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Anggelia MR, Cheng HY, Chuang WY, Hsieh YH, Wang AYL, Lin CH, Wei FC, Brandacher G, Lin CH. Unraveling the Crucial Roles of FoxP3+ Regulatory T Cells in Vascularized Composite Allograft Tolerance Induction and Maintenance. Transplantation 2021; 105:1238-1249. [PMID: 33141809 DOI: 10.1097/tp.0000000000003509] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/20/2022]
Abstract
BACKGROUND The role of regulatory T cells (Treg) in tolerance induction of vascularized composite allotransplantation (VCA) remains unclear. This study was designed to examine characteristics of Treg after VCA and their capacity to rescue allografts from rejection. METHODS Osteomyocutaneous allografts were transplanted from Balb/c to C57BL/6 mice. All mice received costimulatory blockade and a short course of rapamycin. To elucidate the role of Treg for tolerance induction, Treg depletion was performed at postoperative day (POD) 0, 30, or 90. To assess capacity of Treg to rescue allografts from rejection, an injection of 2 × 106 Treg isolated from tolerant mice was applied. RESULTS Eighty percent of VCA recipient mice using costimulatory blockade and rapamycin regimen developed tolerance. The tolerant recipients had a higher ratio of circulating Treg to effector T cells and elevated interleukin-10 at POD 30. A significantly higher rejection rate was observed when Treg were depleted at POD 30. But Treg depletion at POD 90 had no effect on tolerance. Treg from tolerant recipients showed stronger suppressive potential and the ability to rescue allografts from rejection. Furthermore, transplanted Treg-containing skin grafts from tolerant mice delayed rejection elicited by adoptively transferred effector T cells to Rag2-/- mice. CONCLUSIONS Circulating Treg are crucial for inducing VCA tolerance in the early posttransplant phase, and allograft-residing Treg may maintain tolerance. Treg may, therefore, serve as a potential cellular therapeutic to improve VCA outcomes.
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Affiliation(s)
- Madonna Rica Anggelia
- Department of Plastic and Reconstructive Surgery, Center for Vascularized Composite Allotransplantation, Chang Gung Memorial Hospital, Chang Gung Medical College and Chang Gung University, Taoyuan, Gueishan, Taiwan
| | - Hui-Yun Cheng
- Department of Plastic and Reconstructive Surgery, Center for Vascularized Composite Allotransplantation, Chang Gung Memorial Hospital, Chang Gung Medical College and Chang Gung University, Taoyuan, Gueishan, Taiwan
| | - Wen-Yu Chuang
- Department of Pathology, Chang Gung Memorial Hospital, Chang Gung Medical College and Chang Gung University, Taoyuan, Gueishan, Taiwan
| | - Yun-Huan Hsieh
- Department of Plastic and Reconstructive Surgery, Center for Vascularized Composite Allotransplantation, Chang Gung Memorial Hospital, Chang Gung Medical College and Chang Gung University, Taoyuan, Gueishan, Taiwan
| | - Aline Yen Ling Wang
- Department of Plastic and Reconstructive Surgery, Center for Vascularized Composite Allotransplantation, Chang Gung Memorial Hospital, Chang Gung Medical College and Chang Gung University, Taoyuan, Gueishan, Taiwan
| | - Chih-Hung Lin
- Department of Plastic and Reconstructive Surgery, Center for Vascularized Composite Allotransplantation, Chang Gung Memorial Hospital, Chang Gung Medical College and Chang Gung University, Taoyuan, Gueishan, Taiwan
- Department of Plastic and Reconstructive Surgery, Chiayi Chang Gung Memorial Hospital, Puzi City, Chiayi County, Taiwan
| | - Fu-Chan Wei
- Department of Plastic and Reconstructive Surgery, Center for Vascularized Composite Allotransplantation, Chang Gung Memorial Hospital, Chang Gung Medical College and Chang Gung University, Taoyuan, Gueishan, Taiwan
| | - Gerald Brandacher
- Department of Plastic and Reconstructive Surgery, Vascularized Composite Allotransplantation (VCA) Laboratory, Johns Hopkins University School of Medicine, Baltimore, MD
| | - Cheng-Hung Lin
- Department of Plastic and Reconstructive Surgery, Center for Vascularized Composite Allotransplantation, Chang Gung Memorial Hospital, Chang Gung Medical College and Chang Gung University, Taoyuan, Gueishan, Taiwan
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Uehara S, Chase CM, Cornell LD, Madsen JC, Russell PS, Colvin RB. Chronic cardiac transplant arteriopathy in mice: relationship of alloantibody, C4d deposition and neointimal fibrosis. Am J Transplant 2007; 7:57-65. [PMID: 17227558 DOI: 10.1111/j.1600-6143.2006.01599.x] [Citation(s) in RCA: 71] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/25/2023]
Abstract
Murine heterotopic cardiac allografts were used to reveal some of the fundamental interrelationships between donor-specific alloantibodies (DSA), chronic transplant arteriopathy (CTA) and capillary C4d deposition. B10.BR recipients of B10.A hearts developed transient DSA and C4d deposition that peaked on day 7 and became undetectable at day 56 while CTA developed progressively. Male cardiac grafts in female recipients showed similar degrees of CTA at day 56 but never developed DSA or C4d deposition, indicating that T cell-mediated mechanisms are sufficient to produce CTA. Passive transfer of monoclonal IgG2a anti-H-2K(k) into B6.RAG1 KO recipients of B10.BR hearts over 14-28 days led to progressive CTA. If treatment was stopped on day 14, lesions showed little progression and had no C4d deposition or detectable DSA on day 42. If treatment was stopped on day 28 when the lesions were fully developed, no regression occurred over the next 28 days, even though C4d deposition and circulating antibody became undetectable. Therefore, a minimum threshold of antibody exposure is needed to cause CTA. Once the CTA develops, C4d may become negative after DSA disappears. Thus, serial samples are needed in clinical studies to ascertain the relevance of alloantibody to the lesions of chronic graft rejection.
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Affiliation(s)
- S Uehara
- Transplantation and Cardiac Surgical Divisions of the Department of Surgery of the Harvard Medical School at the Massachusetts General Hospital, Boston, USA
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Tanaka M, Zwierzchoniewska M, Mokhtari GK, Terry RD, Balsam LB, Robbins RC, Fedoseyeva EV. Progression of alloresponse and tissue-specific immunity during graft coronary artery disease. Am J Transplant 2005; 5:1286-96. [PMID: 15888032 DOI: 10.1111/j.1600-6143.2005.00880.x] [Citation(s) in RCA: 24] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/25/2023]
Abstract
Chronic rejection remains the major obstacle for long-term transplant survival. Both indirect alloresponse and tissue-specific autoimmunity have been implicated in its pathogenesis. The interrelationship between these two types of host anti-graft response remains poorly understood. We have developed an immunosuppression-free mouse model of graft coronary artery disease (GCAD), in which all FVB (H-2(q)) cardiac allografts placed into minor Ag (mHC)-mismatched DBA/1 (H-2(q)) hosts survived more than 112 days, and developed GCAD. We then examined the kinetics of both anti-mHC alloresponse and host autoimmunity against heart-specific antigen, cardiac myosin (CM). At 8 days post-transplantation, recipient mice showed minimal intragraft inflammation and apoptosis, and limited expansion of allo-specific T cells. In addition, we observed early production of anti-myosin IgG1 autoantibodies, which occurred in the absence of activated CM-specific T lymphocytes. By day 56, GCAD indices, the numbers of mHC- and CM-reactive T cells, and the levels of circulating allo- and CM-specific antibodies were all significantly increased. While host alloresponse was exhausted at 112 days post-transplant, T-cell reactivity against CM persisted. Our data suggest that both allo- and tissue-specific immunity might contribute to the induction of GCAD. They indicate that continual autoimmune response against graft tissue antigens may provide for GCAD sustenance.
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Affiliation(s)
- Masashi Tanaka
- Department of Cardiothoracic Surgery, Stanford University School of Medicine, Stanford, CA 94305-5407, USA.
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