The passenger cell concept in transplantation immunology

Depletion of donor dendritic cells ameliorates immunogenicity of both skin and hind limb transplants

Acute cellular rejection remains a significant obstacle affecting successful outcomes of organ transplantation including vascularized composite tissue allografts (VCA). Donor antigen presenting cells (APCs), particularly dendritic cells (DCs), orchestrate early alloimmune responses by activating recipient effector T cells. Employing a targeted approach, we investigated the impact of donor-derived conventional DCs (cDCs) and APCs on the immunogenicity of skin and skin-containing VCA grafts, using mouse models of skin and hind limb transplantation. By post-transplantation day 6, skin grafts demonstrated severe rejections, characterized by predominance of recipient CD4 T cells. In contrast, hind limb grafts showed moderate rejection, primarily infiltrated by CD8 T cells. Notably, the skin component exhibited heightened immunogenicity when compared to the entire VCA, evidenced by increased frequencies of pan (CD11b-CD11c+), mature (CD11b-CD11c+MHCII+) and active (CD11b-CD11c+CD40+) DCs and cDC2 subset (CD11b+CD11c+ MHCII+) in the lymphoid tissues and the blood of skin transplant recipients. While donor depletion of cDC and APC reduced frequencies, maturation and activation of DCs in all analyzed tissues of skin transplant recipients, reduction in DC activities was only observed in the spleen of hind limb recipients. Donor cDC and APC depletion did not impact all lymphocyte compartments but significantly affected CD8 T cells and activated CD4 T in lymph nodes of skin recipients. Moreover, both donor APC and cDC depletion attenuated the Th17 immune response, evident by significantly reduced Th17 (CD4+IL-17+) cells in the spleen of skin recipients and reduced levels of IL-17E and lymphotoxin-α in the serum samples of both skin and hind limb recipients. In conclusion, our findings underscore the highly immunogenic nature of skin component in VCA. The depletion of donor APCs and cDCs mitigates the immunogenicity of skin grafts while exerting minimal impact on VCA.

Subset-specific Retention of Donor Myeloid Cells After Major Histocompatibility Complex-matched and Mismatched Liver Transplantation

BACKGROUND

During solid organ transplantation, donor leukocytes, including myeloid cells, are transferred within the organ to the recipient. Both tolerogenic and alloreactive roles have been attributed to donor myeloid cells; however, their subset-specific retention posttransplantation has not been investigated in detail.

METHODS

Major histocompatibility complex (MHC)-matched and mismatched liver transplants were performed in mice, and the fate of donor and recipient myeloid cells was assessed.

RESULTS

Following MHC-matched transplantation, a proportion of donor myeloid cells was retained in the graft, whereas others egressed and persisted in the blood, spleen, and bone marrow but not the lymph nodes. In contrast, after MHC-mismatched transplantation, all donor myeloid cells, except Kupffer cells, were depleted. This depletion was caused by recipient T and B cells because all donor myeloid subsets were retained in MHC-mismatched grafts when recipients lacked T and B cells. Recipient myeloid cells rapidly infiltrated MHC-matched and, to a greater extent, MHC-mismatched liver grafts. MHC-mismatched grafts underwent a transient rejection episode on day 7, coinciding with a transition in macrophages to a regulatory phenotype, after which rejection resolved.

CONCLUSIONS

Phenotypic and kinetic differences in the myeloid cell responses between MHC-matched and mismatched grafts were identified. A detailed understanding of the dynamics of immune responses to transplantation is critical to improving graft outcomes.

Pathways of Antigen Recognition by T Cells in Allograft Rejection

The adaptive immune response leading to the rejection of allogeneic transplants is initiated and orchestrated by recipient T cells recognizing donor antigens. T-cell allorecognition is mediated via 3 distinct mechanisms: the direct pathway in which T cells recognize allogeneic major histocompatibility complex (MHC) molecules on donor cells, the indirect pathway through which T cells interact with donor peptides bound with self-MHC molecules on recipient antigen-presenting cells, and the recently described semidirect pathway whereby T cells recognize donor MHC proteins on recipient antigen-presenting cells. In this article, we present a description of each of these allorecognition pathways and discuss their role in acute and chronic rejection of allogeneic transplants.

State of the Art: Role of the Dendritic Cell in Induction of Allograft Tolerance

Despite decades of research, the induction and maintenance of long-term allograft tolerance without immunosuppression remains an elusive goal in the field of solid organ and cell transplantation. Immunosuppressive medications frequently prevent or minimize acute cellular rejection but have failed to halt antidonor antibody production and chronic organ rejection. Past efforts aimed at promoting lasting allograft tolerance have focused primarily on peripheral T-cell depletion, augmentation of regulatory T cells, or induction via simultaneous hematopoietic stem cell transplantation and facilitation of donor chimerism. So far, none of these methods have led to consistently safe, feasible and long lasting donor organ acceptance. Over the course of the past 4 decades, the study of a unique population of antigen-presenting cells known as dendritic cells has shown promise for breaking new ground in achieving indefinite allograft survival without immunosuppression and its associated adverse effects. In this review, we discuss the discovery and early investigations of dendritic cells and chronicle some of the key studies demonstrating their role in transplantation, particularly in indirect allorecognition, the immunologic pathway thought to drive chronic rejection and perhaps tolerance induction.

Emerging role of exosomes in allorecognition and allograft rejection

PURPOSE OF REVIEW

This article reviews recent literature on the nature of extracellular vesicles released by allogeneic transplants and examine their role in T-cell alloimmunity involved in rejection and tolerance of these grafts.

RECENT FINDINGS

Donor cells release extracellular vesicles, including exosomes, after transplantation of allogeneic organs and tissues. Consequently, recipient APCs take up these exosomes and present donor MHC antigens on their surface (allo-MHC cross-dressing) thus, activating some alloreactive T cells via a mechanism called semi-direct pathway of allorecognition. In addition, one study shows that exosomes carrying noninherited maternal antigens are associated with maternal microchimerism and tolerance in offspring. Finally, a few studies describe potential utilization of exosomes as modulators of alloimmunity and biomarkers of rejection in allotransplantation.

SUMMARY

Extracellular vesicles, including exosomes, released by allografts contribute to recognition of donor antigens by T cells after allotransplantation. This occurs through cross-dressing of recipient APCs with donor MHC antigens and subsequent activation of T cells, a process called semi-direct alloreactivity. The relevance of this phenomenon in rejection and tolerance of allografts and the potential utilization of exosomes as biomarkers in transplantation are discussed.

Allorecognition by T Lymphocytes and Allograft Rejection

Recognition of donor antigens by recipient T cells in secondary lymphoid organs initiates the adaptive inflammatory immune response leading to the rejection of allogeneic transplants. Allospecific T cells become activated through interaction of their T cell receptors with intact allogeneic major histocompatibility complex (MHC) molecules on donor cells (direct pathway) and/or donor peptides presented by self-MHC molecules on recipient antigen-presenting cells (APCs) (indirect pathway). In addition, recent studies show that alloreactive T cells can also be stimulated through recognition of allogeneic MHC molecules displayed on recipient APCs (MHC cross-dressing) after their transfer via cell-cell contact or through extracellular vesicles (semi-direct pathway). The specific allorecognition pathway used by T cells is dictated by intrinsic and extrinsic factors to the allograft and can influence the nature and magnitude of the alloresponse and rejection process. Consequently, various organs and tissues such as skin, cornea, and solid organ transplants are recognized differently by pro-inflammatory T cells through these distinct pathways, which may explain why these grafts are rejected in a different fashion. On the other hand, the mechanisms by which anti-inflammatory regulatory T cells (Tregs) recognize alloantigen and promote transplantation tolerance are still unclear. It is likely that thymic Tregs are activated through indirect allorecognition, while peripheral Tregs recognize alloantigens in a direct fashion. As we gain insights into the mechanisms underlying allorecognition by pro-inflammatory and Treg cells, novel strategies are being designed to prevent allograft rejection in the absence of ongoing immunosuppressive drug treatment in patients.

Donor exosomes rather than passenger leukocytes initiate alloreactive T cell responses after transplantation

Transplantation of allogeneic organs and tissues represents a lifesaving procedure for a variety of patients affected with end-stage diseases. Although current immunosuppressive therapy prevents early acute rejection, it is associated with nephrotoxicity and increased risks for infection and neoplasia. This stresses the need for selective immune-based therapies relying on manipulation of lymphocyte recognition of donor antigens. The passenger leukocyte theory states that allograft rejection is initiated by recipient T cells recognizing donor major histocompatibility complex (MHC) molecules displayed on graft leukocytes migrating to the host's lymphoid organs. We revisited this concept in mice transplanted with allogeneic skin, heart, or islet grafts using imaging flow cytometry. We observed no donor cells in the lymph nodes and spleen of skin-grafted mice, but we found high numbers of recipient cells displaying allogeneic MHC molecules (cross-dressed) acquired from donor microvesicles (exosomes). After heart or islet transplantation, we observed few donor leukocytes (100 per million) but large numbers of recipient cells cross-dressed with donor MHC (>90,000 per million). Last, we showed that purified allogeneic exosomes induced proinflammatory alloimmune responses by T cells in vitro and in vivo. Collectively, these results suggest that recipient antigen-presenting cells cross-dressed with donor MHC rather than passenger leukocytes trigger T cell responses after allotransplantation.

Progress in developing virus-like particle influenza vaccines

Recombinant vaccines based on virus-like particles (VLPs) or nanoparticles have been successful in their safety and efficacy in preclinical and clinical studies. The technology of expressing enveloped VLP vaccines has combined with molecular engineering of proteins in membrane-anchor and immunogenic forms mimicking the native conformation of surface proteins on the enveloped viruses. This review summarizes recent developments in influenza VLP vaccines against seasonal, pandemic, and avian influenza viruses from the perspective of use in humans. The immunogenicity and efficacies of influenza VLP vaccine in the homologous and cross-protection were reviewed. Discussions include limitations of current influenza vaccination strategies and future directions to confer broadly cross protective new influenza vaccines as well as vaccination.

Antigen presentation events in autoimmune diabetes

Antigen presenting cells (APC) be they dendritic cells (DC) or macrophages reside in all tissues. Their role varies from presenting antigen, clearing the tissue from unwanted material, helping in the remodeling that follows injury and inflammation, to a supporting or trophic function. Their features, biology, and turnover may be unique for each organ, modulated by the particular anatomy and physiology of the tissue. These features affect the handling and presentation of antigens, either exogenous such as those from viruses or bacteria, or endogenous, autologous proteins in situations of autoimmunity. Herein, we focus on the resident APC of the islets of Langerhans and their role in autoimmune diabetes. The intra-islet APC are central cells in diabetogenesis by presenting beta cell derived antigens and by modulating the localization of T cells into the islets.

Bone marrow-derived mesenchymal stem cells as immunosuppressants in liver transplantation: a review of current data

This article provides an overview of the current knowledge relating to the potential use of bone marrow-derived mesenchymal stem cells (BM-MSCs) acting as immunosuppressants after liver transplantation. Clinical use of BM-MSCs in liver transplantation remains experimental, as there is uncertainty as to their mechanism of action, conflicting studies in animal models, and the possibility of their cellular fusion with hepatocytes leading to potentially genetically unstable hepatocytes. These obstacles, to their underuse, have been decreasing, and BM-MSCs have elicited great interest for possible use in solid organ transplantation. Bone marrow-derived-MSCs, when transplanted systemically, might positively influence grafted organ outcome through cell-cell contact or the secretion of soluble factors that are immunomodulatory. Thus, the use of BM-MSCs to modulate organ rejection may directly or indirectly influence the survival properties of transplanted livers.

Human renal allograft rejection despite the absence of allogeneic passenger leukocytes

Passenger leukocytes have been suggested to be both pro-tolerant and immunogenic. The opportunity to evaluate the role of allogeneic passenger leukocytes in humans was presented by a 47-year-old man who donated bone marrow to his HLA-identical leukemic sister. Eleven years later he developed renal failure. The sister's marrow was noted to be 100% XY karyotype and free of malignancy. She donated a kidney to her brother. Immunosuppression was tapered following transplantation. After 6 months, the recipient was on monotherapy sirolimus, 1 mg every third day. A surveillance biopsy was normal and sirolimus was stopped. Eight weeks later, he presented with severe rejection that reversed with Thymoglobulin. Renal function returned to baseline and has been stable on conventional immunosuppression.

Cryopreservation with dimethyl sulfoxide sustains partially the biological function of osteochondral tissue

The clinical routine use of bone allograft transplants dates back to the discovery that grafts devitalized by freezing bear a reduced antigenicity. Graft failures, caused by a host versus graft reaction, however, remain a clinical problem. Previous investigations on pancreatic islet allografts revealed improved survival and biological function when fast cryopreservation (-70 degrees C/min) was performed in the presence of dimethyl sulfoxide (DMSO). The aim of this study was to determine the effect of fast freezing using DMSO on the biological function of osteochondral tissues. Organ culture was performed with neonatal femora of mice, untreated, rapidly frozen (-70 degrees C/min) with DMSO, or frozen without DMSO. After the culture, tissue morphology, cellular proliferation, osteoblast function, osteoclasts, and the presence of antigen-presenting cells were investigated. In untreated control femora histology appeared normal and proliferating and collagen-synthesizing osteoblasts, osteoclasts, and B-cells and macrophages were present. In frozen femora (with and without DMSO) a disintegration of the periosteum and the epiphyseal growth plate were observed and no active osteoblasts could be detected. Osteoclasts were partially detached from the bone surface. Cell proliferation was fully blocked in femora frozen in the absence of DMSO, while freezing in the presence of DMSO preserved cell proliferation in the medullary canal. The proliferating cells do not express epitopes present on the cells of the B-cell or macrophage lineages. Although the biological function of osteoblasts and osteoclasts was lost upon freezing of osteochondral tissue, DMSO included in freezing protocols preserves some residual cell viability which may be of importance for early graft revascularization as has been previously demonstrated by our group.

T Cell Immunity Induced by Allogeneic Microglia in Relation to Neuronal Retina Transplantation

Microglia share a lineage relationship with bone marrow-derived monocytes/macrophages and dendritic cells, and their inclusion in retinal and brain transplants may function as “passenger leukocytes.” In other solid allografts, passenger leukocytes are the primary sources of immunogenicity, triggering alloimmune rejection. We have conducted a series of in vitro and in vivo studies examining the capacity of microglia cultured from forebrain to activate alloreactive T cells and to induce and elicit alloimmunity. Cultured microglia expressed class II MHC molecules and costimulatory molecules (B7-1, B7-2, and CD40), and they secreted IL-12. Cultured microglia injected s.c. into naive recipients induced allospecific delayed hypersensitivity and elicited delayed hypersensitivity directed at alloantigens. Cultured microglia differed from conventional APCs by secreting significant amounts of mature TGF-β2, but smaller amounts of IL-12. Moreover, while both cultured microglia and conventional APC stimulated T cell proliferation in vitro, microglia directed the responding T cells toward the Th2 pathway in which IL-4, but not IL-2 and IFN-γ, was secreted. The abilities of microglia to secrete TGF-β2, to stimulate alloreactive Th2 cells, and to induce anterior chamber associated immune deviation when injected into the eye of naive allogeneic mice suggest that they are not typical passenger leukocytes. The unique functional properties of cultured microglia may account for the capacity of neonatal retinal tissue transplanted into the eye to alter the systemic alloimmune response in a manner that delays, but does not prevent, graft rejection.

Cellular immunity: the final paradigm?

Cytotoxic T lymphocyte activation and most probably tolerance induction, is dependent on antigen presentation by a specialized group of cells, APC, including macrophages, dendritic cells and B cells. Since T lymphocytes are, at least, the majority of the time MHC molecule class-specific, CD8+ T cells require antigen presented by MHC class I molecules. MHC class I molecules are, however, restricted to presenting endogenously produced antigenic peptides. Most threats to the organism are of exogenous origin and do not uniformly affect all or even most of the cells of an organism. This precludes the likelihood that any number of APC would be involved in every threatening situation, which raises the important question of how T lymphocytes are indeed activated, especially CD8+ T cells (MHC class I restricted).

Multiple pathways in the rejection of skin grafts

We have analyzed the ability of CD4+ and CD8+ T cells to cause rejection of skin grafts in an Ir gene high responder strain. (DA.RT1u x DA.RT1c)F1 B rats (thymectomized, lethally irradiated, reconstituted with fetal liver cells) were grafted with ear skin of the recombinant strain, DA.RT1rl. The only allogeneic difference was a single class I MHC antigen. The B rats, which do not reject these grafts due to the absence of T cells, were reconstituted at various time intervals after skin grafting with either unsorted lymph node cells (LNCs), CD4+, CD8+ or CD4+ and CD8+ T cells. Unsorted LNCs given any time after graft placement always caused rejection (MST = 15d). CD4+ cells alone never caused rejection (MST greater than 60d, n = 8). CD8+ cells alone caused rejection if given within 3 weeks of graft placement. Thereafter, CD8+ cells alone lost their ability to cause rejection (MST greater than 60d, n = 6). B rats with grafts in place more than 3 weeks, when CD8+ cells alone were ineffective, rejected their skin grafts when given both CD8+ and CD4+ cells. These data suggest that there may be two T cell pathways in skin graft rejection. The first requires only CD8+ cells and causes rejection of a recently placed graft. The second pathway requires both CD4+ and CD8+ cells to reject long-standing grafts in which donor antigen-presenting cells have been putatively depleted and, therefore, may be dependent on host antigen-presenting cells.

The biology of acute transplant rejection

An intriguing and increasingly understood facet of immune responses is the ability of a recipient to destroy a foreign tissue or organ graft. The phenomenon of acute rejection of an allograft involves a series of complex and inter-related cellular and humoral events, culminating in graft death. Some of the current thinking surrounding this phenomenon is reviewed.

Epithelial changes following bone marrow transplantation: cytological atypia and epithelial endocrine cells

This report describes the histological and immunocytochemical findings in gastrointestinal biopsies and skin of a patient with chronic granulocytic leukaemia which progressed to blastic transformation, who was then treated with chemotherapy and total body irradiation followed by allogeneic bone marrow transplantation. The gut showed endocrine cells in the lamina propria and these had an immunophenotype similar to the glandular epithelium at the sites studied (stomach, duodenum and rectum), supporting the idea that the endocrine cells of the gut are more resistant to the effect of radiation, chemotherapy and graft-versus-host disease (GVHD) than are other cell types in the epithelium, and that lamina proprial endocrine cells are epithelially derived in this situation. Epidermis and gut epithelium also showed marked atypia due to the conditioning regimen and GVHD, and this case illustrates the possibility of misdiagnosis of carcinoma in this increasingly common situation. An additional, unusual feature of this case was the presence of a B-cell UCHL1 + ve lymphoma of the colon at autopsy, 122 days post-transplantation.

Update on pancreatic islet cell transplantation

The biological validation of islet grafts would free total pancreas resection from the onus of severe diabetes mellitus. Islet cell transplants can reverse diabetes mellitus and prevent complications in animal models. Immune rejection has foiled attempts at human transplantation despite moderate success with whole pancreas grafts. Aggressive rejection of islet grafts has been extensively studied in animal models and seems no different in substance from standard cell-mediated rejection but vastly different in tenacity. Rejection cannot be prevented by immunosuppression strategies effective for transplantation of heart, kidney, or liver. New strategies to circumvent islet rejection include encapsulation of the islets to obfuscate immune recognition, pretreatment of the islets in vitro to reduce immunogenicity, donor manipulation to provide specific tolerance, and combination strategies. In the development of these strategies, much has been learned or confirmed about the nature of immune rejection, and another round of human trials can be anticipated.

Increased populations of endocrine cells in Crohn's ileitis

Hyperplasia of nerves has been described previously in Crohn's disease. To determine whether similar alteration of the enteric endocrine system occurs, endocrine cells of the ileal epithelium were quantified in typical cases of the disease. In the ileum from patients with Crohn's disease, there was an increase in the endocrine cell population, as visualised by immunostaining of chromogranin. Quantification of endocrine cell numbers showed significant increases in both macroscopically uninvolved (i.e. histologically normal) (35.0 +/- 3.8, cells per unit length of muscularis mucosae mean +/- SEM, P less than 0.05) and involved (44.5 +/- 5.5, P less than 0.01) Crohn's disease samples, compared with normal controls (23.7 +/- 3.4). Although individual types of endocrine cell showed slight increases in Crohn's samples, only the enterochromaffin cells in abnormal bowel showed a significantly greater population (normal controls 10.5 +/- 2.3; involved Crohn's 21.3 +/- 4.4, P less than 0.05).

Selective sparing of enterochromaffin cells in graft versus host disease affecting the colonic mucosa

Graft versus host disease affecting the large bowel causes destruction of the crypt epithelium. There is a selective sparing of enterochromaffin cells in the majority of cases. As a consequence, single as well as small clumps of enterochromaffin cells are to be seen in the sites formerly occupied by the destroyed crypt epithelium. The reason for this phenomenon is unclear, but it may be related to the fact that the enterochromaffin cells are end-stage and non-proliferating cells. This is useful diagnostically. However, cytotoxic drugs or irradiation must be excluded as the cause of the mucosal damage to bowel as there are theoretical reasons to expect that a similar phenomenon will be seen after these forms of therapy.

Prolongation of rat islet allograft survival by direct ultraviolet irradiation of the graft

Ultraviolet irradiation of rat dendritic cells completely abrogated their allostimulatory capacity in a mixed lymphocyte reaction. Rat islets of Langerhans similarly irradiated remained hormonally functional when transplanted into syngeneic diabetic rats. Allogeneic transplantation across a major histocompatibility barrier of islets initially treated in vitro with ultraviolet irradiation resulted in prolonged allograft survival without the use of any immunosuppressive agents.

Localization of paternal H-2K antigens on murine trophoblast cells in vivo

We have previously shown the presence of H-2K and D antigens of both parental haplotypes on dispersed murine trophoblast cells. The question still remained whether such antigens are sequestered away from the sinusoidal face of these cells making them inert as allografts. The in vivo expression of H-2 antigens on these cells was therefore examined radioautographically after perfusion of 125I-labeled monoclonal and anti-H-2Kk (anti-paternal) antibody directly into individual placental branches of the uterine artery suppling 15-d-old (C57BL/6J female) X CBA/J male) placentae. Syngeneic C57BL/6J placentae served as negative controls. A radioautographic examination of 0.5-micrometer-thick sections revealed specific labeling of labyrinthine trophoblasts lining the sinusoids of allogeneic placentae. Most of this labeling was localized to the sinusoidal face of the cells as opposed to a weak labeling of the intracellular aspect. Spongiotrophoblasts and trophoblast giant cells did not label, but specific labeling of fetal capillary endothelium and some macrophages was also noted.

A comparison of different cellular inocula in an experimental model of massive periretinal proliferation

We modified a preexisting experimental model of massive periretinal proliferation by injecting cells of differing origins into the rabbit vitreous cavity. These cells included autologous and homologous fibroblasts, homologous chondrocytes, homologous retinal pigment epithelial cells, heterologous bovine endothelial cells, and heterologous murine embryonal cells. All cell injections caused vitreous and retinal membrane formation that resulted in a process similar to massive periretinal proliferation. Clinically the character of the membranes formed and the time course in the development of traction retinal detachments was similar for all the different cell types. The initial cell dosage injected was the critical factor in determining the severity of the traction retinal detachments leading to massive periretinal proliferation.

Evidence for major histocompatibility complex restriction in transplantation immunity

Studies on the survival of histocompatibility-Y antigen (H-Y)-incompatible and skin-specific antigen (Skn)-incompatible skin grafts in mice, as well as those concerned with the survival of cultured parathyroid allografts in rats, indicate that grafts provoke a strong immune response only if they include donor macrophages (or Langerhans cells) or if major histocompatibility complex-compatible macrophages are available to react with cells bearing the foreign antigens.

Immunogenetic aspects of in vivo allotolerance induction during the ontogeny of Xenopus laevis

This study describes the ontogeny of allograft immunity in a partially inbred strain of frogs (Xenopus laevis). At various times during the frogs' premetamorphic, perimetamorphic, and postmetamorphic life, major histocompatibility complex (MHC) homozygous strain JJ Xenopus (MHC haplotype j) were grafted with skin from adult donors of defined MHC homozygous (j,f) and heterozygous (j/f,f/h) haplotypes. This protocol reveals that destructive allograft reactivity to MHC alloantigens in Xenopus matures slowly and that allotolerance can be induced to such MHC-encoded antigens throughout larval life. The ultimate fate of an MHC disparate transplant (survival or rejection) is dependent on several interacting variables, which include antigen dose, haplotype dose, and the developmental stage of the host frog at the time of transplantation. In contrast, minor H-locus disparate (MHC compatible) grafts never appear to be rejected by hosts grafted at any larval stage.

Responses of canine lymphocytes to allogeneic and autologous Islets of Langerhans in mixed cell cultures

Because successful allotransplantation of islets of Langerhans isolated by collagenase digestion has been difficult in many animal species, we asked whether isolated islet preparations might have tissue specific determinants conferring amplified immunogenicity in vitro. Lymphocyte proliferative responses ([(3)H]thymidine uptake) were studied in beagle dogs in mixed culture combinations of lymphocyte vs. lymphocyte (MLC) and lymphocyte vs. islet (MLIC). In five MLC responder and five nonresponder pairs, peripheral blood lymphocytes of dogs A and B were used as responding cells, and dog B x-irradiated lymphocytes (Bx), x-irradiated (or nonirradiated) islets (BI), or hepatic cells (BH) were used as stimulating cells in primary and secondary reactions. For the secondary reactions, A + Bx, A + BI, or B + BI were incubated for 9 d (A'B, A'BI, B'BI, respectively) before addition of new stimulating cells. The results showed that islets were autostimulatory, eliciting a tissue-specific lymphoproliferative response in a primary MLIC. Thus, B + BI reactivity was evident at 3,5, and 7 d in primary culture, whereas collagenase-digested liver cells, or lymphocytes obtained from collagenase-digested lymph nodes did not stimulate autologous lymphocytes. A separate reactivity was observed in the allogeneic A + BI combination in MLC responder pairs, and the peak response of A + BI at 9 d was markedly greater than that of B + BI, suggesting the presence of major histocompatibility complex lymphocyte-defined locus determinants in the islet preparations, in addition to islet-specific determinants. A secondary reaction was observed if lymphocytes were primed with islets and challenged with islets (A'BI + BI or B'BI + BI), but not if they were challenged with lymphocytes (A'BI + Bx, B'BI + Bx) or hepatic cells (A'BI + BH, B'BI + AH). Furthermore, priming of lymphocytes with autologous islets (B'BI) led to exclusion of any reactivity against allogeneic lymphocytes, i.e., B'BI suppressed A + Bx, and B'BI also markedly suppressed phytohemagglutinin-stimulated lymphoproliferative responses. Experiments were performed that excluded the possibility that the insulin levels present in the MLIC, the presence of passenger lymphocytes in the islets, or the maintenance of islets in tissue culture for 1-7 d affected the observations. These results provide evidence for the existence of alloantigens as well as tissue-specific antigens on collagenase-isolated islets of Langerhans.

Interaction of macrophages and lymphocytes in rat skin allografts

Light microscopy of 2 microgram sections of rejecting rat skin allografts, embedded in hydroxyethyl methacrylate, revealed among the cells infiltrating the graft base extravascular macrophages containing a small lymphocyte. Toluidine blue staining indicated DNA degradation in some of these phagocytosed lymphocytes. More frequently small lymphocytes were in intimate contact with the surface of the macrophages, resembling "Periopolesis', which others have previously observed in vitro. These macrophage-lymphocyte interactions were not seen in sections of autografts. Despite a previous report that diphenylhydantoin (phenytoin) impairs macrophage function, these macrophage-lymphocyte interactions were present in grafts placed in rats receiving this drug. This treatment did not hasten or delay the onset of graft rejection. These in vivo findings both accord with recent in vitro studies on the mechanisms of phagocytosis and with reports that phagocytosis is one of the effector mechanisms in allograft rejection. However, macrophage phagocytosis of lymphocytes has also been observed in testicular lymph collected from conscious normal sheep.

Expression of Ia antigens on Langerhans cells in mice, guinea pigs, and man

In all mammalian species so far examined, Langerhans cells or their precursors are the only epidermal cells expressing Ia antigens or their equivalents. In man, xenoantisera raised in rabbits against purified B lymphocyte cell membrane antigens were utilized to stain the Langerhans cells, by either fluorescence or immunoferritin methods. A high proportion of the indeterminate cells in the epidermis also expressed HLA-DR antigens, and a relationship to Langerhans cells is suggested. Confirmation of these results was obtained in mouse. Alloantisera raised against I-A and I-EC subregion products again stained only Langerhans cells. Fluorescence, immunoperoxidase, and immunoferritin methods were used, and confirmation of the specificity of the reaction was achieved at the electron microscope level. Langerhans cells were shown, by ATPase staining, to be absent from the epithelium of the central cornea, but were present in the limbus. Population of the entire corneal epithelium surface was induced by application or irritants or contact sensitizing agents such as dinitrochlorobenzene. Grafting of corneas either deficient or populated with Langerhans cells, to skin beds, may answer the question of the influence of such cells on allograft rejection.

Studies of the immediately vascularized skin allograft

In order to evaluate the effect of the nature of revascularization on survival rates of skin allografts, a rat model was devised which provided simultaneous and immediate establishment of arterial and venous blood supply to a composite skin-renal allograft. For 5 days after transplantation the skin portion of the composite grafts appeared normal, with minimal inflammation in 11 recipients. From 6 to 11 days, in 6 rats, active rejection developed with a marked inflammatory reaction of the skin-kidney interface. In 10 rats in which the composite grafts remained in the secondary hosts for 12--21 days rejection of the skin was complete. The renal portion of all composite grafts appeared normal in all three panels and all recipients of composite grafts rejected subsequent orthotopic skin grafts in an accelerated manner, with median survival time of 8.2 +/- 0.3 days compared with 11.5 +/- 0.7 days in untreated Fisher leads to Lewis controls. These results demonstrate that the skin on the composite graft retained its immunogenicity, that immediately vascularized skin allografts between AgB compatible rats will be rejected in a normal time and that anatomical factors are not sufficient to account for the difference in survival times between skin and solid organs.

Transplantation of organ cultured rat parathyroids

The hypothesis that tissue culture alters the immunogenicity of grafts by removal or inactivation of passenger leucocytes has been investigated in an inbred rat parathyroid allograft model. DA rat (Ag-B4) parathyroid glands cultured for up to three weeks in Eagle's minimal essential medium (MEM) alone, or MEM with added donor-specific antilymphocyte serum, did not survive longer than fresh glands when allografted into Lewis rat (Ag-B1) recipients. Subsequent in vitro comparisons of three different culture media established that RPMI 1640 was superior to MEM and Medium 199 for rat parathyroids. However, further series of transplants after culture in RPMI 1640 alone also failed to produce prolongation of allograft survival.

The absence of H-2 antigens from mouse pancreatic beta-cells demonstrated by immunoferritin labeling

Islets of Langerhans were isolated from mouse pancreases and fixed in periodatelysine-paraformaldehyde. The fixed islets were then dissociated with trypsin and EDTA to yield cell suspensions that contained mainly four cell types; beta-cells, capillary endothelial cells, acinar cells, and pancreatic duct epithelial cells. The nonislet cells were probably associated wtih the surface of the isolated islets. The H-2 antigens of the dissociated pancreatic cells were labeled with an immunoferritin technique. Pancreatic duct epithelial cells showed specific ferritin labeling on their lateral cell membranes but not on apical microvillus membranes. Acinar cells were also labeled on lateral membranes, and the capillary endothelial cells were labeled on both the luminal and albuminal aspects of their surface membranes. In contrast, pancreatic beta-cells were unlabeled. The number of ferritin molecules per unit length of beta-cell membrane was essentially the same on cells from the antigenic strain and the congeneic control strain, and was about 200-fold less than on the labeled pancreatic duct epithelial cell lateral membranes. Pancreatic beta-cells are therefore one of six known epithelial cell types on which H-2 antigens can not be detected by immunoferritin labeling. The apparent absence of H-2 antigens from these cells suggests a study of the viability of beta-cells in allografts of dissociated islet cells, in which the beta-cell would not be in contact with antigenic cells. Such studies might lead to a new approach to the control of diabetes mellitus by transplantation.