ehrhardt
- Pediatric Blood and Bone Marrow Transplant Program, University of Minnesota Cancer Center, Minneapolis, Minnesota, United States of America
| | - Samuel Fogas
- Pediatric Blood and Bone Marrow Transplant Program, University of Minnesota Cancer Center, Minneapolis, Minnesota, United States of America
| | - Jakub Tolar
- Pediatric Blood and Bone Marrow Transplant Program, University of Minnesota Cancer Center, Minneapolis, Minnesota, United States of America
| | - Marshall I Hertz
- Pulmonary, Allergy, Critical Care and Sleep Medicine, University of Minnesota, Minneapolis, Minnesota, United States of America
| | - Angela Panoskaltsis-Mortari
- Pulmonary, Allergy, Critical Care and Sleep Medicine, University of Minnesota, Minneapolis, Minnesota, United States of America; Pediatric Blood and Bone Marrow Transplant Program, University of Minnesota Cancer Center, Minneapolis, Minnesota, United States of America
| |
Collapse
|
7
|
Taylor PA, Ehrhardt MJ, Lees CJ, Tolar J, Weigel BJ, Panoskaltsis-Mortari A, Serody JS, Brinkmann V, Blazar BR. Insights into the mechanism of FTY720 and compatibility with regulatory T cells for the inhibition of graft-versus-host disease (GVHD). Blood 2007; 110:3480-8. [PMID: 17606761 PMCID: PMC2200903 DOI: 10.1182/blood-2007-05-087940] [Citation(s) in RCA: 69] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
The immunomodulator FTY720 (FTY) has been shown to be beneficial in experimental models of organ transplantation and autoimmunity. We show that FTY significantly inhibited but did not prevent graft-versus-host disease (GVHD) in lethally irradiated or nonirradiated allogeneic recipients. Although most studies implicate prevention of lymphocyte egress from lymphoid organs as the primary mechanism of action, our data indicate that FTY effects on the host are more likely to be responsible for GVHD inhibition. FTY reduced splenic CD11c+ cells by 50%, and similarly reduced CD4+ and CD8+ T-cell responder frequencies in the spleen early after transplantation. Imaging of GFP+ effectors indicated that FTY modified donor effector T-cell migration to secondary lymphoid organs, but did not uniformly trap T cells in lymph nodes or prevent early effector migration to GVHD parenchymal target organs. Administration of FTY only prior to transplantation inhibited GVHD, indicating that the primary function of FTY may be targeted to host cells. FTY was additive with regulatory T cells for GVHD inhibition. FTY slightly impaired but did not abrogate a graft-versus-leukemia (GVL) effect against C1498, a myeloid leukemia. Our data further define the mechanisms of action and provide insight as to the potential clinical uses of FTY in allogeneic bone marrow transplant recipients.
Collapse
Affiliation(s)
- Patricia A Taylor
- Department of Pediatrics, Division of Blood and Marrow Transplantation, University of Minnesota Cancer Center, 420 Delaware Street SE, Minneapolis, MN 55455, USA
| | | | | | | | | | | | | | | | | |
Collapse
|
8
|
Taylor PA, Ehrhardt MJ, Roforth MM, Swedin JM, Panoskaltsis-Mortari A, Serody JS, Blazar BR. Preformed antibody, not primed T cells, is the initial and major barrier to bone marrow engraftment in allosensitized recipients. Blood 2006; 109:1307-15. [PMID: 17018854 PMCID: PMC1785137 DOI: 10.1182/blood-2006-05-022772] [Citation(s) in RCA: 96] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
Multiply-transfused individuals are at higher risk for BM rejection. We show that whereas allosensitization resulted in the priming of both cellular and humoral immunity, preformed antibody was the major barrier to engraftment. The generation of cross-reactive alloantibody led to rejection of BM of a different MHC-disparate strain. Imaging studies indicated that antibody-mediated rejection was very rapid (<3 hours) in primed recipients, while T-cell-mediated rejection in nonprimed mice took more than 6 days. Antibody-mediated BM rejection was not due to a defect in BM homing as rejection occurred despite direct intra-BM infusion of donor BM. Rejection was dependent upon host FcR+ cells. BM cells incubated with serum from primed mice were eliminated in nonprimed recipients, indicating that persistent exposure to high-titer antibody was not essential for rejection. High donor engraftment was achieved in a proportion of primed mice by mega-BM cell dose, in vivo T-cell depletion, and high-dose immunoglobulin infusion. The addition of splenectomy to this protocol only modestly added to the efficacy of this combination strategy. These data demonstrate both rapid alloantibody-mediated elimination of BM by host FcR+ cells and priming of host antidonor T cells and suggest a practical strategy to overcome engraftment barriers in primed individuals.
Collapse
Affiliation(s)
- Patricia A Taylor
- University of Minnesota Cancer Center, Department of Pediatrics, Minneapolis 55455, USA
| | | | | | | | | | | | | |
Collapse
|
9
|
Taylor PA, Lees CJ, Wilson JM, Ehrhardt MJ, Campbell MT, Noelle RJ, Blazar BR. Combined effects of calcineurin inhibitors or sirolimus with anti-CD40L mAb on alloengraftment under nonmyeloablative conditions. Blood 2002; 100:3400-7. [PMID: 12384443 DOI: 10.1182/blood-2002-03-0872] [Citation(s) in RCA: 86] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
The immunosuppressive drugs, cyclosporine A (CsA), tacrolimus, or sirolimus, were analyzed as single agents and in combination with anti-CD40L monoclonal antibody (mAb) for their effects on alloengraftment in mice conditioned with minimal total body irradiation (TBI). Whereas anti-CD40L mAb facilitated chimerism, neither sirolimus nor CsA resulted in substantial alloengraftment. However, sirolimus was synergistic with anti-CD40L mAb for inducing donor chimerism. Contrary to expectations, CsA, a T-cell receptor (TCR) signaling inhibitor, did not abrogate anti-CD40L mAb-facilitated engraftment but rather increased engraftment in anti-CD40L mAb-treated mice. Although tacrolimus alone or with anti-CD40L mAb resulted in similar levels of donor chimerism, donor T-cell reconstitution was very low in tacrolimus-treated mice. At 1 week after transplantation, CsA decreased thymic numbers more profoundly than sirolimus or tacrolimus in anti-CD40L mAb-treated recipients. In contrast, only sirolimus resulted in a decrease in host splenic T-cell numbers in anti-CD40L mAb-treated recipients. Importantly, sirolimus and anti-CD40L mAb induced profound donor tolerance with 100% acceptance of donor skin grafts placed early after bone marrow transplantation (BMT). In contrast, anti-CD40L mAb alone or in combination with CsA resulted in 12% or less donor skin graft acceptance early (1 month) and 60% or less later (3 months) after BMT. These data have clinical relevance and indicate that immunosuppressive pharmacologic agents enhance anti-CD40L mAb-facilitated alloengraftment and tolerance induction under nonmyeloablative conditioning.
Collapse
Affiliation(s)
- Patricia A Taylor
- University of Minnesota Cancer Center, Division of Bone Marrow Transplantation, 420 Delaware Street SE, Minneapolis, MN 55455, USA
| | | | | | | | | | | | | |
Collapse
|