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Almonte VM, Uriyanghai U, Egaña-Gorroño L, Parikh D, Oliveira-Paula GH, Zhang J, Jayakumar S, Riascos-Bernal DF, Sibinga NES. PLX3397, a CSF1 receptor inhibitor, limits allotransplantation-induced vascular remodelling. Cardiovasc Res 2021; 118:2718-2731. [PMID: 34478521 PMCID: PMC9890458 DOI: 10.1093/cvr/cvab289] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/04/2021] [Accepted: 09/01/2021] [Indexed: 02/05/2023] Open
Abstract
AIMS Graft vascular disease (GVD), a clinically important and highly complex vascular occlusive disease, arises from the interplay of multiple cellular and molecular pathways. While occlusive intimal lesions are composed predominantly of smooth-muscle-like cells (SMLCs), the origin of these cells and the stimuli leading to their accumulation in GVD are uncertain. Macrophages have recently been identified as both potential drivers of intimal hyperplasia and precursors that undergo transdifferentiation to become SMLCs in non-transplant settings. Colony-stimulating factor-1 (CSF1) is a well-known regulator of macrophage development and differentiation, and prior preclinical studies have shown that lack of CSF1 limits GVD. We sought to identify the origins of SMLCs and of cells expressing the CSF1 receptor (CSF1R) in GVD, and to test the hypothesis that pharmacologic inhibition of CSF1 signalling would curtail both macrophage and SMLC activities and decrease vascular occlusion. METHODS AND RESULTS We used genetically modified mice and a vascular transplant model with minor antigen mismatch to assess cell origins. We found that neointimal SMLCs derive from both donor and recipient, and that transdifferentiation of macrophages to SMLC phenotype is minimal in this model. Cells expressing CSF1R in grafts were identified as recipient-derived myeloid cells of Cx3cr1 lineage, and these cells rarely expressed smooth muscle marker proteins. Blockade of CSF1R activity using the tyrosine kinase inhibitor PLX3397 limited the expression of genes associated with innate immunity and decreased levels of circulating monocytes and intimal macrophages. Importantly, PLX3397 attenuated the development of GVD in arterial allografts. CONCLUSION These studies provide proof of concept for pharmacologic inhibition of the CSF1/CSF1R signalling pathway as a therapeutic strategy in GVD. Further preclinical testing of this pathway in GVD is warranted.
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Affiliation(s)
- Vanessa M Almonte
- Department of Medicine (Cardiology Division), Wilf Family Cardiovascular Research Institute, Albert Einstein College of Medicine, 1300 Morris Park Avenue, Bronx, NY 10461, USA,Department of Developmental and Molecular Biology, Albert Einstein College of Medicine, Bronx, NY 10461, USA
| | - Unimunkh Uriyanghai
- Department of Medicine (Cardiology Division), Wilf Family Cardiovascular Research Institute, Albert Einstein College of Medicine, 1300 Morris Park Avenue, Bronx, NY 10461, USA,Department of Developmental and Molecular Biology, Albert Einstein College of Medicine, Bronx, NY 10461, USA
| | - Lander Egaña-Gorroño
- Present address: Diabetes Research Program, Division of Endocrinology, Diabetes and Metabolism, Department of Medicine, NYU Langone Medical Center, New York, NY 10016, USA
| | - Dippal Parikh
- Department of Medicine (Cardiology Division), Wilf Family Cardiovascular Research Institute, Albert Einstein College of Medicine, 1300 Morris Park Avenue, Bronx, NY 10461, USA,Department of Developmental and Molecular Biology, Albert Einstein College of Medicine, Bronx, NY 10461, USA
| | - Gustavo H Oliveira-Paula
- Department of Medicine (Cardiology Division), Wilf Family Cardiovascular Research Institute, Albert Einstein College of Medicine, 1300 Morris Park Avenue, Bronx, NY 10461, USA,Department of Developmental and Molecular Biology, Albert Einstein College of Medicine, Bronx, NY 10461, USA
| | - Jinghang Zhang
- Department of Microbiology & Immunology, Albert Einstein College of Medicine, Bronx, NY 10461, USA
| | - Smitha Jayakumar
- Department of Medicine (Cardiology Division), Wilf Family Cardiovascular Research Institute, Albert Einstein College of Medicine, 1300 Morris Park Avenue, Bronx, NY 10461, USA,Department of Developmental and Molecular Biology, Albert Einstein College of Medicine, Bronx, NY 10461, USA
| | - Dario F Riascos-Bernal
- Department of Medicine (Cardiology Division), Wilf Family Cardiovascular Research Institute, Albert Einstein College of Medicine, 1300 Morris Park Avenue, Bronx, NY 10461, USA,Department of Developmental and Molecular Biology, Albert Einstein College of Medicine, Bronx, NY 10461, USA
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Yaron JR, Kwiecien JM, Zhang L, Ambadapadi S, Wakefield DN, Clapp WL, Dabrowski W, Burgin M, Munk BH, McFadden G, Chen H, Lucas AR. Modifying the Organ Matrix Pre-engraftment: A New Transplant Paradigm? Trends Mol Med 2019; 25:626-639. [DOI: 10.1016/j.molmed.2019.04.002] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/02/2019] [Revised: 04/01/2019] [Accepted: 04/02/2019] [Indexed: 02/06/2023]
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Chen H, Ambadapadi S, Wakefield D, Bartee M, Yaron JR, Zhang L, Archer-Hartmann SA, Azadi P, Burgin M, Borges C, Zheng D, Ergle K, Muppala V, Morshed S, Rand K, Clapp W, Proudfoot A, Lucas A. Selective Deletion of Heparan Sulfotransferase Enzyme, Ndst1, in Donor Endothelial and Myeloid Precursor Cells Significantly Decreases Acute Allograft Rejection. Sci Rep 2018; 8:13433. [PMID: 30194334 PMCID: PMC6128922 DOI: 10.1038/s41598-018-31779-7] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/19/2018] [Accepted: 08/24/2018] [Indexed: 12/12/2022] Open
Abstract
Early damage to transplanted organs initiates excess inflammation that can cause ongoing injury, a leading cause for late graft loss. The endothelial glycocalyx modulates immune reactions and chemokine-mediated haptotaxis, potentially driving graft loss. In prior work, conditional deficiency of the glycocalyx-modifying enzyme N-deacetylase-N-sulfotransferase-1 (Ndst1f/f TekCre+) reduced aortic allograft inflammation. Here we investigated modification of heparan sulfate (HS) and chemokine interactions in whole-organ renal allografts. Conditional donor allograft Ndst1 deficiency (Ndst1−/−; C57Bl/6 background) was compared to systemic treatment with M-T7, a broad-spectrum chemokine-glycosaminoglycan (GAG) inhibitor. Early rejection was significantly reduced in Ndst1−/− kidneys engrafted into wildtype BALB/c mice (Ndst1+/+) and comparable to M-T7 treatment in C57Bl/6 allografts (P < 0.0081). M-T7 lost activity in Ndst1−/− allografts, while M-T7 point mutants with modified GAG-chemokine binding displayed a range of anti-rejection activity. CD3+ T cells (P < 0.0001), HS (P < 0.005) and CXC chemokine staining (P < 0.012), gene expression in NFκB and JAK/STAT pathways, and HS and CS disaccharide content were significantly altered with reduced rejection. Transplant of donor allografts with conditional Ndst1 deficiency exhibit significantly reduced acute rejection, comparable to systemic chemokine-GAG inhibition. Modified disaccharides in engrafted organs correlate with reduced rejection. Altered disaccharides in engrafted organs provide markers for rejection with potential to guide new therapeutic approaches in allograft rejection.
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Affiliation(s)
- Hao Chen
- The Department of Tumor Surgery, Second Hospital of Lanzhou University, Lanzhou, China
| | - Sriram Ambadapadi
- Divisions of Cardiovascular Medicine and Rheumatology, Department of Medicine, University of Florida, Gainesville, FL, USA.,Department of Molecular Genetics and Microbiology, College of Medicine, University of Florida, Gainesville, FL, USA.,Center for Personalized Diagnostics, and the Center of Immunotherapy, Vaccines and Virotherapy, The Biodesign Institute, Arizona State University, Tempe, AZ, USA
| | - Dara Wakefield
- Department of Pathology, University of Florida, Gainesville, FL, USA
| | - Meeyong Bartee
- Divisions of Cardiovascular Medicine and Rheumatology, Department of Medicine, University of Florida, Gainesville, FL, USA
| | - Jordan R Yaron
- Center for Personalized Diagnostics, and the Center of Immunotherapy, Vaccines and Virotherapy, The Biodesign Institute, Arizona State University, Tempe, AZ, USA
| | - Liqiang Zhang
- Center for Personalized Diagnostics, and the Center of Immunotherapy, Vaccines and Virotherapy, The Biodesign Institute, Arizona State University, Tempe, AZ, USA
| | | | - Parastoo Azadi
- Complex Carbohydrate Research Center, University of Georgia, Athens, GA, USA
| | - Michelle Burgin
- Center for Personalized Diagnostics, and the Center of Immunotherapy, Vaccines and Virotherapy, The Biodesign Institute, Arizona State University, Tempe, AZ, USA
| | - Chad Borges
- Center for Personalized Diagnostics, and the Center of Immunotherapy, Vaccines and Virotherapy, The Biodesign Institute, Arizona State University, Tempe, AZ, USA
| | - Donghang Zheng
- Divisions of Cardiovascular Medicine and Rheumatology, Department of Medicine, University of Florida, Gainesville, FL, USA
| | - Kevin Ergle
- Divisions of Cardiovascular Medicine and Rheumatology, Department of Medicine, University of Florida, Gainesville, FL, USA
| | - Vishnu Muppala
- Divisions of Cardiovascular Medicine and Rheumatology, Department of Medicine, University of Florida, Gainesville, FL, USA
| | - Sufi Morshed
- Divisions of Cardiovascular Medicine and Rheumatology, Department of Medicine, University of Florida, Gainesville, FL, USA
| | - Kenneth Rand
- Department of Pathology, University of Florida, Gainesville, FL, USA
| | - William Clapp
- Department of Pathology, University of Florida, Gainesville, FL, USA
| | | | - Alexandra Lucas
- Divisions of Cardiovascular Medicine and Rheumatology, Department of Medicine, University of Florida, Gainesville, FL, USA. .,Department of Molecular Genetics and Microbiology, College of Medicine, University of Florida, Gainesville, FL, USA. .,Center for Personalized Diagnostics, and the Center of Immunotherapy, Vaccines and Virotherapy, The Biodesign Institute, Arizona State University, Tempe, AZ, USA.
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Stevenson HL, Prats MM, Isse K, Zeevi A, Avitzur Y, Ng VL, Demetris AJ. Isolated vascular "v" lesions in liver allografts: How to approach this unusual finding. Am J Transplant 2018; 18:1534-1543. [PMID: 29464837 DOI: 10.1111/ajt.14708] [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: 09/27/2017] [Revised: 02/13/2018] [Accepted: 02/15/2018] [Indexed: 01/25/2023]
Abstract
According to the Banff criteria for kidney allografts, isolated vascular or "v" lesions are defined as intimal inflammation, age-inappropriate fibro-intimal hyperplasia, or both, without the presence of associated interstitial T cell-mediated rejection (TCMR). In general, these lesions portend a worse outcome for kidney allografts, particularly in those where the "v" lesions are identified in patients with coexistent donor specific antibodies (DSA) or later after transplantation. Although affected arteries are rarely sampled in liver allograft biopsies, we identified nine patients at a mean of 1805 days posttransplantation and compared these to matched controls. Almost half (4 of 9) of the study patient biopsies showed inflammatory arteritis associated with focal or diffuse C4d positivity, which was not observed in matched controls. One "v" lesion patient progressed to rejection-related graft failure and two developed moderate/severe TCMR in subsequent biopsies, whereas only one rejection episode occurred in follow-up biopsies, and no rejection-related deaths or graft failures were detected in controls. In conclusion, patients with liver allograft isolated "v" lesions should undergo further evaluation and closer follow-up for impending TCMR and/or underlying co-existent chronic antibody-mediated rejection (AMR).
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Affiliation(s)
- H L Stevenson
- Department of Pathology, University of Texas Medical Branch, Galveston, TX, USA
| | - M M Prats
- Department of Pathology, University of Texas Medical Branch, Galveston, TX, USA
| | - K Isse
- Division of Liver and Transplantation Pathology, Department of Pathology, University of Pittsburgh Medical Center, Pittsburgh, PA, USA
| | - A Zeevi
- Division of Liver and Transplantation Pathology, Department of Pathology, University of Pittsburgh Medical Center, Pittsburgh, PA, USA
| | - Y Avitzur
- Department of Pediatrics, University of Toronto, The Hospital for Sick Children, Toronto, ON, Canada
| | - V L Ng
- Department of Pediatrics, University of Toronto, The Hospital for Sick Children, Toronto, ON, Canada
| | - A J Demetris
- Division of Liver and Transplantation Pathology, Department of Pathology, University of Pittsburgh Medical Center, Pittsburgh, PA, USA
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Chen H, Ambadapadi S, Dai E, Liu L, Yaron JR, Zhang L, Lucas A. Analysis of In Vivo Serpin Functions in Models of Inflammatory Vascular Disease. Methods Mol Biol 2018; 1826:157-182. [PMID: 30194600 DOI: 10.1007/978-1-4939-8645-3_11] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/08/2023]
Abstract
Serpins have a wide range of functions in regulation of serine proteases in the thrombotic cascade and in immune responses, representing up to 2-10% of circulating proteins in the blood. Selected serpins also have cross-class inhibitory actions for cysteine proteases in inflammasome and apoptosis pathways. The arterial and venous systems transport blood throughout the mammalian body representing a central site for interactions between coagulation proteases and circulating blood cells (immune cells) and target tissues, a very extensive and complex interaction. While analysis of serpin functions in vitro in kinetics or gel shift assays or in tissue culture provides very necessary information on molecular mechanisms, the penultimate assessment of biological or physiological functions and efficacy for serpins as therapeutics requires study in vivo in whole animal models (some also consider cell culture to be an in vivo approach).Mouse models of arterial transplant with immune rejection as well as models of inflammatory vasculitis induced by infection have been used to study the interplay between the coagulation and immune response pathways. We describe here three in vivo vasculitis models that are used to study the roles of serpins in disease and as therapeutics. The models described include (1) mouse aortic allograft transplantation, (2) human temporal artery (TA) xenograft into immunodeficient mouse aorta, and (3) mouse herpes virus (MHV68)-induced inflammatory vasculitis in interferon-gamma receptor (IFNγR) knockout mice.
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Affiliation(s)
- Hao Chen
- The Department of Tumor Surgery, Second Hospital of Lanzhou University, Lanzhou, China.
- The Key Laboratory of the Digestive System Tumors of Gansu Province, Lanzhou, Gansu, China.
| | - Sriram Ambadapadi
- Center for Personalized Diagnostics and Center for Immunotherapy, Vaccines and Virotherapy, Biodesign Institute, Arizona State University, Tempe, AZ, USA
- Department of Medicine, Divisions of Cardiovascular Medicine and Rheumatology, University of Florida, Gainesville, FL, USA
| | - Erbin Dai
- Department of Surgery, BIDMC, Harvard Medical School, Boston, MA, USA
| | - Liying Liu
- Department of Surgery, BIDMC, Harvard Medical School, Boston, MA, USA
| | - Jordan R Yaron
- Centers for Personalized Diagnostics and Immunology, Vaccines and Virotherapy, Biodesign Institute, Arizona State University, 727 E Tyler St, Tempe, AZ, 85287, USA
| | - Liqiang Zhang
- Center for Personalized Diagnostics and Center for Immunotherapy, Vaccines and Virotherapy, Biodesign Institute, Arizona State University, Tempe, AZ, USA
| | - Alexandra Lucas
- Center for Personalized Diagnostics and Center for Immunotherapy, Vaccines and Virotherapy, Biodesign Institute, Arizona State University, Tempe, AZ, USA
- Department of Medicine, Divisions of Cardiovascular Medicine and Rheumatology, University of Florida, Gainesville, FL, USA
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Abstract
PURPOSE OF REVIEW Despite considerable advances in controlling acute rejection, the longevity of cardiac and renal allografts remains significantly limited by chronic rejection in the form of allograft vasculopathy. This review discusses recently reported mechanistic insights of allograft vasculopathy pathogenesis as well as recent clinical evaluations of new therapeutic approaches. RECENT FINDINGS Although adaptive immunity is the major driver of allograft vasculopathy, natural killer cells mediate vasculopathic changes in a transplanted mouse heart following treatment with donor-specific antibody (DSA). However, natural killer cells may also dampen chronic inflammatory responses by killing donor-derived tissue-resident CD4 T cells that provide help to host B cells, the source of DSA. DSA may directly contribute to vascular inflammation by inducing intracellular signaling cascades that upregulate leukocyte adhesion molecules, facilitating recruitment of neutrophils and monocytes. DSA-mediated complement activation additionally enhances endothelial alloimmunogenicity through activation of noncanonical NF-κB signaling. New clinical studies evaluating mammalian target of rapamycin and proteasome inhibitors to target these pathways have been reported. SUMMARY Allograft vasculopathy is a disorder resulting from several innate and adaptive alloimmune responses. Mechanistic insights from preclinical studies have identified agents that are currently being investigated in clinical trials.
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Qin L, Li G, Kirkiles-Smith N, Clark P, Fang C, Wang Y, Yu ZX, Devore D, Tellides G, Pober JS, Jane-wit D. Complement C5 Inhibition Reduces T Cell-Mediated Allograft Vasculopathy Caused by Both Alloantibody and Ischemia Reperfusion Injury in Humanized Mice. Am J Transplant 2016; 16:2865-2876. [PMID: 27104811 PMCID: PMC5075274 DOI: 10.1111/ajt.13834] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/03/2015] [Revised: 04/10/2016] [Accepted: 04/14/2016] [Indexed: 01/25/2023]
Abstract
Allograft vasculopathy (AV) is characterized by diffuse stenoses in the vasculature of solid organ transplants. Previously, we developed two humanized models showing that alloantibody and ischemia reperfusion injury (IRI) exacerbated T cell-mediated AV in human arterial xenografts in vivo. Herein we examined a causal role for terminal complement activation in both settings. IRI, in contrast to alloantibody, elicited widespread membrane attack complex (MAC) assembly throughout the vessel wall. Both alloantibody and IRI caused early (24 h) and robust endothelial cell (EC) activation localized to regions of intimal MAC deposition, indicated by increases in nuclear factor kappa B (NF-κB)-inducing kinase, an MAC-dependent activator of noncanonical NF-kB, VCAM-1 expression and Gr-1+ neutrophil infiltration. Endothelial cell activation by alloantibody was inhibited by antimouse C5 mAb, but not by anti-C5a mAb or by control mAb, implicating MAC as the primary target of anti-C5 mAb. Antimouse C5 mAb significantly reduced alloantibody- and IRI-enhanced T cell infiltration and AV-like changes, including neointimal hyperplasia as well as intraluminal thrombosis in a subset of IRI-treated arterial grafts. These results indicate that increased AV lesion formation in response to either alloantibody or IRI is dependent on complement C5 activation and, accordingly, inhibition of this pathway may attenuate AV.
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Affiliation(s)
- Lingfeng Qin
- Department of Surgery, Yale School of Medicine, New Haven, CT 06519
| | - Guangxin Li
- Department of Surgery, Yale School of Medicine, New Haven, CT 06519
| | | | - Pamela Clark
- Immunobiology, Yale School of Medicine, New Haven, CT 06519
| | - Caodi Fang
- Immunobiology, Yale School of Medicine, New Haven, CT 06519
| | - Yi Wang
- Alexion Pharmaceuticals Inc., 100 College St, New Haven, CT 06511
| | - Zhao-Xue Yu
- Alexion Pharmaceuticals Inc., 100 College St, New Haven, CT 06511
| | - Denise Devore
- Alexion Pharmaceuticals Inc., 100 College St, New Haven, CT 06511
| | - George Tellides
- Department of Surgery, Yale School of Medicine, New Haven, CT 06519
| | - Jordan S Pober
- Immunobiology, Yale School of Medicine, New Haven, CT 06519
| | - Dan Jane-wit
- Cardiovascular Medicine, Yale School of Medicine, New Haven, CT 06519
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