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Opriessnig T, Xiao CT, Mueller NJ, Denner J. Emergence of novel circoviruses in humans and pigs and their possible importance for xenotransplantation and blood transfusions. Xenotransplantation 2024; 31:e12842. [PMID: 38501706 DOI: 10.1111/xen.12842] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/11/2023] [Revised: 11/17/2023] [Accepted: 12/19/2023] [Indexed: 03/20/2024]
Abstract
BACKGROUND As sequencing is becoming more broadly available, virus discovery continues. Small DNA viruses contribute to up to 60% of the overall virus load in pigs. Porcine circoviruses (PCVs) are small DNA viruses with a single-stranded circular genome. They are common in pig breeds and have not been properly addressed for their potential risk in xenotransplantation. Whereas PCV1 is non-pathogenic in pigs, PCV2 has been associated with various disease manifestations. Recently two new circoviruses have been described, PCV3 and PCV4. While PCV4 is currently present mainly in Asia, PCV3 is widely distributed, and has been identified in commercial pigs, wild boars, and pigs generated for xenotransplantation. In one case PCV3 was transmitted by pigs to baboons via heart transplantation. PCV3 pathogenicity in pigs was controversial initially, however, the virus was found to be associated with porcine dermatitis and nephropathy syndrome (PDNS), reproductive failure, and multisystemic inflammation. Inoculation studies with PCV3 infectious clones confirmed that PCV3 is pathogenic. Most importantly, recently discovered human circoviruses (CV) are closely related to PCV3. METHODS Literature was evaluated and summarized. A dendrogram of existing circoviruses in pigs, humans, and other animal species was created and assessed at the species level. RESULTS We found that human circoviruses can be divided into three species, human CV1, CV2, and CV3. Human CV2 and CV3 are closest to PCV3. CONCLUSIONS Circoviruses are ubiquitous. This communication should create awareness of PCV3 and the newly discovered human circoviruses, which may be a problem for blood transfusions and xenotransplantation in immune suppressed individuals.
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Affiliation(s)
- Tanja Opriessnig
- Vaccines and Diagnostics Department, Moredun Research Institute, Penicuik, UK
- Department of Veterinary Diagnostic and Production Animal Medicine, College of Veterinary Medicine, Iowa State University, Ames, Iowa, USA
| | - Chao-Ting Xiao
- Institute of Pathogen Biology and Immunology, College of Biology, Hunan Provincial Key Laboratory of Medical Virology, Hunan University, Changsha, China
| | - Nicolas J Mueller
- Division of Infectious Diseases and Hospital Epidemiology, University Hospital Zurich, University Zurich, Zurich, Switzerland
| | - Joachim Denner
- Institute of Virology, Free University Berlin, Berlin, Germany
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2
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Mohiuddin MM, Singh AK, Scobie L, Goerlich CE, Grazioli A, Saharia K, Crossan C, Burke A, Drachenberg C, Oguz C, Zhang T, Lewis B, Hershfeld A, Sentz F, Tatarov I, Mudd S, Braileanu G, Rice K, Paolini JF, Bondensgaard K, Vaught T, Kuravi K, Sorrells L, Dandro A, Ayares D, Lau C, Griffith BP. Graft dysfunction in compassionate use of genetically engineered pig-to-human cardiac xenotransplantation: a case report. Lancet 2023; 402:397-410. [PMID: 37393920 PMCID: PMC10552929 DOI: 10.1016/s0140-6736(23)00775-4] [Citation(s) in RCA: 55] [Impact Index Per Article: 55.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/06/2023] [Revised: 04/03/2023] [Accepted: 04/06/2023] [Indexed: 07/04/2023]
Abstract
BACKGROUND A genetically engineered pig cardiac xenotransplantation was done on Jan 7, 2022, in a non-ambulatory male patient, aged 57 years, with end-stage heart failure, and on veno-arterial extracorporeal membrane oxygenation support, who was ineligible for an allograft. This report details our current understanding of factors important to the xenotransplantation outcome. METHODS Physiological and biochemical parameters critical for the care of all heart transplant recipients were collected in extensive clinical monitoring in an intensive care unit. To ascertain the cause of xenograft dysfunction, we did extensive immunological and histopathological studies, including electron microscopy and quantification of porcine cytomegalovirus or porcine roseolovirus (PCMV/PRV) in the xenograft, recipient cells, and tissue by DNA PCR and RNA transcription. We performed intravenous immunoglobulin (IVIG) binding to donor cells and single-cell RNA sequencing of peripheral blood mononuclear cells. FINDINGS After successful xenotransplantation, the graft functioned well on echocardiography and sustained cardiovascular and other organ systems functions until postoperative day 47 when diastolic heart failure occurred. At postoperative day 50, the endomyocardial biopsy revealed damaged capillaries with interstitial oedema, red cell extravasation, rare thrombotic microangiopathy, and complement deposition. Increased anti-pig xenoantibodies, mainly IgG, were detected after IVIG administration for hypogammaglobulinaemia and during the first plasma exchange. Endomyocardial biopsy on postoperative day 56 showed fibrotic changes consistent with progressive myocardial stiffness. Microbial cell-free DNA testing indicated increasing titres of PCMV/PRV cell-free DNA. Post-mortem single-cell RNA sequencing showed overlapping causes. INTERPRETATION Hyperacute rejection was avoided. We identified potential mediators of the observed endothelial injury. First, widespread endothelial injury indicates antibody-mediated rejection. Second, IVIG bound strongly to donor endothelium, possibly causing immune activation. Finally, reactivation and replication of latent PCMV/PRV in the xenograft possibly initiated a damaging inflammatory response. The findings point to specific measures to improve xenotransplant outcomes in the future. FUNDING The University of Maryland School of Medicine, and the University of Maryland Medical Center.
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Affiliation(s)
- Muhammad M Mohiuddin
- Program in Cardiac Xenotransplantation, Department of Surgery, University of Maryland School of Medicine, Baltimore, MD, USA.
| | - Avneesh K Singh
- Program in Cardiac Xenotransplantation, Department of Surgery, University of Maryland School of Medicine, Baltimore, MD, USA
| | - Linda Scobie
- Department of Biological and Biomedical Sciences, Glasgow Caledonian University, Glasgow, UK
| | - Corbin E Goerlich
- Program in Cardiac Xenotransplantation, Department of Surgery, University of Maryland School of Medicine, Baltimore, MD, USA
| | - Alison Grazioli
- Cardiac Surgery Intensive Care Unit, University of Maryland Medical Center, Baltimore, MD, USA
| | - Kapil Saharia
- Institute of Human Virology, Division of Infectious Disease, University of Maryland School of Medicine, Baltimore, MD, USA
| | - Claire Crossan
- Department of Biological and Biomedical Sciences, Glasgow Caledonian University, Glasgow, UK
| | - Allen Burke
- Department of Pathology, University of Maryland Medical Center, Baltimore, MD, USA
| | - Cinthia Drachenberg
- Department of Pathology, University of Maryland Medical Center, Baltimore, MD, USA
| | - Cihan Oguz
- Integrated Data Sciences Section, Research Technologies Branch, National Institute of Allergy and Infectious Diseases, National Institutes of Health, Bethesda, MD, USA
| | - Tianshu Zhang
- Program in Cardiac Xenotransplantation, Department of Surgery, University of Maryland School of Medicine, Baltimore, MD, USA
| | - Billeta Lewis
- Program in Cardiac Xenotransplantation, Department of Surgery, University of Maryland School of Medicine, Baltimore, MD, USA
| | - Alena Hershfeld
- Program in Cardiac Xenotransplantation, Department of Surgery, University of Maryland School of Medicine, Baltimore, MD, USA
| | - Faith Sentz
- Program in Cardiac Xenotransplantation, Department of Surgery, University of Maryland School of Medicine, Baltimore, MD, USA
| | - Ivan Tatarov
- Program in Cardiac Xenotransplantation, Department of Surgery, University of Maryland School of Medicine, Baltimore, MD, USA
| | - Sarah Mudd
- Program in Cardiac Xenotransplantation, Department of Surgery, University of Maryland School of Medicine, Baltimore, MD, USA
| | - Gheorghe Braileanu
- Program in Cardiac Xenotransplantation, Department of Surgery, University of Maryland School of Medicine, Baltimore, MD, USA
| | - Kathryn Rice
- Department of Pathology, University of Maryland Medical Center, Baltimore, MD, USA
| | | | | | | | | | | | | | | | - Christine Lau
- Program in Cardiac Xenotransplantation, Department of Surgery, University of Maryland School of Medicine, Baltimore, MD, USA
| | - Bartley P Griffith
- Program in Cardiac Xenotransplantation, Department of Surgery, University of Maryland School of Medicine, Baltimore, MD, USA
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Jhelum H, Bender M, Reichart B, Mokelke M, Radan J, Neumann E, Krabben L, Abicht JM, Kaufer B, Längin M, Denner J. Evidence for Microchimerism in Baboon Recipients of Pig Hearts. Viruses 2023; 15:1618. [PMID: 37515304 PMCID: PMC10385208 DOI: 10.3390/v15071618] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/19/2023] [Revised: 07/14/2023] [Accepted: 07/21/2023] [Indexed: 07/30/2023] Open
Abstract
Xenotransplantation, like allotransplantation, is usually associated with microchimerism, i.e., the presence of cells from the donor in the recipient. Microchimerism was reported in first xenotransplantation trials in humans, as well as in most preclinical trials in nonhuman primates (for review, see Denner, Viruses 2023, 15, 190). When using pigs as xenotransplantation donors, their cells contain porcine endogenous retroviruses (PERVs) in their genome. This makes it difficult to discriminate between microchimerism and PERV infection of the recipient. Here, we demonstrate the appropriate virological methods to be used for the identification of microchimerism, first by screening for porcine cellular genes, and then how to detect infection of the host. Using porcine short interspersed nuclear sequences (SINEs), which have hundreds of thousands of copies in the pig genome, significantly increased the sensitivity of the screening for pig cells. Second, absence of PERV RNA demonstrated an absence of viral genomic RNA or expression as mRNA. Lastly, absence of antibodies against PERV proteins conclusively demonstrated an absence of a PERV infection. When applying these methods for analyzing baboons after pig heart transplantation, microchimerism could be demonstrated and infection excluded in all animals. These methods can be used in future clinical trials.
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Affiliation(s)
- Hina Jhelum
- Institut of Virology, Free University Berlin, 14163 Berlin, Germany
| | - Martin Bender
- Department of Anaesthesiology, University Hospital, LMU Munich, 81377 Munich, Germany
| | - Bruno Reichart
- Transregional Collaborative Research Center 127, Walter Brendel Centre of Experimental Medicine, LMU Munich, 81377 Munich, Germany
| | - Maren Mokelke
- Department of Cardiac Surgery, University Hospital, LMU Munich, 81377 Munich, Germany
| | - Julia Radan
- Department of Cardiac Surgery, University Hospital, LMU Munich, 81377 Munich, Germany
| | - Elisabeth Neumann
- Department of Cardiac Surgery, University Hospital, LMU Munich, 81377 Munich, Germany
| | - Ludwig Krabben
- Institut of Virology, Free University Berlin, 14163 Berlin, Germany
| | - Jan-Michael Abicht
- Department of Anaesthesiology, University Hospital, LMU Munich, 81377 Munich, Germany
| | - Benedikt Kaufer
- Institut of Virology, Free University Berlin, 14163 Berlin, Germany
| | - Matthias Längin
- Department of Anaesthesiology, University Hospital, LMU Munich, 81377 Munich, Germany
| | - Joachim Denner
- Institut of Virology, Free University Berlin, 14163 Berlin, Germany
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Hansen S, Fischer K, Krabben L, Rinke Carrapeiro A, Klinger B, Schnieke A, Kaufer B, Denner J. Detection of porcine cytomegalovirus, a roseolovirus, in pig ovaries and follicular fluid: implications for somatic cells nuclear transfer, cloning and xenotransplantation. Virol J 2023; 20:15. [PMID: 36707837 PMCID: PMC9881377 DOI: 10.1186/s12985-023-01975-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/17/2022] [Accepted: 01/20/2023] [Indexed: 01/28/2023] Open
Abstract
BACKGROUND Porcine cytomegalovirus (PCMV) is a porcine roseolovirus (PCMV/PRV) which is widely distributed in pigs. Transmission of PCMV/PRV in preclinical xenotransplantations was shown to significantly reduce the survival time of the pig transplants in non-human primates. PCMV/PRV was also transmitted in the first transplantation of a pig heart into a human patient. To analyze how PCMV/PRV could be introduced into pig breeds, especially considering cloned transgenic pigs, and subsequently spread in breeding facilities, we screened ovaries and derived materials which are used to perform somatic cell nuclear transfer (SCNT). METHODS DNA was isolated from ovarian tissues, follicular fluids, oocytes with cumulus cells, denuded oocytes and parthenotes. A real-time PCR with PCMV/PRV-specific primers and a probe was performed to detect PCMV/PRV. Furthermore, a Western blot assay using a recombinant fragment of the gB protein of PCMV/PRV was performed to screen for virus-specific antibodies in the follicular fluids. RESULTS PCMV/PRV was found by real-time PCR in ovarian tissues, in the follicular fluid and in oocytes. In parthenotes the virus could not be detected, most-likely due to the low amount of DNA used. By Western blot assay specific antibodies against PCMV/PRV were found in 19 of 20 analyzed follicular fluids. CONCLUSION PCMV/PRV was found in ovarian tissues, in the follicular fluids and also in denuded oocytes, indicating that the virus is present in the animals of which the oocytes were taken from. Despite several washing steps of the denuded oocytes, which are subsequently used for microinjection or SCNT, the virus could still be detected. Therefore, the virus could infect oocytes during genetic modifications or stay attached to the surface of the oocytes, potentially infecting SCNT recipient animals.
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Affiliation(s)
- Sabrina Hansen
- grid.14095.390000 0000 9116 4836Institute of Virology, Free University Berlin, Berlin, Germany
| | - Konrad Fischer
- grid.6936.a0000000123222966Chair of Animal Biotechnology, TUM School of Life Sciences Weihenstephan, Technical University Munich, Freising, Germany
| | - Ludwig Krabben
- grid.14095.390000 0000 9116 4836Institute of Virology, Free University Berlin, Berlin, Germany
| | - Alexander Rinke Carrapeiro
- grid.6936.a0000000123222966Chair of Animal Biotechnology, TUM School of Life Sciences Weihenstephan, Technical University Munich, Freising, Germany
| | - Bernhard Klinger
- grid.6936.a0000000123222966Chair of Animal Biotechnology, TUM School of Life Sciences Weihenstephan, Technical University Munich, Freising, Germany
| | - Angelika Schnieke
- grid.6936.a0000000123222966Chair of Animal Biotechnology, TUM School of Life Sciences Weihenstephan, Technical University Munich, Freising, Germany
| | - Benedikt Kaufer
- grid.14095.390000 0000 9116 4836Institute of Virology, Free University Berlin, Berlin, Germany
| | - Joachim Denner
- Institute of Virology, Free University Berlin, Berlin, Germany.
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Denner J. Microchimerism, PERV and Xenotransplantation. Viruses 2023; 15:190. [PMID: 36680230 PMCID: PMC9862020 DOI: 10.3390/v15010190] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/06/2022] [Revised: 01/02/2023] [Accepted: 01/05/2023] [Indexed: 01/12/2023] Open
Abstract
Microchimerism is the presence of cells in an individual that have originated from a genetically distinct individual. The most common form of microchimerism is fetomaternal microchimerism, i.e., cells from a fetus pass through the placenta and establish cell lineages within the mother. Microchimerism was also described after the transplantation of human organs in human recipients. Consequently, microchimerism may also be expected in xenotransplantation using pig cells or organs. Indeed, microchimerism was described in patients after xenotransplantations as well as in non-human primates after the transplantation of pig organs. Here, for the first time, a comprehensive review of microchimerism in xenotransplantation is given. Since pig cells contain porcine endogenous retroviruses (PERVs) in their genome, the detection of proviral DNA in transplant recipients may be misinterpreted as an infection of the recipient with PERV. To prevent this, methods discriminating between infection and microchimerism are described. This knowledge will be important for the interpretation of screening results in forthcoming human xenotransplantations.
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Affiliation(s)
- Joachim Denner
- Institute of Virology, Free University Berlin, 14163 Berlin, Germany
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6
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Halecker S, Hansen S, Krabben L, Ebner F, Kaufer B, Denner J. How, where and when to screen for porcine cytomegalovirus (PCMV) in donor pigs for xenotransplantation. Sci Rep 2022; 12:21545. [PMID: 36513687 PMCID: PMC9747970 DOI: 10.1038/s41598-022-25624-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/27/2022] [Accepted: 12/01/2022] [Indexed: 12/14/2022] Open
Abstract
Porcine cytomegalovirus (PCMV), that is actually a porcine roseolovirus (PRV), is a common herpesvirus in domestic pigs and wild boars. In xenotransplantation, PCMV/PRV has been shown to significantly reduce the survival time of pig kidneys and hearts in preclinical trials with different non-human primates. Furthermore, PCMV/PRV has been transmitted in the first pig to human heart xenotransplantation and contributed to the death of the patient. Although transmitted to the recipient, there is no evidence that PCMV/PRV can infect primate cells including human cells. PCMV/PRV is closely related to the human herpesviruses 6 and 7, and only distantly related to the human CMV (HCMV). Antiviral drugs used for the treatment of HCMV are less effective against PCMV/PRV. However, there are well described strategies to eliminate the virus from pig facilities. In order to detect the virus and to eliminate it, highly sensitive detection methods and the knowledge of how, where and when to screen the donor pigs is required. Here, a comparative testing of organs from pigs of different ages using polymerase chain reaction (PCR)-based and immunological methods was performed. Testing young piglets, PCMV/PRV was detected effectively by PCR in blood, bronchoalveolar lavage fluid, tonsils and heart. In adult animals, detection by PCR was not successful in most cases, because the virus load was below the detection limit or the virus was in its latent stage. Therefore, detection of antibodies against selected recombinant proteins corresponding to epitopes detected by nearly all infected animals in a Western blot assay is advantageous. By contrast, immunological testing is not beneficial in young animals as piglets might have PCMV/PRV-specific antibodies obtained from their infected mother via the colostrum. Using a thoughtful combination of PCR-based and immunological methods, detection of PCMV/PRV in donor pigs for xenotransplantation is feasible and a controlled elimination of the virus by early weaning or other methods is possible.
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Affiliation(s)
- S. Halecker
- grid.14095.390000 0000 9116 4836Institute of Virology, Free University, Berlin, Germany
| | - S. Hansen
- grid.14095.390000 0000 9116 4836Institute of Virology, Free University, Berlin, Germany
| | - L. Krabben
- grid.14095.390000 0000 9116 4836Institute of Virology, Free University, Berlin, Germany
| | - F. Ebner
- grid.14095.390000 0000 9116 4836Institute of Immunology, Free University, Berlin, Germany
| | - B. Kaufer
- grid.14095.390000 0000 9116 4836Institute of Virology, Free University, Berlin, Germany
| | - J. Denner
- grid.14095.390000 0000 9116 4836Institute of Virology, Free University, Berlin, Germany
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7
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Denner J, Schuurman HJ. Early testing of porcine organ xenotransplantation products in humans: Microbial safety as illustrated for porcine cytomegalovirus. Xenotransplantation 2022; 29:e12783. [PMID: 36336900 DOI: 10.1111/xen.12783] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/31/2022] [Accepted: 09/20/2022] [Indexed: 11/09/2022]
Affiliation(s)
- Joachim Denner
- Institute of Virology, Free University Berlin, Berlin, Germany
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8
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Mueller NJ, Denner J. Porcine cytomegalovirus/porcine roseolovirus (PCMV/PRV): A threat for xenotransplantation? Xenotransplantation 2022; 29:e12775. [PMID: 36082418 DOI: 10.1111/xen.12775] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/19/2022] [Accepted: 08/24/2022] [Indexed: 02/06/2023]
Abstract
The potential for a donor-derived transmission of porcine cytomegalovirus/porcine roseolovirus (PCMV/PRV) to the recipient has been recognized since pigs were considered candidate donors for xenotransplantation. This review gives a short description of the viral properties and summarizes the current evidence of the effects of PCMV/PRV transmission in preclinical xenotransplantation. Despite evidence that PCMV/PRV does not infect human and non-human primate cells, activation in the transplanted organ and detrimental systemic complications have been described. As PCMV/PRV is a herpesvirus able to establish latency, the importance of adequate screening of donor pigs is emphasized, as no efficient treatment is available. Furthermore, easy and successful ways of elimination of PCMV/PRV from pig herds are indicated.
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Affiliation(s)
- Nicolas J Mueller
- Division of Infectious Diseases and Hospital Epidemiology, and University Zurich, University Hospital Zurich, Zurich, Switzerland
| | - Joachim Denner
- Institut of Virology, Free University Berlin, Berlin, Germany
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Virus Safety of Xenotransplantation. Viruses 2022; 14:v14091926. [PMID: 36146732 PMCID: PMC9503113 DOI: 10.3390/v14091926] [Citation(s) in RCA: 17] [Impact Index Per Article: 8.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/06/2022] [Revised: 08/29/2022] [Accepted: 08/29/2022] [Indexed: 01/06/2023] Open
Abstract
The practice of xenotransplantation using pig islet cells or organs is under development to alleviate the shortage of human donor islet cells or organs for the treatment of diabetes or organ failure. Multiple genetically modified pigs were generated to prevent rejection. Xenotransplantation may be associated with the transmission of potentially zoonotic porcine viruses. In order to prevent this, we developed highly sensitive PCR-based, immunologicals and other methods for the detection of numerous xenotransplantation-relevant viruses. These methods were used for the screening of donor pigs and xenotransplant recipients. Of special interest are the porcine endogenous retroviruses (PERVs) that are integrated in the genome of all pigs, which are able to infect human cells, and that cannot be eliminated by methods that other viruses can. We showed, using droplet digital PCR, that the number of PERV proviruses is different in different pigs (usually around 60). Furthermore, the copy number is different in different organs of a single pig, indicating that PERVs are active in the living animals. We showed that in the first clinical trials treating diabetic patients with pig islet cells, no porcine viruses were transmitted. However, in preclinical trials transplanting pig hearts orthotopically into baboons, porcine cytomegalovirus (PCMV), a porcine roseolovirus (PCMV/PRV), and porcine circovirus 3 (PCV3), but no PERVs, were transmitted. PCMV/PRV transmission resulted in a significant reduction of the survival time of the xenotransplant. PCMV/PRV was also transmitted in the first pig heart transplantation to a human patient and possibly contributed to the death of the patient. Transmission means that the virus was detected in the recipient, however it remains unclear whether it can infect primate cells, including human cells. We showed previously that PCMV/PRV can be eliminated from donor pigs by early weaning. PERVs were also not transmitted by inoculation of human cell-adapted PERV into small animals, rhesus monkey, baboons and cynomolgus monkeys, even when pharmaceutical immunosuppression was applied. Since PERVs were not transmitted in clinical, preclinical, or infection experiments, it remains unclear whether they should be inactivated in the pig genome by CRISPR/Cas. In summary, by using our sensitive methods, the safety of xenotransplantation can be ensured.
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Stand der Technik und Durchbruch bei der kardialen Xenotransplantation. ZEITSCHRIFT FUR HERZ THORAX UND GEFASSCHIRURGIE 2022. [DOI: 10.1007/s00398-022-00534-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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11
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Jiang Z, Fu M, Zhu D, Wang X, Li N, Ren L, He J, Yang G. Genetically modified immunomodulatory cell-based biomaterials in tissue regeneration and engineering. Cytokine Growth Factor Rev 2022; 66:53-73. [PMID: 35690567 DOI: 10.1016/j.cytogfr.2022.05.003] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/07/2022] [Accepted: 05/24/2022] [Indexed: 11/25/2022]
Abstract
To date, the wide application of cell-based biomaterials in tissue engineering and regeneration is remarkably hampered by immune rejection. Reducing the immunogenicity of cell-based biomaterials has become the latest direction in biomaterial research. Recently, genetically modified cell-based biomaterials with immunomodulatory genes have become a feasible solution to the immunogenicity problem. In this review, recent advances and future challenges of genetically modified immunomodulatory cell-based biomaterials are elaborated, including fabrication approaches, mechanisms of common immunomodulatory genes, application and, more importantly, current preclinical and clinical advances. The fabrication approaches can be categorized into commonly used (e.g., virus transfection) and newly developed approaches. The immunomodulatory mechanisms of representative genes involve complicated cell signaling pathways and metabolic activities. Wide application in curing multiple end-term diseases and replacing lifelong immunosuppressive therapy in multiple cell and organ transplantation models is demonstrated. Most significantly, practices of genetically modified organ transplantation have been conducted on brain-dead human decedent and even on living patients after a series of experiments on nonhuman primates. Nevertheless, uncertain biosecurity, nonspecific effects and overlooked personalization of current genetically modified immunomodulatory cell-based biomaterials are shortcomings that remain to be overcome.
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Affiliation(s)
- Zhiwei Jiang
- Stomatology Hospital, School of Stomatology, Zhejiang University School of Medicine, Zhejiang Provincial Clinical Research Center of Oral Diseases, Key Laboratory of Oral Biomedical Research of Zhejiang Province, Cancer Center of Zhejiang University, Hangzhou 310000, China
| | - Mengdie Fu
- Stomatology Hospital, School of Stomatology, Zhejiang University School of Medicine, Zhejiang Provincial Clinical Research Center of Oral Diseases, Key Laboratory of Oral Biomedical Research of Zhejiang Province, Cancer Center of Zhejiang University, Hangzhou 310000, China
| | - Danji Zhu
- Stomatology Hospital, School of Stomatology, Zhejiang University School of Medicine, Zhejiang Provincial Clinical Research Center of Oral Diseases, Key Laboratory of Oral Biomedical Research of Zhejiang Province, Cancer Center of Zhejiang University, Hangzhou 310000, China
| | - Xueting Wang
- Stomatology Hospital, School of Stomatology, Zhejiang University School of Medicine, Zhejiang Provincial Clinical Research Center of Oral Diseases, Key Laboratory of Oral Biomedical Research of Zhejiang Province, Cancer Center of Zhejiang University, Hangzhou 310000, China
| | - Na Li
- Stomatology Hospital, School of Stomatology, Zhejiang University School of Medicine, Zhejiang Provincial Clinical Research Center of Oral Diseases, Key Laboratory of Oral Biomedical Research of Zhejiang Province, Cancer Center of Zhejiang University, Hangzhou 310000, China
| | - Lingfei Ren
- Stomatology Hospital, School of Stomatology, Zhejiang University School of Medicine, Zhejiang Provincial Clinical Research Center of Oral Diseases, Key Laboratory of Oral Biomedical Research of Zhejiang Province, Cancer Center of Zhejiang University, Hangzhou 310000, China
| | - Jin He
- Stomatology Hospital, School of Stomatology, Zhejiang University School of Medicine, Zhejiang Provincial Clinical Research Center of Oral Diseases, Key Laboratory of Oral Biomedical Research of Zhejiang Province, Cancer Center of Zhejiang University, Hangzhou 310000, China
| | - Guoli Yang
- Stomatology Hospital, School of Stomatology, Zhejiang University School of Medicine, Zhejiang Provincial Clinical Research Center of Oral Diseases, Key Laboratory of Oral Biomedical Research of Zhejiang Province, Cancer Center of Zhejiang University, Hangzhou 310000, China.
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12
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Denner J. The porcine cytomegalovirus (PCMV) will not stop xenotransplantation. Xenotransplantation 2022; 29:e12763. [PMID: 35695336 DOI: 10.1111/xen.12763] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/23/2022] [Accepted: 05/26/2022] [Indexed: 12/19/2022]
Affiliation(s)
- Joachim Denner
- Institute of Virology, Free University Berlin, Berlin, Germany
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13
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Halecker S, Krabben L, Kristiansen Y, Krüger L, Möller L, Becher D, Laue M, Kaufer B, Reimer C, Denner J. Rare isolation of human-tropic recombinant porcine endogenous retroviruses PERV-A/C from Göttingen minipigs. Virol J 2022; 19:30. [PMID: 35189916 PMCID: PMC8862210 DOI: 10.1186/s12985-022-01742-0] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/12/2021] [Accepted: 01/06/2022] [Indexed: 12/22/2022] Open
Abstract
Background Porcine endogenous retroviruses (PERVs) can infect human cells and pose a risk for xenotransplantation when pig cells, tissues or organs are transplanted to human recipients. Xenotransplantation holds great promise to overcome the shortage of human donor organs after solving the problems of rejection, functionality and virus safety. We recently described the transmission of a human-tropic recombinant PERV-A/C, designated PERV-F, from peripheral blood mononuclear cells (PBMCs) of a Göttingen Minipig (GöMP) to human 293 cells (Krüger et al., in Viruses 12(1):38, 2019). The goal of this study was to characterize PERV-F in more detail and to analyze the probability of virus isolation from other animals. Methods The recombination site in the envelope (env) gene, the long terminal repeats (LTR), the proteins and the morphology of the recombinant PERV-F were characterized by polymerase chain reaction (PCR), sequencing, Western blot analysis, immunofluorescence, and transmissible electron microscopy. Mitogen-stimulated PBMCs from 47 additional pigs, including 17 new GöMP, were co-cultured with highly susceptible human 293 T cells, and the PERV-A/C prevalence and PERV transmission was analyzed by PCR. Results PERV-F, isolated from a GöMP, is an infectious human-tropic PERV-A/C virus with a novel type of recombination in the env gene. The length of the LTR of PERV-F increased after passaging on human cells. In a few minipigs, but not in German landrace pigs, PERV-A/C were found. There was no transmission of human-tropic PERV-A/C from additional 47 pigs, including 17 GöMP, to human cells. Conclusion These data show that human-tropic recombinant PERV-A/C proviruses can only be found in a very small number of minipigs, but not in other pigs, and that their isolation as infectious virus able to replicate on human cells is an extremely rare event, even when using highly susceptible 293 cells. Supplementary Information The online version contains supplementary material available at 10.1186/s12985-022-01742-0.
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Lassiter R, Merchen TD, Fang X, Wang Y. Protective Role of Kynurenine 3-Monooxygenase in Allograft Rejection and Tubular Injury in Kidney Transplantation. Front Immunol 2021; 12:671025. [PMID: 34305900 PMCID: PMC8293746 DOI: 10.3389/fimmu.2021.671025] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/22/2021] [Accepted: 06/11/2021] [Indexed: 11/13/2022] Open
Abstract
Renal tubular epithelial cells (TECs) are the primary targets of ischemia-reperfusion injury (IRI) and rejection by the recipient's immune response in kidney transplantation (KTx). However, the molecular mechanism of rejection and IRI remains to be identified. Our previous study demonstrated that kynurenine 3-monooxygenase (KMO) and kynureninase were reduced in ischemia-reperfusion procedure and further decreased in rejection allografts among mismatched pig KTx. Herein, we reveal that TEC injury in acutely rejection allografts is associated with alterations of Bcl2 family proteins, reduction of tight junction protein 1 (TJP1), and TEC-specific KMO. Three cytokines, IFN γ , TNFα, and IL1β, reported in our previous investigation were identified as triggers of TEC injury by altering the expression of Bcl2, BID, and TJP1. Allograft rejection and TEC injury were always associated with a dramatic reduction of KMO. 3HK and 3HAA, as direct and downstream products of KMO, effectively protected TEC from injury via increasing expression of Bcl-xL and TJP1. Both 3HK and 3HAA further prevented allograft rejection by inhibiting T cell proliferation and up-regulating aryl hydrocarbon receptor expression. Pig KTx with the administration of DNA nanoparticles (DNP) that induce expression of indoleamine 2,3-dioxygenase (IDO) and KMO to increase 3HK/3HAA showed an improvement of allograft rejection as well as murine skin transplant in IDO knockout mice with the injection of 3HK indicated a dramatic reduction of allograft rejection. Taken together, our data provide strong evidence that reduction of KMO in the graft is a key mediator of allograft rejection and loss. KMO can effectively improve allograft outcome by attenuating allograft rejection and maintaining graft barrier function.
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Affiliation(s)
- Randi Lassiter
- Department of Surgery, Medical College of Georgia at Augusta University, Augusta, GA, United States
| | - Todd D. Merchen
- Department of Surgery, Medical College of Georgia at Augusta University, Augusta, GA, United States
| | - Xuexiu Fang
- Division of Nephrology, Department of Medicine, Medical College of Georgia at Augusta University, Augusta, GA, United States
| | - Youli Wang
- Division of Nephrology, Department of Medicine, Medical College of Georgia at Augusta University, Augusta, GA, United States
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Denner J, Längin M, Reichart B, Krüger L, Fiebig U, Mokelke M, Radan J, Mayr T, Milusev A, Luther F, Sorvillo N, Rieben R, Brenner P, Walz C, Wolf E, Roshani B, Stahl-Hennig C, Abicht JM. Impact of porcine cytomegalovirus on long-term orthotopic cardiac xenotransplant survival. Sci Rep 2020; 10:17531. [PMID: 33067513 PMCID: PMC7568528 DOI: 10.1038/s41598-020-73150-9] [Citation(s) in RCA: 47] [Impact Index Per Article: 11.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/11/2020] [Accepted: 09/09/2020] [Indexed: 12/12/2022] Open
Abstract
Xenotransplantation using pig organs has achieved survival times up to 195 days in pig orthotopic heart transplantation into baboons. Here we demonstrate that in addition to an improved immunosuppressive regimen, non-ischaemic preservation with continuous perfusion and control of post-transplantation growth of the transplant, prevention of transmission of the porcine cytomegalovirus (PCMV) plays an important role in achieving long survival times. For the first time we demonstrate that PCMV transmission in orthotopic pig heart xenotransplantation was associated with a reduced survival time of the transplant and increased levels of IL-6 and TNFα were found in the transplanted baboon. Furthermore, high levels of tPA-PAI-1 complexes were found, suggesting a complete loss of the pro-fibrinolytic properties of the endothelial cells. These data show that PCMV has an important impact on transplant survival and call for elimination of PCMV from donor pigs.
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Affiliation(s)
| | - Matthias Längin
- Department of Anaesthesiology, University Hospital, Ludwig-Maximilians-Universität München, Munich, Germany
- Walter Brendel Centre of Experimental Medicine, Ludwig-Maximilians-Universität München, Munich, Germany
| | - Bruno Reichart
- Walter Brendel Centre of Experimental Medicine, Ludwig-Maximilians-Universität München, Munich, Germany
| | | | | | - Maren Mokelke
- Walter Brendel Centre of Experimental Medicine, Ludwig-Maximilians-Universität München, Munich, Germany
| | - Julia Radan
- Walter Brendel Centre of Experimental Medicine, Ludwig-Maximilians-Universität München, Munich, Germany
| | - Tanja Mayr
- Department of Anaesthesiology, University Hospital, Ludwig-Maximilians-Universität München, Munich, Germany
| | - Anastasia Milusev
- Department of Biomedical Research (DMBR), University of Bern, Bern, Switzerland
| | - Fabian Luther
- Department of Biomedical Research (DMBR), University of Bern, Bern, Switzerland
| | - Nicoletta Sorvillo
- Department of Biomedical Research (DMBR), University of Bern, Bern, Switzerland
| | - Robert Rieben
- Department of Biomedical Research (DMBR), University of Bern, Bern, Switzerland
| | - Paolo Brenner
- Department of Cardiac Surgery, University Hospital, Maximilians-Universität München, Munich, Germany
| | - Christoph Walz
- Institute of Pathology, Faculty of Medicine, Ludwig-Maximilians-Universität München, Munich, Germany
| | - Eckhard Wolf
- Animal Breeding and Biotechnology, Gene Center and Department of Veterinary Sciences, Ludwig-Maximilians-Universität München, Munich, Germany
| | - Berit Roshani
- Unit of Infection Models, German Primate Center, Göttingen, Germany
| | | | - Jan-Michael Abicht
- Department of Anaesthesiology, University Hospital, Ludwig-Maximilians-Universität München, Munich, Germany
- Walter Brendel Centre of Experimental Medicine, Ludwig-Maximilians-Universität München, Munich, Germany
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Abstract
PURPOSE OF REVIEW Considerable advancements have been made in the field of cardiac xenotransplantation in the recent years, achieving prolonged survival of the life-supporting cardiac xenograft and paving the way toward first clinical implications. RECENT FINDINGS The combination of genetic modifications and novel immunosuppression with costimulation blockade, as well as supporting therapy with antiinflammatory treatment, growth prevention, and adaptation of the heart procurement system to reduce myocardial ischemia and reperfusion injury improves the overall cardiac xenograft function and overall survival in nonhuman primates. Through the newly identified xenoantigens and novel gene-editing techniques, further genetic modification of the porcine xenografts should be explored, to ensure clinical safety. SUMMARY With continuous progress in all fields of cardiac xenotransplantation, first clinical use in humans seems accomplishable. To ensure the clinical safety and to conform to the ethical regulations, further investigation of the infectious and immunological implications on humans should be explored prior to first clinical use. The first clinical use of cardiac xenotransplantation will be limited to only highly selected patients.
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Denner J. Sensitive detection systems for infectious agents in xenotransplantation. Xenotransplantation 2020:e12594. [PMID: 32304138 DOI: 10.1111/xen.12594] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/16/2020] [Accepted: 03/25/2020] [Indexed: 12/18/2022]
Abstract
Xenotransplantation of pig cells, tissues, or organs may be associated with transmission of porcine microorganisms, first of all of viruses, to the transplant recipient, potentially inducing a disease (zoonosis). I would like to define detection systems as the complex of sample generation, sample preparation, sample origin, time of sampling, and the necessary negative and positive controls along with the specific detection methods, either PCR-based, cell-based, or immunological methods. Some xenotransplantation-relevant viruses have already been defined; others are still unknown. The PCR-based methods include PCR and real-time PCR for DNA viruses, and RT-PCR and real-time RT-PCR for RNA viruses as well as for virus expression studies at the RNA level. Furthermore, droplet digital PCR (ddPCR) can be used for the determination of virus and provirus copies. To detect expression at the protein level, immunofluorescence, immunohistochemistry, and Western blot analyses can be used. To detect virus production and to detect infectious viruses, electron microscopy and infection assays can be used. Furthermore, immunological methods such as Western blot analysis or ELISA can be used to detect virus-specific antibodies. Detection of antiviral antibodies is a reliable and sensitive indirect detection method. For these immunological methods, purified viruses, recombinant viral proteins, or synthetic peptides are used as antigens and control sera and control antigens are needed. All these methods have been used in the past for the characterization of different pig breeds including genetically modified pigs generated for xenotransplantation and for the screening of recipients in preclinical and clinical xenotransplantations. Whereas in preclinical trials a few porcine viruses have been transmitted to the non-human primate recipients, in first clinical trials no such transmissions to humans were observed. Further improvement of the detection systems and their application in virus elimination programs will lead to clean donor animals and a safe xenotransplantation.
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Denner J, Bigley TM, Phan TL, Zimmermann C, Zhou X, Kaufer BB. Comparative Analysis of Roseoloviruses in Humans, Pigs, Mice, and Other Species. Viruses 2019; 11:E1108. [PMID: 31801268 PMCID: PMC6949924 DOI: 10.3390/v11121108] [Citation(s) in RCA: 28] [Impact Index Per Article: 5.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/31/2019] [Revised: 11/13/2019] [Accepted: 11/27/2019] [Indexed: 12/11/2022] Open
Abstract
Viruses of the genus Roseolovirus belong to the subfamily Betaherpesvirinae, family Herpesviridae. Roseoloviruses have been studied in humans, mice and pigs, but they are likely also present in other species. This is the first comparative analysis of roseoloviruses in humans and animals. The human roseoloviruses human herpesvirus 6A (HHV-6A), 6B (HHV-6B), and 7 (HHV-7) are relatively well characterized. In contrast, little is known about the murine roseolovirus (MRV), also known as murine thymic virus (MTV) or murine thymic lymphotrophic virus (MTLV), and the porcine roseolovirus (PRV), initially incorrectly named porcine cytomegalovirus (PCMV). Human roseoloviruses have gained attention because they can cause severe diseases including encephalitis in immunocompromised transplant and AIDS patients and febrile seizures in infants. They have been linked to a number of neurological diseases in the immunocompetent including multiple sclerosis (MS) and Alzheimer's. However, to prove the causality in the latter disease associations is challenging due to the high prevalence of these viruses in the human population. PCMV/PRV has attracted attention because it may be transmitted and pose a risk in xenotransplantation, e.g., the transplantation of pig organs into humans. Most importantly, all roseoloviruses are immunosuppressive, the humoral and cellular immune responses against these viruses are not well studied and vaccines as well as effective antivirals are not available.
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Affiliation(s)
- Joachim Denner
- Robert Koch Institute, Robert Koch Fellow, 13352 Berlin, Germany
| | - Tarin M. Bigley
- Division of Rheumatology, Department. of Medicine, Washington University School of Medicine, St. Louis, MO 63110, USA;
| | - Tuan L. Phan
- Department of Microbiology and Immunology, Tulane University School of Medicine, New Orleans, LA 70118, USA;
- HHV-6 Foundation, Santa Barbara, CA 93108, USA
| | - Cosima Zimmermann
- Institute of Virology, Freie Universität Berlin, 14163 Berlin, Germany;
| | - Xiaofeng Zhou
- Division of Pulmonary and Critical Care Medicine, Department. of Internal Medicine, University of Michigan Medical School, Ann Arbor, MI 48109, USA
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Krüger L, Längin M, Reichart B, Fiebig U, Kristiansen Y, Prinz C, Kessler B, Egerer S, Wolf E, Abicht JM, Denner J. Transmission of Porcine Circovirus 3 (PCV3) by Xenotransplantation of Pig Hearts into Baboons. Viruses 2019; 11:E650. [PMID: 31315245 PMCID: PMC6669873 DOI: 10.3390/v11070650] [Citation(s) in RCA: 29] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/05/2019] [Revised: 07/08/2019] [Accepted: 07/09/2019] [Indexed: 01/26/2023] Open
Abstract
Porcine circovirus 3 (PCV3) is a newly described member of the virus family Circoviridae. PCV3 is highly distributed among pigs and wild boars worldwide. A sudden introduction of PCV3 was recently observed in a herd of triple genetically modified pigs generated for xenotransplantation. These animals were used as donor pigs for orthotopic heart transplantation into baboons. In four cases, PCV3-positive hearts were transplanted, and transmission of PCV3 to the recipient was observed. PCV3 was found in all organs of the recipient baboons and a higher virus load was found in animals with a longer survival time of the transplant, indicating replication of the virus. This is the first report showing trans-species transmission of PCV3 to baboons by transplantation of a heart from a PCV3-positive donor pig. Sequence analysis showed that PCV3a and PCV3b were present in the infected pigs and were transmitted. Experiments to infect human 293 cells with PCV3 failed.
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Affiliation(s)
- Luise Krüger
- Robert Koch Institute, HIV and other retroviruses, 13353 Berlin, Germany
| | - Matthias Längin
- Department of Anaesthesiology, Ludwig-Maximilians-Universität München, 81377 Munich, Germany
| | - Bruno Reichart
- Walter Brendel Centre of Experimental Medicine, Ludwig-Maximilians-Universität München, 81377 Munich, Germany
| | - Uwe Fiebig
- Robert Koch Institute, HIV and other retroviruses, 13353 Berlin, Germany
| | | | - Carolin Prinz
- Robert Koch Institute, HIV and other retroviruses, 13353 Berlin, Germany
| | - Barbara Kessler
- Molecular Animal Breeding and Biotechnology, Gene Center, Ludwig-Maximilians-Universität München, 85764 Oberschleißheim, Germany
| | - Stefanie Egerer
- Molecular Animal Breeding and Biotechnology, Gene Center, Ludwig-Maximilians-Universität München, 85764 Oberschleißheim, Germany
| | - Eckhard Wolf
- Molecular Animal Breeding and Biotechnology, Gene Center, Ludwig-Maximilians-Universität München, 85764 Oberschleißheim, Germany
| | - Jan-Michael Abicht
- Department of Anaesthesiology, Ludwig-Maximilians-Universität München, 81377 Munich, Germany
| | - Joachim Denner
- Robert Koch Institute, Robert Koch Fellow, 13353 Berlin, Germany.
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Al-Shehabi H, Fiebig U, Kutzner J, Denner J, Schaller T, Bannert N, Hofmann H. Human SAMHD1 restricts the xenotransplantation relevant porcine endogenous retrovirus (PERV) in non-dividing cells. J Gen Virol 2019; 100:656-661. [PMID: 30767852 DOI: 10.1099/jgv.0.001232] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/01/2023] Open
Abstract
The release of porcine endogenous retrovirus (PERV) particles from pig cells is a potential risk factor during xenotransplantation by way of productively infecting the human transplant recipient. Potential countermeasures against PERV replication are restriction factors that block retroviral replication. SAMHD1 is a triphosphohydrolase that depletes the cellular pool of dNTPs in non-cycling cells starving retroviral reverse transcription. We investigated the antiviral activity of human SAMHD1 against PERV and found that SAMHD1 potently restricts its reverse transcription in human monocytes, monocyte-derived dendritic cells (MDDC), or macrophages (MDM) and in monocytic THP-1 cells. Degradation of SAMHD1 by SIVmac Vpx or CRISPR/Cas9 knock-out of SAMHD1 allowed for PERV reverse transcription. Addition of deoxynucleosides alleviated the SAMHD1-mediated restriction suggesting that SAMHD1-mediated degradation of dNTPs restricts PERV replication in these human immune cells. In conclusion, our findings highlight SAMHD1 as a potential barrier to PERV transmission from pig transplants to human recipients during xenotransplantation.
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Affiliation(s)
- Hussein Al-Shehabi
- 1Department of HIV and other Retroviruses, Robert Koch Institute, Berlin, Germany
| | - Uwe Fiebig
- 1Department of HIV and other Retroviruses, Robert Koch Institute, Berlin, Germany
| | - Juliane Kutzner
- 2Department of Infectious Diseases, Virology, University Hospital Heidelberg, Heidelberg, Germany
| | - Joachim Denner
- 3Robert Koch Fellow, Robert Koch Institute, Berlin, Germany
| | - Torsten Schaller
- 2Department of Infectious Diseases, Virology, University Hospital Heidelberg, Heidelberg, Germany
| | - Norbert Bannert
- 1Department of HIV and other Retroviruses, Robert Koch Institute, Berlin, Germany.,4Institute of Virology, Charité Universitätsmedizin Berlin, Berlin, Germany
| | - Henning Hofmann
- 1Department of HIV and other Retroviruses, Robert Koch Institute, Berlin, Germany
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21
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Egerer S, Fiebig U, Kessler B, Zakhartchenko V, Kurome M, Reichart B, Kupatt C, Klymiuk N, Wolf E, Denner J, Bähr A. Early weaning completely eliminates porcine cytomegalovirus from a newly established pig donor facility for xenotransplantation. Xenotransplantation 2019; 25:e12449. [PMID: 30264883 DOI: 10.1111/xen.12449] [Citation(s) in RCA: 30] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/08/2018] [Revised: 06/27/2018] [Accepted: 07/10/2018] [Indexed: 01/02/2023]
Abstract
For clinical xenotransplantation, transplants must be free of porcine cytomegalovirus (PCMV). Piglets become infected primarily in the perinatal period by the mother sow. While individual donor animals can be protected from infection by isolation husbandry, success is not guaranteed and this strategy poses the risk of undetected infections and raises animal welfare questions. Here, we present the establishment of a completely PCMV-negative pig herd for breeding donor animals for xenotransplantation. Eleven pregnant DanAvl Basic hybrid sows were purchased from a designated pathogen-free (DPF), PCMV-positive colony and transferred to a new pig facility at the Centre for Innovative Medical Models (CiMM) 4 weeks prior to farrowing. At the age of 24 hours, piglets were early-weaned and transferred to a commercially available Rescue Deck system dedicated to motherless rearing of piglets. Sows were removed from the facility. The PCMV status of F1-generation animals was determined at regular intervals over a period of 14 months by a sensitive real-time PCR-based detection method testing blood, nasal swabs and cultured peripheral blood mononuclear cells (PBMCs). F1 sows were used as recipients of genetically modified embryos to generate a xenotransplant donor herd. Offspring were tested for PCMV accordingly. All offspring have remained PCMV negative over the whole observation period of 14 months. A completely PCMV-negative pig herd for xenotransplantation has thus been successfully established.
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Affiliation(s)
- Stefanie Egerer
- Center for Innovative Medical Models (CiMM), Institute for Molecular Animal Breeding and Biotechnology, LMU Munich, Munich, Germany
| | | | - Barbara Kessler
- Center for Innovative Medical Models (CiMM), Institute for Molecular Animal Breeding and Biotechnology, LMU Munich, Munich, Germany
| | - Valeri Zakhartchenko
- Center for Innovative Medical Models (CiMM), Institute for Molecular Animal Breeding and Biotechnology, LMU Munich, Munich, Germany
| | - Mayuko Kurome
- Center for Innovative Medical Models (CiMM), Institute for Molecular Animal Breeding and Biotechnology, LMU Munich, Munich, Germany
| | - Bruno Reichart
- Transregional Collaborative Research Center 127, Walter Brendel Centre of Experimental Medicine, LMU Munich, Munich, Germany
| | - Christian Kupatt
- Klinikum Rechts der Isar, Innere Medizin I, TU Munich, Munich, Germany
| | - Nikolai Klymiuk
- Center for Innovative Medical Models (CiMM), Institute for Molecular Animal Breeding and Biotechnology, LMU Munich, Munich, Germany
| | - Eckhard Wolf
- Center for Innovative Medical Models (CiMM), Institute for Molecular Animal Breeding and Biotechnology, LMU Munich, Munich, Germany
| | | | - Andrea Bähr
- Center for Innovative Medical Models (CiMM), Institute for Molecular Animal Breeding and Biotechnology, LMU Munich, Munich, Germany.,Klinikum Rechts der Isar, Innere Medizin I, TU Munich, Munich, Germany
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Denner J. Reduction of the survival time of pig xenotransplants by porcine cytomegalovirus. Virol J 2018; 15:171. [PMID: 30409210 PMCID: PMC6225623 DOI: 10.1186/s12985-018-1088-2] [Citation(s) in RCA: 28] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/10/2018] [Accepted: 10/28/2018] [Indexed: 02/06/2023] Open
Abstract
Background Xenotransplantation using pig cells, tissues and organs may help to overcome the shortage of human tissues and organs for the treatment of tissue and organ failure. Progress in the prevention of immunological rejection using genetically modified pigs and new, more effective, immunosuppression regimens will allow clinical application of xenotransplantation in near future. However, xenotransplantation may be associated with the transmission of potentially zoonotic porcine microorganisms. Until now the only xenotransplantation-associated transmission was the transmission of the porcine cytomegalovirus (PCMV) into non-human primates. PCMV caused a significant reduction of the survival time of the pig transplant. Main body of the abstract Here the available publications were analysed in order to establish the mechanism how PCMV shortened the survival time of xenotransplants. PCMV is a herpesvirus related to the human cytomegalovirus and the human herpesviruses 6 and 7. These three human herpesviruses can cause serious disease among immunocompromised human individuals, including transplant recipients. It was shown that PCMV predominantly contributes to the reduction of transplant survival in non-human primates by disruption of the coagulation system and by suppression and exhaustion of the immune system. Conclusion Although it is still unknown whether PCMV infects primate cells including human cells, indirect mechanism of the virus infection may cause reduction of the xenotransplant survival in future clinical trials and therefore PCMV has to be eliminated from donor pigs.
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Affiliation(s)
- Joachim Denner
- Robert Koch Fellow, Robert Koch Institute, Nordufer 20, 13353, Berlin, Germany.
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