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Schussler O, Lila N, Perneger T, Mootoosamy P, Grau J, Francois A, Smadja DM, Lecarpentier Y, Ruel M, Carpentier A. Recipients with blood group A associated with longer survival rates in cardiac valvular bioprostheses. EBioMedicine 2019; 42:54-63. [PMID: 30878598 PMCID: PMC6491382 DOI: 10.1016/j.ebiom.2019.02.047] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/03/2018] [Revised: 02/12/2019] [Accepted: 02/20/2019] [Indexed: 01/02/2023] Open
Abstract
Background Pigs/bovines share with humans some of the antigens present on cardiac valves. Two such antigens are: the major xenogenic Ag, “Gal” present in all pig/bovine very close to human B-antigen of ABO-blood-group system; the minor Ag, pig histo-blood-group AH-antigen identical to human AH-antigen and present by some animals. We hypothesize that these antigens may modify the immunogenicity of the bioprosthesis and also its longevity. ABO distribution may vary between patients with low (<6 years) and high (≥15 years) bioprostheses longevity. Methods Single-centre registry study (Paris, France) including all degenerative porcine bioprostheses (mostly Carpentier-Edwards 2nd/3rd generation heart valves) explanted between 1985 and 1998 and some bovine bioprostheses. For period 1998–2014, all porcine bioprostheses with longevity ≥13 years (follow-up ≥29 years). Important predictive factors for bioprosthesis longevity: number, site of implantation, age were collected. Blood group and other variables were entered into an ordinal logistic regression analysis model predicting valve longevity, categorized as low (<6 years), medium (6–14.9 years), and high (≥15 years). Findings Longevity and ABO-blood group were obtained for 483 explanted porcine bioprostheses. Mean longevity was 10.2 ± 3.9 years [0–28] and significantly higher for A-patients than others (P = 0.009). Using multivariate analysis, group A was a strong predictive factor of longevity (OR 2.09; P < 0.001). For the 64 explanted bovine bioprosthesis with low/medium longevity, the association, with A-group was even more significant. Interpretation Patients of A-group but not B have a higher longevity of their bioprostheses. Future graft-host phenotyping and matching may give rise to a new generation of long-lasting bioprosthesis for implantation in humans, especially for the younger population. Fund None.
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Affiliation(s)
- O Schussler
- Division of Cardiovascular Surgery and Cardiovascular Research Laboratory, Geneva University Hospitals and Faculty of Medicine, Geneva, Switzerland.
| | - N Lila
- Laboratory of Biosurgical Research (Alain Carpentier Foundation), University Paris Descartes, Sorbonne Paris Cité, Paris F-75475, France
| | - T Perneger
- Department of Clinical Epidemiology, Geneva University Hospitals and Faculty of Medicine, Geneva, Switzerland
| | - P Mootoosamy
- Division of Cardiovascular Surgery and Cardiovascular Research Laboratory, Geneva University Hospitals and Faculty of Medicine, Geneva, Switzerland
| | - J Grau
- Division of Cardiac Surgery and Research Laboratory, Department of Epidemiology, Ottawa Heart Institute, University of Ottawa Heart, Ottawa, Ontario, Canada
| | - A Francois
- Etablissement Français du Sang (EFS), Ile de France, Immuno-hematology Laboratory, Georges Pompidou Hospital, Paris, France
| | - D M Smadja
- Division of Cardiovascular Surgery and Cardiovascular Research Laboratory, Geneva University Hospitals and Faculty of Medicine, Geneva, Switzerland; AP-HP, Hôpital Européen Georges Pompidou, Hematology Department, Paris Descartes University, Sorbonne Paris Cite, Inserm UMR-S1140, Paris, France
| | - Y Lecarpentier
- Centre de Recherche Clinique, Grand Hôpital de l'Est Francilien (GHEF), Meaux, France
| | - M Ruel
- Division of Cardiac Surgery and Research Laboratory, Department of Epidemiology, Ottawa Heart Institute, University of Ottawa Heart, Ottawa, Ontario, Canada
| | - A Carpentier
- Laboratory of Biosurgical Research (Alain Carpentier Foundation), University Paris Descartes, Sorbonne Paris Cité, Paris F-75475, France; AP-HP, Hôpital Européen Georges Pompidou, Department of Cardiovascular Surgery, Paris, France
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In Search of the Ideal Valve: Optimizing Genetic Modifications to Prevent Bioprosthetic Degeneration. Ann Thorac Surg 2019; 108:624-635. [PMID: 30836101 DOI: 10.1016/j.athoracsur.2019.01.054] [Citation(s) in RCA: 16] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/04/2018] [Revised: 01/10/2019] [Accepted: 01/21/2019] [Indexed: 12/21/2022]
Abstract
BACKGROUND Bioprosthetic heart valves undergo structural degeneration and calcification. Similarities exist in the histopathologic features of explanted bioprosthetic valves and rejected pig tissues and organs after xenotransplantation into nonhuman primates. The development of more durable bioprosthetic valves, namely from genetically modified pigs, could negate the need for the insertion of mechanical prostheses in children and young adults with the requirement for life-long anticoagulation and might avoid the need for reoperation in elderly patients. METHODS We reviewed the literature (MedlinePlus, PubMed, Google Scholar) through September 1, 2018, under four key terms: (1) bioprosthetic heart valves, (2) xenograft antigens, (3) immunologic responses to bioprosthetic valves, and (4) genetic modification of xenografts. RESULTS Advances in tissue and organ xenotransplantation have elucidated important immunologic barriers that provide innovative approaches to prevent structural degeneration of bioprosthetic heart valves. The current evidence suggests that bioprosthetic valves derived from genetically modified pigs lacking xenogeneic antigens (namely Gal, Neu5Gc, and Sda), termed triple-knockout pigs, would function considerably longer than current wild-type (genetically unmodified) porcine valves in human recipients. CONCLUSIONS Preclinical and clinical studies to determine the safety and efficacy of triple-knockout porcine bioprosthetic valves will likely establish that they are more resistant to human immune responses and thus less susceptible to structural degeneration.
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Immune Responses of HLA Highly Sensitized and Nonsensitized Patients to Genetically Engineered Pig Cells. Transplantation 2019; 102:e195-e204. [PMID: 29266033 DOI: 10.1097/tp.0000000000002060] [Citation(s) in RCA: 23] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/20/2022]
Abstract
BACKGROUND We investigated in vitro whether HLA highly sensitized patients with end-stage renal disease will be disadvantaged immunologically after a genetically engineered pig kidney transplant. METHODS Blood was drawn from patients with a calculated panel-reactive antibody (cPRA) 99% to 100% (Gp1, n = 10) or cPRA 0% (Gp2, n = 12), and from healthy volunteers (Gp3, n = 10). Serum IgM and IgG binding was measured (i) to galactose-α1-3 galactose and N-glycolylneuraminic acid glycans by enzyme-linked immunosorbent assay, and (ii) to pig red blood cell, pig aortic endothelial cells, and pig peripheral blood mononuclear cell from α1,3-galactosyltransferase gene-knockout (GTKO)/CD46 and GTKO/CD46/cytidine monophosphate-N-acetylneuraminic acid hydroxylase-knockout (CMAHKO) pigs by flow cytometry. (iii) T-cell and B-cell phenotypes were determined by flow cytometry, and (iv) proliferation of T-cell and B-cell carboxyfluorescein diacetate succinimidyl ester-mixed lymphocyte reaction. RESULTS (i) By enzyme-linked immunosorbent assay, there was no difference in IgM or IgG binding to galactose-α1-3 galactose or N-glycolylneuraminic acid between Gps1 and 2, but binding was significantly reduced in both groups compared to Gp3. (ii) IgM and IgG binding in Gps1 and 2 was also significantly lower to GTKO/CD46 pig cells than in healthy controls, but there were no differences between the 3 groups in binding to GTKO/CD46/CMAHKO cells. (iii and iv) Gp1 patients had more memory T cells than Gp2, but there was no difference in T or B cell proliferation when stimulated by any pig cells. The proliferative responses in all 3 groups were weakest when stimulated by GTKO/CD46/CMAHKO pig peripheral blood mononuclear cell. CONCLUSIONS (i) End-stage renal disease was associated with low antipig antibody levels. (ii) Xenoreactivity decreased with increased genetic engineering of pig cells. (iii) High cPRA status had no significant effect on antibody binding or T-cell and B-cell response.
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Kim GA, Lee EM, Cho B, Alam Z, Kim SJ, Lee S, Oh HJ, Hwang JI, Ahn C, Lee BC. Generation by somatic cell nuclear transfer of GGTA1 knockout pigs expressing soluble human TNFRI-Fc and human HO-1. Transgenic Res 2018; 28:91-102. [DOI: 10.1007/s11248-018-0103-0] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/28/2018] [Accepted: 11/01/2018] [Indexed: 11/29/2022]
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106
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Längin M, Mayr T, Reichart B, Michel S, Buchholz S, Guethoff S, Dashkevich A, Baehr A, Egerer S, Bauer A, Mihalj M, Panelli A, Issl L, Ying J, Fresch AK, Buttgereit I, Mokelke M, Radan J, Werner F, Lutzmann I, Steen S, Sjöberg T, Paskevicius A, Qiuming L, Sfriso R, Rieben R, Dahlhoff M, Kessler B, Kemter E, Kurome M, Zakhartchenko V, Klett K, Hinkel R, Kupatt C, Falkenau A, Reu S, Ellgass R, Herzog R, Binder U, Wich G, Skerra A, Ayares D, Kind A, Schönmann U, Kaup FJ, Hagl C, Wolf E, Klymiuk N, Brenner P, Abicht JM. Consistent success in life-supporting porcine cardiac xenotransplantation. Nature 2018; 564:430-433. [PMID: 30518863 DOI: 10.1038/s41586-018-0765-z] [Citation(s) in RCA: 318] [Impact Index Per Article: 53.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/18/2018] [Accepted: 11/02/2018] [Indexed: 01/01/2023]
Abstract
Heart transplantation is the only cure for patients with terminal cardiac failure, but the supply of allogeneic donor organs falls far short of the clinical need1-3. Xenotransplantation of genetically modified pig hearts has been discussed as a potential alternative4. Genetically multi-modified pig hearts that lack galactose-α1,3-galactose epitopes (α1,3-galactosyltransferase knockout) and express a human membrane cofactor protein (CD46) and human thrombomodulin have survived for up to 945 days after heterotopic abdominal transplantation in baboons5. This model demonstrated long-term acceptance of discordant xenografts with safe immunosuppression but did not predict their life-supporting function. Despite 25 years of extensive research, the maximum survival of a baboon after heart replacement with a porcine xenograft was only 57 days and this was achieved, to our knowledge, only once6. Here we show that α1,3-galactosyltransferase-knockout pig hearts that express human CD46 and thrombomodulin require non-ischaemic preservation with continuous perfusion and control of post-transplantation growth to ensure long-term orthotopic function of the xenograft in baboons, the most stringent preclinical xenotransplantation model. Consistent life-supporting function of xenografted hearts for up to 195 days is a milestone on the way to clinical cardiac xenotransplantation7.
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Affiliation(s)
- Matthias Längin
- Department of Anaesthesiology, University Hospital, LMU Munich, Munich, Germany.,Transregional Collaborative Research Center 127, Walter Brendel Centre of Experimental Medicine, LMU Munich, Munich, Germany
| | - Tanja Mayr
- Department of Anaesthesiology, University Hospital, LMU Munich, Munich, Germany.,Transregional Collaborative Research Center 127, Walter Brendel Centre of Experimental Medicine, LMU Munich, Munich, Germany
| | - Bruno Reichart
- Transregional Collaborative Research Center 127, Walter Brendel Centre of Experimental Medicine, LMU Munich, Munich, Germany.
| | - Sebastian Michel
- Department of Cardiac Surgery, University Hospital, LMU Munich, Munich, Germany
| | - Stefan Buchholz
- Department of Cardiac Surgery, University Hospital, LMU Munich, Munich, Germany
| | - Sonja Guethoff
- Transregional Collaborative Research Center 127, Walter Brendel Centre of Experimental Medicine, LMU Munich, Munich, Germany.,Department of Cardiac Surgery, University Hospital, LMU Munich, Munich, Germany
| | - Alexey Dashkevich
- Department of Cardiac Surgery, University Hospital, LMU Munich, Munich, Germany
| | - Andrea Baehr
- Institute of Molecular Animal Breeding and Biotechnology, Gene Center, LMU Munich, Munich, Germany
| | - Stefanie Egerer
- Institute of Molecular Animal Breeding and Biotechnology, Gene Center, LMU Munich, Munich, Germany
| | - Andreas Bauer
- Department of Anaesthesiology, University Hospital, LMU Munich, Munich, Germany
| | - Maks Mihalj
- Department of Cardiac Surgery, University Hospital, LMU Munich, Munich, Germany
| | - Alessandro Panelli
- Transregional Collaborative Research Center 127, Walter Brendel Centre of Experimental Medicine, LMU Munich, Munich, Germany
| | - Lara Issl
- Transregional Collaborative Research Center 127, Walter Brendel Centre of Experimental Medicine, LMU Munich, Munich, Germany
| | - Jiawei Ying
- Transregional Collaborative Research Center 127, Walter Brendel Centre of Experimental Medicine, LMU Munich, Munich, Germany
| | - Ann Kathrin Fresch
- Transregional Collaborative Research Center 127, Walter Brendel Centre of Experimental Medicine, LMU Munich, Munich, Germany
| | - Ines Buttgereit
- Transregional Collaborative Research Center 127, Walter Brendel Centre of Experimental Medicine, LMU Munich, Munich, Germany
| | - Maren Mokelke
- Transregional Collaborative Research Center 127, Walter Brendel Centre of Experimental Medicine, LMU Munich, Munich, Germany
| | - Julia Radan
- Transregional Collaborative Research Center 127, Walter Brendel Centre of Experimental Medicine, LMU Munich, Munich, Germany
| | - Fabian Werner
- Department of Anaesthesiology, University Hospital, LMU Munich, Munich, Germany
| | - Isabelle Lutzmann
- Transregional Collaborative Research Center 127, Walter Brendel Centre of Experimental Medicine, LMU Munich, Munich, Germany
| | - Stig Steen
- Department of Cardiothoracic Surgery, Lund University and Skåne University Hospital, Lund, Sweden
| | - Trygve Sjöberg
- Department of Cardiothoracic Surgery, Lund University and Skåne University Hospital, Lund, Sweden
| | - Audrius Paskevicius
- Department of Cardiothoracic Surgery, Lund University and Skåne University Hospital, Lund, Sweden
| | - Liao Qiuming
- Department of Cardiothoracic Surgery, Lund University and Skåne University Hospital, Lund, Sweden
| | - Riccardo Sfriso
- Department for BioMedical Research (DMBR), University of Bern, Bern, Switzerland
| | - Robert Rieben
- Department for BioMedical Research (DMBR), University of Bern, Bern, Switzerland
| | - Maik Dahlhoff
- Institute of Molecular Animal Breeding and Biotechnology, Gene Center, LMU Munich, Munich, Germany
| | - Barbara Kessler
- Institute of Molecular Animal Breeding and Biotechnology, Gene Center, LMU Munich, Munich, Germany
| | - Elisabeth Kemter
- Institute of Molecular Animal Breeding and Biotechnology, Gene Center, LMU Munich, Munich, Germany
| | - Mayuko Kurome
- Institute of Molecular Animal Breeding and Biotechnology, Gene Center, LMU Munich, Munich, Germany
| | - Valeri Zakhartchenko
- Institute of Molecular Animal Breeding and Biotechnology, Gene Center, LMU Munich, Munich, Germany
| | - Katharina Klett
- I. Medizinische Klinik, Klinikum Rechts der Isar, Technical University of Munich, Munich, Germany.,Institute for Cardiovascular Prevention (IPEK), LMU Munich, Munich, Germany.,DZHK (German Center for Cardiovascular Research), partner site Munich Heart Alliance, Munich, Germany
| | - Rabea Hinkel
- I. Medizinische Klinik, Klinikum Rechts der Isar, Technical University of Munich, Munich, Germany.,Institute for Cardiovascular Prevention (IPEK), LMU Munich, Munich, Germany.,DZHK (German Center for Cardiovascular Research), partner site Munich Heart Alliance, Munich, Germany
| | - Christian Kupatt
- I. Medizinische Klinik, Klinikum Rechts der Isar, Technical University of Munich, Munich, Germany.,DZHK (German Center for Cardiovascular Research), partner site Munich Heart Alliance, Munich, Germany
| | - Almuth Falkenau
- Institute of Veterinary Pathology, LMU Munich, Munich, Germany
| | - Simone Reu
- Institute of Pathology, Medical Faculty, LMU Munich, Munich, Germany
| | - Reinhard Ellgass
- Department of Cardiac Surgery, University Hospital, LMU Munich, Munich, Germany
| | - Rudolf Herzog
- Department of Cardiac Surgery, University Hospital, LMU Munich, Munich, Germany
| | | | | | - Arne Skerra
- Munich Center for Integrated Protein Science (CIPS-M) and Lehrstuhl für Biologische Chemie, School of Life Sciences Weihenstephan, Technical University of Munich, Munich, Germany
| | | | - Alexander Kind
- Chair of Livestock Biotechnology, School of Life Sciences Weihenstephan, Technical University of Munich, Munich, Germany
| | | | | | - Christian Hagl
- Department of Cardiac Surgery, University Hospital, LMU Munich, Munich, Germany
| | - Eckhard Wolf
- Institute of Molecular Animal Breeding and Biotechnology, Gene Center, LMU Munich, Munich, Germany
| | - Nikolai Klymiuk
- Institute of Molecular Animal Breeding and Biotechnology, Gene Center, LMU Munich, Munich, Germany
| | - Paolo Brenner
- Transregional Collaborative Research Center 127, Walter Brendel Centre of Experimental Medicine, LMU Munich, Munich, Germany.,Department of Cardiac Surgery, University Hospital, LMU Munich, Munich, Germany
| | - Jan-Michael Abicht
- Department of Anaesthesiology, University Hospital, LMU Munich, Munich, Germany.,Transregional Collaborative Research Center 127, Walter Brendel Centre of Experimental Medicine, LMU Munich, Munich, Germany
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Stahl EC, Bonvillain RW, Skillen CD, Burger BL, Hara H, Lee W, Trygg CB, Didier PJ, Grasperge BF, Pashos NC, Bunnell BA, Bianchi J, Ayares DL, Guthrie KI, Brown BN, Petersen TH. Evaluation of the host immune response to decellularized lung scaffolds derived from α-Gal knockout pigs in a non-human primate model. Biomaterials 2018; 187:93-104. [DOI: 10.1016/j.biomaterials.2018.09.038] [Citation(s) in RCA: 32] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/07/2018] [Revised: 09/21/2018] [Accepted: 09/23/2018] [Indexed: 12/11/2022]
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Cooper DK, Ezzelarab M, Iwase H, Hara H. Perspectives on the Optimal Genetically Engineered Pig in 2018 for Initial Clinical Trials of Kidney or Heart Xenotransplantation. Transplantation 2018; 102:1974-1982. [PMID: 30247446 PMCID: PMC6249080 DOI: 10.1097/tp.0000000000002443] [Citation(s) in RCA: 30] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
Abstract
For a clinical trial today, what might realistically be the optimal pig among those currently available? Deletion of expression of the 3 pig carbohydrate antigens, against which humans have natural (preformed) antibodies (triple-knockout pigs), should form the basis of any clinical trial. However, because both complement and coagulation can be activated in the absence of antibody, the expression of human complement- and coagulation-regulatory proteins is likely to be important in protecting the graft further. Any genetic manipulation that might reduce inflammation of the graft, for example, expression of hemeoxygenase-1 or A20, may also be beneficial to the long-term survival of the graft. The transgene for human CD47 is likely to have a suppressive effect on monocyte/macrophage and T-cell activity. Furthermore, deletion of xenoantigen expression and expression of a human complement-regulatory protein are both associated with a reduced T-cell response. Although there are several other genetic manipulations that may reduce the T-cell response further, it seems likely that exogenous immunosuppressive therapy, particularly if it includes costimulation blockade, will be sufficient. We would therefore suggest that, with our present knowledge and capabilities, the optimal pig might be a triple-knockout pig that expressed 1 or more human complement-regulatory proteins, 1 or more human coagulation-regulatory proteins, a human anti-inflammatory transgene, and CD47. Absent or minimal antibody binding is important, but we suggest that the additional insertion of protective human transgenes will be beneficial, and may be essential.
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Affiliation(s)
- David K.C. Cooper
- Xenotransplantation Program, Department of Surgery, University of Alabama at Birmingham, Birmingham, AL, USA
| | - Mohamed Ezzelarab
- Thomas E. Starzl Transplantation Institute, Department of Surgery, University of Pittsburgh, Pittsburgh, PA, USA
| | - Hayato Iwase
- Xenotransplantation Program, Department of Surgery, University of Alabama at Birmingham, Birmingham, AL, USA
| | - Hidetaka Hara
- Xenotransplantation Program, Department of Surgery, University of Alabama at Birmingham, Birmingham, AL, USA
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109
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Yamamoto T, Li Q, Hara H, Wang L, Zhou H, Li J, Eckhoff DE, Joseph Tector A, Klein EC, Lovingood R, Ezzelarab M, Ayares D, Wang Y, Cooper DKC, Iwase H. B cell phenotypes in baboons with pig artery patch grafts receiving conventional immunosuppressive therapy. Transpl Immunol 2018; 51:12-20. [PMID: 30092338 PMCID: PMC6249078 DOI: 10.1016/j.trim.2018.08.005] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/25/2018] [Revised: 08/03/2018] [Accepted: 08/03/2018] [Indexed: 12/29/2022]
Abstract
BACKGROUND In the pig-to-baboon artery patch model with no immunosuppressive therapy, a graft from an α1,3-galactosyltransferase gene-knockout (GTKO) pig elicits a significant anti-nonGal IgG response, indicating sensitization to the graft. A costimulation blockade-based regimen, e.g., anti-CD154mAb or anti-CD40mAb, prevents sensitization. However, neither of these agents is currently FDA-approved. The aim of the present study was to determine the efficacy of FDA-approved agents on the T and B cell responses. METHODS Artery patch xenotransplantation in baboons was carried out using GTKO/CD46 pigs with (n = 2) or without (n = 1) the mutant transgene for CIITA-knockdown. Immunosuppressive therapy consisted of induction with ATG and anti-CD20mAb, and maintenance with different combinations of CTLA4-Ig, tacrolimus, and rapamycin. In addition, all 3 baboons received daily corticosteroids, the IL-6R blocker, tocilizumab, at regular intervals, and the TNF-α blocker, etanercept, for the first 2 weeks. Recipient blood was monitored for anti-nonGal antibody levels by flow cytometry (using GTKO/CD46 pig aortic endothelial cells), and mixed lymphocyte reaction (MLR). CD22+B cell profiles (naïve [IgD+/CD27-], non-switched memory [IgD+/CD27+], and switched memory [IgD-/CD27+] B cell subsets) were measured by flow cytometry. At 6 months, the baboons were euthanized and the grafts were examined histologically. RESULTS No elicited anti-pig antibodies developed in any baboon. The frequency of naïve memory B cells increased significantly (from 34% to 90%, p = 0.0015), but there was a significant decrease in switched memory B cells (from 17% to 0.5%, p = 0.015). MLR showed no increase in the proliferative T cell response in those baboons that had received CTLA4-Ig (n = 2). Histological examination showed few or no features of rejection in any graft. CONCLUSIONS The data suggest that immunosuppressive therapy with only FDA-approved agents may be adequate to prevent an adaptive immune response to a genetically-engineered pig graft, particularly if CTLA4-Ig is included in the regimen, in part because the development of donor-specific memory B cells is inhibited.
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Affiliation(s)
- Takayuki Yamamoto
- Xenotransplantation Program, Department of Surgery, University of Alabama at Birmingham, Birmingham, AL, USA
| | - Qi Li
- Xenotransplantation Program, Department of Surgery, University of Alabama at Birmingham, Birmingham, AL, USA; Second Affiliated Hospital, University of South China, Hengyang City, Hunan, China
| | - Hidetaka Hara
- Xenotransplantation Program, Department of Surgery, University of Alabama at Birmingham, Birmingham, AL, USA
| | - Liaoran Wang
- Xenotransplantation Program, Department of Surgery, University of Alabama at Birmingham, Birmingham, AL, USA; Second Affiliated Hospital, University of South China, Hengyang City, Hunan, China
| | - Hongmin Zhou
- Xenotransplantation Program, Department of Surgery, University of Alabama at Birmingham, Birmingham, AL, USA; Department of Cardiothoracic Surgery, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Juan Li
- Xenotransplantation Program, Department of Surgery, University of Alabama at Birmingham, Birmingham, AL, USA; Second Affiliated Hospital, University of South China, Hengyang City, Hunan, China
| | - Devin E Eckhoff
- Xenotransplantation Program, Department of Surgery, University of Alabama at Birmingham, Birmingham, AL, USA
| | - A Joseph Tector
- Xenotransplantation Program, Department of Surgery, University of Alabama at Birmingham, Birmingham, AL, USA
| | - Edwin C Klein
- Thomas E. Starzl Transplantation Institute, University of Pittsburgh, Pittsburgh, PA, USA
| | - Ray Lovingood
- Kirklin Clinic Pharmacy, University of Alabama at Birmingham, Birmingham, AL, USA
| | - Mohamed Ezzelarab
- Thomas E. Starzl Transplantation Institute, University of Pittsburgh, Pittsburgh, PA, USA
| | | | - Yi Wang
- Second Affiliated Hospital, University of South China, Hengyang City, Hunan, China
| | - David K C Cooper
- Xenotransplantation Program, Department of Surgery, University of Alabama at Birmingham, Birmingham, AL, USA
| | - Hayato Iwase
- Xenotransplantation Program, Department of Surgery, University of Alabama at Birmingham, Birmingham, AL, USA.
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Sykes M. IXA Honorary Member Lecture, 2017: The long and winding road to tolerance. Xenotransplantation 2018; 25:e12419. [PMID: 29913040 DOI: 10.1111/xen.12419] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/09/2018] [Accepted: 05/03/2018] [Indexed: 12/18/2022]
Abstract
The last 15 years or so have seen exciting progress in xenotransplantation, with porcine organ grafts surviving months or even years in non-human primates. These advances reflect the application of new scientific knowledge, improved immunosuppressive agents, and genetic engineering. The field has recently enjoyed a renaissance of interest and hope, largely due to the exponential increase in our capacity to genetically engineer porcine source animals. However, immune responses to xenografts are very powerful and widespread clinical application of xenotransplantation will depend on the ability to suppress these immune responses while preserving the capacity to protect both the recipient and the graft from infectious microorganisms. Our work over the last three decades has aimed to engineer the immune system of the recipient in a manner that achieves specific tolerance to the xenogeneic donor while preserving otherwise normal immune function. Important proofs of principle have been obtained, first in rodents, and later in human immune systems in "humanized mice" and finally in non-human primates, demonstrating the capacity and potential synergy of mixed xenogeneic chimerism and xenogeneic thymic transplantation in tolerizing multiple arms of the immune system. Considering the fact that clinical tolerance has recently been achieved for allografts and the even greater importance of avoiding excessive immunosuppression for xenografts, it is my belief that it is both possible and imperative that we likewise achieve xenograft tolerance. I expect this to be accomplished through the availability of targeted approaches to recipient immune conditioning, understanding of immunological mechanisms of tolerance, advanced knowledge of physiological incompatibilities, and the availability of inbred miniature swine with optimized use of genetic engineering.
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Affiliation(s)
- Megan Sykes
- Columbia Center for Translational Immunology, Columbia University Medical Center, New York, NY, USA.,Department of Medicine, Columbia University, New York, NY, USA.,Department of Microbiology & Immunology, Columbia University, New York, NY, USA.,Department of Surgery, Columbia University, New York, NY, USA
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111
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Development of aortic endothelial cells to express CD37 and CD73 isolated from alpha 1,3-galactosyltransferase knock-out and MCP expressing pig. JOURNAL OF ANIMAL REPRODUCTION AND BIOTECHNOLOGY 2018. [DOI: 10.12750/jet.2018.33.3.129] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022] Open
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112
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Yang H, Wu Z. Genome Editing of Pigs for Agriculture and Biomedicine. Front Genet 2018; 9:360. [PMID: 30233645 PMCID: PMC6131568 DOI: 10.3389/fgene.2018.00360] [Citation(s) in RCA: 54] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/28/2018] [Accepted: 08/21/2018] [Indexed: 12/26/2022] Open
Abstract
Pigs serve as an important agricultural resource and animal model in biomedical studies. Efficient and precise modification of pig genome by using recently developed gene editing tools has significantly broadened the application of pig models in various research areas. The three types of site-specific nucleases, namely, zinc-finger nucleases, transcription activator-like effector nucleases, and clustered regularly interspaced short palindromic repeats (CRISPR)/CRISPR-associated protein, are the main gene editing tools that can efficiently introduce predetermined modifications, including knockouts and knockins, into the pig genome. These modifications can confer desired phenotypes to pigs to improve production traits, such as optimal meat production, enhanced feed digestibility, and disease resistance. Besides, given their genetic, anatomic, and physiologic similarities to humans, pigs can also be modified to model human diseases or to serve as an organ source for xenotransplantation to save human lives. To date, many genetically modified pig models with agricultural or biomedical values have been established by using gene editing tools. These pig models are expected to accelerate research progress in related fields and benefit humans.
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Affiliation(s)
- Huaqiang Yang
- National Engineering Research Center for Breeding Swine Industry, College of Animal Science, South China Agricultural University, Guangzhou, China
| | - Zhenfang Wu
- National Engineering Research Center for Breeding Swine Industry, College of Animal Science, South China Agricultural University, Guangzhou, China
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113
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Immunological Compatibility of Bone Tissues from Alpha-1,3-galactosyltransferase Knockout Pig for Xenotransplantation. BIOMED RESEARCH INTERNATIONAL 2018; 2018:1597531. [PMID: 29967767 PMCID: PMC6008681 DOI: 10.1155/2018/1597531] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/22/2017] [Revised: 03/20/2018] [Accepted: 04/15/2018] [Indexed: 01/08/2023]
Abstract
We investigated whether the lack of galactosyltransferase (α-Gal) expression in bone tissue is associated with reduced immune response of human peripheral blood mononuclear cells (PBMCs) against pig bone tissue. When human PBMC obtained from heparinized blood of healthy volunteers was stimulated with bone extracts of pigs with α-1,3-galactosyltransferase knock out (α-Gal KO), the proliferation of human PBMCs and production of proinflammatory cytokines such as TNF-α and IL-1β were significantly reduced compared to those stimulated with bone extracts of wild type (WT) pigs. In addition, activation of CD4+ helper T cells and production of IL-2, IFN-γ, and IL-17 were reduced upon stimulation with bone tissue extracts from α-Gal KO pigs. This is possibly due to the lowered activities of the NF-κB, p38, ERK, and JNK signaling pathways. Our findings can be used to evaluate the compatibility of bone tissues from α-Gal KO pigs with human bone grafting as novel natural biomaterials, thereby increasing the feasibility of future clinical applications.
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114
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Wang L, Cooper DKC, Burdorf L, Wang Y, Iwase H. Overcoming Coagulation Dysregulation in Pig Solid Organ Transplantation in Nonhuman Primates: Recent Progress. Transplantation 2018; 102:1050-1058. [PMID: 29538262 PMCID: PMC7228622 DOI: 10.1097/tp.0000000000002171] [Citation(s) in RCA: 37] [Impact Index Per Article: 6.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/08/2017] [Revised: 01/22/2018] [Accepted: 01/26/2018] [Indexed: 01/17/2023]
Abstract
There has recently been considerable progress in the results of pig organ transplantation in nonhuman primates, largely associated with the availability of (i) pigs genetically engineered to overcome coagulation dysregulation, and (ii) novel immunosuppressive agents. The barriers of thrombotic microangiopathy and/or consumptive coagulation were believed to be associated with (i) activation of the graft vascular endothelial cells by a low level of antipig antibody binding and/or complement deposition and/or innate immune cell activity, and (ii) molecular incompatibilities between the nonhuman primate and pig coagulation-anticoagulation systems. The introduction of a human coagulation-regulatory transgene, for example, thrombomodulin, endothelial protein C receptor, into the pig vascular endothelial cells has contributed to preventing a procoagulant state from developing, resulting in a considerable increase in graft survival. In the heterotopic (non-life-supporting) heart transplant model, graft survival has increased from a maximum of 179 days in 2005 to 945 days. After life-supporting kidney transplantation, survival has been extended from 90 days in 2004 to 499 days. In view of the more complex coagulation dysfunction seen after pig liver and, particularly, lung transplantation, progress has been less dramatic, but the maximum survival of a pig liver has been increased from 7 days in 2010 to 29 days, and of a pig lung from 4 days in 2007 to 9 days. There is a realistic prospect that the transplantation of a kidney or heart, in combination with a conventional immunosuppressive regimen, will enable long-term recipient survival.
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Affiliation(s)
- Liaoran Wang
- Xenotransplantation Program, Department of Surgery, University of Alabama at Birmingham, Birmingham AL
- Second Affiliated Hospital, University of South China, Hengyang City, Hunan, China
| | - David K C Cooper
- Xenotransplantation Program, Department of Surgery, University of Alabama at Birmingham, Birmingham AL
| | - Lars Burdorf
- Division of Cardiac Surgery, Department of Surgery, University of Maryland, Baltimore VAMC, Baltimore, MD
| | - Yi Wang
- Second Affiliated Hospital, University of South China, Hengyang City, Hunan, China
| | - Hayato Iwase
- Xenotransplantation Program, Department of Surgery, University of Alabama at Birmingham, Birmingham AL
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115
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Rivard CJ, Tanabe T, Lanaspa MA, Watanabe H, Nomura S, Andres-Hernando A, Garth K, Sekijima M, Ishimoto T, Ariyoshi Y, Garcia GE, Shah J, Lennan B, Tasaki M, Pomposelli T, Shimizu A, Sachs DH, Johnson RJ, Yamada K. Upregulation of CD80 on glomerular podocytes plays an important role in development of proteinuria following pig-to-baboon xeno-renal transplantation - an experimental study. Transpl Int 2018; 31:1164-1177. [PMID: 29722117 DOI: 10.1111/tri.13273] [Citation(s) in RCA: 29] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/13/2017] [Revised: 01/04/2018] [Accepted: 04/23/2018] [Indexed: 01/02/2023]
Abstract
We have previously reported that co-transplantation of the kidney with vascularized donor thymus from α-1,3-galactosyltransferase gene knockout pigs with an anti-CD154 with rituximab-based regimen led to improved xenograft survival in baboons with donor-specific unresponsiveness. However, nephrotic syndrome emerged as a complication in which the glomeruli showed mild mesangial expansion with similarities to minimal change disease (MCD) in humans. Since MCD is associated with CD80 expression in glomeruli and elevated urinary excretion, we evaluated a potential role for CD80 in xenograft nephropathy. Study 1 confirmed high urinary CD80 excretion in nephrotic animals with renal xenografts showing CD80 expression in glomeruli. In Study 2, baboons receiving xenografts received CTLA4-Ig once a week from the second postoperative week or no CTLA4-Ig. The non-CTLA4-Ig group developed severe proteinuria with modest mesangial expansion with high urinary excretion of CD80 and documented CD80 expression in glomerular podocytes. All of the recipients in non-CTLA4-Ig groups had to be euthanized before POD 60. In contrast, CTLA4-Ig group showed a marked reduction in proteinuria and survived significantly longer, up to 193 days. These results demonstrate that anti-CD80 targeted therapy represents a promising strategy for reduction of proteinuria following renal xeno-transplantation with improved survival.
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Affiliation(s)
- Christopher J Rivard
- Division of Renal Diseases and Hypertension, University of Colorado Denver, Aurora, CO, USA
| | - Tatsu Tanabe
- Columbia Center for Translational Immunology, Columbia University Medical Center, New York, NY, USA
| | - Miguel A Lanaspa
- Division of Renal Diseases and Hypertension, University of Colorado Denver, Aurora, CO, USA
| | - Hironosuke Watanabe
- Columbia Center for Translational Immunology, Columbia University Medical Center, New York, NY, USA
| | - Shunichiro Nomura
- Columbia Center for Translational Immunology, Columbia University Medical Center, New York, NY, USA
| | - Ana Andres-Hernando
- Division of Renal Diseases and Hypertension, University of Colorado Denver, Aurora, CO, USA
| | - Krystle Garth
- Division of Renal Diseases and Hypertension, University of Colorado Denver, Aurora, CO, USA
| | - Mitsuhiro Sekijima
- TBRC Laboratories, CTS, Massachusetts General Hospital, Charlestown, MA, USA
| | - Takuji Ishimoto
- Division of Renal Diseases and Hypertension, University of Colorado Denver, Aurora, CO, USA
| | - Yuichi Ariyoshi
- Columbia Center for Translational Immunology, Columbia University Medical Center, New York, NY, USA
| | - Gabriela E Garcia
- Division of Renal Diseases and Hypertension, University of Colorado Denver, Aurora, CO, USA
| | - Jigesh Shah
- TBRC Laboratories, CTS, Massachusetts General Hospital, Charlestown, MA, USA
| | - Boyd Lennan
- Columbia Center for Translational Immunology, Columbia University Medical Center, New York, NY, USA
| | - Masayuki Tasaki
- TBRC Laboratories, CTS, Massachusetts General Hospital, Charlestown, MA, USA
| | - Thomas Pomposelli
- Columbia Center for Translational Immunology, Columbia University Medical Center, New York, NY, USA
| | - Akira Shimizu
- TBRC Laboratories, CTS, Massachusetts General Hospital, Charlestown, MA, USA
| | - David H Sachs
- Columbia Center for Translational Immunology, Columbia University Medical Center, New York, NY, USA.,TBRC Laboratories, CTS, Massachusetts General Hospital, Charlestown, MA, USA
| | - Richard J Johnson
- Division of Renal Diseases and Hypertension, University of Colorado Denver, Aurora, CO, USA
| | - Kazuhiko Yamada
- Columbia Center for Translational Immunology, Columbia University Medical Center, New York, NY, USA
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116
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Daugs A, Lehmann N, Eroglu D, Meinke MC, Markhoff A, Bloch O. In VitroDetection System to Evaluate the Immunogenic Potential of Xenografts. Tissue Eng Part C Methods 2018; 24:280-288. [DOI: 10.1089/ten.tec.2017.0532] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/11/2023] Open
Affiliation(s)
- Aila Daugs
- Auto Tissue Berlin GmbH, Berlin, Germany
| | | | | | - Martina C. Meinke
- Center of Experimental and Applied Cutaneous Physiology, Charité—Universitätsmedizin Berlin, Berlin, Germany
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117
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Byrne G, Ahmad-Villiers S, Du Z, McGregor C. B4GALNT2 and xenotransplantation: A newly appreciated xenogeneic antigen. Xenotransplantation 2018; 25:e12394. [PMID: 29604134 PMCID: PMC6158069 DOI: 10.1111/xen.12394] [Citation(s) in RCA: 84] [Impact Index Per Article: 14.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/20/2017] [Revised: 03/08/2018] [Accepted: 03/13/2018] [Indexed: 12/20/2022]
Abstract
Analysis of non‐Gal antibody induced after pig‐to‐baboon cardiac xenotransplantation identified the glycan produced by porcine beta‐1,4‐N‐acetyl‐galactosaminyltransferase 2 (B4GALNT2) as an immunogenic xenotransplantation antigen. The porcine B4GALNT2 enzyme is homologous to the human enzyme, which synthesizes the human SDa blood group antigen. Most humans produce low levels of anti‐SDa IgM which polyagglutinates red blood cells from rare individuals with high levels of SDa expression. The SDa glycan is also present on GM2 gangliosides. Clinical GM2 vaccination studies for melanoma patients suggest that a human antibody response to SDa can be induced. Expression of porcine B4GALNT2 in human HEK293 cells results in increased binding of anti‐SDa antibody and increased binding of Dolichos biflorus agglutinin (DBA), a lectin commonly used to detect SDa. In pigs, B4GALNT2 is expressed by vascular endothelial cells and endothelial cells from a wide variety of pig backgrounds stain with DBA, suggesting that porcine vascular expression of B4GALNT2 is not polymorphic. Mutations in B4GALNT2 have been engineered in mice and pigs. In both species, the B4GALNT2‐KO animals are apparently normal and no longer show evidence of SDa antigen expression. Pig tissues with a mutation in B4GALNT2, added to a background of alpha‐1,3‐galactosyltransferase deficient (GGTA1‐KO) and cytidine monophosphate‐N‐acetylneuraminic acid hydroxylase deficient (CMAH‐KO), show reduced antibody binding, confirming the presence of B4GALNT2‐dependent antibodies in both humans and non‐human primates. Preclinical xenotransplantation using B4GALNT2‐deficient donors has recently been reported. Elimination of this source of immunogenic pig antigen should minimize acute injury by preformed anti‐pig antibody and eliminate an induced clinical immune response to this newly appreciated xenotransplantation antigen.
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Affiliation(s)
- Guerard Byrne
- Institute of Cardiovascular Science, University College London, London, UK.,Department of Surgery, Mayo Clinic, Rochester, MN, USA
| | | | - Zeji Du
- Department of Surgery, Mayo Clinic, Rochester, MN, USA
| | - Christopher McGregor
- Institute of Cardiovascular Science, University College London, London, UK.,Department of Surgery, Mayo Clinic, Rochester, MN, USA
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118
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Ock SA, Oh KB, Hwang S, Yun IJ, Ahn C, Chee HK, Kim H, Ullah I, Im GS, Park EW. Immune molecular profiling of whole blood drawn from a non-human primate cardiac xenograft model treated with anti-CD154 monoclonal antibodies. Xenotransplantation 2018; 25:e12392. [PMID: 29582477 DOI: 10.1111/xen.12392] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/02/2017] [Revised: 01/17/2018] [Accepted: 02/22/2018] [Indexed: 12/17/2022]
Abstract
Most studies of xenografts have been carried out with complex immunosuppressive regimens to prevent immune rejection; however, such treatments may be fatal owing to unknown causes. Here, we performed immune molecular profiling following anti-CD154 monoclonal antibody (mAb) treatment in heterotopic abdominal cardiac xenografts from α-1,3-galactosyltransferase-knockout pigs into cynomolgus monkeys to elucidate the mechanisms mediating the undesirable fatal side effects of immunosuppressive agents. Blood samples were collected from healthy monkeys as control and then at 2 days after xenograft transplantation and just before humane euthanasia; 94 genes related to the immune system were analyzed. The basic immunosuppressive regimen included cobra venom factor, anti-thymocyte globulin, and rituximab, with and without anti-CD154 mAbs. The maintenance therapy was followed with tacrolimus, MMF, and methylprednisolone. The number of upregulated genes was initially decreased on Day 2 (-/+ anti-CD154 mAb, 22/13) and then increased before euthanasia in recipients treated with anti-CD154 mAbs (-/+ anti-CD154 mAb, 30/37). The number of downregulated genes was not affected by anti-CD154 mAb treatment. Additionally, the number of upregulated genes increased over time for both groups. Interestingly, treatment with anti-CD154 mAbs upregulated coagulation inducers (CCL2/IL6) before euthanasia. In conclusion, immunosuppressive regimens used for cardiac xenografting affected upregulation of 6 inflammation genes (CXCL10, MPO, MYD88, NLRP3, TNFα, and TLR1) and downregulation of 8 genes (CCR4, CCR6, CD40, CXCR3, FOXP3, GATA3, STAT4, and TBX21).
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Affiliation(s)
- Sun A Ock
- Animal Biotechnology Division, National Institute of Animal Science, Rural Development Administration, Wanju-gun, Jeollabuk-do, Korea
| | - Keon Bong Oh
- Animal Biotechnology Division, National Institute of Animal Science, Rural Development Administration, Wanju-gun, Jeollabuk-do, Korea
| | - Seongsoo Hwang
- Animal Biotechnology Division, National Institute of Animal Science, Rural Development Administration, Wanju-gun, Jeollabuk-do, Korea
| | - Ik Jin Yun
- Department of Surgery, Konkuk University School of Medicine, Seoul, Korea
| | - Curie Ahn
- Division of Nephrology, Seoul National University College of Medicine, Seoul, Korea.,Designed Animal & Transplantation Research institute, Institute of Green BioScience & Technology, Seoul National University, Pyeongchang, Gangwon-do, Korea
| | - Hyun Ken Chee
- Department of Cardiothoracic Surgery, Konkuk University School of Medicine, Seoul, Korea
| | - Hwajung Kim
- Division of Nephrology, Seoul National University College of Medicine, Seoul, Korea
| | - Imran Ullah
- Animal Biotechnology Division, National Institute of Animal Science, Rural Development Administration, Wanju-gun, Jeollabuk-do, Korea
| | - Gi-Sun Im
- Animal Biotechnology Division, National Institute of Animal Science, Rural Development Administration, Wanju-gun, Jeollabuk-do, Korea
| | - Eung Woo Park
- Animal Biotechnology Division, National Institute of Animal Science, Rural Development Administration, Wanju-gun, Jeollabuk-do, Korea
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119
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Abicht JM, Sfriso R, Reichart B, Längin M, Gahle K, Puga Yung GL, Seebach JD, Rieben R, Ayares D, Wolf E, Klymiuk N, Baehr A, Kind A, Mayr T, Bauer A. Multiple genetically modified GTKO/hCD46/HLA-E/hβ2−mg porcine hearts are protected from complement activation and natural killer cell infiltration during ex vivo perfusion with human blood. Xenotransplantation 2018. [DOI: 10.1111/xen.12390] [Citation(s) in RCA: 22] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
Affiliation(s)
- Jan-Michael Abicht
- Department of Anaesthesiology; Ludwig Maximilian University; Munich Germany
| | - Riccardo Sfriso
- Department of Clinical Research; University of Bern; Bern Switzerland
| | - Bruno Reichart
- Transregio Collaborative Research Center 127; Walter Brendel Centre of Experimental Medicine; Ludwig Maximilian University; Munich Germany
| | - Matthias Längin
- Department of Anaesthesiology; Ludwig Maximilian University; Munich Germany
| | - Katja Gahle
- Department of Anaesthesiology; Ludwig Maximilian University; Munich Germany
| | - Gisella L. Puga Yung
- Division of Immunology and Allergology; University Hospital and Faculty of Medicine; University of Geneva; Geneva Switzerland
| | - Jörg D. Seebach
- Division of Immunology and Allergology; University Hospital and Faculty of Medicine; University of Geneva; Geneva Switzerland
| | - Robert Rieben
- Department of Clinical Research; University of Bern; Bern Switzerland
| | | | - Eckhard Wolf
- Department of Molecular Animal Breeding and Biotechnology; Ludwig Maximilian University; Munich Germany
| | - Nikolai Klymiuk
- Department of Molecular Animal Breeding and Biotechnology; Ludwig Maximilian University; Munich Germany
| | - Andrea Baehr
- Department of Molecular Animal Breeding and Biotechnology; Ludwig Maximilian University; Munich Germany
| | - Alexander Kind
- Chair of Livestock Biotechnology; School of Life Sciences Weihenstephan; Technical University of Munich; Munich Germany
| | - Tanja Mayr
- Department of Anaesthesiology; Ludwig Maximilian University; Munich Germany
| | - Andreas Bauer
- Department of Anaesthesiology; Ludwig Maximilian University; Munich Germany
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120
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Abstract
This article summarizes studies in which the author has been involved over several decades, directed toward providing solutions for the three major limitations to the field of transplantation: (1) drug treatment-related complications; (2) chronic rejection; and (3) the availability of transplantable organs. The first two of these limitations may be overcome by induction of transplantation tolerance, while the third will also require a new source of organs, for which great strides are now being made in xenotransplantation through genetic engineering.
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121
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Montassier E, Berthelot L, Soulillou JP. Are the decrease in circulating anti-α1,3-Gal IgG and the lower content of galactosyl transferase A1 in the microbiota of patients with multiple sclerosis a novel environmental risk factor for the disease? Mol Immunol 2018; 93:162-165. [DOI: 10.1016/j.molimm.2017.09.016] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/08/2017] [Revised: 09/22/2017] [Accepted: 09/27/2017] [Indexed: 01/10/2023]
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122
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Singh AK, Chan JL, Seavey CN, Corcoran PC, Hoyt RF, Lewis BGT, Thomas ML, Ayares DL, Horvath KA, Mohiuddin MM. CD4+CD25 Hi FoxP3+ regulatory T cells in long-term cardiac xenotransplantation. Xenotransplantation 2017; 25:e12379. [PMID: 29250828 DOI: 10.1111/xen.12379] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/05/2017] [Revised: 10/12/2017] [Accepted: 11/24/2017] [Indexed: 01/02/2023]
Abstract
BACKGROUND CD4+CD25Hi FoxP3+ T (Treg) cells are a small subset of CD4+ T cells that have been shown to exhibit immunoregulatory function. Although the absolute number of Treg cells in peripheral blood lymphocytes (PBL) is very small, they play an important role in suppressing immune reactivity. Several studies have demonstrated that the number of Treg cells, rather than their intrinsic suppressive capacity, may contribute to determining the long-term fate of transplanted grafts. In this study, we analyzed Treg cells in PBL of long-term baboon recipients who have received genetically modified cardiac xenografts from pig donors. METHODS Heterotopic cardiac xenotransplantation was performed on baboons using hearts obtained from GTKO.hCD46 (n = 8) and GTKO.hCD46.TBM (n = 5) genetically modified pigs. Modified immunosuppression regimen included antithymocyte globulin (ATG), anti-CD20, mycophenolate mofetil (MMF), cobra venom factor (CVF), and costimulation blockade (anti-CD154/anti-CD40 monoclonal antibody). FACS analysis was performed on PBLs labeled with anti-human CD4, CD25, and FoxP3 monoclonal antibodies (mAb) to analyze the percentage of Treg cells in six baboons that survived longer than 2 months (range: 42-945 days) after receiving a pig cardiac xenograft. RESULTS Total WBC count was low due to immunosuppression in baboons who received cardiac xenograft from GTKO.hCD46 and GTKO.hCD46.hTBM donor pigs. However, absolute numbers of CD4+CD25Hi FoxP3 Treg cells in PBLs of long-term xenograft cardiac xenograft surviving baboon recipients were found to be increased (15.13 ± 1.50 vs 7.38 ± 2.92; P < .018) as compared to naïve or pre-transplant baboons. Xenograft rejection in these animals was correlated with decreased numbers of regulatory T cells. CONCLUSION Our results suggest that regulatory T (Treg) cells may contribute to preventing or delaying xenograft rejection by controlling the activation and expansion of donor-reactive T cells, thereby masking the antidonor immune response, leading to long-term survival of cardiac xenografts.
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Affiliation(s)
- Avneesh K Singh
- Cardiothoracic Surgery Research Program/National Heart, Lung and Blood Institute, National Institutes of Health, Bethesda, MD, USA.,Department of Surgery, School of Medicine, University of Maryland, Baltimore, MD, USA
| | - Joshua L Chan
- Cardiothoracic Surgery Research Program/National Heart, Lung and Blood Institute, National Institutes of Health, Bethesda, MD, USA
| | - Caleb N Seavey
- Cardiothoracic Surgery Research Program/National Heart, Lung and Blood Institute, National Institutes of Health, Bethesda, MD, USA
| | - Philip C Corcoran
- Cardiothoracic Surgery Research Program/National Heart, Lung and Blood Institute, National Institutes of Health, Bethesda, MD, USA
| | - Robert F Hoyt
- Cardiothoracic Surgery Research Program/National Heart, Lung and Blood Institute, National Institutes of Health, Bethesda, MD, USA
| | - Billeta G T Lewis
- Department of Surgery, School of Medicine, University of Maryland, Baltimore, MD, USA.,Division of Veterinary Resources, Office of Research Services, National Institutes of Health, Bethesda, MD, USA
| | - Marvin L Thomas
- Division of Veterinary Resources, Office of Research Services, National Institutes of Health, Bethesda, MD, USA
| | | | - Keith A Horvath
- Cardiothoracic Surgery Research Program/National Heart, Lung and Blood Institute, National Institutes of Health, Bethesda, MD, USA
| | - Muhammad M Mohiuddin
- Cardiothoracic Surgery Research Program/National Heart, Lung and Blood Institute, National Institutes of Health, Bethesda, MD, USA.,Department of Surgery, School of Medicine, University of Maryland, Baltimore, MD, USA
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123
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Porcine to Human Heart Transplantation: Is Clinical Application Now Appropriate? J Immunol Res 2017; 2017:2534653. [PMID: 29238731 PMCID: PMC5697125 DOI: 10.1155/2017/2534653] [Citation(s) in RCA: 23] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/06/2017] [Accepted: 10/08/2017] [Indexed: 11/24/2022] Open
Abstract
Cardiac xenotransplantation (CXTx) is a promising solution to the chronic shortage of donor hearts. Recent advancements in immune suppression have greatly improved the survival of heterotopic CXTx, now extended beyond 2 years, and life-supporting kidney XTx. Advances in donor genetic modification (B4GALNT2 and CMAH mutations) with proven Gal-deficient donors expressing human complement regulatory protein(s) have also accelerated, reducing donor pig organ antigenicity. These advances can now be combined and tested in life-supporting orthotopic preclinical studies in nonhuman primates and immunologically appropriate models confirming their efficacy and safety for a clinical CXTx program. Preclinical studies should also allow for organ rejection to develop xenospecific assays and therapies to reverse rejection. The complexity of future clinical CXTx presents a substantial and unique set of regulatory challenges which must be addressed to avoid delay; however, dependent on these prospective life-supporting preclinical studies in NHPs, it appears that the scientific path forward is well defined and the era of clinical CXTx is approaching.
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124
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Sahara H, Sekijima M, Ariyoshi Y, Kawai A, Miura K, Waki S, Nathan L, Tomita Y, Iwanaga T, Nakano K, Matsunari H, Date H, Nagashima H, Shimizu A, Yamada K. Effects of carbon monoxide on early dysfunction and microangiopathy following GalT-KO porcine pulmonary xenotransplantation in cynomolgus monkeys. Xenotransplantation 2017; 25. [PMID: 29067747 DOI: 10.1111/xen.12359] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/19/2017] [Revised: 08/21/2017] [Accepted: 09/21/2017] [Indexed: 12/22/2022]
Abstract
BACKGROUND Despite progress in the current genetic manipulation of donor pigs, most non-human primates were lost within a day of receiving porcine lung transplants. We previously reported that carbon monoxide (CO) treatment improved pulmonary function in an allogeneic lung transplant (LTx) model using miniature swine. In this study, we evaluated whether the perioperative treatment with low-dose inhalation of CO has beneficial effects on porcine lung xenografts in cynomolgus monkeys (cynos). METHODS Eight cynos received orthotopic left LTx using either α-1,3-galactosyltransferase knockout (GalT-KO; n = 2) or GalT-KO with human decay accelerating factor (hDAF) (GalT-KO/hDAF; n = 6) swine donors. These eight animals were divided into three groups. In Group 1 (n = 2), neither donor nor recipients received CO therapy. In Group 2 (n = 4), donors were treated with inhaled CO for 180-minute. In Group 3 (n = 2), both donors and recipients were treated with CO (donor: 180-minute; recipient: 360-minute). Concentration of inhaled CO was adjusted based on measured levels of carboxyhemoglobin in the blood (15%-20%). RESULTS Two recipients survived for 3 days; 75 hours (no-CO) and 80 hours (CO in both the donor and the recipient), respectively. Histology showed less inflammatory cell infiltrates, intravascular thrombi, and hemorrhage in the 80-hour survivor with the CO treatment than the 75-hours non-CO treatment. Anti-non-Gal cytotoxicity levels did not affect the early loss of the grafts. Although CO treatment did not prolong overall xeno lung graft survival, the recipient/donor CO treatment helped to maintain platelet counts and inhibit TNF-α and IL-6 secretion at 2 hours after revascularization of grafts. In addition, lung xenografts that were received recipient/donor CO therapy demonstrated fewer macrophage and neutrophil infiltrates. Infiltrating macrophages as well as alveolar epithelial cells in the CO-treated graft expressed heme oxygenase-1. CONCLUSION Although further investigation is required, CO treatment may provide a beneficial strategy for pulmonary xenografts.
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Affiliation(s)
- Hisashi Sahara
- Division of Organ Replacement and Xenotransplantation Surgery, Center for Advanced Biomedical Science and Swine Research, Kagoshima University, Kagoshima, Japan
| | - Mitsuhiro Sekijima
- Division of Organ Replacement and Xenotransplantation Surgery, Center for Advanced Biomedical Science and Swine Research, Kagoshima University, Kagoshima, Japan
| | - Yuichi Ariyoshi
- Division of Organ Replacement and Xenotransplantation Surgery, Center for Advanced Biomedical Science and Swine Research, Kagoshima University, Kagoshima, Japan
| | - Akihiro Kawai
- Division of Organ Replacement and Xenotransplantation Surgery, Center for Advanced Biomedical Science and Swine Research, Kagoshima University, Kagoshima, Japan
| | - Kohei Miura
- Division of Organ Replacement and Xenotransplantation Surgery, Center for Advanced Biomedical Science and Swine Research, Kagoshima University, Kagoshima, Japan
| | - Shiori Waki
- Division of Organ Replacement and Xenotransplantation Surgery, Center for Advanced Biomedical Science and Swine Research, Kagoshima University, Kagoshima, Japan
| | - Louras Nathan
- Division of Organ Replacement and Xenotransplantation Surgery, Center for Advanced Biomedical Science and Swine Research, Kagoshima University, Kagoshima, Japan.,Transplantation Biology Research Laboratories, Massachusetts General Hospital, Boston, MA, USA
| | - Yusuke Tomita
- Division of Organ Replacement and Xenotransplantation Surgery, Center for Advanced Biomedical Science and Swine Research, Kagoshima University, Kagoshima, Japan
| | - Takehiro Iwanaga
- Division of Organ Replacement and Xenotransplantation Surgery, Center for Advanced Biomedical Science and Swine Research, Kagoshima University, Kagoshima, Japan
| | - Kazuaki Nakano
- Laboratory of Developmental Engineering, Meiji University School of Agriculture, Kawasaki, Japan
| | - Hitomi Matsunari
- Laboratory of Developmental Engineering, Meiji University School of Agriculture, Kawasaki, Japan
| | - Hiroshi Date
- Department of Thoracic Surgery, Graduate School of Medicine, Kyoto University, Kyoto, Japan
| | - Hiroshi Nagashima
- Laboratory of Developmental Engineering, Meiji University School of Agriculture, Kawasaki, Japan
| | - Akira Shimizu
- Division of Organ Replacement and Xenotransplantation Surgery, Center for Advanced Biomedical Science and Swine Research, Kagoshima University, Kagoshima, Japan
| | - Kazuhiko Yamada
- Division of Organ Replacement and Xenotransplantation Surgery, Center for Advanced Biomedical Science and Swine Research, Kagoshima University, Kagoshima, Japan
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Cooper DKC, Ezzelarab MB, Hara H. Low anti-pig antibody levels are key to the success of solid organ xenotransplantation: But is this sufficient? Xenotransplantation 2017; 24. [PMID: 29067714 DOI: 10.1111/xen.12360] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/30/2017] [Revised: 08/09/2017] [Accepted: 09/26/2017] [Indexed: 12/15/2022]
Affiliation(s)
- David K C Cooper
- Xenotransplantation Program, Department of Surgery, University of Alabama at Birmingham, Birmingham, AL, USA
| | - Mohamed B Ezzelarab
- Thomas E. Starzl Transplantation Institute, University of Pittsburgh, Pittsburgh, PA, USA
| | - Hidetaka Hara
- Xenotransplantation Program, Department of Surgery, University of Alabama at Birmingham, Birmingham, AL, USA
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126
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Li M, Eckl J, Abicht JM, Mayr T, Reichart B, Schendel DJ, Pohla H. Induction of porcine-specific regulatory T cells with high specificity and expression of IL-10 and TGF-β1 using baboon-derived tolerogenic dendritic cells. Xenotransplantation 2017; 25. [DOI: 10.1111/xen.12355] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/29/2017] [Revised: 08/18/2017] [Accepted: 09/01/2017] [Indexed: 01/26/2023]
Affiliation(s)
- Mingqian Li
- Laboratory of Tumor Immunology; LIFE Center; Ludwig-Maximilians-Universität; Munich Germany
- Department of Urology; University Hospital; Ludwig-Maximilians-Universität; Munich Germany
| | - Judith Eckl
- Institute of Molecular Immunology; Helmholtz Zentrum München; German Research Center for Environmental Health; Munich Germany
- Medigene Immunotherapies GmbH; Planegg-Martinsried Germany
| | - Jan-Michael Abicht
- Department of Anaesthesiology; Ludwig-Maximilians-Universität; Munich Germany
- Walter Brendel Centre of Experimental Medicine; Ludwig-Maximilians-Universität; Munich Germany
| | - Tanja Mayr
- Department of Anaesthesiology; Ludwig-Maximilians-Universität; Munich Germany
- Walter Brendel Centre of Experimental Medicine; Ludwig-Maximilians-Universität; Munich Germany
| | - Bruno Reichart
- Walter Brendel Centre of Experimental Medicine; Ludwig-Maximilians-Universität; Munich Germany
| | - Dolores J. Schendel
- Institute of Molecular Immunology; Helmholtz Zentrum München; German Research Center for Environmental Health; Munich Germany
- Medigene Immunotherapies GmbH; Planegg-Martinsried Germany
| | - Heike Pohla
- Laboratory of Tumor Immunology; LIFE Center; Ludwig-Maximilians-Universität; Munich Germany
- Department of Urology; University Hospital; Ludwig-Maximilians-Universität; Munich Germany
- Institute of Molecular Immunology; Helmholtz Zentrum München; German Research Center for Environmental Health; Munich Germany
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127
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The Role of Costimulation Blockade in Solid Organ and Islet Xenotransplantation. J Immunol Res 2017; 2017:8415205. [PMID: 29159187 PMCID: PMC5660816 DOI: 10.1155/2017/8415205] [Citation(s) in RCA: 38] [Impact Index Per Article: 5.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/17/2017] [Accepted: 09/17/2017] [Indexed: 12/17/2022] Open
Abstract
Pig-to-human xenotransplantation offers a potential bridge to the growing disparity between patients with end-stage organ failure and graft availability. Early studies attempting to overcome cross-species barriers demonstrated robust humoral immune responses to discordant xenoantigens. Recent advances have led to highly efficient and targeted genomic editing, drastically altering the playing field towards rapid production of less immunogenic porcine tissues and even the discussion of human xenotransplantation trials. However, as these humoral immune barriers to cross-species transplantation are overcome with advanced transgenics, cellular immunity to these novel xenografts remains an outstanding issue. Therefore, understanding and optimizing immunomodulation will be paramount for successful clinical xenotransplantation. Costimulation blockade agents have been introduced in xenotransplantation research in 2000 with anti-CD154mAb. Most recently, prolonged survival has been achieved in solid organ (kidney xenograft survival > 400 days with anti-CD154mAb, heart xenograft survival > 900 days, and liver xenograft survival 29 days with anti-CD40mAb) and islet xenotransplantation (>600 days with anti-CD154mAb) with the use of these potent experimental agents. As the development of novel genetic modifications and costimulation blocking agents converges, we review their impact thus far on preclinical xenotransplantation and the potential for future application.
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128
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Naso F, Stefanelli U, Buratto E, Lazzari G, Perota A, Galli C, Gandaglia A. Alpha-Gal Inactivated Heart Valve Bioprostheses Exhibit an Anti-Calcification Propensity Similar to Knockout Tissues. Tissue Eng Part A 2017; 23:1181-1195. [DOI: 10.1089/ten.tea.2016.0474] [Citation(s) in RCA: 22] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Affiliation(s)
- Filippo Naso
- Biocompatibility Innovation, Medical Device Biocompatibility Laboratory, Padova, Italy
| | - Ugo Stefanelli
- Biocompatibility Innovation, Medical Device Biocompatibility Laboratory, Padova, Italy
| | - Edward Buratto
- Cardiac Surgery Unit, Royal Children's Hospital, Melbourne, Australia
- Department of Paediatrics, University of Melbourne, Melbourne, Australia
| | | | - Andrea Perota
- Avantea, Laboratory of Reproductive Technology, Cremona, Italy
| | - Cesare Galli
- Avantea, Laboratory of Reproductive Technology, Cremona, Italy
- Department of Veterinary Medical Sciences, University of Bologna, Bologna, Italy
- Fondazione Avantea, Cremona, Italy
| | - Alessandro Gandaglia
- Biocompatibility Innovation, Medical Device Biocompatibility Laboratory, Padova, Italy
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129
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Chan JL, Singh AK, Corcoran PC, Thomas ML, Lewis BG, Ayares DL, Vaught T, Horvath KA, Mohiuddin MM. Encouraging experience using multi-transgenic xenografts in a pig-to-baboon cardiac xenotransplantation model. Xenotransplantation 2017; 24. [PMID: 28940570 DOI: 10.1111/xen.12330] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/07/2017] [Revised: 07/05/2017] [Accepted: 07/15/2017] [Indexed: 12/11/2022]
Abstract
BACKGROUND Innovations in transgenic technology have facilitated improved xenograft survival. Additional gene expression appears to be necessary to overcome the remaining immune and biologic incompatibilities. We report for the first time the novel use of six-gene modifications within a pig-to-baboon cardiac xenotransplantation model. METHODS Baboons (8-15 kg) underwent heterotopic cardiac transplantation using xenografts obtained from genetically engineered pigs. Along with previously described modifications (GTKO, hCD46), additional expression of human transgenes for thromboregulation (endothelial protein C receptor, tissue factor pathway inhibitor, thrombomodulin), complement inhibition (decay accelerating factor), and cellular immune suppression (hCD39, hCD47) was used. Immunosuppression consisted of targeted T-cell and B-cell depletion and conventional anti-rejection agents. RESULTS Heterotopic cardiac transplantations were performed without complication. Flow cytometry and immunohistochemistry on donor biopsies confirmed transgenic phenotype. In contrast to the prior three-gene generation, significant coagulopathy or consumptive thrombocytopenia has not been observed in the six-gene cohort. As a result, these recipients have experienced decreased bleeding-related complications. Pro-inflammatory responses also appear to be mitigated based on cytokine analysis. Baboons survived the critical 30-day post-operative period when mortality has historically been highest, with no evidence of graft rejection. CONCLUSIONS The inclusion of additional human genes in genetically engineered pigs appears to confer superior xenograft outcomes. Introduction of these genes has not been associated with adverse outcomes. This multifactorial approach to genetic engineering furthers the prospect of long-term cardiac xenograft survival and subsequent clinical application.
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Affiliation(s)
- Joshua L Chan
- Cardiothoracic Surgery Research Program/National Heart, Lung and Blood Institute, National Institutes of Health, Bethesda, MD, USA
| | - Avneesh K Singh
- Cardiothoracic Surgery Research Program/National Heart, Lung and Blood Institute, National Institutes of Health, Bethesda, MD, USA
| | - Philip C Corcoran
- Cardiothoracic Surgery Research Program/National Heart, Lung and Blood Institute, National Institutes of Health, Bethesda, MD, USA
| | - Marvin L Thomas
- Division of Veterinary Resources, National Institutes of Health, Bethesda, MD, USA
| | - Billeta Gt Lewis
- Division of Veterinary Resources, National Institutes of Health, Bethesda, MD, USA
| | | | | | - Keith A Horvath
- Cardiothoracic Surgery Research Program/National Heart, Lung and Blood Institute, National Institutes of Health, Bethesda, MD, USA
| | - Muhammad M Mohiuddin
- Cardiothoracic Surgery Research Program/National Heart, Lung and Blood Institute, National Institutes of Health, Bethesda, MD, USA
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130
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CRISPR editing in biological and biomedical investigation. J Cell Physiol 2017; 233:3875-3891. [DOI: 10.1002/jcp.26141] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/03/2017] [Accepted: 08/07/2017] [Indexed: 12/23/2022]
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131
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Potential Antigens Involved in Delayed Xenograft Rejection in a Ggta1/Cmah Dko Pig-to-Monkey Model. Sci Rep 2017; 7:10024. [PMID: 28855711 PMCID: PMC5577312 DOI: 10.1038/s41598-017-10805-0] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/14/2017] [Accepted: 08/15/2017] [Indexed: 12/25/2022] Open
Abstract
When hyperacute rejection is avoided by deletion of Gal expression in the pig, delayed xenograft rejection (DXR) becomes a major immunologic barrier to successful xenotransplantation. This study was to investigate the potential antigens involved in DXR. We isolated primary renal microvascular endothelial cells (RMEC) and aortic endothelial cells (AEC) from a GGTA1/CMAH double-knockout (DKO) pig (and a GGTA1-KO pig) and immunized cynomolgus monkeys with both of these cells. After sensitization, monkey serum antibody binding and cytotoxicity to RMEC was significantly higher than to AEC(p < 0.05), suggesting that RMEC are more immunogenic than AEC. Transcriptome sequencing of GGTA1/CMAH DKO pigs indicated that the expression of 1,500 genes was higher in RMEC than in AEC, while expression of 896 genes was lower. Next, we selected 101 candidate genes expressed only in pig RMEC, but not in pig AEC or in monkey or human RMEC. When these genes were knocked out individually in GGTA1/CMAH DKO RMEC, 32 genes were associated with reduced antibody binding, indicating that these genes might be primary immunologic targets involved in DXR. These genes may be important candidates for deletion in producing pigs against which there is a reduced primate immune response in pig kidney xenograft.
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132
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Nottle MB, Salvaris EJ, Fisicaro N, McIlfatrick S, Vassiliev I, Hawthorne WJ, O'Connell PJ, Brady JL, Lew AM, Cowan PJ. Targeted insertion of an anti-CD2 monoclonal antibody transgene into the GGTA1 locus in pigs using FokI-dCas9. Sci Rep 2017; 7:8383. [PMID: 28814758 PMCID: PMC5559588 DOI: 10.1038/s41598-017-09030-6] [Citation(s) in RCA: 26] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/07/2017] [Accepted: 07/17/2017] [Indexed: 12/21/2022] Open
Abstract
Xenotransplantation from pigs has been advocated as a solution to the perennial shortage of donated human organs and tissues. CRISPR/Cas9 has facilitated the silencing of genes in donor pigs that contribute to xenograft rejection. However, the generation of modified pigs using second-generation nucleases with much lower off-target mutation rates than Cas9, such as FokI-dCas9, has not been reported. Furthermore, there have been no reports on the use of CRISPR to knock protective transgenes into detrimental porcine genes. In this study, we used FokI-dCas9 with two guide RNAs to integrate a 7.1 kilobase pair transgene into exon 9 of the GGTA1 gene in porcine fetal fibroblasts. The modified cells lacked expression of the αGal xenoantigen, and secreted an anti-CD2 monoclonal antibody encoded by the transgene. PCR and sequencing revealed precise integration of the transgene into one allele of GGTA1, and a small deletion in the second allele. The cells were used for somatic cell nuclear transfer to generate healthy male knock-in piglets, which did not express αGal and which contained anti-CD2 in their serum. We have therefore developed a versatile high-fidelity system for knocking transgenes into the pig genome for xenotransplantation purposes.
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Affiliation(s)
- Mark B Nottle
- Robinson Research Institute & Adelaide School of Medicine, University of Adelaide, Adelaide, Australia
| | - Evelyn J Salvaris
- Immunology Research Centre, St. Vincent's Hospital Melbourne, Melbourne, Victoria, Australia
| | - Nella Fisicaro
- Immunology Research Centre, St. Vincent's Hospital Melbourne, Melbourne, Victoria, Australia
| | - Stephen McIlfatrick
- Robinson Research Institute & Adelaide School of Medicine, University of Adelaide, Adelaide, Australia
| | - Ivan Vassiliev
- Robinson Research Institute & Adelaide School of Medicine, University of Adelaide, Adelaide, Australia
| | - Wayne J Hawthorne
- Westmead Millennium Institute, University of Sydney, Sydney, Australia
| | | | - Jamie L Brady
- Walter and Eliza Hall Institute, Melbourne, Victoria, Australia
| | - Andrew M Lew
- Walter and Eliza Hall Institute, Melbourne, Victoria, Australia.,Department of Microbiology & Immunology, University of Melbourne, Victoria, Australia
| | - Peter J Cowan
- Immunology Research Centre, St. Vincent's Hospital Melbourne, Melbourne, Victoria, Australia. .,Department of Medicine, University of Melbourne, Victoria, Australia.
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133
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Gao B, Long C, Lee W, Zhang Z, Gao X, Landsittel D, Ezzelarab M, Ayares D, Huang Y, Cooper DKC, Wang Y, Hara H. Anti-Neu5Gc and anti-non-Neu5Gc antibodies in healthy humans. PLoS One 2017; 12:e0180768. [PMID: 28715486 PMCID: PMC5513429 DOI: 10.1371/journal.pone.0180768] [Citation(s) in RCA: 37] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/28/2017] [Accepted: 06/21/2017] [Indexed: 02/03/2023] Open
Abstract
Our group previously investigated the levels of anti-Gal and anti-nonGal IgM and IgG in a cohort of 75 healthy humans of various backgrounds, and found some significant differences related to factors such as age, gender, ABO blood group, diet, vaccination history, and geographic location during childhood. We have now expanded our cohort (n = 84) to investigate the levels of anti-Neu5Gc and anti-nonGal/nonNeu5Gc antibodies in healthy humans. Anti-nonGal and anti-nonGal/nonNeu5Gc human IgM and IgG binding to pRBCs and pAECs from GTKO/CD46 and GTKO/CD46/Neu5GcKO pigs were measured by flow cytometry. Anti-Gal and anti-Neu5Gc IgM and IgG levels were measured by ELISA. In summary, (i) the great majority (almost 100%) of humans had anti-Neu5Gc IgM and IgG antibodies that bound to pAECs and approximately 50% had anti-Neu5Gc antibodies that bound to pRBCs, (ii) there was significantly less human antibody binding to pig cells that did not express either Gal or Neu5Gc compared with those that did not express Gal alone, (iii) the levels of both IgM and IgG binding to GTKO/CD46/Neu5GcKO pRBCs and pAECs were low, (iv) the level of anti-Neu5Gc IgG was higher in men than women, (v) the level did not change with age or diet, and there was some variability associated with (vi) previous vaccination history and (vii) the geographic region in which the individual spent his or her childhood. Our study confirms that human antibody binding to RBCs and AECs from GTKO/CD46/Neu5GcKO pigs is greatly reduced compared to binding to GTKO/CD46 cells. However, all humans appear to have a low level of antibody that binds to pAECs that is not directed to either Gal or Neu5Gc. Our findings require consideration in planning clinical trials of xenotransplantation.
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Affiliation(s)
- Bingsi Gao
- Thomas E. Starzl Transplantation Institute, University of Pittsburgh, Pittsburgh, PA, United States of America
- Center for Kidney Transplantation, Second Affiliated Hospital of the University of South China, Hengyang, Hunan, China
- Department of Obstetrics and Gynecology, Second Affiliated Hospital of the University of South China, Hengyang, Hunan, China
| | - Cassandra Long
- Thomas E. Starzl Transplantation Institute, University of Pittsburgh, Pittsburgh, PA, United States of America
| | - Whayoung Lee
- Thomas E. Starzl Transplantation Institute, University of Pittsburgh, Pittsburgh, PA, United States of America
| | - Zhongqiang Zhang
- Thomas E. Starzl Transplantation Institute, University of Pittsburgh, Pittsburgh, PA, United States of America
- Department of General Surgery, Second Xiangya Hospital of the Central South University, Changsha, Hunan, China
| | - Xiaotian Gao
- Department of Biostatistics, University of Pittsburgh, Pittsburgh, PA, United States of America
| | - Doug Landsittel
- Department of Biostatistics and Clinical and Translational Science, University of Pittsburgh, Pittsburgh, PA, United States of America
| | - Mohamed Ezzelarab
- Thomas E. Starzl Transplantation Institute, University of Pittsburgh, Pittsburgh, PA, United States of America
| | - David Ayares
- Revivicor, Blacksburg, VA, United States of America
| | - Yuliang Huang
- Department of Obstetrics and Gynecology, Second Affiliated Hospital of the University of South China, Hengyang, Hunan, China
| | - David K. C. Cooper
- Thomas E. Starzl Transplantation Institute, University of Pittsburgh, Pittsburgh, PA, United States of America
| | - Yi Wang
- Center for Kidney Transplantation, Second Affiliated Hospital of the University of South China, Hengyang, Hunan, China
- * E-mail: (HH); (YW)
| | - Hidetaka Hara
- Thomas E. Starzl Transplantation Institute, University of Pittsburgh, Pittsburgh, PA, United States of America
- * E-mail: (HH); (YW)
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134
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Lee SC, Lee H, Oh KB, Hwang IS, Yang H, Park MR, Ock SA, Woo JS, Im GS, Hwang S. Production and Breeding of Transgenic Cloned Pigs Expressing Human CD73. Dev Reprod 2017; 21:157-165. [PMID: 28785737 PMCID: PMC5532308 DOI: 10.12717/dr.2017.21.2.157] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/01/2017] [Revised: 05/04/2017] [Accepted: 05/08/2017] [Indexed: 11/17/2022]
Abstract
One of the reasons to causing blood coagulation in the tissue of xenografted
organs was known to incompatibility of the blood coagulation and
anti-coagulation regulatory system between TG pigs and primates. Thus,
overexpression of human CD73 (hCD73) in the pig endothelial cells is considered
as a method to reduce coagulopathy after pig-to-non-human-primate
xenotransplantation. This study was performed to produce and breed transgenic
pigs expressing hCD73 for the studies immune rejection responses and could
provide a successful application of xenotransplantation. The transgenic cells
were constructed an hCD73 expression vector under control porcine Icam2 promoter
(pIcam2-hCD73) and established donor cell lines expressing hCD73. The numbers of
transferred reconstructed embryos were 127 ± 18.9. The pregnancy and delivery
rate of surrogates were 8/18 (44%) and 3/18 (16%). The total number of delivered
cloned pigs were 10 (2 alive, 7 mummy, and 1 died after birth). Among them,
three live hCD73-pigs were successfully delivered by Caesarean section, but one
was dead after birth. The two hCD73 TG cloned pigs had normal reproductive
ability. They mated with wild type (WT) MGH (Massachusetts General Hospital)
female sows and produced totally 16 piglets. Among them, 5 piglets were
identified as hCD73 TG pigs. In conclusion, we successfully generated the hCD73
transgenic cloned pigs and produced their litters by natural mating. It can be
possible to use a mate for the production of multiple transgenic pigs such as
α-1,3-galactosyltransferase knock-out /hCD46 for xenotransplantation.
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Affiliation(s)
- Seung-Chan Lee
- Animal Biotechnology Division, National Institute of Animal Science, RDA, Wanju 55365, Republic of Korea
| | - Haesun Lee
- Animal Biotechnology Division, National Institute of Animal Science, RDA, Wanju 55365, Republic of Korea
| | - Keon Bong Oh
- Animal Biotechnology Division, National Institute of Animal Science, RDA, Wanju 55365, Republic of Korea
| | - In-Sul Hwang
- Animal Biotechnology Division, National Institute of Animal Science, RDA, Wanju 55365, Republic of Korea
| | - Hyeon Yang
- Animal Biotechnology Division, National Institute of Animal Science, RDA, Wanju 55365, Republic of Korea
| | - Mi-Ryung Park
- Animal Biotechnology Division, National Institute of Animal Science, RDA, Wanju 55365, Republic of Korea
| | - Sun-A Ock
- Animal Biotechnology Division, National Institute of Animal Science, RDA, Wanju 55365, Republic of Korea
| | - Jae-Seok Woo
- Animal Biotechnology Division, National Institute of Animal Science, RDA, Wanju 55365, Republic of Korea
| | - Gi-Sun Im
- Animal Biotechnology Division, National Institute of Animal Science, RDA, Wanju 55365, Republic of Korea
| | - Seongsoo Hwang
- Animal Biotechnology Division, National Institute of Animal Science, RDA, Wanju 55365, Republic of Korea
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135
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Li M, Eckl J, Geiger C, Schendel DJ, Pohla H. A novel and effective method to generate human porcine-specific regulatory T cells with high expression of IL-10, TGF-β1 and IL-35. Sci Rep 2017. [PMID: 28638110 PMCID: PMC5479824 DOI: 10.1038/s41598-017-04322-3] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023] Open
Abstract
Organ transplantation remains the most effective treatment for patients with late stage organ failure. Transgenic pigs provide an alternative organ donor source to the limited availability of human organs. However, cellular rejection still remains to be the obstacle for xenotransplantation. Superior to other methods, antigen-specific regulatory T cells (Treg) alleviate cellular rejection with fewer side effects. Here we demonstrate the use of a fast method to provide tolerogenic dendritic cells (tolDC) that can be used to generate effective porcine-specific Treg cells (PSTreg). TolDC were produced within three days from human monocytes in medium supplemented with anti-inflammatory cytokines. Treg were generated from naïve CD4+ T cells and induced to become PSTreg by cocultivation with porcine-antigen-loaded tolDC. Results showed that PSTreg exhibited the expected phenotype, CD4+CD25+CD127low/− Foxp3+, and a more activated phenotype. The specificity of PSTreg was demonstrated by suppression of effector T cell (Teff) activation markers of different stages and inhibition of Teff cell proliferation. TolDC and PSTreg exhibited high expression of IL-10 and TGF-β1 at both protein and RNA levels, and PSTreg also highly expressed IL-35 at RNA levels. Upon restimulation, PSTreg retained the activated phenotype and specificity. Taken together, the newly developed procedure allows efficient generation of highly suppressive PSTreg.
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Affiliation(s)
- Mingqian Li
- Laboratory of Tumor Immunology, LIFE Center, Ludwig-Maximilians-Universität, Munich, Germany.,Department of Urology, University Hospital, Ludwig-Maximilians-Universität, Munich, Germany
| | - Judith Eckl
- Institute of Molecular Immunology, HelmholtzZentrum München, German Research Center for Environmental Health, and Clinical Cooperation Group "Immune Monitoring", Munich, Germany.,Medigene Immunotherapies GmbH, Planegg, Martinsried, Germany
| | - Christiane Geiger
- Institute of Molecular Immunology, HelmholtzZentrum München, German Research Center for Environmental Health, and Clinical Cooperation Group "Immune Monitoring", Munich, Germany.,Medigene Immunotherapies GmbH, Planegg, Martinsried, Germany
| | - Dolores J Schendel
- Institute of Molecular Immunology, HelmholtzZentrum München, German Research Center for Environmental Health, and Clinical Cooperation Group "Immune Monitoring", Munich, Germany.,Medigene Immunotherapies GmbH, Planegg, Martinsried, Germany
| | - Heike Pohla
- Laboratory of Tumor Immunology, LIFE Center, Ludwig-Maximilians-Universität, Munich, Germany. .,Department of Urology, University Hospital, Ludwig-Maximilians-Universität, Munich, Germany. .,Institute of Molecular Immunology, HelmholtzZentrum München, German Research Center for Environmental Health, and Clinical Cooperation Group "Immune Monitoring", Munich, Germany.
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136
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Chen P, Gao H, Lu Y, Nie H, Liu Z, Zhao Y, Fan N, Zou Q, Dai Y, Tang A, Hara H, Cai Z, Cooper DKC, Lai L, Mou L. Altered expression of eNOS, prostacyclin synthase, prostaglandin G/H synthase, and thromboxane synthase in porcine aortic endothelial cells after exposure to human serum-relevance to xenotransplantation. Cell Biol Int 2017; 41:798-808. [PMID: 28462511 DOI: 10.1002/cbin.10782] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/31/2017] [Accepted: 04/23/2017] [Indexed: 01/27/2023]
Abstract
Under normal conditions, the activity of platelets is stringently and precisely balanced between activation and quiescent state. This guarantees rapid hemostasis and avoids uncontrolled thrombosis. However, excessive platelet activation and resulting thrombotic microangiopathy are frequently observed in pig-to-primate xenotransplantation models. Endothelium-derived inhibitory mechanisms play an important role in regulation of platelet activation. These mainly include nitric oxide (NO), prostacyclin PGI2 , and adenosine, which are synthesized by endothelial NO synthases (eNOS), prostacyclin synthase, and CD39/CD73, respectively. We investigated whether endothelium-derived regulatory mechanisms are affected in porcine aortic endothelial cells (PAECs) after exposure to human serum. In the present study, exposure of PAECs or porcine iliac arteries to human serum suppressed gene expression of eNOS and prostacyclin synthase, while induced gene expression of prostaglandin G/H synthase and thromboxane synthase. Simultaneously, exposure to human serum reduced NO and PGI2 production in PAEC culture supernatants. Thus, human serum altered the balance of endothelium-derived inhibitory mechanisms in PAECs, which may indicate a regulatory mechanism of excessive platelet activation in pig-to-primate xenotransplantation.
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Affiliation(s)
- Pengfei Chen
- Shenzhen Xenotransplantation Medical Engineering Research and Development Center, Institute of Translational Medicine, Shenzhen Second People's Hospital, First Affiliated Hospital of Shenzhen University, Shenzhen, China.,Department of Pharmacology, Zhongshan School of Medicine, Sun Yat-sen University, Guangzhou, China
| | - Hanchao Gao
- Shenzhen Xenotransplantation Medical Engineering Research and Development Center, Institute of Translational Medicine, Shenzhen Second People's Hospital, First Affiliated Hospital of Shenzhen University, Shenzhen, China
| | - Ying Lu
- Shenzhen Xenotransplantation Medical Engineering Research and Development Center, Institute of Translational Medicine, Shenzhen Second People's Hospital, First Affiliated Hospital of Shenzhen University, Shenzhen, China
| | - Huirong Nie
- Shenzhen Xenotransplantation Medical Engineering Research and Development Center, Institute of Translational Medicine, Shenzhen Second People's Hospital, First Affiliated Hospital of Shenzhen University, Shenzhen, China
| | - Zhaoming Liu
- CAS Key Laboratory of Regenerative Biology, South China Institute for Stem Cell Biology and Regenerative Medicine, Guangzhou Institutes of Biomedicine and Health, Chinese Academy of Sciences, Guangzhou, China
| | - Yu Zhao
- CAS Key Laboratory of Regenerative Biology, South China Institute for Stem Cell Biology and Regenerative Medicine, Guangzhou Institutes of Biomedicine and Health, Chinese Academy of Sciences, Guangzhou, China
| | - Nana Fan
- CAS Key Laboratory of Regenerative Biology, South China Institute for Stem Cell Biology and Regenerative Medicine, Guangzhou Institutes of Biomedicine and Health, Chinese Academy of Sciences, Guangzhou, China
| | - Qingjian Zou
- CAS Key Laboratory of Regenerative Biology, South China Institute for Stem Cell Biology and Regenerative Medicine, Guangzhou Institutes of Biomedicine and Health, Chinese Academy of Sciences, Guangzhou, China
| | - Yifan Dai
- Jiangsu Key Laboratory of Xenotransplantation, Nanjing Medical University, Nanjing, Jiangsu, China
| | - Aifa Tang
- Shenzhen Xenotransplantation Medical Engineering Research and Development Center, Institute of Translational Medicine, Shenzhen Second People's Hospital, First Affiliated Hospital of Shenzhen University, Shenzhen, China
| | - Hidetaka Hara
- Xenotransplantation Program, Department of Surgery, University of Alabama at Birmingham, Birmingham, Alabama
| | - Zhiming Cai
- Shenzhen Xenotransplantation Medical Engineering Research and Development Center, Institute of Translational Medicine, Shenzhen Second People's Hospital, First Affiliated Hospital of Shenzhen University, Shenzhen, China
| | - David K C Cooper
- Xenotransplantation Program, Department of Surgery, University of Alabama at Birmingham, Birmingham, Alabama
| | - Liangxue Lai
- CAS Key Laboratory of Regenerative Biology, South China Institute for Stem Cell Biology and Regenerative Medicine, Guangzhou Institutes of Biomedicine and Health, Chinese Academy of Sciences, Guangzhou, China
| | - Lisha Mou
- Shenzhen Xenotransplantation Medical Engineering Research and Development Center, Institute of Translational Medicine, Shenzhen Second People's Hospital, First Affiliated Hospital of Shenzhen University, Shenzhen, China
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Kim J, Kim DH, Choi HJ, Lee HJ, Kang HJ, Park CG, Hwang ES, Kim MK, Wee WR. Anti-CD40 antibody-mediated costimulation blockade promotes long-term survival of deep-lamellar porcine corneal grafts in non-human primates. Xenotransplantation 2017; 24:10.1111/xen.12298. [PMID: 28393447 PMCID: PMC5464973 DOI: 10.1111/xen.12298] [Citation(s) in RCA: 25] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/25/2016] [Revised: 12/26/2016] [Accepted: 03/01/2017] [Indexed: 01/01/2023]
Abstract
BACKGROUND Corneal xenotransplantation is an effective solution for the shortage of human donor corneas, and the porcine cornea may be a suitable candidate for the donor cornea because of its optical similarity with humans. However, it is necessary to administer additional immunosuppressants to overcome antigenic differences. We aimed to investigate the feasibility of porcine corneas with anti-CD40 antibody-mediated costimulation blockade in a clinically applicable pig-to-non-human primate corneal xenotransplantation model. METHODS Five Chinese rhesus macaques underwent deep-lamellar corneal transplantation using clinically acceptable sized (7.5 mm diameter) porcine corneal grafts. The anti-CD40 antibody was intravenously administered on a programmed schedule. Graft survival, central corneal thickness, and intraocular pressure were evaluated. Changes in effector and memory T and B cell subsets and anti-αGal and donor-specific antibodies were investigated in the blood, and the changes in complement levels in the aqueous humor and blood were evaluated. Memory cell profiles in the anti-CD40 antibody-treated group were compared with those from the anti-CD154 antibody-treated group or rejected controls presented in our previous report. The changes in anti-αGal, non-αGal, and donor-specific antibodies after 6 months were compared with baseline values. RESULTS Anti-CD40 antibody-mediated costimulation blockade resulted in the successful survival of xenocorneal grafts (>389, >382, >236, >201, and >61 days), with 80% reaching 6 months of survival. Injection of anti-CD40 antibody considerably reduced the infiltration of inflammatory cells into the grafts and significantly blocked the complement response in the aqueous humor (P=.0159, Mann-Whitney U test). Systemic expansion of central or effector memory T cells was abrogated in the anti-CD40 antibody-treated primates compared with those in the rejected controls (P<.05, Mann-Whitney U test) or those in the anti-CD154 antibody-treated primates (P>.05, Mann-Whitney U test). The levels of anti-αGal, non-αGal, and donor-specific antibodies at 6 months were not significantly increased compared with baseline levels (P>.05, Wilcoxon signed rank test). CONCLUSIONS An anti-CD40 antibody-mediated blockade appears to be effective immunosuppressive approach for porcine corneal deep-lamellar xenotransplantation in primates.
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Affiliation(s)
- Jaeyoung Kim
- Department of Ophthalmology, Seoul National University College of Medicine, Seoul, Republic of Korea
- Laboratory of Ocular Regenerative Medicine and Immunology, Seoul Artificial Eye Center, Seoul National University Hospital Biomedical Research Institute, Seoul, Republic of Korea
- Translational Xenotransplantation Research Center, Seoul National University College of Medicine and Seoul National University Hospital Biomedical Research Institute, Seoul, Republic of Korea
| | - Dong Hyun Kim
- Laboratory of Ocular Regenerative Medicine and Immunology, Seoul Artificial Eye Center, Seoul National University Hospital Biomedical Research Institute, Seoul, Republic of Korea
- Translational Xenotransplantation Research Center, Seoul National University College of Medicine and Seoul National University Hospital Biomedical Research Institute, Seoul, Republic of Korea
- Department of Ophthalmology, Gachon University Gil Medical Center, Incheon, Republic of Korea
| | - Hyuk Jin Choi
- Laboratory of Ocular Regenerative Medicine and Immunology, Seoul Artificial Eye Center, Seoul National University Hospital Biomedical Research Institute, Seoul, Republic of Korea
- Translational Xenotransplantation Research Center, Seoul National University College of Medicine and Seoul National University Hospital Biomedical Research Institute, Seoul, Republic of Korea
- Department of Ophthalmology, Seoul National University Hospital Healthcare System Gangnam Center, Seoul, Republic of Korea
| | - Hyun Ju Lee
- Laboratory of Ocular Regenerative Medicine and Immunology, Seoul Artificial Eye Center, Seoul National University Hospital Biomedical Research Institute, Seoul, Republic of Korea
| | - Hee Jung Kang
- Department of Laboratory Medicine, Hallym University College of Medicine, Anyang, Gyeonggi-do, Republic of Korea
| | - Chung-Gyu Park
- Translational Xenotransplantation Research Center, Seoul National University College of Medicine and Seoul National University Hospital Biomedical Research Institute, Seoul, Republic of Korea
- Department of Microbiology and Immunology, Cancer Research Institute, Seoul National University College of Medicine, Seoul, Republic of Korea
| | - Eung-Soo Hwang
- Department of Microbiology and Immunology, Cancer Research Institute, Seoul National University College of Medicine, Seoul, Republic of Korea
| | - Mee Kum Kim
- Department of Ophthalmology, Seoul National University College of Medicine, Seoul, Republic of Korea
- Laboratory of Ocular Regenerative Medicine and Immunology, Seoul Artificial Eye Center, Seoul National University Hospital Biomedical Research Institute, Seoul, Republic of Korea
- Translational Xenotransplantation Research Center, Seoul National University College of Medicine and Seoul National University Hospital Biomedical Research Institute, Seoul, Republic of Korea
| | - Won Ryang Wee
- Department of Ophthalmology, Seoul National University College of Medicine, Seoul, Republic of Korea
- Laboratory of Ocular Regenerative Medicine and Immunology, Seoul Artificial Eye Center, Seoul National University Hospital Biomedical Research Institute, Seoul, Republic of Korea
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Aristizabal AM, Caicedo LA, Martínez JM, Moreno M, J Echeverri G. Clinical xenotransplantation, a closer reality: Literature review. Cir Esp 2017; 95:62-72. [PMID: 28237390 DOI: 10.1016/j.ciresp.2016.12.008] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/26/2016] [Revised: 11/29/2016] [Accepted: 12/15/2016] [Indexed: 01/22/2023]
Abstract
Xenotransplantation could provide an unlimited supply of organs and solve the current shortage of organs for transplantation. To become a reality in clinical practice, the immunological and physiological barriers and the risk of xenozoonosis that they possess should be resolved. From the immunological point of view, in the last 30 years a significant progress in the production of transgenic pigs has prevented the hyperacute rejection. About xenozoonosis, attention has been focused on the risk of transmission of porcine endogenous retroviruses; however, today, it is considered that the risk is very low and the inevitable transmission should not prevent the clinical xenotransplantation. Regarding the physiological barriers, encouraging results have been obtained and it's expected that the barriers that still need to be corrected can be solved in the future through genetic modifications.
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Affiliation(s)
- Ana María Aristizabal
- Centro de Investigaciones Clínicas, Fundación Valle del Lili, Cali, Colombia; Centro para la Investigación en Cirugía Avanzada y Trasplantes (CICAT), Universidad Icesi, Cali, Colombia
| | - Luis Armando Caicedo
- Centro de Investigaciones Clínicas, Fundación Valle del Lili, Cali, Colombia; Centro para la Investigación en Cirugía Avanzada y Trasplantes (CICAT), Universidad Icesi, Cali, Colombia
| | - Juan Manuel Martínez
- Centro de Investigaciones Clínicas, Fundación Valle del Lili, Cali, Colombia; Centro para la Investigación en Cirugía Avanzada y Trasplantes (CICAT), Universidad Icesi, Cali, Colombia
| | - Manuel Moreno
- Centro de Investigaciones Clínicas, Fundación Valle del Lili, Cali, Colombia; Centro para la Investigación en Cirugía Avanzada y Trasplantes (CICAT), Universidad Icesi, Cali, Colombia
| | - Gabriel J Echeverri
- Centro de Investigaciones Clínicas, Fundación Valle del Lili, Cali, Colombia; Centro para la Investigación en Cirugía Avanzada y Trasplantes (CICAT), Universidad Icesi, Cali, Colombia.
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Böer U, Buettner FFR, Schridde A, Klingenberg M, Sarikouch S, Haverich A, Wilhelmi M. Antibody formation towards porcine tissue in patients implanted with crosslinked heart valves is directed to antigenic tissue proteins and αGal epitopes and is reduced in healthy vegetarian subjects. Xenotransplantation 2017; 24. [DOI: 10.1111/xen.12288] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/08/2016] [Revised: 12/14/2016] [Accepted: 12/27/2016] [Indexed: 12/31/2022]
Affiliation(s)
- Ulrike Böer
- Lower Saxony Centre of Biotechnology Implant Research and Development (NIFE); Hannover Medical School; Hannover Germany
- Division for Cardiothoracic-, Transplantation- and Vascular Surgery; Hannover Medical School; Hannover Germany
| | | | - Ariane Schridde
- Lower Saxony Centre of Biotechnology Implant Research and Development (NIFE); Hannover Medical School; Hannover Germany
| | - Melanie Klingenberg
- Lower Saxony Centre of Biotechnology Implant Research and Development (NIFE); Hannover Medical School; Hannover Germany
- Division for Cardiothoracic-, Transplantation- and Vascular Surgery; Hannover Medical School; Hannover Germany
| | - Samir Sarikouch
- Division for Cardiothoracic-, Transplantation- and Vascular Surgery; Hannover Medical School; Hannover Germany
| | - Axel Haverich
- Lower Saxony Centre of Biotechnology Implant Research and Development (NIFE); Hannover Medical School; Hannover Germany
- Division for Cardiothoracic-, Transplantation- and Vascular Surgery; Hannover Medical School; Hannover Germany
| | - Mathias Wilhelmi
- Lower Saxony Centre of Biotechnology Implant Research and Development (NIFE); Hannover Medical School; Hannover Germany
- Division for Cardiothoracic-, Transplantation- and Vascular Surgery; Hannover Medical School; Hannover Germany
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Kang HJ, Lee H, Park EM, Kim JM, Shin JS, Kim JS, Park CG, Kim SJ. Increase in anti-Gal IgM level is associated with early graft failure in intraportal porcine islet xenotransplantation. Ann Lab Med 2016; 35:611-7. [PMID: 26354349 PMCID: PMC4579105 DOI: 10.3343/alm.2015.35.6.611] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/16/2015] [Revised: 05/04/2015] [Accepted: 08/08/2015] [Indexed: 11/19/2022] Open
Abstract
BACKGROUND Anti-Gal is a major antibody induced in non-human primates (NHPs) after xenotransplantation. To understand the mechanism of graft rejection, we investigated the association between anti-Gal responses and graft failure in NHP recipients of porcine islet transplantation (PITx). METHODS Intraportal PITx was performed in 35 diabetic NHPs, and graft function was monitored. Early graft failure (EGF) was defined as loss of graft function within a month after PITx. Seven, 19, nine NHPs received immunosuppression (IS) without CD40 pathway blockade (Group I), with anti-CD154 (Group II), and with anti-CD40 (Group III), respectively. The anti-Gal levels on day 0 and day 7 of PITx were measured by ELISA. RESULTS The frequency of EGF was significantly lower in Group II (26.3%) than in Group I (100%, P=0.0012) and Group III (77.8%, P=0.0166). While levels of anti-Gal IgG in Group I and anti-Gal IgM in Group III increased on day 7 compared with day 0 (P=0.0156 and 0.0273), there was no increase in either on day 7 in Group II. The ratio of anti-Gal IgM or IgG level on day 7 to that on day 0 (Ratio7/0) was significantly higher in recipients with EGF than without EGF (P=0.0009 and 0.0027). ROC curve analysis of anti-Gal IgM Ratio7/0 revealed an area under the curve of 0.789 (P=0.0003). CONCLUSIONS IS with anti-CD154 suppressed anti-Gal responses and prevented EGF in PITx. Anti-Gal IgM Ratio7/0, being associated with EGF, is a predictive marker for EGF.
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Affiliation(s)
- Hee Jung Kang
- Department of Laboratory Medicine, Hallym University College of Medicine, Anyang, Korea.
| | - Haneulnari Lee
- Department of Laboratory Medicine, Hallym University College of Medicine, Anyang, Korea
| | - Eun Mi Park
- Department of Laboratory Medicine, Hallym University College of Medicine, Anyang, Korea
| | - Jong Min Kim
- Xenotransplantation Research Center, Seoul National University College of Medicine, Seoul, Korea
| | - Jun Seop Shin
- Xenotransplantation Research Center, Seoul National University College of Medicine, Seoul, Korea
| | - Jung Sik Kim
- Xenotransplantation Research Center, Seoul National University College of Medicine, Seoul, Korea
| | - Chung Gyu Park
- Xenotransplantation Research Center, Seoul National University College of Medicine, Seoul, Korea.,Department of Microbiology and Immunology, Cancer Research Institute, Seoul National University College of Medicine, Seoul National University Hospital Biomedical Research Institute, Seoul, Korea
| | - Sang Joon Kim
- Xenotransplantation Research Center, Seoul National University College of Medicine, Seoul, Korea
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141
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Choi K, Shim J, Ko N, Eom H, Kim J, Lee JW, Jin DI, Kim H. Production of heterozygous alpha 1,3-galactosyltransferase (GGTA1) knock-out transgenic miniature pigs expressing human CD39. Transgenic Res 2016; 26:209-224. [PMID: 27830476 DOI: 10.1007/s11248-016-9996-7] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/31/2015] [Accepted: 11/02/2016] [Indexed: 12/21/2022]
Abstract
Production of transgenic pigs for use as xenotransplant donors is a solution to the severe shortage of human organs for transplantation. The first barrier to successful xenotransplantation is hyperacute rejection, a rapid, massive humoral immune response directed against the pig carbohydrate GGTA1 epitope. Platelet activation, adherence, and clumping, all major features of thrombotic microangiopathy, are inevitable results of immune-mediated transplant rejection. Human CD39 rapidly hydrolyzes ATP and ADP to AMP; AMP is hydrolyzed by ecto-5'-nucleotidase (CD73) to adenosine, an anti-thrombotic and cardiovascular protective mediator. In this study, we developed a vector-based strategy for ablation of GGTA1 function and concurrent expression of human CD39 (hCD39). An hCD39 expression cassette was constructed to target exon 4 of GGTA1. We established heterozygous GGTA1 knock-out cell lines expressing hCD39 from pig ear fibroblasts for somatic cell nuclear transfer (SCNT). We also described production of heterozygous GGTA1 knock-out piglets expressing hCD39 and analyzed expression and function of the transgene. Human CD39 was expressed in heart, kidney and aorta. Human CD39 knock-in heterozygous ear fibroblast from transgenic cloned pigs, but not in non-transgenic pig's cells. Expression of GGTA1 gene was lower in the knock-in heterozygous ear fibroblast from transgenic pigs compared to the non-transgenic pig's cell. The peripheral blood mononuclear cells (PBMC) from the transgenic pigs were more resistant to lysis by pooled complement-preserved normal human serum than that from wild type (WT) pig. Accordingly, GGTA1 mutated piglets expressing hCD39 will provide a new organ source for xenotransplantation research.
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Affiliation(s)
- Kimyung Choi
- Optipharm Inc., 63, Osongsaengmyeong 6-ro, Osong-eup, Heungdeok-gu, Cheongju-si, Chungcheongbuk-do, Republic of Korea
| | - Joohyun Shim
- Optipharm Inc., 63, Osongsaengmyeong 6-ro, Osong-eup, Heungdeok-gu, Cheongju-si, Chungcheongbuk-do, Republic of Korea
| | - Nayoung Ko
- Optipharm Inc., 63, Osongsaengmyeong 6-ro, Osong-eup, Heungdeok-gu, Cheongju-si, Chungcheongbuk-do, Republic of Korea
| | - Heejong Eom
- Optipharm Inc., 63, Osongsaengmyeong 6-ro, Osong-eup, Heungdeok-gu, Cheongju-si, Chungcheongbuk-do, Republic of Korea
| | - Jiho Kim
- Optipharm Inc., 63, Osongsaengmyeong 6-ro, Osong-eup, Heungdeok-gu, Cheongju-si, Chungcheongbuk-do, Republic of Korea
| | - Jeong-Woong Lee
- Functional Genomics Research Center, Korea Research Institute of Bioscience and Biotechnology, Daejeon, Republic of Korea
| | - Dong-Il Jin
- Department of Animal Science and Biotechnology, Chungnam National University, Daejeon, Republic of Korea
| | - Hyunil Kim
- Optipharm Inc., 63, Osongsaengmyeong 6-ro, Osong-eup, Heungdeok-gu, Cheongju-si, Chungcheongbuk-do, Republic of Korea.
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142
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Gao H, Zhao C, Xiang X, Li Y, Zhao Y, Li Z, Pan D, Dai Y, Hara H, Cooper DKC, Cai Z, Mou L. Production of α1,3-galactosyltransferase and cytidine monophosphate-N-acetylneuraminic acid hydroxylase gene double-deficient pigs by CRISPR/Cas9 and handmade cloning. J Reprod Dev 2016; 63:17-26. [PMID: 27725344 PMCID: PMC5320426 DOI: 10.1262/jrd.2016-079] [Citation(s) in RCA: 40] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/04/2023] Open
Abstract
Gene-knockout pigs hold great promise as a solution to the shortage of organs from donor animals for xenotransplantation. Several groups have generated
gene-knockout pigs via clustered regularly interspaced short palindromic repeats (CRISPR)/CRISPR-associated 9 (Cas9) and somatic cell nuclear transfer (SCNT).
Herein, we adopted a simple and micromanipulator-free method, handmade cloning (HMC) instead of SCNT, to generate double gene-knockout pigs. First, we applied
the CRISPR/Cas9 system to target α1,3-galactosyltransferase (GGTA1) and cytidine monophosphate-N-acetylneuraminic acid hydroxylase (CMAH) genes simultaneously
in porcine fetal fibroblast cells (PFFs), which were derived from wild-type Chinese domestic miniature Wuzhishan pigs. Cell colonies were obtained by screening
and were identified by Surveyor assay and sequencing. Next, we chose the GGTA1/CMAH double-knockout (DKO) cells for HMC to produce piglets. As
a result, we obtained 11 live bi-allelic GGTA1/CMAH DKO piglets with the identical phenotype. Compared to cells from
GGTA1-knockout pigs, human antibody binding and antibody-mediated complement-dependent cytotoxicity were significantly reduced in cells from
GGTA1/CMAH DKO pigs, which demonstrated that our pigs would exhibit reduced humoral rejection in xenotransplantation. These data suggested
that the combination of CRISPR/Cas9 and HMC technology provided an efficient and new strategy for producing pigs with multiple genetic modifications.
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Affiliation(s)
- Hanchao Gao
- Shenzhen Xenotransplantation Medical Engineering Research and Development Center, Shenzhen Second People's Hospital, First Affiliated Hospital of Shenzhen University, Shenzhen 518035, China
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Petersen B, Frenzel A, Lucas-Hahn A, Herrmann D, Hassel P, Klein S, Ziegler M, Hadeler KG, Niemann H. Efficient production of biallelic GGTA1 knockout pigs by cytoplasmic microinjection of CRISPR/Cas9 into zygotes. Xenotransplantation 2016; 23:338-46. [PMID: 27610605 DOI: 10.1111/xen.12258] [Citation(s) in RCA: 75] [Impact Index Per Article: 9.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/22/2016] [Revised: 07/01/2016] [Accepted: 08/12/2016] [Indexed: 02/06/2023]
Abstract
BACKGROUND Xenotransplantation is considered to be a promising solution to the growing demand for suitable donor organs for transplantation. Despite tremendous progress in the generation of pigs with multiple genetic modifications thought to be necessary to overcoming the severe rejection responses after pig-to-non-human primate xenotransplantation, the production of knockout pigs by somatic cell nuclear transfer (SCNT) is still an inefficient process. Producing genetically modified pigs by intracytoplasmic microinjection of porcine zygotes is an alluring alternative. The porcine GGTA1 gene encodes for the α1,3-galactosyltransferase that synthesizes the Gal epitopes on porcine cells which constitute the major antigen in a xenotransplantation setting. GGTA1-KO pigs have successfully been produced by transfecting somatic cells with zinc-finger nucleases (ZFNs), transcription activator-like effector nucleases (TALENs), or CRISPR/Cas targeting GGTA1, followed by SCNT. METHODS Here, we microinjected a CRISPR/Cas9 vector coding for a single-guide RNA (sgRNA) targeting exon 8 of the GGTA1 gene into the cytoplasm of 97 in vivo-derived porcine zygotes and transferred 86 of the microinjected embryos into three hormonally synchronized recipients. Fetuses and piglets were analyzed by flow cytometry for remaining Gal epitopes. DNA was sequenced to detect mutations at the GGTA1 locus. RESULTS Two of the recipients remained pregnant as determined by ultrasound scanning on day 25 of gestation. One pregnancy was terminated on day 26, and six healthy fetuses were recovered. The second pregnancy was allowed to go to term and resulted in the birth of six healthy piglets. Flow cytometry analysis revealed the absence of Gal epitopes in four of six fetuses (66%), indicating a biallelic KO of GGTA1. Additionally, three of the six live-born piglets (50%) did not express Gal epitopes on their cell surface. Two fetuses and two piglets showed a mosaicism with a mixed population of Gal-free and Gal-expressing cells. Only a single piglet did not have any genomic modifications. Genomic sequencing revealed indel formation at the GGTA1 locus ranging from +17 bp to -20 bp. CONCLUSIONS These results demonstrate the efficacy of CRISPR/Cas to generate genetic modifications in pigs by simplified technology, such as intracytoplasmic microinjection into zygotes, which would significantly facilitate the production of genetically modified pigs suitable for xenotransplantation. Importantly, this simplified injection protocol avoids the penetration of the vulnerable pronuclear membrane, and is thus compatible with higher survival rates of microinjected embryos, which in turn facilitates production of genetically modified piglets.
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Affiliation(s)
- Bjoern Petersen
- Institute of Farm Animal Genetics, Friedrich-Loeffler-Institut, Mariensee, Neustadt, Germany.
| | - Antje Frenzel
- Institute of Farm Animal Genetics, Friedrich-Loeffler-Institut, Mariensee, Neustadt, Germany
| | - Andrea Lucas-Hahn
- Institute of Farm Animal Genetics, Friedrich-Loeffler-Institut, Mariensee, Neustadt, Germany
| | - Doris Herrmann
- Institute of Farm Animal Genetics, Friedrich-Loeffler-Institut, Mariensee, Neustadt, Germany
| | - Petra Hassel
- Institute of Farm Animal Genetics, Friedrich-Loeffler-Institut, Mariensee, Neustadt, Germany
| | - Sabine Klein
- Institute of Farm Animal Genetics, Friedrich-Loeffler-Institut, Mariensee, Neustadt, Germany
| | - Maren Ziegler
- Institute of Farm Animal Genetics, Friedrich-Loeffler-Institut, Mariensee, Neustadt, Germany
| | - Klaus-Gerd Hadeler
- Institute of Farm Animal Genetics, Friedrich-Loeffler-Institut, Mariensee, Neustadt, Germany
| | - Heiner Niemann
- Institute of Farm Animal Genetics, Friedrich-Loeffler-Institut, Mariensee, Neustadt, Germany.
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Lee W, Long C, Ramsoondar J, Ayares D, Cooper DKC, Manji RA, Hara H. Human antibody recognition of xenogeneic antigens (NeuGc and Gal) on porcine heart valves: could genetically modified pig heart valves reduce structural valve deterioration? Xenotransplantation 2016; 23:370-80. [DOI: 10.1111/xen.12254] [Citation(s) in RCA: 28] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/10/2016] [Accepted: 07/07/2016] [Indexed: 02/02/2023]
Affiliation(s)
- Whayoung Lee
- Thomas E. Starzl Transplantation Institute; University of Pittsburgh; Pittsburgh PA USA
| | - Cassandra Long
- Thomas E. Starzl Transplantation Institute; University of Pittsburgh; Pittsburgh PA USA
| | | | | | - David K. C. Cooper
- Thomas E. Starzl Transplantation Institute; University of Pittsburgh; Pittsburgh PA USA
| | - Rizwan A. Manji
- Department of Surgery; University of Manitoba; Winnipeg MB Canada
- Cardiac Sciences Program; Winnipeg Regional Health Authority and St Boniface Hospital; Winnipeg MB Canada
| | - Hidetaka Hara
- Thomas E. Starzl Transplantation Institute; University of Pittsburgh; Pittsburgh PA USA
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145
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Yao J, Huang J, Zhao J. Genome editing revolutionize the creation of genetically modified pigs for modeling human diseases. Hum Genet 2016; 135:1093-105. [DOI: 10.1007/s00439-016-1710-6] [Citation(s) in RCA: 35] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/29/2016] [Accepted: 07/06/2016] [Indexed: 01/03/2023]
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146
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Hurh S, Kang B, Choi I, Cho B, Lee EM, Kim H, Kim YJ, Chung YS, Jeong JC, Hwang JI, Kim JY, Lee BC, Surh CD, Yang J, Ahn C. Human antibody reactivity against xenogeneic N-glycolylneuraminic acid and galactose-α-1,3-galactose antigen. Xenotransplantation 2016; 23:279-92. [PMID: 27373998 DOI: 10.1111/xen.12239] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/07/2016] [Accepted: 05/07/2016] [Indexed: 12/19/2022]
Abstract
BACKGROUND Despite the development of α1,3-galactosyl transferase-knockout (GTKO) pigs, acute humoral xenograft rejection caused by antibodies against non-Gal antigens, along with complement activation, are hurdles that need to be overcome. Among non-Gal antigens, N-glycolylneuraminic acid (Neu5Gc) is considered to play an important role in xenograft rejection in human. METHODS We generated human embryonic kidney 293 (HEK293) cells that expressed xenogeneic Neu5Gc (HEK293-pCMAH) or α1,3Gal (HEK293-pGT) antigen and investigated the degree of human antibody binding and complement-dependent cytotoxicity (CDC) against these antigens using 100 individual human sera. RESULTS Both IgM and IgG bound to α1,3Gal, while only IgG bound to Neu5Gc. Of the ABO blood groups, the degree of IgG binding to α1,3Gal was highest for blood group A. The degree of CDC against HEK293-pCMAH cells was significantly lower than that against HEK293-pGT cells. However, CDC against HEK293-pCMAH cells was significantly higher than that against control HEK293 cells. In addition, the severity of CDC against HEK293-pCMAH cells positively correlated with that against GTKO pig aortic endothelial cells (PAECs), suggesting that Neu5Gc is the main antigen in GTKO PAECs. Similar to antibody-binding activity, only IgG binding correlated with CDC against HEK293-pCMAH cells. The most common subclass of IgGs against Neu5Gc was IgG1, which typically induces strong complement activation. CONCLUSIONS We showed that IgG-mediated CDC was detected in Neu5Gc-overexpressed HEK293 cells incubated with human sera; however, this antibody reactivity to Neu5Gc was highly variable among individuals. Our results suggest that additional modifications to the CMAH gene should be considered for widespread use of pig organs for human transplants.
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Affiliation(s)
- Sunghoon Hurh
- Transplantation Research Institute, Seoul National University College of Medicine, Seoul, Korea.,Graduate School of Translational Medicine, Seoul National University College of Medicine, Seoul, Korea
| | - Bohae Kang
- Transplantation Research Institute, Seoul National University College of Medicine, Seoul, Korea.,Graduate School of Translational Medicine, Seoul National University College of Medicine, Seoul, Korea
| | - Inho Choi
- Department of Pharmaceutical Engineering, College of Life and Health Sciences, Hoseo University, Asan, Chungcheongnam-do, Korea
| | - Bumrae Cho
- Designed Animal & Transplantation Research Institute, Institute of Green Bio Science & Technology, Seoul National University, Pyeongchang, Gangwon-do, Korea
| | - Eun Mi Lee
- Transplantation Research Institute, Seoul National University College of Medicine, Seoul, Korea.,Graduate School of Translational Medicine, Seoul National University College of Medicine, Seoul, Korea
| | - Hwajung Kim
- Transplantation Research Institute, Seoul National University College of Medicine, Seoul, Korea
| | - Young June Kim
- Designed Animal & Transplantation Research Institute, Institute of Green Bio Science & Technology, Seoul National University, Pyeongchang, Gangwon-do, Korea
| | - Yun Shin Chung
- Transplantation Research Institute, Seoul National University College of Medicine, Seoul, Korea
| | - Jong Cheol Jeong
- Department of Nephrology, Ajou University School of Medicine, Suwon, Gyeonggi-do, Korea
| | - Jong-Ik Hwang
- Graduate School of Medicine, Korea University, Seoul, Korea
| | - Jae Young Kim
- Department of Life Science, Gachon University, Seongnam, Korea
| | - Byeong Chun Lee
- Designed Animal & Transplantation Research Institute, Institute of Green Bio Science & Technology, Seoul National University, Pyeongchang, Gangwon-do, Korea.,Department of Theriogenology and Biotechnology, College of Veterinary Medicine, Seoul National University, Seoul, Korea.,Research Institute for Veterinary Science, Seoul National University, Seoul, Korea
| | - Charles D Surh
- Academy of Immunology and Microbiology, Institute for Basic Science, Pohang, Korea.,Department of Integrative Biosciences and Biotechnology, Pohang University of Science and Technology, Pohang, Korea.,Division of Developmental Immunology, La Jolla Institute for Allergy and Immunology, La Jolla, CA, USA
| | - Jaeseok Yang
- Transplantation Research Institute, Seoul National University College of Medicine, Seoul, Korea.,Transplantation Center, Seoul National University Hospital, Seoul, Korea
| | - Curie Ahn
- Transplantation Research Institute, Seoul National University College of Medicine, Seoul, Korea.,Designed Animal & Transplantation Research Institute, Institute of Green Bio Science & Technology, Seoul National University, Pyeongchang, Gangwon-do, Korea.,Transplantation Center, Seoul National University Hospital, Seoul, Korea.,Department of Internal Medicine, Seoul National University College of Medicine, Seoul, Korea
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147
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Silencing porcine genes significantly reduces human-anti-pig cytotoxicity profiles: an alternative to direct complement regulation. Transgenic Res 2016; 25:751-9. [DOI: 10.1007/s11248-016-9958-0] [Citation(s) in RCA: 31] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/15/2015] [Accepted: 04/12/2016] [Indexed: 02/03/2023]
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148
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Guo W, Cao S, Yan B, Zhang G, Li J, Zhao Y, Zhang S. Myocardial protective effects of a c-Jun N-terminal kinase inhibitor in rats with brain death. J Cell Mol Med 2016; 20:1214-8. [PMID: 27072084 PMCID: PMC4929305 DOI: 10.1111/jcmm.12676] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/03/2015] [Accepted: 08/03/2015] [Indexed: 02/05/2023] Open
Abstract
To investigate whether the mitochondrial apoptotic pathway mediates myocardial cell injuries in rats under brain death (BD), and observe the effects and mechanisms of the c‐Jun N‐terminal kinase (JNK) inhibitor SP600125 on cell death in the heart. Forty healthy male Sprague‐Dawley (SD) rats were randomized into four groups: sham group (dural external catheter with no BD); BD group (maintain the induced BD state for 6 hrs); BD + SP600125 group (intraperitoneal injection of SP600125 10 mg/kg 1 hr before inducing BD, and maintain BD for 6 hrs); and BD + Dimethyl Sulphoxide (DMSO) group (intraperitoneal injection of DMSO 1 hr before inducing BD, and maintain BD for 6 hrs). Real‐time quantitative PCR was used to evaluate mRNA levels of Cyt‐c and caspase‐3. Western blot analysis was performed to examine the levels of mitochondrial apoptosis‐related proteins p‐JNK, Bcl‐2, Bax, Cyt‐c and Caspase‐3. TUNEL assay was employed to evaluate myocardial apoptosis. Compared with the sham group, the BD group exhibited increased mitochondrial apoptosis‐related gene expression, accompanied by the elevation of p‐JNK expression and myocardial apoptosis. As the vehicle control, DMSO had no treatment effects. The BD + SP600125 group had decreased p‐JNK expression, and reduced mitochondrial apoptosis‐related gene expression. Furthermore, the apoptosis rate of myocardial cells was reduced. The JNK inhibitor SP600125 could protect myocardial cells under BD through the inhibition of mitochondrial apoptosis‐related pathways.
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Affiliation(s)
- Wenzhi Guo
- Department of Hepatobiliary and Pancreatic Surgery, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, Henan, China.,Henan Key Laboratory of Digestive Organ Transplantation, Zhengzhou, Henan, China
| | - Shengli Cao
- Department of Hepatobiliary and Pancreatic Surgery, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, Henan, China.,Henan Key Laboratory of Digestive Organ Transplantation, Zhengzhou, Henan, China
| | - Bing Yan
- Henan Key Laboratory of Digestive Organ Transplantation, Zhengzhou, Henan, China
| | - Gong Zhang
- Department of Hepatobiliary and Pancreatic Surgery, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, Henan, China.,Henan Key Laboratory of Digestive Organ Transplantation, Zhengzhou, Henan, China
| | - Jie Li
- Department of Hepatobiliary and Pancreatic Surgery, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, Henan, China.,Henan Key Laboratory of Digestive Organ Transplantation, Zhengzhou, Henan, China
| | - Yongfu Zhao
- Department of Hepatobiliary and Pancreatic Surgery, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, Henan, China
| | - Shuijun Zhang
- Department of Hepatobiliary and Pancreatic Surgery, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, Henan, China.,Henan Key Laboratory of Digestive Organ Transplantation, Zhengzhou, Henan, China
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149
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Mohiuddin MM, Singh AK, Corcoran PC, Thomas III ML, Clark T, Lewis BG, Hoyt RF, Eckhaus M, Pierson III RN, Belli AJ, Wolf E, Klymiuk N, Phelps C, Reimann KA, Ayares D, Horvath KA. Chimeric 2C10R4 anti-CD40 antibody therapy is critical for long-term survival of GTKO.hCD46.hTBM pig-to-primate cardiac xenograft. Nat Commun 2016; 7:11138. [PMID: 27045379 PMCID: PMC4822024 DOI: 10.1038/ncomms11138] [Citation(s) in RCA: 321] [Impact Index Per Article: 40.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/20/2016] [Accepted: 02/23/2016] [Indexed: 12/11/2022] Open
Abstract
Preventing xenograft rejection is one of the greatest challenges of transplantation medicine. Here, we describe a reproducible, long-term survival of cardiac xenografts from alpha 1-3 galactosyltransferase gene knockout pigs, which express human complement regulatory protein CD46 and human thrombomodulin (GTKO.hCD46.hTBM), that were transplanted into baboons. Our immunomodulatory drug regimen includes induction with anti-thymocyte globulin and αCD20 antibody, followed by maintenance with mycophenolate mofetil and an intensively dosed αCD40 (2C10R4) antibody. Median (298 days) and longest (945 days) graft survival in five consecutive recipients using this regimen is significantly prolonged over our recently established survival benchmarks (180 and 500 days, respectively). Remarkably, the reduction of αCD40 antibody dose on day 100 or after 1 year resulted in recrudescence of anti-pig antibody and graft failure. In conclusion, genetic modifications (GTKO.hCD46.hTBM) combined with the treatment regimen tested here consistently prevent humoral rejection and systemic coagulation pathway dysregulation, sustaining long-term cardiac xenograft survival beyond 900 days.
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Affiliation(s)
| | - Avneesh K. Singh
- Cardiothoracic Surgery Research Program, NHLBI, NIH, Bethesda, Maryland 20892, USA
| | - Philip C. Corcoran
- Cardiothoracic Surgery Research Program, NHLBI, NIH, Bethesda, Maryland 20892, USA
| | | | | | - Billeta G. Lewis
- Division of Veterinary Resources, ORS, NIH, Bethesda, Maryland 20892, USA
| | - Robert F. Hoyt
- Leidos Biomedical Research, Inc., Bethesda, Maryland 20892, USA
| | - Michael Eckhaus
- Division of Veterinary Resources, ORS, NIH, Bethesda, Maryland 20892, USA
| | | | - Aaron J. Belli
- MassBiologics, University of Massachusetts Medical School, Boston, Massachusetts 02126, USA
| | - Eckhard Wolf
- Ludwig Maximilian University, Munich 81377, Germany
| | | | | | - Keith A. Reimann
- MassBiologics, University of Massachusetts Medical School, Boston, Massachusetts 02126, USA
| | | | - Keith A. Horvath
- Cardiothoracic Surgery Research Program, NHLBI, NIH, Bethesda, Maryland 20892, USA
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150
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Murthy R, Bajona P, Bhama JK, Cooper DK. Heart Xenotransplantation: Historical Background, Experimental Progress, and Clinical Prospects. Ann Thorac Surg 2016; 101:1605-13. [DOI: 10.1016/j.athoracsur.2015.10.017] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/27/2015] [Revised: 09/14/2015] [Accepted: 10/01/2015] [Indexed: 12/29/2022]
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