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Cooper DKC, Satyananda V, Ekser B, van der Windt DJ, Hara H, Ezzelarab MB, Schuurman HJ. Progress in pig-to-non-human primate transplantation models (1998-2013): a comprehensive review of the literature. Xenotransplantation 2014; 21:397-419. [PMID: 25176336 DOI: 10.1111/xen.12127] [Citation(s) in RCA: 100] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/14/2014] [Accepted: 06/03/2014] [Indexed: 12/11/2022]
Abstract
BACKGROUND The pig-to-non-human primate model is the standard choice for in vivo studies of organ and cell xenotransplantation. In 1998, Lambrigts and his colleagues surveyed the entire world literature and reported all experimental studies in this model. With the increasing number of genetically engineered pigs that have become available during the past few years, this model is being utilized ever more frequently. METHODS We have now reviewed the literature again and have compiled the data we have been able to find for the period January 1, 1998 to December 31, 2013, a period of 16 yr. RESULTS The data are presented for transplants of the heart (heterotopic and orthotopic), kidney, liver, lung, islets, neuronal cells, hepatocytes, corneas, artery patches, and skin. Heart, kidney, and, particularly, islet xenograft survival have increased significantly since 1998. DISCUSSION The reasons for this are briefly discussed. A comment on the limitations of the model has been made, particularly with regard to those that will affect progression of xenotransplantation toward the clinic.
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Affiliation(s)
- David K C Cooper
- Thomas E. Starzl Transplantation Institute, University of Pittsburgh, Pittsburgh, PA, USA
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2
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Bridging innate and adaptive antitumor immunity targeting glycans. J Biomed Biotechnol 2010; 2010:354068. [PMID: 20617150 PMCID: PMC2896669 DOI: 10.1155/2010/354068] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/26/2010] [Accepted: 04/22/2010] [Indexed: 01/12/2023] Open
Abstract
Effective immunotherapy for cancer depends on cellular responses to tumor antigens. The role of major histocompatibility complex (MHC) in T-cell recognition and T-cell receptor repertoire selection has become a central tenet in immunology. Structurally, this does not contradict earlier findings that T-cells can differentiate between small hapten structures like simple glycans. Understanding T-cell recognition of antigens as defined genetically by MHC and combinatorially by T cell receptors led to the “altered self” hypothesis. This notion reflects a more fundamental principle underlying immune surveillance and integrating evolutionarily and mechanistically diverse elements of the immune system. Danger associated molecular patterns, including those generated by glycan remodeling, represent an instance of altered self. A prominent example is the modification of the tumor-associated antigen MUC1. Similar examples emphasize glycan reactivity patterns of antigen receptors as a phenomenon bridging innate and adaptive but also humoral and cellular immunity and providing templates for immunotherapies.
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The Baboon in Xenotransplant Research. THE BABOON IN BIOMEDICAL RESEARCH 2009. [PMCID: PMC7120791 DOI: 10.1007/978-0-387-75991-3_19] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
If cross-species transplantation is ever to become a reasonable therapeutic modality for human beings, it will be because the potential for success has been demonstrated in a nonhuman primate model. The imperative has always been to select a primate research subject from a species that is plentiful, is not endangered, readily procreates in a managed environment, and mimics the human response (immunologic homology) to both organ transplantation and potential transfer of infectious disease. Several Papio subspecies of baboons, including Papio hamadryas anubis (olive baboon), meet these important criteria. These animals remain ubiquitous throughout sub-Saharan Africa and have adapted well to the managed environments of major primate centers worldwide. A list of United States-based primate centers housing breeding colonies of baboons can be found in Table 19.1. The Surgical Research Laboratory at Loma Linda University, for instance, has maintained a salutary relationship with the Southwest National Primate Research Center in San Antonio, Texas, for the procurement of juvenile baboon research subjects.
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Dehoux JP, Gianello P. Accommodation and antibodies. Transpl Immunol 2008; 21:106-10. [PMID: 18973811 DOI: 10.1016/j.trim.2008.10.002] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/02/2008] [Accepted: 10/09/2008] [Indexed: 12/26/2022]
Abstract
Accommodation refers to the condition in which an organ transplant functions normally by acquiring resistance to immune-mediated injury (especially), despite the presence of anti-transplant antibodies in the recipient. This status is associated with several modifications in the recipient as well as in the graft, such as previous depletion of anti-graft antibodies and their slow return once the graft is placed; expression of several protective genes in the graft; a Th2 immune response in the recipient; and inhibition of the membrane attack complex of complement.
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Affiliation(s)
- Jean-Paul Dehoux
- Laboratory of Experimental Surgery, Faculté de médecine, Université catholique de Louvain, Brussels, Belgium
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5
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Ding JW, Zhou T, Zeng H, Ma L, Verbeek JS, Yin D, Shen J, Chong AS. Hyperacute Rejection by Anti-Gal IgG1, IgG2a, and IgG2bIs Dependent on Complement and Fc-γ Receptors. THE JOURNAL OF IMMUNOLOGY 2007; 180:261-8. [DOI: 10.4049/jimmunol.180.1.261] [Citation(s) in RCA: 23] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/21/2022]
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Kearns-Jonker M, Barteneva N, Mencel R, Hussain N, Shulkin I, Xu A, Yew M, Cramer DV. Use of molecular modeling and site-directed mutagenesis to define the structural basis for the immune response to carbohydrate xenoantigens. BMC Immunol 2007; 8:3. [PMID: 17352819 PMCID: PMC1851715 DOI: 10.1186/1471-2172-8-3] [Citation(s) in RCA: 15] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/16/2006] [Accepted: 03/12/2007] [Indexed: 11/25/2022] Open
Abstract
BACKGROUND Natural antibodies directed at carbohydrates reject porcine xenografts. They are initially expressed in germline configuration and are encoded by a small number of structurally-related germline progenitors. The transplantation of genetically-modified pig organs prevents hyperacute rejection, but delayed graft rejection still occurs, partly due to humoral responses. IgVH genes encoding induced xenoantibodies are predominantly, not exclusively, derived from germline progenitors in the VH3 family. We have previously identified the immunoglobulin heavy chain genes encoding VH3 xenoantibodies in patients and primates. In this manuscript, we complete the structural analysis of induced xenoantibodies by identifying the IgVH genes encoding the small proportion of VH4 xenoantibodies and the germline progenitors encoding xenoantibody light chains. This information has been used to define the xenoantibody/carbohydrate binding site using computer-simulated modeling. RESULTS The VH4-59 gene encodes antibodies in the VH4 family that are induced in human patients mounting active xenoantibody responses. The light chain of xenoantibodies is encoded by DPK5 and HSIGKV134. The structural information obtained by sequencing analysis was used to create computer-simulated models. Key contact sites for xenoantibody/carbohydrate interaction for VH3 family xenoantibodies include amino acids in sites 31, 33, 50, 57, 58 and the CDR3 region of the IgVH gene. Site-directed mutagenesis indicates that mutations in predicted contact sites alter binding to carbohydrate xenoantigens. Computer-simulated modeling suggests that the CDR3 region directly influences binding. CONCLUSION Xenoantibodies induced during early and delayed xenograft responses are predominantly encoded by genes in the VH3 family, with a small proportion encoded by VH4 germline progenitors. This restricted group can be identified by the unique canonical structure of the light chain, heavy chain and CDR3. Computer-simulated models depict this structure with accuracy, as confirmed by site-directed mutagenesis. Computer-simulated drug design using computer-simulated models may now be applied to develop new drugs that may enhance the survival of xenografted organs.
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Affiliation(s)
- Mary Kearns-Jonker
- Department of Cardiothoracic Surgery, Saban Research Institute of the Children's Hospital of Los Angeles, University of Southern California Keck School of Medicine, 4650 Sunset Blvd, Mailstop #137, Los Angeles, CA 90027 USA
| | - Natasha Barteneva
- Department of Cardiothoracic Surgery, Saban Research Institute of the Children's Hospital of Los Angeles, University of Southern California Keck School of Medicine, 4650 Sunset Blvd, Mailstop #137, Los Angeles, CA 90027 USA
| | - Robert Mencel
- Department of Cardiothoracic Surgery, Saban Research Institute of the Children's Hospital of Los Angeles, University of Southern California Keck School of Medicine, 4650 Sunset Blvd, Mailstop #137, Los Angeles, CA 90027 USA
| | - Namath Hussain
- Department of Cardiothoracic Surgery, Saban Research Institute of the Children's Hospital of Los Angeles, University of Southern California Keck School of Medicine, 4650 Sunset Blvd, Mailstop #137, Los Angeles, CA 90027 USA
| | - Irina Shulkin
- Department of Cardiothoracic Surgery, Saban Research Institute of the Children's Hospital of Los Angeles, University of Southern California Keck School of Medicine, 4650 Sunset Blvd, Mailstop #137, Los Angeles, CA 90027 USA
| | - Alan Xu
- Department of Cardiothoracic Surgery, Saban Research Institute of the Children's Hospital of Los Angeles, University of Southern California Keck School of Medicine, 4650 Sunset Blvd, Mailstop #137, Los Angeles, CA 90027 USA
| | - Margaret Yew
- Department of Cardiothoracic Surgery, Saban Research Institute of the Children's Hospital of Los Angeles, University of Southern California Keck School of Medicine, 4650 Sunset Blvd, Mailstop #137, Los Angeles, CA 90027 USA
| | - Donald V Cramer
- Department of Cardiothoracic Surgery, Saban Research Institute of the Children's Hospital of Los Angeles, University of Southern California Keck School of Medicine, 4650 Sunset Blvd, Mailstop #137, Los Angeles, CA 90027 USA
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7
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Stone KR, Abdel-Motal UM, Walgenbach AW, Turek TJ, Galili U. Replacement of human anterior cruciate ligaments with pig ligaments: a model for anti-non-gal antibody response in long-term xenotransplantation. Transplantation 2007; 83:211-9. [PMID: 17264818 DOI: 10.1097/01.tp.0000250598.29377.13] [Citation(s) in RCA: 69] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
BACKGROUND Understanding anti-non-gal antibody response is of significance for success in xenotransplantation. Long-term anti-non-gal response in humans was studied in patients transplanted with porcine patellar tendon (PT) lacking alpha-gal epitopes, for replacing ruptured anterior cruciate ligament (ACL). METHODS Porcine PTs were treated with recombinant alpha-galactosidase to eliminate alpha-gal epitopes and with glutaraldehyde for moderate cross-linking of collagen fibers. The processed pig PTs were implanted to replace ruptured ACL in patients. RESULTS In five of six evaluable subjects, the xenografts have continued to function for over two years and passed all functional stability assessments. Thus, processed porcine PT seems to be appropriate for replacing ruptured human ACL. Enzyme-linked immunosorbent assay and Western blot studies indicated that all subjects produced anti-non-gal antibodies against multiple pig xenoproteins, but not against human ligament proteins. Production of anti-non-gal antibodies peaked two to six months posttransplantation and disappeared after two years. CONCLUSIONS These antibodies contribute to a low-level inflammatory process that aids in gradual xenograft replacement by infiltrating host fibroblasts that align with the pig collagen "scaffold" and secrete collagen matrix. The assays monitoring anti-non-gal antibodies will help to determine whether long-term survival of live organ xenografts requires complete suppression of this antibody response.
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Affiliation(s)
- Kevin R Stone
- The Stone Clinic and CrossCart, San Francisco, CA, USA
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8
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Zahorsky-Reeves JL, Kearns-Jonker MK, Lam TT, Jackson JR, Morris RE, Starnes VA, Cramer DV. The xenoantibody response and immunoglobulin gene expression profile of cynomolgus monkeys transplanted with hDAF-transgenic porcine hearts. Xenotransplantation 2007; 14:135-44. [PMID: 17381688 DOI: 10.1111/j.1399-3089.2007.00381.x] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
BACKGROUND Recent work has indicated a role for anti-Gal alpha 1-3Gal (Gal) and anti-non-Gal xenoantibodies in the primate humoral rejection response against human-decay accelerating factor (hDAF) transgenic pig organs. Our laboratory has shown that anti-porcine xenograft antibodies in humans and non-human primates are encoded by a small number of germline IgV(H) progenitors. In this study, we extended our analysis to identify the IgV(H) genes encoding xenoantibodies in immunosuppressed cynomolgus monkeys (Macaca fascicularis) transplanted with hDAF-transgenic pig organs. METHODS Three immunosuppressed monkeys underwent heterotopic heart transplantation with hDAF porcine heart xenografts. Two of three animals were given GAS914, a poly-L-lysine derivative shown to bind to anti-Gal xenoantibodies and neutralize them. One animal rejected its heart at post-operative day (POD) 39; a second animal rejected the transplanted heart at POD 78. The third monkey was euthanized on POD 36 but the heart was not rejected. Peripheral blood leukocytes (PBL) and serum were obtained from each animal before and at multiple time points after transplantation. We analyzed the immune response by enzyme-linked immunosorbent assay (ELISA) to confirm whether anti-Gal or anti-non-Gal xenoantibodies were induced after graft placement. Immunoglobulin heavy-chain gene (V(H)) cDNA libraries were then produced and screened. We generated soluble single-chain antibodies (scFv) to establish the binding specificity of the cloned immunoglobulin genes. RESULTS Despite immunosuppression, which included the use of the polymer GAS914, the two animals that rejected their hearts showed elevated levels of cytotoxic anti-pig red blood cell (RBC) antibodies and anti-pig aortic endothelial cell (PAEC) antibodies. The monkey that did not reject its graft showed a decline in serum anti-RBC, anti-PAEC, and anti-Gal xenoantibodies when compared with pre-transplant levels. A V(H)3 family gene with a high level of sequence similarity to an allele of V(H)3-11, designated V(H)3-11(cyno), was expressed at elevated levels in the monkey that was not given GAS914 and whose graft was not rejected until POD 78. IgM but not IgG xenoantibodies directed at N-acetyl lactosamine (a precursor of the Gal epitope) were also induced in this animal. We produced soluble scFv from this new gene to determine whether this antibody could bind to the Gal carbohydrate, and demonstrated that this protein was capable of blocking the binding of human serum xenoantibody to Gal oligosaccharide, as had previously been shown with human V(H)3-11 scFv. CONCLUSIONS DAF-transgenic organs transplanted into cynomolgus monkeys induce anti-Gal and anti-non-Gal xenoantibody responses mediated by both IgM and IgG xenoantibodies. Anti-non-Gal xenoantibodies are induced at high levels in animals treated with GAS914. Antibodies that bind to the Gal carbohydrate and to N-acetyl lactosamine are induced in the absence of GAS914 treatment. The animal whose heart remained beating for 78 days demonstrated increased usage of an antibody encoded by a germline progenitor that is structurally related, but distinct from IGHV311. This antibody binds to the Gal carbohydrate but does not induce the rapid rejection of the xenograft when expressed at high levels as early as day 8 post-transplantation.
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Affiliation(s)
- Joanne L Zahorsky-Reeves
- Cardiothoracic Surgery Research, The Saban Research Institute of Childrens Hospital Los Angeles, The Keck School of Medicine, University of Southern California, Los Angeles, CA 90027, USA
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9
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Jin R, Greenwald A, Peterson MD, Waddell TK. Human monocytes recognize porcine endothelium via the interaction of galectin 3 and alpha-GAL. THE JOURNAL OF IMMUNOLOGY 2006; 177:1289-95. [PMID: 16818789 DOI: 10.4049/jimmunol.177.2.1289] [Citation(s) in RCA: 52] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
Abstract
Monocytes are one of the key inflammatory cells recruited to xenografts and play an important role in delayed xenograft rejection. Previous studies have demonstrated the ability of monocytes to bind to the major xenoantigen Gal-alpha(1,3)Gal-beta(1,4)GlcNAc-R; however, the receptor that mediates this interaction has yet to be identified. We provide evidence that it is Galectin-3, a approximately 30-kDa lectin that recognizes beta-galactosides (Gal-beta(1-3/4)GlcNAc) and plays diverse roles in many physiological and pathological events. Human monocyte binding is strikingly increased on porcine aortic endothelial cells (PAEC), which express high levels of Gal-alpha(1,3)Gal-beta(1,4)GlcNAc-R, compared with human aortic endothelial cells. Human monocytes obtained from healthy donors bind to Gal-alpha(1,3)Gal-beta(1,4)GlcNAc-R at variable intensities. This variation of binding intensity was consistent and reproducible in individual donors. Galectin-3 is mainly expressed in human monocytes, not lymphocytes. Purified Galectin-3 is able to bind directly to Gal-alpha(1,3)Gal-beta(1,4)GlcNAc-R. Galectin-3 can also be affinity isolated from monocytes (and not lymphocytes) using an Gal-alpha(1,3)Gal-beta(1,4)GlcNAc-R-biotin/streptavidin-bead pull-down system. Soluble Galectin-3 binds preferentially to PAEC vs human aortic endothelial cells, and this binding can be inhibited by lactose, indicating dependence on the carbohydrate recognition domain of Galectin-3. Gal-alpha(1,3)Gal-beta(1,4)GlcNAc-R is at least partly responsible for this phenomenon, as binding decreased after digestion of PAEC with alpha-galactosidase. Furthermore, monocytes pretreated with a blocking anti-Galectin-3 Ab show decreased adhesion to PAEC when compared with isotype control in a parallel plate flow chamber perfusion assay. Thus, we conclude that Galectin-3 expressed in human monocytes is a receptor for the major xenoantigen (Gal-alpha(1,3)Gal-beta(1,4)GlcNAc-R), expressed on porcine endothelial cells.
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MESH Headings
- Animals
- Antigens, Heterophile/biosynthesis
- Antigens, Heterophile/immunology
- Antigens, Heterophile/metabolism
- Binding Sites, Antibody
- Cells, Cultured
- Down-Regulation/immunology
- Endothelium, Vascular/cytology
- Endothelium, Vascular/immunology
- Endothelium, Vascular/metabolism
- Epitopes/metabolism
- Galectin 3/antagonists & inhibitors
- Galectin 3/biosynthesis
- Galectin 3/immunology
- Galectin 3/metabolism
- Humans
- Lectins/metabolism
- Ligands
- Monocytes/cytology
- Monocytes/immunology
- Monocytes/metabolism
- Protein Binding/immunology
- Receptors, Immunologic/antagonists & inhibitors
- Receptors, Immunologic/biosynthesis
- Receptors, Immunologic/immunology
- Receptors, Immunologic/metabolism
- Swine
- Trisaccharides/metabolism
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Affiliation(s)
- Rongyu Jin
- Division of Thoracic Surgery, Department of Surgery, Toronto General Hospital Research Institute, University Health Network, University of Toronto, 200 Elizabeth Street, Toronto, Ontario, Canada
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10
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Zahorsky-Reeves JL, Gregory CR, Cramer DV, Patanwala IY, Kyles AE, Borie DC, Kearns-Jonker MK. Similarities in the immunoglobulin response and VH gene usage in rhesus monkeys and humans exposed to porcine hepatocytes. BMC Immunol 2006; 7:3. [PMID: 16549031 PMCID: PMC1448184 DOI: 10.1186/1471-2172-7-3] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/04/2005] [Accepted: 03/20/2006] [Indexed: 01/13/2023] Open
Abstract
Background The use of porcine cells and organs as a source of xenografts for human patients would vastly increase the donor pool; however, both humans and Old World primates vigorously reject pig tissues due to xenoantibodies that react with the polysaccharide galactose α (1,3) galactose (αGal) present on the surface of many porcine cells. We previously examined the xenoantibody response in patients exposed to porcine hepatocytes via treatment(s) with bioartficial liver devices (BALs), composed of porcine cells in a support matrix. We determined that xenoantibodies in BAL-treated patients are predominantly directed at porcine αGal carbohydrate epitopes, and are encoded by a small number of germline heavy chain variable region (VH) immunoglobulin genes. The studies described in this manuscript were designed to identify whether the xenoantibody responses and the IgVH genes encoding antibodies to porcine hepatocytes in non-human primates used as preclinical models are similar to those in humans. Adult non-immunosuppressed rhesus monkeys (Macaca mulatta) were injected intra-portally with porcine hepatocytes or heterotopically transplanted with a porcine liver lobe. Peripheral blood leukocytes and serum were obtained prior to and at multiple time points after exposure, and the immune response was characterized, using ELISA to evaluate the levels and specificities of circulating xenoantibodies, and the production of cDNA libraries to determine the genes used by B cells to encode those antibodies. Results Xenoantibodies produced following exposure to isolated hepatocytes and solid organ liver grafts were predominantly encoded by genes in the VH3 family, with a minor contribution from the VH4 family. Immunoglobulin heavy-chain gene (VH) cDNA library screening and gene sequencing of IgM libraries identified the genes as most closely-related to the IGHV3-11 and IGHV4-59 germline progenitors. One of the genes most similar to IGHV3-11, VH3-11cyno, has not been previously identified, and encodes xenoantibodies at later time points post-transplant. Sequencing of IgG clones revealed increased usage of the monkey germline progenitor most similar to human IGHV3-11 and the onset of mutations. Conclusion The small number of IGVH genes encoding xenoantibodies to porcine hepatocytes in non-human primates and humans is highly conserved. Rhesus monkeys are an appropriate preclinical model for testing novel reagents such as those developed using structure-based drug design to target and deplete antibodies to porcine xenografts.
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Affiliation(s)
- Joanne L Zahorsky-Reeves
- Cardiothoracic Surgery Research, The Saban Research Institute of Childrens Hospital Los Angeles, The Keck School of Medicine, University of Southern California, 4650 Sunset Blvd. MS #137, Los Angeles, CA, 90027, USA
| | - Clare R Gregory
- Department of Surgical and Radiological Sciences, University of California, Davis School of Veterinary Medicine, Davis, CA, 95616, USA
| | - Donald V Cramer
- Cardiothoracic Surgery Research, The Saban Research Institute of Childrens Hospital Los Angeles, The Keck School of Medicine, University of Southern California, 4650 Sunset Blvd. MS #137, Los Angeles, CA, 90027, USA
| | - Insiyyah Y Patanwala
- Cardiothoracic Surgery Research, The Saban Research Institute of Childrens Hospital Los Angeles, The Keck School of Medicine, University of Southern California, 4650 Sunset Blvd. MS #137, Los Angeles, CA, 90027, USA
| | - Andrew E Kyles
- Department of Surgical and Radiological Sciences, University of California, Davis School of Veterinary Medicine, Davis, CA, 95616, USA
| | - Dominic C Borie
- Department of Cardiothoracic Surgery, Stanford University, Stanford, CA, 94305, USA
| | - Mary K Kearns-Jonker
- Cardiothoracic Surgery Research, The Saban Research Institute of Childrens Hospital Los Angeles, The Keck School of Medicine, University of Southern California, 4650 Sunset Blvd. MS #137, Los Angeles, CA, 90027, USA
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Banz Y, Rieben R. Endothelial cell protection in xenotransplantation: looking after a key player in rejection. Xenotransplantation 2006; 13:19-30. [PMID: 16497209 DOI: 10.1111/j.1399-3089.2005.00266.x] [Citation(s) in RCA: 14] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
The endothelium, as an organ at the interface between the intra- and extravascular space, actively participates in maintaining an anti-inflammatory and anti-coagulant environment under physiological conditions. Severe humoral as well as cellular rejection responses, which accompany cross-species transplantation of vascularized organs as well as ischemia/reperfusion injury, primarily target the endothelium and disrupt this delicate balance. Activation of pro-inflammatory and pro-coagulant pathways often lead to irreversible injury not only of the endothelial layer but also of the entire graft, with ensuing rejection. This review focuses on strategies targeted at protecting the endothelium from such damaging effects, ranging from genetic manipulation of the donor organ to soluble, as well as membrane-targeted, protective strategies.
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Affiliation(s)
- Yara Banz
- Department of Clinical Research, University of Bern, Switzerland
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12
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Kleihauer A, Gregory CR, Borie DC, Kyles AE, Shulkin I, Patanwala I, Zahorsky-Reeves J, Starnes VA, Mullen Y, Todorov IT, Kearns-Jonker M. Identification of the V genes encoding xenoantibodies in non-immunosuppressed rhesus monkeys. Immunology 2005; 116:89-102. [PMID: 16108821 PMCID: PMC1802413 DOI: 10.1111/j.1365-2567.2005.02204.x] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022] Open
Abstract
The major immunological barrier that prevents the use of wild-type pig xenografts as an alternative source of organs for human xenotransplantation is antibody-mediated rejection. In this study, we identify the immunoglobulin variable region heavy (IgV(H)) chain genes encoding xenoantibodies to porcine heart and fetal porcine islet xenografts in non-immunosuppressed rhesus monkeys. We sought to compare the IgV(H) genes encoding xenoantibodies to porcine islets and solid organ xenografts. The immunoglobulin M (IgM) and IgG xenoantibody response was analysed by enzyme-linked immunosorbent assay and cDNA libraries from peripheral blood lymphocytes were prepared and sequenced. The relative frequency of IgV(H) gene usage was established by colony filter hybridization. Induced xenoantibodies were encoded by the IGHV3-11 germline progenitor, the same germline gene that encodes xenoantibodies in humans mounting active xenoantibody responses. The immune response to pig xenografts presented as solid organs or isolated cells is mediated by identical IgV(H) genes in rhesus monkeys. These animals represent a clinically relevant model to identify the immunological basis of pig-to-human xenograft rejection.
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Affiliation(s)
- Annette Kleihauer
- Cardiothoracic Surgery Research, The Saban Research Institute, Children's Hospital of Los Angeles, The Keck School of Medicine, University of Southern CaliforniaCA, USA
| | - Clare R Gregory
- Surgical and Radiological Sciences, University of California, Davis, School of Veterinary Medicine, California National Primate Research CenterDavis, CA, USA
| | - Dominic C Borie
- Falk Cardiovascular Research Center, Stanford University School of MedicineStanford, CA, USA
| | - Andrew E Kyles
- Surgical and Radiological Sciences, University of California, Davis, School of Veterinary Medicine, California National Primate Research CenterDavis, CA, USA
| | - Irina Shulkin
- Cardiothoracic Surgery Research, The Saban Research Institute, Children's Hospital of Los Angeles, The Keck School of Medicine, University of Southern CaliforniaCA, USA
| | - Insiyyah Patanwala
- Cardiothoracic Surgery Research, The Saban Research Institute, Children's Hospital of Los Angeles, The Keck School of Medicine, University of Southern CaliforniaCA, USA
| | - Joanne Zahorsky-Reeves
- Cardiothoracic Surgery Research, The Saban Research Institute, Children's Hospital of Los Angeles, The Keck School of Medicine, University of Southern CaliforniaCA, USA
| | - Vaughn A Starnes
- Cardiothoracic Surgery Research, The Saban Research Institute, Children's Hospital of Los Angeles, The Keck School of Medicine, University of Southern CaliforniaCA, USA
| | - Yoko Mullen
- Diabetes, Endocrinology and Metabolism, City of HopeDuarte, CA, USA
| | - Ivan T Todorov
- Diabetes, Endocrinology and Metabolism, City of HopeDuarte, CA, USA
| | - Mary Kearns-Jonker
- Cardiothoracic Surgery Research, The Saban Research Institute, Children's Hospital of Los Angeles, The Keck School of Medicine, University of Southern CaliforniaCA, USA
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13
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Lam TT, Paniagua R, Shivaram G, Schuurman HJ, Borie DC, Morris RE. Anti-non-Gal porcine endothelial cell antibodies in acute humoral xenograft rejection of hDAF-transgenic porcine hearts in cynomolgus monkeys. Xenotransplantation 2005; 11:531-5. [PMID: 15479463 DOI: 10.1111/j.1399-3089.2004.00175.x] [Citation(s) in RCA: 42] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
BACKGROUND Anti-Gal alpha 1-3Gal (Gal) antibodies play a major role in hyperacute rejection and acute humoral xenograft rejection (AHXR) in porcine-to-nonhuman primate transplantation. The role of anti-non-Gal antibodies in AHXR is less well defined. METHODS Eleven cynomolgus monkeys received a heterotopic heart transplant from a human decay-accelerating factor transgenic pig, and maintenance immunosuppression with cyclosporin A or tacrolimus, steroids, mycophenolate sodium or mycophenolate mofetil, and in 10 animals the Gal-containing soluble glycoconjugate GAS914. Six ended with AHXR (6 to 78 day survival) and five did not show AHXR (9 to 36 day survival). Anti-Gal antibodies were depleted in vivo with GAS914, or in vitro with Gal-coated Sepharose beads. IgM- and IgG-class anti-non-Gal antibodies in serum depleted of anti-Gal antibodies were measured by flow cytometry using porcine endothelial target cells. RESULTS Compared with pre-transplant values, all six recipients with AHXR showed a substantially higher level of anti-non-Gal IgM antibodies at rejection; in five animals there was also an increase in IgG-class antibodies. There was no relevant change in recipients without AHXR. AHXR at time of cessation of heart contraction could be preceeded by a steady increase in antibody level starting 2 to 3 weeks earlier. CONCLUSIONS AHXR is invariably associated with increased circulating anti-non-Gal antibodies. These antibodies are not observed in recipients without AHXR, and five of six recipients with AHXR were adequately depleted of anti-Gal antibodies by maintenance GAS914. This indicates that anti-non-Gal antibodies play a significant role in the pathogenesis of AHXR. Also, the assessment of these antibodies could be used as an early monitor of AHXR.
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Affiliation(s)
- Tuan T Lam
- Transplantation Immunology Laboratory, Department of Cardiothoracic Surgery, Stanford University School of Medicine, Stanford, CA 94305-5407, USA
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Séveno C, Fellous M, Ashton-Chess J, Soulillou JP, Vanhove B. Les xénogreffes finiront-elles par être acceptées ? Med Sci (Paris) 2005; 21:302-8. [PMID: 15745706 DOI: 10.1051/medsci/2005213302] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
Transplantation represents a major advance in modern medicine with a major impact on the interactions between individuals and society. The numbers of patients undergoing organ transplantation increased steadily over the years and around 250,000 individuals are living nowadays in Europe with a transplanted organ. On the other hand, the numbers of cadaveric (brain-dead) donors used for organ transplantation remains stable, at around 5,000 each year, and the numbers of transplantation from living donors only slowly increase in Europe. Therefore, a gap is growing between the numbers of patients in need of a transplant and the numbers of organs available for transplantation. About 45,000 patients are currently on renal transplant waiting lists in Europe and, depending on the countries considered, 15 to 30 % of candidates for liver or heart transplantation die before a life-saving transplant becomes available to them. There is therefore an urgent need to implement innovative research and to take full advantage of recent biotechnological advances to explore new avenues in xenotransplantation, and to simultaneously address the ethical, societal and public health issues related to organ replacement. Much progresses have been accomplished in the understanding of xenograft rejection processes that include hyperacute, acute vascular and cellular rejection mechanisms. Strategies to promote xenograft survival that are currently under evaluation include genetic engineering of donor pigs, adapted immunosuppressive treatments and tolerance induction. Also, the psychological acceptance has been evaluated.
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Affiliation(s)
- Céline Séveno
- Institut de transplantation et de recherche en transplantation (ITERT), Inserm U.643, CHU Hôtel Dieu, 30, boulevard Jean Monnet, 44093 Nantes, France
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Brandl U, Michel S, Erhardt M, Brenner P, Bittmann I, Rössle M, Baschnegger H, Bauer A, Hammer C, Schmoeckel M, Reichart B. Administration of GAS914 in an orthotopic pig-to-baboon heart transplantation model. Xenotransplantation 2005; 12:134-41. [PMID: 15693844 DOI: 10.1111/j.1399-3089.2005.00208.x] [Citation(s) in RCA: 34] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
BACKGROUND Long-term survival of transgenic cardiac xenografts is currently limited by a form of humoral rejection named acute vascular rejection. Preformed and elicited cytotoxic antibodies against Galalpha(1,3)Gal terminating carbohydrate chains, known as the primary cause of hyperacute rejection, are crucial for this process. We investigated whether GAS914, a soluble, polymeric form of a Galalpha(1,3)Gal trisaccharide would sufficiently minimize xenograft rejection of hDAF-transgenic pig hearts orthotopically transplanted into baboons. METHODS Orthotopic heart transplantations were performed using hDAF transgenic piglets as donors and four non-splenectomized baboons as recipients. Baseline immunosuppression consisted of tacrolimus, sirolimus, ATG, steroids. In addition two animals received low-dose GAS914, and two animals high-dose GAS914. One of these baboons received high dose GAS914 and cyclophosphamide induction therapy. Serum levels of anti-Galalpha(1,3)Gal IgM and IgG antibodies, and anti-pig antibodies were controlled daily by anti-Galalpha(1,3)Gal enzyme-linked immunosorbant assay and anti-pig hemolytic assays. Histomorphological (hematoxylin and eosin, elastic van Gieson) and immunohistochemical (IgM, IgG) evaluations were performed on tissue specimens. RESULTS Following low-dose GAS914 therapy survival time was 1 and 9 days, respectively. In baboons treated with high dosages of GAS914 a survival of 30 h and 25 days could be obtained. GAS914 caused an immediate and significant reduction of both anti-Galalpha(1,3)Gal IgM and IgG antibodies. However, sufficient antibody reduction was independent of dosage and form of application of GAS914. A pre-transplant GAS914 treatment was not necessary to effectively reduce antibody levels and prevent hyperacute rejection. In the early postoperative period preformed anti-pig antibodies corresponded predominantly to anti-Galalpha(1,3)Gal antibodies making them susceptible to GAS914. Subsequently, while anti-Galalpha(1,3)Gal antibodies remained low, anti-pig antibodies increased despite of GAS914 application. Corresponding to increased anti-pig antibody titers depositions of IgM and IgG immunoglobulins were detected, which were possibly non-Galalpha(1,3)Gal-specific. CONCLUSIONS Following orthotopic transplantation of hDAF-transgenic pig hearts into baboons, GAS914 is able to maintain a sufficient reduction of Galalpha(1,3)Gal-specific cytotoxicity to the graft. GAS914 therefore is able to prevent not only hyperacute rejection, but also acute vascular rejection at its beginning, when serum cytotoxicity to the pig heart appears to be predominantly Galalpha(1,3)Gal-specific. A sustained prevention of acute vascular rejection, however, still requires the identification of antibody specificities other than to Galalpha(1,3)Gal.
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Affiliation(s)
- Ulrike Brandl
- Department of Cardiac Surgery, Ludwig-Maximilians-University, Munich, Germany.
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Yin D, Zeng H, Ma L, Shen J, Xu H, Byrne GW, Chong AS. Cutting Edge: NK Cells Mediate IgG1-Dependent Hyperacute Rejection of Xenografts. THE JOURNAL OF IMMUNOLOGY 2004; 172:7235-8. [PMID: 15187097 DOI: 10.4049/jimmunol.172.12.7235] [Citation(s) in RCA: 50] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
Abstract
Classic hyperacute rejection is dependent on the activation of the terminal components of complement. Recently, xenoantibodies with limited abilities to activate the classical pathway of complement in vitro have been implicated in the acute vascular rejection of xenografts. It is unclear how these Abs affect their pathogenic activities in vivo. In this study, we demonstrate the ability of an anti-Gal-alpha1,3Gal (Gal) IgG1, with modest complement-activating abilities in vitro, to induce xenograft rejection. This rejection was dependent on the activation of complement, on FcgammaR-mediated interactions, and on the presence of NK cells. Inhibition of any one of these factors resulted in the abrogation of IgG1-mediated rejection. In contrast, an anti-Gal IgG3 mAb induced classic, hyperacute rejection that was solely dependent on complement activation. Our observations implicate two types of IgG-mediated rejection; one that is dependent on complement activation, and a second that is uniquely dependent on complement, FcgammaR, and NK cells.
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Affiliation(s)
- Dengping Yin
- Section of Transplantation, Department of Surgery, The University of Chicago, 5841 South Maryland Avenue, Chicago, IL 60637, USA
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