1
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Zemlin M, Hendriks RW, Schroeder HW. Editorial: Emerging talents in B cell biology: 2022. Front Immunol 2023; 14:1335263. [PMID: 38094293 PMCID: PMC10716695 DOI: 10.3389/fimmu.2023.1335263] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/08/2023] [Accepted: 11/20/2023] [Indexed: 12/18/2023] Open
Affiliation(s)
- Michael Zemlin
- Departmen for General Pediatrics and Neonatology, Saarland University Medical Center, Homburg, Saarland, Germany
| | - Rudi W Hendriks
- Department of Pulmonary Medicine, Erasmus Medical Care, University Medical Center, Rotterdam, Netherlands
| | - Harry W Schroeder
- Division of Clinical Immunology and Rheumatology, Department of Medicine, University of Alabama at Birmingham Heersink School of Medicine, Birmingham, AL, United States
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2
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Ji X, Wu L, Marion T, Luo Y. Lipid metabolism in regulation of B cell development and autoimmunity. Cytokine Growth Factor Rev 2023; 73:40-51. [PMID: 37419766 DOI: 10.1016/j.cytogfr.2023.06.008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/04/2023] [Accepted: 06/29/2023] [Indexed: 07/09/2023]
Abstract
B cells play an important role in adaptive immunity and participate in the process of humoral immunity mainly by secreting antibodies. The entire development and differentiation process of B cells occurs in multiple microenvironments and is regulated by a variety of environmental factors and immune signals. Differentiation biases or disfunction of B cells participate in the process of many autoimmune diseases. Emerging studies report the impact of altered metabolism in B cell biology, including lipid metabolism. Here, we discuss how extracellular lipid environment and metabolites, membrane lipid-related components, and lipid synthesis and catabolism programs coordinate B cell biology and describe the crosstalk of lipid metabolic programs with signal transduction pathways and transcription factors. We conclude with a summary of therapeutic targets for B cell lipid metabolism and signaling in autoimmune diseases and discuss important future directions.
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Affiliation(s)
- Xing Ji
- Laboratory of Rheumatology and Immunology, Institute of Immunology and Inflammation, Frontiers Science Center for Disease-related Molecular Network, West China Hospital, Sichuan University, Chengdu, Sichuan, China
| | - Liang Wu
- Laboratory of Rheumatology and Immunology, Institute of Immunology and Inflammation, Frontiers Science Center for Disease-related Molecular Network, West China Hospital, Sichuan University, Chengdu, Sichuan, China
| | - Tony Marion
- Department of Microbiology, Immunology, and Biochemistry, University of Tennessee Health Science Center, Memphis, TN, USA
| | - Yubin Luo
- Laboratory of Rheumatology and Immunology, Institute of Immunology and Inflammation, Frontiers Science Center for Disease-related Molecular Network, West China Hospital, Sichuan University, Chengdu, Sichuan, China.
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3
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Guinn MT, Szuter ES, Yokose T, Ge J, Rosales IA, Chetal K, Sadreyev RI, Cuenca AG, Kreisel D, Sage PT, Russell PS, Madsen JC, Colvin RB, Alessandrini A. Intragraft B cell differentiation during the development of tolerance to kidney allografts is associated with a regulatory B cell signature revealed by single cell transcriptomics. Am J Transplant 2023; 23:1319-1330. [PMID: 37295719 DOI: 10.1016/j.ajt.2023.05.036] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/06/2023] [Revised: 05/23/2023] [Accepted: 05/28/2023] [Indexed: 06/12/2023]
Abstract
Mouse kidney allografts are spontaneously accepted in select, fully mismatched donor-recipient strain combinations, like DBA/2J to C57BL/6 (B6), by natural tolerance. We previously showed accepted renal grafts form aggregates containing various immune cells within 2 weeks posttransplant, referred to as regulatory T cell-rich organized lymphoid structures, which are a novel regulatory tertiary lymphoid organ. To characterize the cells within T cell-rich organized lymphoid structures, we performed single-cell RNA sequencing on CD45+ sorted cells from accepted and rejected renal grafts from 1-week to 6-months posttransplant. Analysis of single-cell RNA sequencing data revealed a shifting from a T cell-dominant to a B cell-rich population by 6 months with an increased regulatory B cell signature. Furthermore, B cells were a greater proportion of the early infiltrating cells in accepted vs rejecting grafts. Flow cytometry of B cells at 20 weeks posttransplant revealed T cell, immunoglobulin domain and mucin domain-1+ B cells, potentially implicating a regulatory role in the maintenance of allograft tolerance. Lastly, B cell trajectory analysis revealed intragraft differentiation from precursor B cells to memory B cells in accepted allografts. In summary, we show a shifting T cell- to B cell-rich environment and a differential cellular pattern among accepted vs rejecting kidney allografts, possibly implicating B cells in the maintenance of kidney allograft acceptance.
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Affiliation(s)
- Michael Tyler Guinn
- Michael E. DeBakey Department of Surgery, Baylor College of Medicine, Houston, Texas, USA; Center for Transplantation Sciences, Department of Surgery, Massachusetts General Hospital, Boston, Massachusetts, USA
| | - Edward S Szuter
- Center for Transplantation Sciences, Department of Surgery, Massachusetts General Hospital, Boston, Massachusetts, USA
| | - Takahiro Yokose
- Center for Transplantation Sciences, Department of Surgery, Massachusetts General Hospital, Boston, Massachusetts, USA
| | - Jifu Ge
- Boston's Children Hospital, Harvard Medical School, Boston, Massachusetts, USA
| | - Ivy A Rosales
- Center for Transplantation Sciences, Department of Surgery, Massachusetts General Hospital, Boston, Massachusetts, USA; Department of Pathology, Massachusetts General Hospital, Boston, Massachusetts, USA
| | - Kashish Chetal
- Department of Molecular Biology, Massachusetts General Hospital, Boston, Massachusetts, USA
| | - Ruslan I Sadreyev
- Department of Pathology, Massachusetts General Hospital, Boston, Massachusetts, USA; Department of Molecular Biology, Massachusetts General Hospital, Boston, Massachusetts, USA
| | - Alex G Cuenca
- Boston's Children Hospital, Harvard Medical School, Boston, Massachusetts, USA
| | - Daniel Kreisel
- Departments of Surgery, Pathology, and Immunology, Washington University School of Medicine, St. Louis, Missouri, USA
| | - Peter T Sage
- Transplantation Research Center, Renal Division, Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts, USA
| | - Paul S Russell
- Center for Transplantation Sciences, Department of Surgery, Massachusetts General Hospital, Boston, Massachusetts, USA
| | - Joren C Madsen
- Center for Transplantation Sciences, Department of Surgery, Massachusetts General Hospital, Boston, Massachusetts, USA; Division of Cardiac Surgery, Massachusetts General Hospital, Boston, Massachusetts, USA
| | - Robert B Colvin
- Center for Transplantation Sciences, Department of Surgery, Massachusetts General Hospital, Boston, Massachusetts, USA; Department of Pathology, Massachusetts General Hospital, Boston, Massachusetts, USA
| | - Alessandro Alessandrini
- Center for Transplantation Sciences, Department of Surgery, Massachusetts General Hospital, Boston, Massachusetts, USA.
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4
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Yap J, Yuan J, Ng WH, Chen GB, Sim YRM, Goh KC, Teo J, Lim TYH, Goay SM, Teo JHJ, Lao Z, Lam P, Sabapathy K, Hu J. BRAF(V600E) mutation together with loss of Trp53 or pTEN drives the origination of hairy cell leukemia from B-lymphocytes. Mol Cancer 2023; 22:125. [PMID: 37543582 PMCID: PMC10403926 DOI: 10.1186/s12943-023-01817-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/14/2023] [Accepted: 07/04/2023] [Indexed: 08/07/2023] Open
Abstract
Hairy cell leukemia (HCL) is a B-lymphoma induced by BRAF(V600E) mutation. However, introducing BRAF(V600E) in B-lymphocytes fails to induce hematological malignancy, suggesting that BRAF(V600E) needs concurrent mutations to drive HCL ontogeny. To resolve this issue, here we surveyed human HCL genomic sequencing data. Together with previous reports, we speculated that the tumor suppressor TP53, P27, or PTEN restrict the oncogenicity of BRAF(V600E) in B-lymphocytes, and therefore that their loss-of-function facilitates BRAF(V600E)-driven HCL ontogeny. Using genetically modified mouse models, we demonstrate that indeed BRAF(V600E)KI together with Trp53KO or pTENKO in B-lymphocytes induces chronic lymphoma with pathological features of human HCL. To further understand the cellular programs essential for HCL ontogeny, we profiled the gene expression of leukemic cells isolated from BRAF(V600E)KI and Trp53KO or pTENKO mice, and found that they had similar but different gene expression signatures that resemble that of M2 or M1 macrophages. In addition, we examined the expression signature of transcription factors/regulators required for germinal center reaction and memory B cell versus plasma cell differentiation in these leukemic cells and found that most transcription factors/regulators essential for these programs were severely inhibited, illustrating why hairy cells are arrested at a transitional stage between activated B cells and memory B cells. Together, our study has uncovered concurrent mutations required for HCL ontogeny, revealed the B cell origin of hairy cells and investigated the molecular basis underlying the unique pathological features of the disease, with important implications for HCL research and treatment.
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Affiliation(s)
- Jiajun Yap
- Division of Cellular and Molecular Research, National Cancer Centre Singapore, 30 Hospital Boulevard, 168583, Singapore, Singapore
- Cancer and Stem Cell Program, Duke-NUS Medical School, 8 College Road, 169857, Singapore, Singapore
| | - Jimin Yuan
- Division of Cellular and Molecular Research, National Cancer Centre Singapore, 30 Hospital Boulevard, 168583, Singapore, Singapore
- Cancer and Stem Cell Program, Duke-NUS Medical School, 8 College Road, 169857, Singapore, Singapore
- Department of Urology, The Second Clinical Medical College, The First Affiliated Hospital, Shenzhen People's Hospital, Jinan University, Southern University of Science and Technology), Shenzhen, 518020, Guangdong, China
- Geriatric Department, The Second Clinical Medical College, The First Affiliated Hospital, Shenzhen People's Hospital, Jinan University, Southern University of Science and Technology), Shenzhen, 518020, Guangdong, China
| | - Wan Hwa Ng
- Division of Cellular and Molecular Research, National Cancer Centre Singapore, 30 Hospital Boulevard, 168583, Singapore, Singapore
| | - Gao Bin Chen
- Division of Cellular and Molecular Research, National Cancer Centre Singapore, 30 Hospital Boulevard, 168583, Singapore, Singapore
| | - Yuen Rong M Sim
- Division of Cellular and Molecular Research, National Cancer Centre Singapore, 30 Hospital Boulevard, 168583, Singapore, Singapore
| | - Kah Chun Goh
- Division of Cellular and Molecular Research, National Cancer Centre Singapore, 30 Hospital Boulevard, 168583, Singapore, Singapore
| | - Joey Teo
- Division of Cellular and Molecular Research, National Cancer Centre Singapore, 30 Hospital Boulevard, 168583, Singapore, Singapore
| | - Trixie Y H Lim
- Division of Cellular and Molecular Research, National Cancer Centre Singapore, 30 Hospital Boulevard, 168583, Singapore, Singapore
| | - Shee Min Goay
- Division of Cellular and Molecular Research, National Cancer Centre Singapore, 30 Hospital Boulevard, 168583, Singapore, Singapore
| | - Jia Hao Jackie Teo
- Division of Cellular and Molecular Research, National Cancer Centre Singapore, 30 Hospital Boulevard, 168583, Singapore, Singapore
| | - Zhentang Lao
- Department of Hematology, Singapore General Hospital, Blk7 Outram Road, 169608, Singapore, Singapore
| | - Paula Lam
- Cancer and Stem Cell Program, Duke-NUS Medical School, 8 College Road, 169857, Singapore, Singapore
- Department of Physiology, National University of Singapore, 2 Medical Drive, 117597, Singapore, Singapore
- Cellvec Pte. Ltd, 100 Pasir Panjang Road, 118518, Singapore, Singapore
| | - Kanaga Sabapathy
- Division of Cellular and Molecular Research, National Cancer Centre Singapore, 30 Hospital Boulevard, 168583, Singapore, Singapore
- Cancer and Stem Cell Program, Duke-NUS Medical School, 8 College Road, 169857, Singapore, Singapore
| | - Jiancheng Hu
- Division of Cellular and Molecular Research, National Cancer Centre Singapore, 30 Hospital Boulevard, 168583, Singapore, Singapore.
- Cancer and Stem Cell Program, Duke-NUS Medical School, 8 College Road, 169857, Singapore, Singapore.
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5
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Hill JA, Kiem ES, Bhatti A, Liu W, Keane-Candib J, Fitzpatrick KS, Boonyaratanakornkit J, Gardner RA, Green DJ, Maloney DG, Turtle CJ, Smith JM, Gimferrer I, Blosser CD, Jackson SW. Anti-HLA antibodies in recipients of CD19 versus BCMA-targeted CAR T-cell therapy. Am J Transplant 2023; 23:416-422. [PMID: 36748802 PMCID: PMC10266802 DOI: 10.1016/j.ajt.2022.11.001] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/14/2022] [Revised: 10/05/2022] [Accepted: 11/06/2022] [Indexed: 01/15/2023]
Abstract
Antibodies against foreign human leukocyte antigen (HLA) molecules are barriers to successful organ transplantation. B cell-depleting treatments are used to reduce anti-HLA antibodies but have limited efficacy. We hypothesized that the primary source for anti-HLA antibodies is long-lived plasma cells, which are ineffectively targeted by B cell depletion. To study this, we screened for anti-HLA antibodies in a prospectively enrolled cohort of 49 patients who received chimeric antigen receptor T-cell therapy (CARTx), targeting naïve and memory B cells (CD19-targeted, n = 21) or plasma cells (BCMA-targeted, n = 28) for hematologic malignancies. Longitudinal samples were collected before and up to 1 year after CARTx. All individuals were in sustained remission. We identified 4 participants with anti-HLA antibodies before CD19-CARTx. Despite B cell depletion, anti-HLA antibodies and calculated panel reactive antibody scores were stable for 1 year after CD19-CARTx. Only 1 BCMA-CARTx recipient had pre-CARTx low-level anti-HLA antibodies, with no follow-up samples available. These data implicate CD19neg long-lived plasma cells as an important source for anti-HLA antibodies, a model supported by infrequent HLA sensitization in BCMA-CARTx subjects receiving previous plasma cell-targeted therapies. Thus, plasma cell-targeted therapies may be more effective against HLA antibodies, thereby enabling improved access to organ transplantation and rejection management.
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Affiliation(s)
- Joshua A Hill
- Departments of Medicine, University of Washington School of Medicine, Seattle, Washington, USA; Vaccine and Infectious Disease Division, Fred Hutchinson Cancer Center, Seattle, Washington, USA; Clinical Research Division, Fred Hutchinson Cancer Center, Seattle, Washington, USA.
| | - Erika S Kiem
- Vaccine and Infectious Disease Division, Fred Hutchinson Cancer Center, Seattle, Washington, USA
| | - Atif Bhatti
- Vaccine and Infectious Disease Division, Fred Hutchinson Cancer Center, Seattle, Washington, USA
| | - Winnie Liu
- Vaccine and Infectious Disease Division, Fred Hutchinson Cancer Center, Seattle, Washington, USA
| | - Jacob Keane-Candib
- Vaccine and Infectious Disease Division, Fred Hutchinson Cancer Center, Seattle, Washington, USA
| | - Kristin S Fitzpatrick
- Vaccine and Infectious Disease Division, Fred Hutchinson Cancer Center, Seattle, Washington, USA; Laboratory Medicine and Pathology, University of Washington School of Medicine, Seattle, Washington, USA
| | - Jim Boonyaratanakornkit
- Departments of Medicine, University of Washington School of Medicine, Seattle, Washington, USA; Vaccine and Infectious Disease Division, Fred Hutchinson Cancer Center, Seattle, Washington, USA
| | - Rebecca A Gardner
- Seattle Children's Research Institute, Seattle, Washington, USA; Pediatrics, University of Washington School of Medicine, Seattle, Washington, USA
| | - Damian J Green
- Departments of Medicine, University of Washington School of Medicine, Seattle, Washington, USA; Clinical Research Division, Fred Hutchinson Cancer Center, Seattle, Washington, USA
| | - David G Maloney
- Departments of Medicine, University of Washington School of Medicine, Seattle, Washington, USA; Clinical Research Division, Fred Hutchinson Cancer Center, Seattle, Washington, USA
| | - Cameron J Turtle
- Departments of Medicine, University of Washington School of Medicine, Seattle, Washington, USA; Clinical Research Division, Fred Hutchinson Cancer Center, Seattle, Washington, USA
| | - Jodi M Smith
- Seattle Children's Research Institute, Seattle, Washington, USA; Pediatrics, University of Washington School of Medicine, Seattle, Washington, USA
| | - Idoia Gimferrer
- Immunogenetics/HLA laboratory Bloodworks Northwest, Seattle, Washington, USA
| | - Christopher D Blosser
- Departments of Medicine, University of Washington School of Medicine, Seattle, Washington, USA; Pediatrics, University of Washington School of Medicine, Seattle, Washington, USA
| | - Shaun W Jackson
- Laboratory Medicine and Pathology, University of Washington School of Medicine, Seattle, Washington, USA; Seattle Children's Research Institute, Seattle, Washington, USA; Pediatrics, University of Washington School of Medicine, Seattle, Washington, USA.
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6
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Nickerson PW. Rationale for the IMAGINE study for chronic active antibody-mediated rejection (caAMR) in kidney transplantation. Am J Transplant 2022; 22 Suppl 4:38-44. [PMID: 36453707 DOI: 10.1111/ajt.17210] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/09/2022] [Accepted: 10/19/2022] [Indexed: 12/02/2022]
Abstract
Chronic active antibody-mediated rejection (caAMR) in kidney transplantation is a major cause of late graft loss and despite all efforts to date, there is no proven effective therapy. Indeed, the Transplant Society (TTS) consensus opinion called for a conservative approach optimizing baseline immunosuppression and supportive care focused on blood pressure, blood glucose, and lipid control. This review provides the rationale and early evidence in kidney transplant recipients with caAMR that supported the design of the IMAGINE study whose goal is to evaluate the potential impact of targeting the IL6/IL6R pathway.
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Affiliation(s)
- Peter W Nickerson
- Department of Internal Medicine, Max Rady College of Medicine, University of Manitoba, Winnipeg, Canada.,Department of Immunology, Max Rady College of Medicine, University of Manitoba, Winnipeg, Canada
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7
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Hasgur S, Yamamoto Y, Fan R, Nicosia M, Gorbacheva V, Zwick D, Araki M, Fairchild RL, Valujskikh A. Macrophage-inducible C-type lectin activates B cells to promote T cell reconstitution in heart allograft recipients. Am J Transplant 2022; 22:1779-1790. [PMID: 35294793 PMCID: PMC9296143 DOI: 10.1111/ajt.17033] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/11/2021] [Revised: 02/21/2022] [Accepted: 03/12/2022] [Indexed: 01/25/2023]
Abstract
Diminishing homeostatic proliferation of memory T cells is essential for improving the efficacy of lymphoablation in transplant recipients. Our previous studies in a mouse heart transplantation model established that B lymphocytes secreting proinflammatory cytokines are critical for T cell recovery after lymphoablation. The goal of the current study was to identify mediators of B cell activation following lymphoablation in allograft recipients. Transcriptome analysis revealed that macrophage-inducible C-type lectin (Mincle, Clec4e) expression is up-regulated in B cells from heart allograft recipients treated with murine anti-thymocyte globulin (mATG). Recipient Mincle deficiency diminishes B cell production of pro-inflammatory cytokines and impairs T lymphocyte reconstitution. Mixed bone marrow chimeras lacking Mincle only in B lymphocytes have similar defects in T cell recovery. Conversely, treatment with a synthetic Mincle ligand enhances T cell reconstitution after lymphoablation in non-transplanted mice. Treatment with agonistic CD40 mAb facilitates T cell reconstitution in CD4 T cell-depleted, but not in Mincle-deficient, recipients indicating that CD40 signaling induces T cell proliferation via a Mincle-dependent pathway. These findings are the first to identify an important function of B cell Mincle as a sensor of damage-associated molecular patterns released by the graft and demonstrate its role in clinically relevant settings of organ transplantation.
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Affiliation(s)
- Suheyla Hasgur
- Department of Inflammation and ImmunityLerner Research InstituteCleveland ClinicClevelandOhioUSA
| | - Yosuke Yamamoto
- Department of Inflammation and ImmunityLerner Research InstituteCleveland ClinicClevelandOhioUSA
| | - Ran Fan
- Department of Inflammation and ImmunityLerner Research InstituteCleveland ClinicClevelandOhioUSA
| | - Michael Nicosia
- Department of Inflammation and ImmunityLerner Research InstituteCleveland ClinicClevelandOhioUSA
| | - Victoria Gorbacheva
- Department of Inflammation and ImmunityLerner Research InstituteCleveland ClinicClevelandOhioUSA
| | - Daniel Zwick
- Department of Inflammation and ImmunityLerner Research InstituteCleveland ClinicClevelandOhioUSA,Present address:
AutonomousTherapeutics, IncRockvilleMarylandUSA
| | - Motoo Araki
- Department of UrologyOkayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesOkayamaJapan
| | - Robert L. Fairchild
- Department of Inflammation and ImmunityLerner Research InstituteCleveland ClinicClevelandOhioUSA
| | - Anna Valujskikh
- Department of Inflammation and ImmunityLerner Research InstituteCleveland ClinicClevelandOhioUSA
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8
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Somers V, Dunn-Walters DK, van der Burg M, Fraussen J. Editorial: New Insights Into B Cell Subsets in Health and Disease. Front Immunol 2022; 13:854889. [PMID: 35178054 PMCID: PMC8843931 DOI: 10.3389/fimmu.2022.854889] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/14/2022] [Accepted: 01/17/2022] [Indexed: 11/20/2022] Open
Affiliation(s)
- Veerle Somers
- University MS Center (UMSC), Hasselt-Pelt, Belgium.,Department of Immunology and Infection, Biomedical Research Institute, Hasselt University, Hasselt, Belgium
| | | | - Mirjam van der Burg
- Laboratory for Pediatric Immunology, Department of Pediatrics, Willem-Alexander Children's Hospital, Leiden University Medical Center, Leiden, Netherlands
| | - Judith Fraussen
- University MS Center (UMSC), Hasselt-Pelt, Belgium.,Department of Immunology and Infection, Biomedical Research Institute, Hasselt University, Hasselt, Belgium
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9
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Fu Q, Lee KM, Huai G, Deng K, Agarwal D, Rickert CG, Feeney N, Matheson R, Yang H, LeGuern C, Deng S, Markmann JF. Properties of regulatory B cells regulating B cell targets. Am J Transplant 2021; 21:3847-3857. [PMID: 34327838 PMCID: PMC8639638 DOI: 10.1111/ajt.16772] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/05/2021] [Revised: 07/09/2021] [Accepted: 07/21/2021] [Indexed: 01/25/2023]
Abstract
Regulatory B cells (Bregs) have shown promise as anti-rejection therapy applied to organ transplantation. However, less is known about their effect on other B cell populations that are involved in chronic graft rejection. We recently uncovered that naïve B cells, stimulated by TLR ligand agonists, converted into B cells with regulatory properties (Bregs-TLR) that prevented allograft rejection. Here, we examine the granular phenotype and regulatory properties of Breg-TLR cells suppressing B cells. Cocultures of Bregs-TLR with LPS-activated B cells showed a dose-dependent suppression of targeted B cell proliferation. Adoptive transfers of Bregs-TLR induced a decline in antibody responses to antigenically disparate skin grafts. The role of Breg BCR specificity in regulation was assessed using B cell-deficient mice replenished with transgenic BCR (OB1) and TCR (OT-II) lymphocytes of matching antigenic specificity. Results indicated that proliferation of OB1 B cells, mediated through help from CD4+ OT-II cells, was suppressed by OB1 Bregs of similar specificity. Transcriptomic analyses indicated that Bregs-TLR suppression is associated with a block in targeted B cell differentiation controlled by PRDM1 (Blimp1). This work uncovered the regulatory properties of a new brand of Breg cells and provided mechanistic insights into potential applications of Breg therapy in transplantation.
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Affiliation(s)
- Qiang Fu
- Organ Transplantation Center, Sichuan Provincial People’s Hospital and School of Medicine, University of Electronic Science and Technology of China, Chengdu, China,Center for Transplantation Sciences, Massachusetts General Hospital, Boston, MA, USA
| | - Kang Mi Lee
- Center for Transplantation Sciences, Massachusetts General Hospital, Boston, MA, USA
| | - Guoli Huai
- Organ Transplantation Center, Sichuan Provincial People’s Hospital and School of Medicine, University of Electronic Science and Technology of China, Chengdu, China,Center for Transplantation Sciences, Massachusetts General Hospital, Boston, MA, USA
| | - Kevin Deng
- Center for Transplantation Sciences, Massachusetts General Hospital, Boston, MA, USA
| | - Divyansh Agarwal
- Division of Transplantation, Department of Surgery, Hospital of the University of Pennsylvania, Philadelphia, PA, USA
| | - Charles G. Rickert
- Center for Transplantation Sciences, Massachusetts General Hospital, Boston, MA, USA
| | - Noel Feeney
- Center for Transplantation Sciences, Massachusetts General Hospital, Boston, MA, USA
| | - Rudy Matheson
- Center for Transplantation Sciences, Massachusetts General Hospital, Boston, MA, USA
| | - Hongji Yang
- Organ Transplantation Center, Sichuan Provincial People’s Hospital and School of Medicine, University of Electronic Science and Technology of China, Chengdu, China
| | - Christian LeGuern
- Center for Transplantation Sciences, Massachusetts General Hospital, Boston, MA, USA
| | - Shaoping Deng
- Organ Transplantation Center, Sichuan Provincial People’s Hospital and School of Medicine, University of Electronic Science and Technology of China, Chengdu, China,Corresponding author: James F. Markmann , Shaoping Deng
| | - James F. Markmann
- Center for Transplantation Sciences, Massachusetts General Hospital, Boston, MA, USA,Corresponding author: James F. Markmann , Shaoping Deng
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10
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Pacaud M, Colas L, Brouard S. Microbiota and immunoregulation: A focus on regulatory B lymphocytes and transplantation. Am J Transplant 2021; 21:2341-2347. [PMID: 33559282 DOI: 10.1111/ajt.16522] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/27/2020] [Revised: 12/29/2020] [Indexed: 01/25/2023]
Abstract
The microbiota plays a major role in the regulation of the host immune functions thus establishing a symbiotic relationship that maintains immune homeostasis. Among immune cells, regulatory B cells (Bregs), which can inhibit effector T cell responses, may be involved in the intestinal homeostasis. Recent works suggest that the interaction between the microbiota and Bregs appears to be important to limit autoimmune diseases and help to maintain tolerance in transplantation. Short-chain fatty acids (SCFAs), recognized as major metabolites of the microbiota, seem to be involved in the generation of a pro-tolerogenic environment in the gut, particularly through the regulation of B cell differentiation, limiting mature B cells and promoting the function of Bregs. In this review, we show that this B cells-microbiota interaction may open a path toward new potential therapeutic applications not only for patients with autoimmune diseases but also in transplantation.
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Affiliation(s)
- Margaux Pacaud
- Centre De Recherche En Transplantation Et Immunologie, UMR1064, INSERM, Université De Nantes, Nantes, France
| | - Luc Colas
- Centre De Recherche En Transplantation Et Immunologie, UMR1064, INSERM, Université De Nantes, Nantes, France.,Plateforme Transversale d'Allergologie et d'Immunologie Clinique, Institut du Thorax, CHU de Nantes, Nantes, France
| | - Sophie Brouard
- Centre De Recherche En Transplantation Et Immunologie, UMR1064, INSERM, Université De Nantes, Nantes, France.,Institut De Transplantation Urologie Néphrologie (ITUN, CHU Nantes, Nantes, France.,Laboratoire d'Immunologie, CHU Nantes, Nantes, France
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11
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Matsuda Y, Watanabe T, Li XK. Approaches for Controlling Antibody-Mediated Allograft Rejection Through Targeting B Cells. Front Immunol 2021; 12:682334. [PMID: 34276669 PMCID: PMC8282180 DOI: 10.3389/fimmu.2021.682334] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/18/2021] [Accepted: 06/17/2021] [Indexed: 01/14/2023] Open
Abstract
Both acute and chronic antibody-mediated allograft rejection (AMR), which are directly mediated by B cells, remain difficult to treat. Long-lived plasma cells (LLPCs) in bone marrow (BM) play a crucial role in the production of the antibodies that induce AMR. However, LLPCs survive through a T cell-independent mechanism and resist conventional immunosuppressive therapy. Desensitization therapy is therefore performed, although it is accompanied by severe side effects and the pathological condition may be at an irreversible stage when these antibodies, which induce AMR development, are detected in the serum. In other words, AMR control requires the development of a diagnostic method that predicts its onset before LLPC differentiation and enables therapeutic intervention and the establishment of humoral immune monitoring methods providing more detailed information, including individual differences in the susceptibility to immunosuppressive agents and the pathological conditions. In this study, we reviewed recent studies related to the direct or indirect involvement of immunocompetent cells in the differentiation of naïve-B cells into LLPCs, the limitations of conventional methods, and the possible development of novel control methods in the context of AMR. This information will significantly contribute to the development of clinical applications for AMR and improve the prognosis of patients who undergo organ transplantation.
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Affiliation(s)
- Yoshiko Matsuda
- Division of Transplantation Immunology, National Research Institute for Child Health and Development, Tokyo, Japan
| | - Takeshi Watanabe
- Laboratory of Immunology, Institute for Frontier Life and Medical Sciences, Kyoto University, Kyoto, Japan
| | - Xiao-Kang Li
- Division of Transplantation Immunology, National Research Institute for Child Health and Development, Tokyo, Japan
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12
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Yang X, Wang M, Wu J, Shi D, Zhang Y, Zeng H, Zhu Y, Lan C, Deng Y, Guo S, Xu L, Ma C, Zhang Y, Ou J, Liu CJ, Chen Y, Wang Q, Xie W, Guan J, Ding J, Wang Z, Chang C, Yang W, Zhang H, Chen J, Qin L, Zhou H, Bei JX, Wei L, Cao G, Yu X, Zhang Z. Large-scale analysis of 2,152 Ig-seq datasets reveals key features of B cell biology and the antibody repertoire. Cell Rep 2021; 35:109110. [PMID: 33979623 DOI: 10.1016/j.celrep.2021.109110] [Citation(s) in RCA: 14] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/27/2020] [Revised: 03/09/2021] [Accepted: 04/20/2021] [Indexed: 12/20/2022] Open
Abstract
Antibody repertoire sequencing enables researchers to acquire millions of B cell receptors and investigate these molecules at the single-nucleotide level. This power and resolution in studying humoral responses have led to its wide applications. However, most of these studies were conducted with a limited number of samples. Given the extraordinary diversity, assessment of these key features with a large sample set is demanded. Thus, we collect and systematically analyze 2,152 high-quality heavy-chain antibody repertoires. Our study reveals that 52 core variable genes universally contribute to more than 99% of each individual's repertoire; a distal interspersed preferences characterize V gene recombination; the number of public clones between two repertoires follows a linear model, and the positive selection dominates at RGYW motif in somatic hypermutations. Thus, this population-level analysis resolves some critical features of the antibody repertoire and may have significant value to the large cadre of scientists.
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13
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Mohammed MT, Cai S, Hanson BL, Zhang H, Clement RL, Daccache J, Cavazzoni CB, Blazar BR, Alessandrini A, Rennke HG, Chandraker A, Sage PT. Follicular T cells mediate donor-specific antibody and rejection after solid organ transplantation. Am J Transplant 2021; 21:1893-1901. [PMID: 33421294 PMCID: PMC8096660 DOI: 10.1111/ajt.16484] [Citation(s) in RCA: 25] [Impact Index Per Article: 8.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/27/2020] [Revised: 12/09/2020] [Accepted: 01/01/2021] [Indexed: 01/25/2023]
Abstract
Following solid organ transplantation, a substantial proportion of chronic allograft loss is attributed to the formation of donor-specific antibodies (DSAs) and antibody-mediated rejection (AbMR). The frequency and phenotype of T follicular helper (Tfh) and T follicular regulatory (Tfr) cells is altered in the setting of kidney transplantation, particularly in patients who develop AbMR. However, the roles of Tfh and Tfr cells in AbMR after solid organ transplantation is unclear. We developed mouse models to inducibly and potently perturb Tfh and Tfr cells to assess the roles of these cells in the development of DSA and AbMR. We found that Tfh cells are required for both de novo DSA responses as well as augmentation of DSA following presensitization. Using orthotopic allogeneic kidney transplantation models, we found that deletion of Tfh cells at the time of transplantation resulted in less severe transplant rejection. Furthermore, using inducible Tfr cell deletion strategies we found that Tfr cells inhibit de novo DSA formation but only have a minor role in controlling kidney transplant rejection. These studies demonstrate that Tfh cells promote, whereas Tfr cells inhibit, DSA to control rejection after kidney transplantation. Therefore, targeting these cells represent a new therapeutic strategy to prevent and treat AbMR.
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Affiliation(s)
- Mostafa T. Mohammed
- Clinical Pathology Department, Faculty of Medicine, Minia University, Minia, Egypt,Transplantation Research Center, Renal Division, Brigham and Women’s Hospital, Harvard Medical School, Boston, MA, 02115
| | - Songjie Cai
- Transplantation Research Center, Renal Division, Brigham and Women’s Hospital, Harvard Medical School, Boston, MA, 02115
| | - Benjamin L. Hanson
- Transplantation Research Center, Renal Division, Brigham and Women’s Hospital, Harvard Medical School, Boston, MA, 02115
| | - Hengcheng Zhang
- Transplantation Research Center, Renal Division, Brigham and Women’s Hospital, Harvard Medical School, Boston, MA, 02115
| | - Rachel L. Clement
- Transplantation Research Center, Renal Division, Brigham and Women’s Hospital, Harvard Medical School, Boston, MA, 02115
| | - Joe Daccache
- Transplantation Research Center, Renal Division, Brigham and Women’s Hospital, Harvard Medical School, Boston, MA, 02115
| | - Cecilia B. Cavazzoni
- Transplantation Research Center, Renal Division, Brigham and Women’s Hospital, Harvard Medical School, Boston, MA, 02115
| | - Bruce R. Blazar
- Department of Pediatrics, Division of Blood and Marrow Transplantation, University of Minnesota, Minneapolis, MN, 55455
| | - Alessandro Alessandrini
- Center for Transplantation Sciences, Department of Surgery, Massachusetts General Hospital and Harvard Medical School, Boston, MA, 02114
| | - Helmut G. Rennke
- Department of Pathology, Brigham and Women’s Hospital, Harvard Medical School, Boston, MA, 02115
| | - Anil Chandraker
- Transplantation Research Center, Renal Division, Brigham and Women’s Hospital, Harvard Medical School, Boston, MA, 02115
| | - Peter T. Sage
- Transplantation Research Center, Renal Division, Brigham and Women’s Hospital, Harvard Medical School, Boston, MA, 02115
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14
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Becker PD, Ratnasothy K, Sen M, Peng Q, Romano M, Bazoer J, Suvitra E, Stout A, Hylton SG, Dorling A, Lechler RI, Smyth LA, Lombardi G. B lymphocytes contribute to indirect pathway T cell sensitization via acquisition of extracellular vesicles. Am J Transplant 2021; 21:1415-1426. [PMID: 32483894 DOI: 10.1111/ajt.16088] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/06/2019] [Revised: 05/15/2020] [Accepted: 05/21/2020] [Indexed: 01/25/2023]
Abstract
B cells have been implicated in transplant rejection via antibody-mediated mechanisms and more recently by presenting donor antigens to T cells. We have shown in patients with chronic antibody-mediated rejection that B cells control the indirect T cell alloresponses. To understand more about the role of B cells as antigen-presenting cells for CD4+ T cell with indirect allospecificity, B cells were depleted in C57BL/6 mice, using an anti-CD20 antibody, prior to receiving MHC class I-mismatched (Kd ) skin. The absence of B cells at the time of transplantation prolonged skin graft survival. To study the mechanisms behind this observation, T cells with indirect allospecificity were transferred in mice receiving a Kd skin transplant. T cell proliferation was markedly inhibited in the absence of recipient B cells, suggesting that B cells contribute to indirect pathway sensitization. Furthermore, we have shown that a possible way in which B cells present alloantigens is via acquisition of MHC-peptide complexes. Finally, we demonstrate that the addition of B cell depletion to the transfer of regulatory T cells (Tregs) with indirect alloresponse further prolonged skin graft survival. This study supports an important role for B cells in indirect T cell priming and further emphasizes the advantage of combination therapies in prolonging transplant survival.
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Affiliation(s)
- Pablo D Becker
- MRC Centre for Transplantation, Peter Gorer Department of Immunobiology, School of Immunology & Microbial Sciences, King's College London, London, SE1 9RT, UK
| | - Kulachelvy Ratnasothy
- MRC Centre for Transplantation, Peter Gorer Department of Immunobiology, School of Immunology & Microbial Sciences, King's College London, London, SE1 9RT, UK
| | - Monica Sen
- MRC Centre for Transplantation, Peter Gorer Department of Immunobiology, School of Immunology & Microbial Sciences, King's College London, London, SE1 9RT, UK.,School of Health, Sports and Biosciences, University of East London, London, UK
| | - Qi Peng
- MRC Centre for Transplantation, Peter Gorer Department of Immunobiology, School of Immunology & Microbial Sciences, King's College London, London, SE1 9RT, UK
| | - Marco Romano
- MRC Centre for Transplantation, Peter Gorer Department of Immunobiology, School of Immunology & Microbial Sciences, King's College London, London, SE1 9RT, UK
| | - Jordan Bazoer
- School of Health, Sports and Biosciences, University of East London, London, UK
| | - Erik Suvitra
- School of Health, Sports and Biosciences, University of East London, London, UK
| | - Anas Stout
- School of Health, Sports and Biosciences, University of East London, London, UK
| | - Shannon G Hylton
- School of Health, Sports and Biosciences, University of East London, London, UK
| | - Anthony Dorling
- MRC Centre for Transplantation, Department of Inflammation Biology, Faculty of Life Sciences & Medicine, King's College London, London, UK
| | - Robert I Lechler
- MRC Centre for Transplantation, Peter Gorer Department of Immunobiology, School of Immunology & Microbial Sciences, King's College London, London, SE1 9RT, UK
| | - Lesley A Smyth
- MRC Centre for Transplantation, Peter Gorer Department of Immunobiology, School of Immunology & Microbial Sciences, King's College London, London, SE1 9RT, UK.,School of Health, Sports and Biosciences, University of East London, London, UK
| | - Giovanna Lombardi
- MRC Centre for Transplantation, Peter Gorer Department of Immunobiology, School of Immunology & Microbial Sciences, King's College London, London, SE1 9RT, UK
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15
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Braun WE, Herlitz L, Li J, Schold J, Poggio E, Stephany B, Fatica R, Nally J, Brown K, Fairchild R, Baldwin W, Goldfarb D, Kiser W, Augustine J, Avery R, Tomford JW, Nakamoto S. Continuous function of 80 primary renal allografts for 30-47 years with maintenance prednisone and azathioprine/mycophenolate mofetil therapy: A clinical mosaic of long-term successes. Clin Transplant 2020; 35:e14131. [PMID: 33112428 DOI: 10.1111/ctr.14131] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/29/2020] [Revised: 10/09/2020] [Accepted: 10/14/2020] [Indexed: 11/30/2022]
Abstract
Eighty primary renal allograft recipients, 61 living-related and 19 deceased donor, transplanted from 1963 through 1984 had continuous graft function for 30-47 years. They were treated with three different early immunosuppression programs (1963-1970: thymectomy, splenectomy, high oral prednisone; 1971-1979: divided-dose intravenous methylprednisolone; and 1980-1984: antilymphocyte globulin) each with maintenance prednisone and azathioprine, and no calcineurin inhibitor. Long-term treatment often included the anti-platelet medication, dipyridamole. Although both recipient and donor ages were young (27.2 ± 9.5 and 33.1 ± 12.0 years, respectively), six recipients with a parent donor had >40-year success. At 35 years, death-censored graft survival was 85.3% and death with a functioning graft 84.2%; overall graft survival was 69.5% (Kaplan-Meier estimate). Biopsy-documented early acute cellular and highly probable antibody-mediated rejections were reversed with divided-dose intravenous methylprednisolone. Complications are detailed in an integrated timeline. Hypogammaglobulinemia identified after 20 years doubled the infection rate. An association between a monoclonal gammopathy of undetermined significance and non-plasma-cell malignancies was identified. Twenty-seven azathioprine-treated patients tested after 37 years had extremely low levels of T1/T2 B lymphocytes representing a "low immunosuppression state of allograft acceptance (LISAA)". The lifetime achievements of these patients following a single renal allograft and low-dose maintenance immunosuppression are remarkable. Their success evolved as a clinical mosaic.
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Affiliation(s)
- William E Braun
- Department of Nephrology & Hypertension, Cleveland Clinic, Cleveland, OH, USA
| | - Leal Herlitz
- Department of Pathology, Cleveland Clinic, Cleveland, OH, USA
| | - Jianbo Li
- Department of Quantitative Health Sciences, Cleveland Clinic, Cleveland, OH, USA
| | - Jesse Schold
- Department of Quantitative Health Sciences, Cleveland Clinic, Cleveland, OH, USA
| | - Emilio Poggio
- Department of Nephrology & Hypertension, Cleveland Clinic, Cleveland, OH, USA
| | - Brian Stephany
- Department of Nephrology & Hypertension, Cleveland Clinic, Cleveland, OH, USA
| | - Richard Fatica
- Department of Nephrology & Hypertension, Cleveland Clinic, Cleveland, OH, USA
| | - Joseph Nally
- Department of Nephrology & Hypertension, Cleveland Clinic, Cleveland, OH, USA
| | - Kathleen Brown
- Department of Inflammation and Immunity, Cleveland Clinic, Cleveland, OH, USA
| | - Robert Fairchild
- Department of Inflammation and Immunity, Cleveland Clinic, Cleveland, OH, USA
| | - William Baldwin
- Department of Inflammation and Immunity, Cleveland Clinic, Cleveland, OH, USA
| | - David Goldfarb
- Department of Urology, Cleveland Clinic, Cleveland, OH, USA
| | - William Kiser
- Department of Urology, Cleveland Clinic, Cleveland, OH, USA
| | - Joshua Augustine
- Department of Nephrology & Hypertension, Cleveland Clinic, Cleveland, OH, USA
| | - Robin Avery
- Division of Infectious Disease (Transplant/Oncology), Johns Hopkins, Baltimore, MD, USA
| | - J Walton Tomford
- Department of Infectious Disease, Cleveland Clinic, Cleveland, OH, USA
| | - Satoru Nakamoto
- Department of Nephrology & Hypertension, Cleveland Clinic, Cleveland, OH, USA
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16
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Hasgur S, Fan R, Zwick DB, Fairchild RL, Valujskikh A. B cell-derived IL-1β and IL-6 drive T cell reconstitution following lymphoablation. Am J Transplant 2020; 20:2740-2754. [PMID: 32342598 PMCID: PMC7956246 DOI: 10.1111/ajt.15960] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/10/2020] [Revised: 03/26/2020] [Accepted: 04/15/2020] [Indexed: 01/25/2023]
Abstract
Understanding the mechanisms of T cell homeostatic expansion is crucial for clinical applications of lymphoablative therapies. We previously established that T cell recovery in mouse heart allograft recipients treated with anti-thymocyte globulin (mATG) critically depends on B cells and is mediated by B cell-derived soluble factors. B cell production of interleukin (IL)-1β and IL-6 is markedly upregulated after heart allotransplantation and lymphoablation. Neutralizing IL-1β or IL-6 with mAb or the use of recipients lacking mature IL-1β, IL-6, IL-1R, MyD88, or IL-6R impair CD4+ and CD8+ T cell recovery and significantly enhance the graft-prolonging efficacy of lymphoablation. Adoptive co-transfer experiments demonstrate a direct effect of IL-6 but not IL-1β on T lymphocytes. Furthermore, B cells incapable of IL-1β or IL-6 production have diminished capacity to mediate T cell reconstitution and initiate heart allograft rejection upon adoptive transfer into mATG treated B cell deficient recipients. These findings reveal the essential role of B cell-derived IL-1β and IL-6 during homeostatic T cell expansion in a clinically relevant model of lymphoablation.
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Affiliation(s)
- Suheyla Hasgur
- Department of Inflammation and Immunity, Lerner Research Institute, Cleveland Clinic, Cleveland, Ohio 44195, USA
| | - Ran Fan
- Department of Inflammation and Immunity, Lerner Research Institute, Cleveland Clinic, Cleveland, Ohio 44195, USA
| | - Daniel B. Zwick
- Department of Inflammation and Immunity, Lerner Research Institute, Cleveland Clinic, Cleveland, Ohio 44195, USA
| | - Robert L. Fairchild
- Department of Inflammation and Immunity, Lerner Research Institute, Cleveland Clinic, Cleveland, Ohio 44195, USA
| | - Anna Valujskikh
- Department of Inflammation and Immunity, Lerner Research Institute, Cleveland Clinic, Cleveland, Ohio 44195, USA
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17
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Jain D, Rajab A, Young JS, Yin D, Nadasdy T, Chong AS, Pelletier RP. Reversing donor-specific antibody responses and antibody-mediated rejection with bortezomib and belatacept in mice and kidney transplant recipients. Am J Transplant 2020; 20:2675-2685. [PMID: 32243663 PMCID: PMC8232017 DOI: 10.1111/ajt.15881] [Citation(s) in RCA: 23] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/16/2019] [Revised: 03/16/2020] [Accepted: 03/20/2020] [Indexed: 01/25/2023]
Abstract
Active antibody-mediated rejection (AMR) is a potentially devastating complication and consistently effective treatment remains elusive. We hypothesized that the reversal of acute AMR requires rapid elimination of antibody-secreting plasma cells (PC) with a proteasome inhibitor, bortezomib, followed by the sustained inhibition of PC generation with CTLA4-Ig or belatacept (B/B). We show in mice that B/B therapy selectively depleted mature PC producing donor-specific antibodies (DSA) and reduced DSA, when administered after primary and secondary DSA responses had been established. A pilot investigation was initiated to treat six consecutive patients with active AMR with B/B. Compassionate use of this regimen was initiated for the first patient who developed early, severe acute AMR that did not respond to steroids, plasmapheresis, and intravenous immunoglobulin after his third kidney transplant. B/B treatment resulted in a rapid reversal of AMR, leading us to treat five additional patients who also resolved their acute AMR episode and had sustained disappearance of circulating DSA for ≤30 months. This study provides a proof-of-principle demonstration that mouse models can identify mechanistically rational therapies for the clinic. Follow-up investigations with a more stringent clinical design are warranted to test whether B/B improves on the standard of care for the treatment of acute AMR.
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Affiliation(s)
- Dharmendra Jain
- Section of Transplantation, Department of Surgery, University of Chicago, Chicago, IL
| | - Amer Rajab
- Department of Surgery, The Ohio State University, Columbus, OH
| | - James S Young
- Section of Transplantation, Department of Surgery, University of Chicago, Chicago, IL
| | - Dengping Yin
- Section of Transplantation, Department of Surgery, University of Chicago, Chicago, IL
| | - Tibor Nadasdy
- Department of Pathology, The Ohio State University, Columbus, OH
| | - Anita S Chong
- Section of Transplantation, Department of Surgery, University of Chicago, Chicago, IL
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18
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See SB, Mantell BS, Clerkin KJ, Ray B, Vasilescu ER, Marboe CC, Naka Y, Restaino S, Colombo PC, Addonizio LJ, Farr MA, Zorn E. Profiling non-HLA antibody responses in antibody-mediated rejection following heart transplantation. Am J Transplant 2020; 20:2571-2580. [PMID: 32190967 PMCID: PMC8117249 DOI: 10.1111/ajt.15871] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/04/2019] [Revised: 02/24/2020] [Accepted: 03/11/2020] [Indexed: 01/25/2023]
Abstract
Antibody-mediated rejection (AMR) driven by the development of donor-specific antibodies (DSA) directed against mismatched donor human leukocyte antigen (HLA) is a major risk factor for graft loss in cardiac transplantation. Recently, the relevance of non-HLA antibodies has become more prominent as AMR can be diagnosed in the absence of circulating DSA. Here, we assessed a single-center cohort of 64 orthotopic heart transplant recipients transplanted between 1994 and 2014. Serum collected from patients with ≥ pAMR1 (n = 43) and non-AMR (n = 21) were tested for reactivity against a panel of 44 non-HLA autoantigens. The AMR group had a significantly greater percentage of patients with elevated reactivity to autoantigens compared to non-AMR (P = .002) and healthy controls (n = 94, P < .0001). DSA-positive AMR patients exhibited greater reactivity to autoantigens compared to DSA-negative (P < .0001) and AMR patients with DSA and PRA > 10% were identified as the subgroup with significantly elevated responses. Reactivity to 4 antigens, vimentin, beta-tubulin, lamin A/C, and apolipoprotein L2, was significantly different between AMR and non-AMR patients. Moreover, increased reactivity to these antigens was associated with graft failure. These results suggest that antibodies to non-HLA are associated with DSA-positive AMR although their specific role in mediating allograft injury is not yet understood.
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Affiliation(s)
- Sarah B. See
- Columbia Center for Translational Immunology, Columbia University Irving Medical Center, New York, NY
| | - Benjamin S. Mantell
- Columbia Center for Translational Immunology, Columbia University Irving Medical Center, New York, NY,Department of Pediatrics, Division of Pediatric Cardiology, Columbia University Irving Medical Center, New York, NY
| | - Kevin J. Clerkin
- Department of Medicine, Division of Cardiology, Columbia University Irving Medical Center, New York, NY
| | | | - E. Rodica Vasilescu
- Department of Pathology and Cell Biology, Columbia University Irving Medical Center, New York, NY
| | - Charles C. Marboe
- Department of Pathology and Cell Biology, Columbia University Irving Medical Center, New York, NY
| | - Yoshifumi Naka
- Department of Surgery, Division of Cardiothoracic Surgery, Columbia University Irving Medical Center, New York, NY
| | - Susan Restaino
- Department of Medicine, Division of Cardiology, Columbia University Irving Medical Center, New York, NY
| | - Paolo C. Colombo
- Department of Pediatrics, Division of Pediatric Cardiology, Columbia University Irving Medical Center, New York, NY
| | - Linda J. Addonizio
- Department of Pediatrics, Division of Pediatric Cardiology, Columbia University Irving Medical Center, New York, NY
| | - Maryjane A. Farr
- Department of Medicine, Division of Cardiology, Columbia University Irving Medical Center, New York, NY
| | - Emmanuel Zorn
- Columbia Center for Translational Immunology, Columbia University Irving Medical Center, New York, NY
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19
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Chong AS. Mechanisms of organ transplant injury mediated by B cells and antibodies: Implications for antibody-mediated rejection. Am J Transplant 2020; 20 Suppl 4:23-32. [PMID: 32538534 PMCID: PMC7482418 DOI: 10.1111/ajt.15844] [Citation(s) in RCA: 17] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/22/2019] [Revised: 02/06/2020] [Accepted: 02/19/2020] [Indexed: 01/25/2023]
Abstract
Recent adjustments to the histological diagnosis and the introduction of molecular classification are providing renewed support for the paradigm that antibody-mediated rejection (ABMR) is an important clinical problem for which there is an urgent need for better therapies. Acute ABMR is observed when the graft is exposed to rapid increases in high-titer donor-specific antibodies (DSA) that are most often generated as anamnestic responses in sensitized recipients or de novo responses in nonsensitized patients who are nonadherent. Chronic ABMR is associated with slower increases in DSA, which may be high or low titer and transient or persistent. These DSA elicit cycles of injury and repair that manifest as multilamination of the peritubular capillary basement membrane or arteriopathy manifesting as intimal fibrosis. Mitigating the problem of AMBR requires the anamnestic and de novo DSA responses to be prevented and established DSA responses to be reversed. To this end, a better understanding of the immunobiology of DSA production is necessary and also the development of assays capable of detecting early humoral immune responses.Recent advances in understanding the immunobiology of B cells and areas requiring further investigation that might lead to new therapies or better diagnosis are discussed in this review.
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Affiliation(s)
- Anita S Chong
- Section of Transplantation, Department of Surgery, University of Chicago, Chicago, Illinois, USA
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20
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Sicard A, Lamarche C, Speck M, Wong M, Rosado-Sánchez I, Blois M, Glaichenhaus N, Mojibian M, Levings MK. Donor-specific chimeric antigen receptor Tregs limit rejection in naive but not sensitized allograft recipients. Am J Transplant 2020; 20:1562-1573. [PMID: 31957209 DOI: 10.1111/ajt.15787] [Citation(s) in RCA: 58] [Impact Index Per Article: 14.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/08/2019] [Revised: 12/19/2019] [Accepted: 01/13/2020] [Indexed: 02/06/2023]
Abstract
Cell therapy with autologous donor-specific regulatory T cells (Tregs) is a promising strategy to minimize immunosuppression in transplant recipients. Chimeric antigen receptor (CAR) technology has recently been used successfully to generate donor-specific Tregs and overcome the limitations of enrichment protocols based on repetitive stimulations with alloantigens. However, the ability of CAR-Treg therapy to control alloreactivity in immunocompetent recipients is unknown. We first analyzed the effect of donor-specific CAR Tregs on alloreactivity in naive, immunocompetent mice receiving skin allografts. Tregs expressing an irrelevant or anti-HLA-A2-specific CAR were administered to Bl/6 mice at the time of transplanting an HLA-A2+ Bl/6 skin graft. Donor-specific CAR-Tregs, but not irrelevant-CAR Tregs, significantly delayed skin rejection and diminished donor-specific antibodies (DSAs) and frequencies of DSA-secreting B cells. Donor-specific CAR-Treg-treated mice also had a weaker recall DSA response, but normal responses to an irrelevant antigen, demonstrating antigen-specific suppression. When donor-specific CAR Tregs were tested in HLA-A2-sensitized mice, they were unable to delay allograft rejection or diminish DSAs. The finding that donor-specific CAR-Tregs restrain de novo but not memory alloreactivity has important implications for their use as an adoptive cell therapy in transplantation.
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Affiliation(s)
- Antoine Sicard
- British Columbia Children's Hospital Research Institute, Vancouver, BC, Canada.,Department of Surgery, University of British Columbia, Vancouver, BC, Canada.,Department of Nephrology-Dialysis-Transplantation, Nice University Hospital, Clinical Research Unit of University of Côte d'Azur, Nice, France.,CNRS, Institute of Molecular and Cellular Pharmacology, UMR7275, Valbonne, France
| | - Caroline Lamarche
- British Columbia Children's Hospital Research Institute, Vancouver, BC, Canada.,Department of Surgery, University of British Columbia, Vancouver, BC, Canada
| | - Madeleine Speck
- British Columbia Children's Hospital Research Institute, Vancouver, BC, Canada.,Department of Surgery, University of British Columbia, Vancouver, BC, Canada
| | - May Wong
- British Columbia Children's Hospital Research Institute, Vancouver, BC, Canada.,Department of Surgery, University of British Columbia, Vancouver, BC, Canada
| | - Isaac Rosado-Sánchez
- British Columbia Children's Hospital Research Institute, Vancouver, BC, Canada.,Department of Surgery, University of British Columbia, Vancouver, BC, Canada.,School of Biomedical Engineering, University of British Columbia, Vancouver, BC, Canada
| | - Mathilde Blois
- Department of Nephrology-Dialysis-Transplantation, Nice University Hospital, Clinical Research Unit of University of Côte d'Azur, Nice, France.,CNRS, Institute of Molecular and Cellular Pharmacology, UMR7275, Valbonne, France
| | - Nicolas Glaichenhaus
- CNRS, Institute of Molecular and Cellular Pharmacology, UMR7275, Valbonne, France
| | - Majid Mojibian
- British Columbia Children's Hospital Research Institute, Vancouver, BC, Canada.,Department of Surgery, University of British Columbia, Vancouver, BC, Canada
| | - Megan K Levings
- British Columbia Children's Hospital Research Institute, Vancouver, BC, Canada.,Department of Surgery, University of British Columbia, Vancouver, BC, Canada.,School of Biomedical Engineering, University of British Columbia, Vancouver, BC, Canada
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21
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Kwun J, Knechtle S. Experimental modeling of desensitization: What have we learned about preventing AMR? Am J Transplant 2020; 20 Suppl 4:2-11. [PMID: 32538533 PMCID: PMC7522789 DOI: 10.1111/ajt.15873] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/21/2020] [Revised: 03/06/2020] [Accepted: 03/09/2020] [Indexed: 01/25/2023]
Abstract
During the past 5 decades, short-term outcomes in kidney transplant have significantly improved, in large part due to reduced rates and severity of acute rejection. Development of better immunosuppressive maintenance agents, as well as new induction therapies, helped make these advances. Nonhuman primate models provided a rigorous testing platform to evaluate candidate biologics during this process. However, antibody-mediated rejection remains a major cause of late failure of kidney allografts despite advances made in pharmacologic immunosuppression and strategies developed to facilitate improved donor-recipient matching. Our laboratory has been actively working to develop strategies to prevent and treat antibody-mediated rejection and immunologic sensitization in organ transplant, relying largely on a nonhuman primate model of kidney transplant. In this review, we will cover outcomes achieved by managing antibody-mediated rejection or sensitization in nonhuman primate models and discuss promises, limitations, and future directions for this model.
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Affiliation(s)
- Jean Kwun
- Address all correspondence and requests for reprints to: Jean Kwun, PhD, 207 Research Drive, Jones 362, DUMC Box 2645, Durham, NC 27710, USA Phone: 919-668-6792; Fax: 919-684-8716;
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22
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Moore C, Gao B, Roskin KM, Vasilescu ERM, Addonizio L, Givertz MM, Madsen JC, Zorn E. B cell clonal expansion within immune infiltrates in human cardiac allograft vasculopathy. Am J Transplant 2020; 20:1431-1438. [PMID: 31811777 PMCID: PMC7238293 DOI: 10.1111/ajt.15737] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/10/2019] [Revised: 11/21/2019] [Accepted: 11/24/2019] [Indexed: 01/25/2023]
Abstract
Cardiac allograft vasculopathy (CAV) is associated with intragraft B cell infiltrates. Here, we studied the clonal composition of B cell infiltrates using 4 graft specimens with CAV. Using deep sequencing, we analyzed the immunoglobulin heavy chain variable region repertoire in both graft and blood. Results showed robust B cell clonal expansion in the graft but not in the blood for all cases. Several expanded B cell clones, characterized by their uniquely rearranged complementarity-determining region 3, were detected in different locations in the graft. Sequences from intragraft B cells also showed elevated levels of mutated rearrangements in the graft compared to blood B cells. The number of somatic mutations per rearrangement was also higher in the graft than in the blood, suggesting that B cells continued maturing in situ. Overall, our studies demonstrated B cell clonal expansion in human cardiac allografts with CAV. This local B cell response may contribute to the pathophysiology of CAV through a mechanism that needs to be identified.
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Affiliation(s)
- Carolina Moore
- Center for Transplantation Science, Department of Surgery, Massachusetts General Hospital, Harvard Medical School, Boston, Massachusetts,Division of Biomedical Informatics, Cincinnati Children’s Hospital Medical Center, Cincinnati, Ohio,Division of Immunobiology, Cincinnati Children’s Hospital Medical Center, Cincinnati, Ohio
| | - Baoshan Gao
- Center for Transplantation Science, Department of Surgery, Massachusetts General Hospital, Harvard Medical School, Boston, Massachusetts,Transplant Center, The First Hospital of Jilin University, Changchun, China
| | - Krishna M. Roskin
- Division of Biomedical Informatics, Cincinnati Children’s Hospital Medical Center, Cincinnati, Ohio,Division of Immunobiology, Cincinnati Children’s Hospital Medical Center, Cincinnati, Ohio,Department of Pediatrics, University of Cincinnati, College of Medicine, Cincinnati, Ohio
| | | | - Linda Addonizio
- Division of Cardiothoracic Surgery, Department of Surgery, Columbia University Medical Center, New York, New York
| | - Michael M. Givertz
- Department of Medicine, Brigham and Women’s Hospital, Harvard Medical School, Boston, Massachusetts
| | - Joren C. Madsen
- Center for Transplantation Science, Department of Surgery, Massachusetts General Hospital, Harvard Medical School, Boston, Massachusetts,Division of Cardiac Surgery, Department of Surgery, Massachusetts General Hospital, Harvard Medical School, Boston, Massachusetts
| | - Emmanuel Zorn
- Center for Transplantation Science, Department of Surgery, Massachusetts General Hospital, Harvard Medical School, Boston, Massachusetts,Columbia Center for Translational Immunology, Columbia University Medical Center, New York, New York
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23
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Kimura S, Rickert CG, Kojima L, Aburawi M, Tanimine N, Fontan F, Deng K, Tector H, Mi Lee K, Yeh H, Markmann JF. Regulatory B cells require antigen recognition for effective allograft tolerance induction. Am J Transplant 2020; 20:977-987. [PMID: 31823520 PMCID: PMC7372932 DOI: 10.1111/ajt.15739] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/26/2019] [Revised: 10/25/2019] [Accepted: 11/11/2019] [Indexed: 01/25/2023]
Abstract
Through multiple mechanisms, regulatory B cells (Breg) have been shown to play an important role in the development of allograft tolerance. However, a careful understanding of the role of antigen-specificity in Breg-mediated allograft tolerance has remained elusive. In experimental models of islet and cardiac transplantation, it has been established that Bregs can be induced in vivo by anti-CD45RB ± anti-TIM1antibody treatment, resulting in prolonged, Breg-dependent allograft tolerance. The importance of Breg antigen recognition has been suggested but not confirmed through adoptive transfer experiments, using tolerant WT C57BL/6 animals challenged with either BALB/c or C3H grafts. However, the importance of receptor-specificity has not been formally tested. Here, we utilize the novel ovalbumin-specific B cell receptor transnuclear (OBI) mice in multiple primary tolerance and adoptive transfer experiments to establish that Breg-dependent allograft tolerance relies on antigen recognition by B cells. Additionally, we identify that this Breg-dependent tolerance relies on the function of transforming growth factor-β. Together, these experiments mark important progress toward understanding how best to improve Breg-mediated allograft tolerance.
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Affiliation(s)
- Shoko Kimura
- Transplantation Unit, Department of Surgery, Massachusetts General Hospital, Harvard Medical School, Boston, Massachusetts
| | - Charles G Rickert
- Transplantation Unit, Department of Surgery, Massachusetts General Hospital, Harvard Medical School, Boston, Massachusetts
| | - Lisa Kojima
- Transplantation Unit, Department of Surgery, Massachusetts General Hospital, Harvard Medical School, Boston, Massachusetts
| | - Mohamed Aburawi
- Transplantation Unit, Department of Surgery, Massachusetts General Hospital, Harvard Medical School, Boston, Massachusetts
| | - Naoki Tanimine
- Transplantation Unit, Department of Surgery, Massachusetts General Hospital, Harvard Medical School, Boston, Massachusetts
| | - Fermin Fontan
- Transplantation Unit, Department of Surgery, Massachusetts General Hospital, Harvard Medical School, Boston, Massachusetts
| | - Kevin Deng
- Transplantation Unit, Department of Surgery, Massachusetts General Hospital, Harvard Medical School, Boston, Massachusetts
| | - Haley Tector
- Transplantation Unit, Department of Surgery, Massachusetts General Hospital, Harvard Medical School, Boston, Massachusetts
| | - Kang Mi Lee
- Transplantation Unit, Department of Surgery, Massachusetts General Hospital, Harvard Medical School, Boston, Massachusetts
| | - Heidi Yeh
- Transplantation Unit, Department of Surgery, Massachusetts General Hospital, Harvard Medical School, Boston, Massachusetts
| | - James F Markmann
- Transplantation Unit, Department of Surgery, Massachusetts General Hospital, Harvard Medical School, Boston, Massachusetts
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24
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Xu H, Mehta AK, Gao Q, Lee HJ, Ghali A, Guasch A, Kirk AD. B cell reconstitution following alemtuzumab induction under a belatacept-based maintenance regimen. Am J Transplant 2020; 20:653-662. [PMID: 31596034 PMCID: PMC7202689 DOI: 10.1111/ajt.15639] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/23/2019] [Revised: 09/06/2019] [Accepted: 09/24/2019] [Indexed: 01/25/2023]
Abstract
Lymphocyte depletion has been shown to control costimulation blockade-resistant rejection but, in some settings, to exacerbate antibody-mediated rejection (AMR). We have used alemtuzumab, which depletes T and B cells, combined with belatacept and rapamycin and previously reported control of both costimulation blockade-resistant rejection and AMR. To evaluate this regimen's effect on B cell signatures, we investigated 40 patients undergoing this therapy. B cell counts and phenotypes were interrogated using flow cytometry, and serum was analyzed for total IgG, IgM, and donor-specific alloantibody (DSA). Alemtuzumab induction produced pan-lymphocyte depletion; B cells repopulated faster and more completely than T cells. Reconstituting B cells were predominantly naïve, and memory B cells were significantly reduced (P = .001) post repopulation. Two B cell populations with potential immunomodulatory effects-regulatory (CD38hi CD24hi IgMhi CD20hi ) and transitional B cells (CD19+ CD27- IgD+ CD38hi )-were enriched posttransplant (P = .001). Total serum IgG decreased from baseline (P = .016) while IgM levels remained stable. Five patients developed DSAs within 36 months posttransplant, but none developed AMR. Baseline IgG levels in these patients were significantly higher than those in patients without DSAs. These findings suggest that belatacept and rapamycin together limit homeostatic B cell activation following B cell depletion and may lessen the risk of AMR. This regimen warrants prospective, comparative study. ClinicalTrials.gov NCT00565773.
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Affiliation(s)
- He Xu
- Department of Surgery, Duke University School of Medicine, Durham, NC,,Corresponding author: He Xu, M.D., Mailing Address: Department of Surgery, Duke University Medical Center, Edwin Jones Building, Room 368, Durham, NC 27710, Telephone: (919) 681-4853, Fax Number: (919) 681-2779,
| | - Aneesh K. Mehta
- Emory Transplant Center, Emory University, Atlanta, GA, United States
| | - Qimeng Gao
- Department of Surgery, Duke University School of Medicine, Durham, NC
| | - Hui-Jie Lee
- Department of Biostatistics & Bioinformatics, Duke University School of Medicine, Durham, NC
| | - Ada Ghali
- Emory Transplant Center, Emory University, Atlanta, GA, United States
| | - Antonio Guasch
- Emory Transplant Center, Emory University, Atlanta, GA, United States
| | - Allan D. Kirk
- Department of Surgery, Duke University School of Medicine, Durham, NC
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25
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Michaels AJ, Stoppato M, Flores WJ, Reimann KA, Engelman KD. Anti-CD40 antibody 2C10 binds to a conformational epitope at the CD40-CD154 interface that is conserved among primate species. Am J Transplant 2020; 20:298-305. [PMID: 31430418 PMCID: PMC6940519 DOI: 10.1111/ajt.15574] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/01/2019] [Revised: 07/28/2019] [Accepted: 08/09/2019] [Indexed: 01/25/2023]
Abstract
The antagonistic anti-CD40 antibody, 2C10, and its recombinant primate derivative, 2C10R4, are potent immunosuppressive antibodies whose utility in allo- and xenotransplantation have been demonstrated in nonhuman primate studies. In this study, we defined the 2C10 binding epitope and found only slight differences in affinity of 2C10 for CD40 derived from four primate species. Staining of truncation mutants mapped the 2C10 binding epitope to the N-terminal portion of CD40. Alanine scanning mutagenesis of the first 60 residues in the CD40 ectodomain highlighted key amino acids important for binding of 2C10 and for binding of the noncross-blocking anti-CD40 antibodies 3A8 and 5D12. All four 2C10-binding residues defined by mutagenesis clustered near the membrane-distal tip of CD40 and partially overlap the CD154 binding surface. In contrast, the overlapping 3A8 and 5D12 epitopes map to an opposing surface away from the CD154 binding domain. This biochemical characterization of 2C10 confirms the validity of nonhuman primate studies in the translation of this therapeutic antibody and provides insight its mechanism of action.
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Affiliation(s)
- Anthony J Michaels
- MassBiologics, University of Massachusetts Medical School, Boston, Massachusetts
| | - Matteo Stoppato
- MassBiologics, University of Massachusetts Medical School, Boston, Massachusetts
| | - Walter J Flores
- MassBiologics, University of Massachusetts Medical School, Boston, Massachusetts
| | - Keith A Reimann
- MassBiologics, University of Massachusetts Medical School, Boston, Massachusetts
| | - Kathleen D Engelman
- MassBiologics, University of Massachusetts Medical School, Boston, Massachusetts
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26
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Watanabe T, Martinu T, Chruscinski A, Boonstra K, Joe B, Horie M, Guan Z, Bei KF, Hwang DM, Liu M, Keshavjee S, Juvet SC. A B cell-dependent pathway drives chronic lung allograft rejection after ischemia-reperfusion injury in mice. Am J Transplant 2019; 19:3377-3389. [PMID: 31365766 DOI: 10.1111/ajt.15550] [Citation(s) in RCA: 22] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/29/2019] [Revised: 07/23/2019] [Accepted: 07/26/2019] [Indexed: 01/25/2023]
Abstract
Chronic lung allograft dysfunction (CLAD) limits long-term survival after lung transplant (LT). Ischemia-reperfusion injury (IRI) promotes chronic rejection (CR) and CLAD, but the underlying mechanisms are not well understood. To examine mechanisms linking IRI to CR, a mouse orthotopic LT model using a minor alloantigen strain mismatch (C57BL/10 [B10, H-2b ] → C57BL/6 [B6, H-2b ]) and isograft controls (B6→B6) was used with antecedent minimal or prolonged graft storage. The latter resulted in IRI with subsequent airway and parenchymal fibrosis in prolonged storage allografts but not isografts. This pattern of CR after IRI was associated with the formation of B cell-rich tertiary lymphoid organs within the grafts and circulating autoantibodies. These processes were attenuated by B cell depletion, despite preservation of allograft T cell content. Our observations suggest that IRI may promote B cell recruitment that drives CR after LT. These observations have implications for the mechanisms leading to CLAD after LT.
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Affiliation(s)
- Tatsuaki Watanabe
- Latner Thoracic Surgery Research Laboratories, University Health Network, University of Toronto, Toronto, Ontario, Canada
| | - Tereza Martinu
- Latner Thoracic Surgery Research Laboratories, University Health Network, University of Toronto, Toronto, Ontario, Canada
| | - Andrzej Chruscinski
- Toronto General Hospital Research Institute, University Health Network, Toronto, Ontario, Canada
| | - Kristen Boonstra
- Latner Thoracic Surgery Research Laboratories, University Health Network, University of Toronto, Toronto, Ontario, Canada
| | - Betty Joe
- Latner Thoracic Surgery Research Laboratories, University Health Network, University of Toronto, Toronto, Ontario, Canada
| | - Miho Horie
- Joint Department of Medical Imaging, University Health Network, Toronto, Ontario, Canada
| | - Zehong Guan
- Latner Thoracic Surgery Research Laboratories, University Health Network, University of Toronto, Toronto, Ontario, Canada
| | - Ke Fan Bei
- Latner Thoracic Surgery Research Laboratories, University Health Network, University of Toronto, Toronto, Ontario, Canada
| | - David M Hwang
- Department of Laboratory Medicine and Pathobiology, Sunnybrook Hospital, Toronto, Ontario, Canada
| | - Mingyao Liu
- Latner Thoracic Surgery Research Laboratories, University Health Network, University of Toronto, Toronto, Ontario, Canada
| | - Shaf Keshavjee
- Latner Thoracic Surgery Research Laboratories, University Health Network, University of Toronto, Toronto, Ontario, Canada
| | - Stephen C Juvet
- Latner Thoracic Surgery Research Laboratories, University Health Network, University of Toronto, Toronto, Ontario, Canada
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27
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Redfield RR, Jordan SC, Busque S, Vincenti F, Woodle ES, Desai N, Reed EF, Tremblay S, Zachary AA, Vo AA, Formica R, Schindler T, Tran H, Looney C, Jamois C, Green C, Morimoto A, Rajwanshi R, Schroeder A, Cascino MD, Brunetta P, Borie D. Safety, pharmacokinetics, and pharmacodynamic activity of obinutuzumab, a type 2 anti-CD20 monoclonal antibody for the desensitization of candidates for renal transplant. Am J Transplant 2019; 19:3035-3045. [PMID: 31257724 PMCID: PMC6899639 DOI: 10.1111/ajt.15514] [Citation(s) in RCA: 42] [Impact Index Per Article: 8.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/02/2019] [Revised: 05/28/2019] [Accepted: 06/18/2019] [Indexed: 01/25/2023]
Abstract
The limited effectiveness of rituximab plus intravenous immunoglobulin (IVIG) in desensitization may be due to incomplete B cell depletion. Obinutuzumab is a type 2 anti-CD20 antibody that induces increased B cell depletion relative to rituximab and may therefore be more effective for desensitization. This open-label phase 1b study assessed the safety, pharmacokinetics, and pharmacodynamics of obinutuzumab in highly sensitized patients with end-stage renal disease. Patients received 1 (day 1, n = 5) or 2 (days 1 and 15; n = 20) infusions of 1000-mg obinutuzumab followed by 2 doses of IVIG on days 22 and 43. Eleven patients received additional obinutuzumab doses at the time of transplant and/or at week 24. The median follow-up duration was 9.4 months. Obinutuzumab was well tolerated, and most adverse events were grade 1-2 in severity. There were 11 serious adverse events (SAEs) in 9 patients (36%); 10 of these SAEs were infections and 4 occurred after kidney transplant. Obinutuzumab plus IVIG resulted in profound peripheral B cell depletion and appeared to reduce B cells in retroperitoneal lymph nodes. Reductions in anti-HLA antibodies, number of unacceptable antigens, and the calculated panel reactive antibody score as centrally assessed using single-antigen bead assay were limited and not clinically meaningful for most patients (NCT02586051).
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Affiliation(s)
| | | | | | | | | | - Niraj Desai
- Johns Hopkins University School of MedicineBaltimoreMaryland
| | - Elaine F. Reed
- David Geffen School of MedicineUniversity of CaliforniaLos AngelesCalifornia
| | - Simon Tremblay
- University of Cincinnati College of MedicineCincinnatiOhio
| | | | - Ashley A. Vo
- Cedars‐Sinai Medical CenterLos AngelesCalifornia
| | | | | | - Ha Tran
- Genentech, Inc.South San FranciscoCalifornia
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28
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Brosseau C, Danger R, Durand M, Durand E, Foureau A, Lacoste P, Tissot A, Roux A, Reynaud-Gaubert M, Kessler R, Mussot S, Dromer C, Brugière O, Mornex JF, Guillemain R, Claustre J, Magnan A, Brouard S, Velly J, Rozé H, Blanchard E, Antoine M, Cappello M, Ruiz M, Sokolow Y, Vanden Eynden F, Van Nooten G, Barvais L, Berré J, Brimioulle S, De Backer D, Créteur J, Engelman E, Huybrechts I, Ickx B, Preiser T, Tuna T, Van Obberghe L, Vancutsem N, Vincent J, De Vuyst P, Etienne I, Féry F, Jacobs F, Knoop C, Vachiéry J, Van den Borne P, Wellemans I, Amand G, Collignon L, Giroux M, Angelescu D, Chavanon O, Hacini R, Martin C, Pirvu A, Porcu P, Albaladejo P, Allègre C, Bataillard A, Bedague D, Briot E, Casez‐Brasseur M, Colas D, Dessertaine G, Francony G, Hebrard A, Marino M, Protar D, Rehm D, Robin S, Rossi‐Blancher M, Augier C, Bedouch P, Boignard A, Bouvaist H, Briault A, Camara B, Chanoine S, Dubuc M, Quétant S, Maurizi J, Pavèse P, Pison C, Saint‐Raymond C, Wion N, Chérion C, Grima R, Jegaden O, Maury J, Tronc F, Flamens C, Paulus S, Philit F, Senechal A, Glérant J, Turquier S, Gamondes D, Chalabresse L, Thivolet‐Bejui F, Barnel C, Dubois C, Tiberghien A, Pimpec‐Barthes F, Bel A, Mordant P, Achouh P, Boussaud V, Méléard D, Bricourt M, Cholley B, Pezella V, Brioude G, D'Journo X, Doddoli C, Thomas P, Trousse D, Dizier S, Leone M, Papazian L, Bregeon F, Coltey B, Dufeu N, Dutau H, Garcia S, Gaubert J, Gomez C, Laroumagne S, Mouton G, Nieves A, Picard C, Rolain J, Sampol E, Secq V, Perigaud C, Roussel J, Senage T, Mugniot A, Danner I, Haloun A, Abbes S, Bry C, Blanc F, Lepoivre T, Botturi‐Cavaillès K, Loy J, Bernard M, Godard E, Royer P, Henrio K, Dartevelle P, Fabre D, Fadel E, Mercier O, Stephan F, Viard P, Cerrina J, Dorfmuller P, Feuillet S, Ghigna M, Hervén P, Le Roy Ladurie F, Le Pavec J, Thomas de Montpreville V, Lamrani L, Castier Y, Mordant P, Cerceau P, Augustin P, Jean‐Baptiste S, Boudinet S, Montravers P, Dauriat G, Jébrak G, Mal H, Marceau A, Métivier A, Thabut G, Lhuillier E, Dupin C, Bunel V, Falcoz P, Massard G, Santelmo N, Ajob G, Collange O, Helms O, Hentz J, Roche A, Bakouboula B, Degot T, Dory A, Hirschi S, Ohlmann‐Caillard S, Kessler L, Schuller A, Bennedif K, Vargas S, Bonnette P, Chapelier A, Puyo P, Sage E, Bresson J, Caille V, Cerf C, Devaquet J, Dumans‐Nizard V, Felten M, Fischler M, Si Larbi A, Leguen M, Ley L, Liu N, Trebbia G, De Miranda S, Douvry B, Gonin F, Grenet D, Hamid A, Neveu H, Parquin F, Picard C, Stern M, Bouillioud F, Cahen P, Colombat M, Dautricourt C, Delahousse M, D'Urso B, Gravisse J, Guth A, Hillaire S, Honderlick P, Lequintrec M, Longchampt E, Mellot F, Scherrer A, Temagoult L, Tricot L, Vasse M, Veyrie C, Zemoura L, Dahan M, Murris M, Benahoua H, Berjaud J, Le Borgne Krams A, Crognier L, Brouchet L, Mathe O, Didier A, Krueger T, Ris H, Gonzalez M, Aubert J, Nicod L, Marsland B, Berutto T, Rochat T, Soccal P, Jolliet P, Koutsokera A, Marcucci C, Manuel O, Bernasconi E, Chollet M, Gronchi F, Courbon C, Hillinger S, Inci I, Kestenholz P, Weder W, Schuepbach R, Zalunardo M, Benden C, Buergi U, Huber L, Isenring B, Schuurmans M, Gaspert A, Holzmann D, Müller N, Schmid C, Vrugt B, Rechsteiner T, Fritz A, Maier D, Deplanche K, Koubi D, Ernst F, Paprotka T, Schmitt M, Wahl B, Boissel J, Olivera‐Botello G, Trocmé C, Toussaint B, Bourgoin‐Voillard S, Séve M, Benmerad M, Siroux V, Slama R, Auffray C, Charron D, Lefaudeux D, Pellet J. Blood CD9 + B cell, a biomarker of bronchiolitis obliterans syndrome after lung transplantation. Am J Transplant 2019; 19:3162-3175. [PMID: 31305014 DOI: 10.1111/ajt.15532] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/03/2018] [Revised: 06/12/2019] [Accepted: 07/07/2019] [Indexed: 01/25/2023]
Abstract
Bronchiolitis obliterans syndrome is the main limitation for long-term survival after lung transplantation. Some specific B cell populations are associated with long-term graft acceptance. We aimed to monitor the B cell profile during early development of bronchiolitis obliterans syndrome after lung transplantation. The B cell longitudinal profile was analyzed in peripheral blood mononuclear cells from patients with bronchiolitis obliterans syndrome and patients who remained stable over 3 years of follow-up. CD24hi CD38hi transitional B cells were increased in stable patients only, and reached a peak 24 months after transplantation, whereas they remained unchanged in patients who developed a bronchiolitis obliterans syndrome. These CD24hi CD38hi transitional B cells specifically secrete IL-10 and express CD9. Thus, patients with a total CD9+ B cell frequency below 6.6% displayed significantly higher incidence of bronchiolitis obliterans syndrome (AUC = 0.836, PPV = 0.75, NPV = 1). These data are the first to associate IL-10-secreting CD24hi CD38hi transitional B cells expressing CD9 with better allograft outcome in lung transplant recipients. CD9-expressing B cells appear as a contributor to a favorable environment essential for the maintenance of long-term stable graft function and as a new predictive biomarker of bronchiolitis obliterans syndrome-free survival.
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Affiliation(s)
- Carole Brosseau
- Centre de Recherche en Transplantation et Immunologie, UMR 1064, INSERM, Université de Nantes, Nantes, France.,Institut de Transplantation Urologie Néphrologie (ITUN), CHU Nantes, Nantes, France.,Institut du thorax, Inserm UMR 1087, CNRS, UMR 6291, Université de Nantes, Nantes, France.,Institut du thorax, CHU de Nantes, Nantes, France
| | - Richard Danger
- Centre de Recherche en Transplantation et Immunologie, UMR 1064, INSERM, Université de Nantes, Nantes, France.,Institut de Transplantation Urologie Néphrologie (ITUN), CHU Nantes, Nantes, France
| | - Maxim Durand
- Centre de Recherche en Transplantation et Immunologie, UMR 1064, INSERM, Université de Nantes, Nantes, France.,Institut de Transplantation Urologie Néphrologie (ITUN), CHU Nantes, Nantes, France.,Faculté de Médecine, Université de Nantes, Nantes, France
| | - Eugénie Durand
- Centre de Recherche en Transplantation et Immunologie, UMR 1064, INSERM, Université de Nantes, Nantes, France.,Institut de Transplantation Urologie Néphrologie (ITUN), CHU Nantes, Nantes, France
| | - Aurore Foureau
- Institut du thorax, Inserm UMR 1087, CNRS, UMR 6291, Université de Nantes, Nantes, France.,Institut du thorax, CHU de Nantes, Nantes, France
| | - Philippe Lacoste
- Institut du thorax, Inserm UMR 1087, CNRS, UMR 6291, Université de Nantes, Nantes, France.,Institut du thorax, CHU de Nantes, Nantes, France
| | - Adrien Tissot
- Centre de Recherche en Transplantation et Immunologie, UMR 1064, INSERM, Université de Nantes, Nantes, France.,Institut de Transplantation Urologie Néphrologie (ITUN), CHU Nantes, Nantes, France.,Institut du thorax, Inserm UMR 1087, CNRS, UMR 6291, Université de Nantes, Nantes, France.,Institut du thorax, CHU de Nantes, Nantes, France.,Faculté de Médecine, Université de Nantes, Nantes, France
| | - Antoine Roux
- Hôpital Foch, Suresnes, France.,Université Versailles Saint-Quentin-en-Yvelines, UPRES EA220, Versailles, France
| | | | | | - Sacha Mussot
- Centre Chirurgical Marie Lannelongue, Service de Chirurgie Thoracique, Vasculaire et Transplantation Cardiopulmonaire, Le Plessis Robinson, France
| | | | - Olivier Brugière
- Hôpital Bichat, Service de Pneumologie et Transplantation Pulmonaire, Paris, France
| | | | | | - Johanna Claustre
- Clinique Universitaire Pneumologie, Pôle Thorax et Vaisseaux, CHU Grenoble Alpes, Université Grenoble Alpes, Inserm U1055, Grenoble, France
| | - Antoine Magnan
- Institut du thorax, Inserm UMR 1087, CNRS, UMR 6291, Université de Nantes, Nantes, France.,Institut du thorax, CHU de Nantes, Nantes, France
| | - Sophie Brouard
- Centre de Recherche en Transplantation et Immunologie, UMR 1064, INSERM, Université de Nantes, Nantes, France.,Institut de Transplantation Urologie Néphrologie (ITUN), CHU Nantes, Nantes, France.,Centre d'Investigation Clinique (CIC) Biothérapie, CHU Nantes, Nantes, France
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29
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Chong AS, Rothstein D, Safa K, Riella LV. Outstanding questions in transplantation: B cells, alloantibodies, and humoral rejection. Am J Transplant 2019; 19:2155-2163. [PMID: 30803121 PMCID: PMC6691724 DOI: 10.1111/ajt.15323] [Citation(s) in RCA: 32] [Impact Index Per Article: 6.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/06/2019] [Revised: 02/06/2019] [Accepted: 02/16/2019] [Indexed: 01/25/2023]
Abstract
Over the past three decades, improved immunosuppression has significantly reduced T cell-mediated acute rejection rates, but long-term graft survival rates have seen only marginal improvement. The cause of late graft loss has been under intense investigation, and chronic antibody-mediated rejection (AMR) has been identified as one of the leading causes, thus providing a strong rationale for basic science investigation into donor-specific B cells and antibodies in transplantation and ways to mitigate their pathogenicity. In 2018, the American Society of Transplantation launched a community-wide online discussion of Outstanding Questions in Transplantation, and the topic of B cell biology and donor-specific antibody prevention emerged as a major area of interest to the community, leading to a highly engaged dialogue, with comments from basic and translational scientists as well as physicians (http://community.myast.org/communities/community-home/digestviewer). We have summarized this discussion from a bedside to bench perspective and have organized this review into outstanding questions within the paradigm that AMR is a leading cause of graft loss in the clinic, and points of view that challenge aspects of this paradigm. We also highlight opportunities for basic and translational scientists to contribute to the resolution of these questions, mapping important future directions for the transplant research field.
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Affiliation(s)
- Anita S. Chong
- Department of Surgery, The University of Chicago,Corresponding author: Anita S. Chong, PhD, 5841 S. Maryland Ave, Chicago, IL 60637, Ofc: 773-702-5521; Fax: 773-702-5517;
| | - David Rothstein
- Thomas E. Starzl Transplantation Institute, University of Pittsburgh
| | - Kassem Safa
- Transplant Center and Division of Nephrology, Massachusetts General Hospital, Harvard Medical School
| | - Leonardo V. Riella
- Schuster Transplantation Research Center, Renal Division, Brigham & Women’s Hospital, Harvard Medical School, Boston, MA, USA
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30
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Azzi J, Alegre ML. Outstanding questions in transplantation: An introduction to this minireview series. Am J Transplant 2019; 19:2149-2150. [PMID: 30903734 DOI: 10.1111/ajt.15367] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/14/2019] [Revised: 03/10/2019] [Accepted: 03/10/2019] [Indexed: 01/25/2023]
Affiliation(s)
- Jamil Azzi
- Transplantation Research Center, Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts
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31
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Korutla L, Rickels MR, Hu RW, Freas A, Reddy S, Habertheuer A, Harmon J, Korutla V, Ram C, Naji A, Vallabhajosyula P. Noninvasive diagnosis of recurrent autoimmune type 1 diabetes after islet cell transplantation. Am J Transplant 2019; 19:1852-1858. [PMID: 30801971 PMCID: PMC7043773 DOI: 10.1111/ajt.15322] [Citation(s) in RCA: 22] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/16/2018] [Revised: 02/06/2019] [Accepted: 02/11/2019] [Indexed: 01/25/2023]
Abstract
Islet cell transplantation is curative therapy for patients with complicated autoimmune type 1 diabetes (T1D). We report the diagnostic potential of circulating transplant islet-specific exosomes to noninvasively distinguish pancreatic β cell injury secondary to recurrent autoimmunity vs immunologic rejection. A T1D patient with hypoglycemic unawareness underwent islet transplantation and maintained normoglycemia until posttransplant day 1098 before requiring exogenous insulin. Plasma analysis showed decreased donor islet exosome quantities on day 1001, before hyperglycemia onset. This drop in islet exosome quantity signified islet injury, but did not distinguish injury type. However, analysis of purified transplant islet exosome cargoes showed decrease in insulin-containing exosomes, but not glucagon-containing exosomes, indicating selective destruction of transplanted β cells secondary to recurrent T1D autoimmunity. Furthermore, donor islet exosome cargo analysis showed time-specific increase in islet autoantigen, glutamic acid decarboxylase 65 (GAD65), implicated in T1D autoimmunity. Time-matched analysis of plasma transplant islet exosomes in 3 control subjects undergoing islet cell transplantation failed to show changes in islet exosome quantities or intraexosomal cargo expression of insulin, glucagon, and GAD65. This is the first report of noninvasive diagnosis of recurrent autoimmunity after islet cell transplantation, suggesting that transplant tissue exosome platform may serve as a biomarker in islet transplant diagnostics.
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Affiliation(s)
- Laxminarayana Korutla
- Division of Cardiovascular Surgery, Department of Surgery, University of Pennsylvania Perelman School of Medicine, Philadelphia, Pennsylvania
| | - Michael R. Rickels
- Division of Endocrinology, Diabetes & Metabolism, Department of Medicine, University of Pennsylvania Perelman School of Medicine, Philadelphia, Pennsylvania
- Institute for Diabetes, Obesity & Metabolism, University of Pennsylvania Perelman School of Medicine, Philadelphia, Pennsylvania
| | - Robert W. Hu
- Division of Cardiovascular Surgery, Department of Surgery, University of Pennsylvania Perelman School of Medicine, Philadelphia, Pennsylvania
| | - Andrew Freas
- Division of Cardiovascular Surgery, Department of Surgery, University of Pennsylvania Perelman School of Medicine, Philadelphia, Pennsylvania
| | - Sanjana Reddy
- Division of Cardiovascular Surgery, Department of Surgery, University of Pennsylvania Perelman School of Medicine, Philadelphia, Pennsylvania
| | - Andreas Habertheuer
- Division of Cardiovascular Surgery, Department of Surgery, University of Pennsylvania Perelman School of Medicine, Philadelphia, Pennsylvania
| | - Joey Harmon
- Division of Cardiovascular Surgery, Department of Surgery, University of Pennsylvania Perelman School of Medicine, Philadelphia, Pennsylvania
| | - Varun Korutla
- Division of Cardiovascular Surgery, Department of Surgery, University of Pennsylvania Perelman School of Medicine, Philadelphia, Pennsylvania
| | - Chirag Ram
- Division of Cardiovascular Surgery, Department of Surgery, University of Pennsylvania Perelman School of Medicine, Philadelphia, Pennsylvania
| | - Ali Naji
- Institute for Diabetes, Obesity & Metabolism, University of Pennsylvania Perelman School of Medicine, Philadelphia, Pennsylvania
- Division of Transplantation, Department of Surgery, University of Pennsylvania Perelman School of Medicine, Philadelphia, Pennsylvania
| | - Prashanth Vallabhajosyula
- Division of Cardiovascular Surgery, Department of Surgery, University of Pennsylvania Perelman School of Medicine, Philadelphia, Pennsylvania
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32
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Padet L, Dieudé M, Karakeussian‐Rimbaud A, Yang B, Turgeon J, Cailhier J, Cardinal H, Hébert M. New insights into immune mechanisms of antiperlecan/LG3 antibody production: Importance of T cells and innate B1 cells. Am J Transplant 2019; 19:699-712. [PMID: 30129231 PMCID: PMC6519043 DOI: 10.1111/ajt.15082] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/07/2018] [Revised: 07/25/2018] [Accepted: 07/29/2018] [Indexed: 01/25/2023]
Abstract
Autoantibodies against perlecan/LG3 (anti-LG3) have been associated with increased risks of delayed graft function, acute rejection, and reduced long-term survival. High titers of anti-LG3 antibodies have been found in de novo renal transplants recipients in the absence of allosensitizing or autoimmune conditions. Here, we seek to understand the pathways controlling anti-LG3 production prior to transplantation. Mice immunized with recombinant LG3 produce concomitantly IgM and IgG anti-LG3 antibodies suggesting a memory response. ELISpot confirmed the presence of LG3-specific memory B cells in nonimmunized mice. Purification of B1 and B2 subtypes identified peritoneal B1 cells as the major source of memory B cells reactive to LG3. Although nonimmunized CD4-deficient mice were found to express LG3-specific memory B cells, depletion of CD4+ T cells in wild type mice during immunization significantly decreased anti-LG3 production. These results demonstrate that B cell memory to LG3 is T cell independent but that production of anti-LG3 antibodies requires T cell help. Further supporting an important role for T cells in controlling anti-LG3 levels, we found that human renal transplant recipients show a significant decrease in anti-LG3 titers upon the initiation of CNI-based immunosuppression. Collectively, these results identify T cell targeting interventions as a means of reducing anti-LG3 levels in renal transplant patients.
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Affiliation(s)
- Lauriane Padet
- Research CentreCentre Hospitalier de l'Université de Montréal (CRCHUM)MontrealQuebecCanada,Canadian National Transplant Research ProgramEdmontonAlbertaCanada,Université de MontréalMontrealQuebecCanada
| | - Mélanie Dieudé
- Research CentreCentre Hospitalier de l'Université de Montréal (CRCHUM)MontrealQuebecCanada,Canadian National Transplant Research ProgramEdmontonAlbertaCanada
| | - Annie Karakeussian‐Rimbaud
- Research CentreCentre Hospitalier de l'Université de Montréal (CRCHUM)MontrealQuebecCanada,Canadian National Transplant Research ProgramEdmontonAlbertaCanada
| | - Bing Yang
- Research CentreCentre Hospitalier de l'Université de Montréal (CRCHUM)MontrealQuebecCanada,Canadian National Transplant Research ProgramEdmontonAlbertaCanada,Université de MontréalMontrealQuebecCanada
| | - Julie Turgeon
- Research CentreCentre Hospitalier de l'Université de Montréal (CRCHUM)MontrealQuebecCanada,Canadian National Transplant Research ProgramEdmontonAlbertaCanada
| | - Jean‐François Cailhier
- Research CentreCentre Hospitalier de l'Université de Montréal (CRCHUM)MontrealQuebecCanada,Canadian National Transplant Research ProgramEdmontonAlbertaCanada
| | - Héloïse Cardinal
- Research CentreCentre Hospitalier de l'Université de Montréal (CRCHUM)MontrealQuebecCanada,Canadian National Transplant Research ProgramEdmontonAlbertaCanada
| | - Marie‐Josée Hébert
- Research CentreCentre Hospitalier de l'Université de Montréal (CRCHUM)MontrealQuebecCanada,Canadian National Transplant Research ProgramEdmontonAlbertaCanada,Université de MontréalMontrealQuebecCanada
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33
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Bestard O, Grinyó J. Refinement of humoral rejection effector mechanisms to identify specific pathogenic histological lesions with different graft outcomes. Am J Transplant 2019; 19:952-953. [PMID: 30411840 DOI: 10.1111/ajt.15171] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/25/2023]
Affiliation(s)
- Oriol Bestard
- Kidney Transplant Unit, Nephrology Department, Bellvitge University Hospital, IDIBELL, Barcelona University, Barcelona, Spain
| | - Josep Grinyó
- Kidney Transplant Unit, Nephrology Department, Bellvitge University Hospital, IDIBELL, Barcelona University, Barcelona, Spain
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34
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Silveira ELV, Dominguez MR, Soares IS. To B or Not to B: Understanding B Cell Responses in the Development of Malaria Infection. Front Immunol 2018; 9:2961. [PMID: 30619319 PMCID: PMC6302011 DOI: 10.3389/fimmu.2018.02961] [Citation(s) in RCA: 23] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/30/2018] [Accepted: 12/03/2018] [Indexed: 12/18/2022] Open
Abstract
Malaria is a widespread disease caused mainly by the Plasmodium falciparum (Pf) and Plasmodium vivax (Pv) protozoan parasites. Depending on the parasite responsible for the infection, high morbidity and mortality can be triggered. To escape the host immune responses, Plasmodium parasites disturb the functionality of B cell subsets among other cell types. However, some antibodies elicited during a malaria infection have the potential to block pathogen invasion and dissemination into the host. Thus, the question remains, why is protection not developed and maintained after the primary parasite exposure? In this review, we discuss different aspects of B cell responses against Plasmodium antigens during malaria infection. Since most studies have focused on the quantification of serum antibody titers, those B cell responses have not been fully characterized. However, to secrete antibodies, a complex cellular response is set up, including not only the activation and differentiation of B cells into antibody-secreting cells, but also the participation of other cell subsets in the germinal center reactions. Therefore, a better understanding of how B cell subsets are stimulated during malaria infection will provide essential insights toward the design of potent interventions.
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Affiliation(s)
- Eduardo L V Silveira
- Department of Clinical and Toxicological Analyses, School of Pharmaceutical Sciences, University of São Paulo, São Paulo, Brazil
| | - Mariana R Dominguez
- Department of Clinical and Toxicological Analyses, School of Pharmaceutical Sciences, University of São Paulo, São Paulo, Brazil
| | - Irene S Soares
- Department of Clinical and Toxicological Analyses, School of Pharmaceutical Sciences, University of São Paulo, São Paulo, Brazil
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35
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Abstract
Potential solid organ transplant recipients broadly sensitized to HLA have long wait times, low transplant rates and poor outcomes. The new kidney allocation system has improved access to the most highly sensitized recipients; however, their long-term outcomes are unknown. Emerging data suggest that memory B cell repertoire is broader than the plasma cell repertoire, therefore, despite refinements in anti-HLA antibody detection technology, donor-specific HLA- specific memory B cells may in fact be present in some, if not most, highly sensitized recipients with no detectable donor-specific antibodies. In addition, new findings have underscored the heterogeneity in memory B cell generation, and in the signals that determine memory versus plasma cell fate during primary antigen encounter, as well as memory B cell differentiation upon antigen reencounter into plasma cells or reentry into germinal centers to subsequently emerge as higher affinity and class-switched plasma cells. Thus, heterogeneity memory B cells generation may affect the efficacy of specific immunomodulation during the recall response. We propose that the ability to quantify donor-specific B cell in transplant recipients is urgently required to provide insights into the mechanisms of sensitization and recall, and for the early detection of acute and chronic AMR.
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Affiliation(s)
- Anita S Chong
- Department of Surgery, Section of Transplantation, University of Chicago, Chicago, IL, USA
- Division of Nephrology, Department of Medicine, Northwestern University Feinberg School of Medicine, Chicago, IL, USA
| | - M Javeed Ansari
- Department of Surgery, Section of Transplantation, University of Chicago, Chicago, IL, USA
- Division of Nephrology, Department of Medicine, Northwestern University Feinberg School of Medicine, Chicago, IL, USA
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36
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Lachmann N, Niemann M, Reinke P, Budde K, Schmidt D, Halleck F, Pruß A, Schönemann C, Spierings E, Staeck O. Invited letter in response to "Predicted indirectly recognizable HLA epitopes (PIRCHE): Only the tip of the iceberg?". Am J Transplant 2018; 18:523-524. [PMID: 28992384 DOI: 10.1111/ajt.14535] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/25/2023]
Affiliation(s)
- Nils Lachmann
- Center for Tumor Medicine, H&I Laboratory, Charité University Medicine Berlin, Berlin, Germany
| | | | - Petra Reinke
- Department of Nephrology, Charité University Medicine Berlin, Berlin, Germany
| | - Klemens Budde
- Department of Nephrology, Charité University Medicine Berlin, Berlin, Germany
| | - Danilo Schmidt
- Department of Nephrology, Charité University Medicine Berlin, Berlin, Germany
| | - Fabian Halleck
- Department of Nephrology, Charité University Medicine Berlin, Berlin, Germany
| | - Axel Pruß
- Universitary Tissue Bank, Charité University Medicine Berlin, Berlin, Germany
| | - Constanze Schönemann
- Center for Tumor Medicine, H&I Laboratory, Charité University Medicine Berlin, Berlin, Germany
| | - Eric Spierings
- UMC Utrecht, Laboratory of Translational Immunology, Utrecht, The Netherlands
| | - Oliver Staeck
- Department of Nephrology, Charité University Medicine Berlin, Berlin, Germany
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37
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Guidicelli G, Taupin JL, Visentin J. Predicted indirectly recognizable HLA epitopes (PIRCHE): Only the tip of the iceberg? Am J Transplant 2018; 18:521-522. [PMID: 28834224 DOI: 10.1111/ajt.14474] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/06/2017] [Revised: 07/30/2017] [Accepted: 08/12/2017] [Indexed: 01/25/2023]
Affiliation(s)
| | - Jean-Luc Taupin
- AP-HP, Laboratoire d'Immunologie et Histocompatibilité, Hôpital Saint-Louis, Paris, France.,INSERM U1160, Centre Hayem, Paris, France
| | - Jonathan Visentin
- Laboratoire d'Immunologie et Immunogénétique, CHU de Bordeaux, Bordeaux, France.,Université de Bordeaux, UMR CNRS 5164 ImmunoConcept, Bordeaux, France
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38
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Affiliation(s)
- Adam Asare
- Immune Tolerance Network, Massachusetts General Hospital, Bethesda, MD, USA
| | - Sai Kanaparthi
- Immune Tolerance Network, Massachusetts General Hospital, Bethesda, MD, USA
| | - Noha Lim
- Immune Tolerance Network, Massachusetts General Hospital, Bethesda, MD, USA
| | - Kenneth A Newell
- Department of Surgery, Emory University School of Medicine, Emory University, Atlanta, GA, USA
| | - Laurence A Turka
- Center for Transplantation Sciences and Immune Tolerance Network, Massachusetts General Hospital, Boston, MA, USA
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39
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Fribourg M, Ni J, Papavasiliou FN, Yue Z, Heeger PS, Leventhal JS. Allospecific Memory B Cell Responses Are Dependent on Autophagy. Am J Transplant 2018; 18:102-112. [PMID: 28621910 PMCID: PMC5732898 DOI: 10.1111/ajt.14394] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/15/2016] [Revised: 06/07/2017] [Accepted: 06/08/2017] [Indexed: 01/25/2023]
Abstract
Long-lived, donor-reactive memory B cells (Bmems) can produce alloantibodies that mediate transplant injury. Autophagy, an intrinsic mechanism of cell organelle/component recycling, is required for Bmem survival in infectious and model antigen systems, but whether autophagy affects alloreactive Bmem is unknown. We studied mice with an inducible yellow fluorescent protein (YFP) reporter expressed under the activation-induced cytidine deaminase (AID) promoter active in B cells undergoing germinal center reactions. Up to 12 months after allogeneic sensitization, splenic YFP+ B cells were predominantly IgD- IgM- IgG+ and expressed CD73, CD80, and PD-L2, consistent with Bmems. Labeled cells contained significantly more cells with autophagosomes and more autophagosomes per cell than unlabeled, naïve B cells. To test for a functional link, we quantified alloantibody formation in mice with B cells conditionally deficient in the requisite autophagy gene ATG7. These experiments revealed absent B cell ATG7 (1) prevented B cell autophagy, (2) inhibited secondary alloantibody responses without altering primary alloantibody formation, and (3) diminished frequencies of alloreactive Bmems. Pharmacological autophagy inhibition with 3-methyladenine had similar effects on wild-type mice. Together with new documentation of increased autophagosomes within human Bmems, our data indicate that targeting autophagy has potential for eliminating donor-reactive Bmems in transplant recipients.
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Affiliation(s)
- Miguel Fribourg
- Department of Neurology and Center for Translational Systems Biology, Icahn School of Medicine at Mount Sinai, New York, USA
| | - Jie Ni
- Division of Nephrology, Department of Medicine, Icahn School of Medicine at Mount Sinai, New York, USA
| | - F. Nina Papavasiliou
- Department of Immunology, Virology, and Microbiology, The Rockefeller University, New York, USA
| | - Zhenyu Yue
- Department of Neurology, Friedman Brain Institute, Icahn School of Medicine at Mount Sinai, New York, USA
| | - Peter S. Heeger
- Division of Nephrology, Department of Medicine, Icahn School of Medicine at Mount Sinai, New York, USA,Transplant Research Institute, Icahn School of Medicine at Mount Sinai, New York, USA
| | - Jeremy S. Leventhal
- Division of Nephrology, Department of Medicine, Icahn School of Medicine at Mount Sinai, New York, USA,Transplant Research Institute, Icahn School of Medicine at Mount Sinai, New York, USA,Renal Division, James J Peters Bronx VA Medical Center, Bronx, New York, USA
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40
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Azzi J, Raimondi G, Mas V, Riella LV, Elfadawy N, Safa K, Wojciechowski D, Kanak M, Nog R, Maltzman JS, Ford ML, Pober JS, Luo XR, Rothstein D, Miller ML, Matthews D, Burlingham W, Levings M, Heeger P, Higdon L, Gill J, Gill RG, Alegre ML. The outstanding questions in transplantation: It's about time…. Am J Transplant 2018; 18:271-272. [PMID: 28758364 DOI: 10.1111/ajt.14450] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/25/2023]
Affiliation(s)
- Jamil Azzi
- Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA
| | | | - Valeria Mas
- University of Virginia, Charlottesville, VA, USA
| | - Leonardo V Riella
- Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA
| | | | - Kassem Safa
- Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA
| | | | - Mazhar Kanak
- Virginia Commonwealth University School of Medicine, Richmond, VA, USA
| | - Rajat Nog
- Westchester Medical Center, Valhalla, NY, USA
| | | | | | | | | | | | | | | | | | - Megan Levings
- University of British Columbia, Vancouver, BC, Canada
| | - Peter Heeger
- Mount Sinai School of Medicine, New York, NY, USA
| | | | - John Gill
- University of British Columbia, Vancouver, BC, Canada
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41
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Su D, Vanhee S, Soria R, Gyllenbäck EJ, Starnes LM, Højfeldt MK, Pedersen GK, Yuan J, Daniel JA. PTIP chromatin regulator controls development and activation of B cell subsets to license humoral immunity in mice. Proc Natl Acad Sci U S A 2017; 114:E9328-37. [PMID: 29078319 DOI: 10.1073/pnas.1707938114] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/21/2022] Open
Abstract
To provide optimal host defense, the full spectrum of antibody-based immunity requires natural antibodies and immunization-induced antigen-specific antibodies. Here we show that the PTIP (Pax transactivation domain-interacting protein) chromatin regulator is induced by B cell activation to potentiate the establishment of steady-state and postimmune serum antibody levels. It does so by promoting activation-associated proliferation and differentiation of all the major B cell subsets, at least in part, through regulating the NF-κB pathway. With the genetic basis still unknown for a majority of patients with common variable immunodeficiency, further work investigating how PTIP controls cell signaling may generate valuable new insight for human health and disease. B cell receptor signaling and downstream NF-κB activity are crucial for the maturation and functionality of all major B cell subsets, yet the molecular players in these signaling events are not fully understood. Here we use several genetically modified mouse models to demonstrate that expression of the multifunctional BRCT (BRCA1 C-terminal) domain-containing PTIP (Pax transactivation domain-interacting protein) chromatin regulator is controlled by B cell activation and potentiates steady-state and postimmune antibody production in vivo. By examining the effects of PTIP deficiency in mice at various ages during ontogeny, we demonstrate that PTIP promotes bone marrow B cell development as well as the neonatal establishment and subsequent long-term maintenance of self-reactive B-1 B cells. Furthermore, we find that PTIP is required for B cell receptor- and T:B interaction-induced proliferation, differentiation of follicular B cells during germinal center formation, and normal signaling through the classical NF-κB pathway. Together with the previously identified role for PTIP in promoting sterile transcription at the Igh locus, the present results establish PTIP as a licensing factor for humoral immunity that acts at several junctures of B lineage maturation and effector cell differentiation by controlling B cell activation.
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42
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Suthers AN, Sarantopoulos S. TLR7/TLR9- and B Cell Receptor-Signaling Crosstalk: Promotion of Potentially Dangerous B Cells. Front Immunol 2017; 8:775. [PMID: 28751890 PMCID: PMC5507964 DOI: 10.3389/fimmu.2017.00775] [Citation(s) in RCA: 69] [Impact Index Per Article: 9.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/21/2017] [Accepted: 06/19/2017] [Indexed: 12/12/2022] Open
Abstract
B cells are capable of receptor-mediated responses to foreign antigens. Recognition of microbial-derived nucleic acid (NA) by toll-like receptors (TLRs) 7 and 9 in B cells has been substantiated. Endogenous NA released from damaged or dying cells can also be immunogenic in certain contexts and can incite aberrant activation of B cells. When TLR-driven B cell receptor (BCR)-activated B cells are not properly constrained, pathologic autoantibodies are produced. It is also clear that endosomal TLR7/TLR9 can operate in conjunction with BCR. In addition to BCR signaling, a balance between TLR7 and TLR9 is pivotal in the development of B cell autoreactivity. While TLR9 is important in normal memory B cell responses through BCR, TLR9 activation has been implicated in autoantibody production. Paradoxically, TLR9 also plays known protective roles against autoimmunity by directly and indirectly inhibiting TLR7-mediated autoantibody production. Herein, we summarize literature supporting mechanisms underpinning the promotion of pathological BCR-activated B cells by TLR7 and TLR9. We focus on the literature regarding known points of TLR7/TLR9 and BCR crosstalk. Data also suggest that the degree of TLR responsiveness relies on alterations of certain intrinsic B-cell signaling molecules and is also context specific. Because allogeneic hematopoietic stem cell transplantation is a high NA and B cell-activating factor environment, we conclude that B cell studies of synergistic TLR-BCR signaling in human diseases like chronic graft-versus-host disease are warranted. Further understanding of the distinct molecular pathways mediating TLR-BCR synergy will lead to the development of therapeutic strategies in autoimmune disease states.
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Affiliation(s)
- Amy N Suthers
- Department of Medicine, Division of Hematological Malignancies and Cellular Therapy, Duke Cancer Institute, Duke University Medical Center, Durham, NC, United States
| | - Stefanie Sarantopoulos
- Department of Medicine, Division of Hematological Malignancies and Cellular Therapy, Duke Cancer Institute, Duke University Medical Center, Durham, NC, United States.,Department of Immunology, Duke University Medical Center, Durham, NC, United States
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43
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Schuetz C, Lee KM, Scott R, Kojima L, Washburn L, Liu L, Liu WH, Tector H, Lei J, Yeh H, Kim JI, Markmann JF. Regulatory B Cell-Dependent Islet Transplant Tolerance Is Also Natural Killer Cell Dependent. Am J Transplant 2017; 17:1656-1662. [PMID: 28296255 PMCID: PMC5444975 DOI: 10.1111/ajt.14265] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/29/2016] [Revised: 02/06/2017] [Accepted: 02/22/2017] [Indexed: 01/25/2023]
Abstract
Immunologic tolerance to solid organ and islet cell grafts has been achieved in various rodent models by using antibodies directed at CD45RB and Tim-1. We have shown that this form of tolerance depends on regulatory B cells (Bregs). To elucidate further the mechanism by which Bregs induce tolerance, we investigated the requirement of natural killer (NK) and NKT cells in this model. To do so, hyperglycemic B6, μMT, Beige, or CD1d-/- mice received BALB/c islet grafts and treatment with the tolerance-inducing regimen consisting of anti-CD45RB and anti-TIM1. B6 mice depleted of both NK and NKT cells by anti-NK1.1 antibody and mice deficient in NK activity (Beige) did not develop tolerance after dual-antibody treatment. In contrast, transplant tolerance induction was successful in CD1d-/- recipients (deficient in NKT cells), indicating that NK, but not NKT, cells are essential in B cell-dependent tolerance. In addition, reconstitution of Beige host with NK cells restored the ability to induce transplant tolerance with dual-antibody treatment. Transfer of tolerance by B cells from tolerant mice was also dependent on host Nk1.1+ cells. In conclusion, these results show that regulatory function of B cells is dependent on NK cells in this model of transplantation tolerance.
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Affiliation(s)
- C Schuetz
- Division of Transplantation, Department of Surgery, Massachusetts General Hospital, Boston, MA
| | - K M Lee
- Division of Transplantation, Department of Surgery, Massachusetts General Hospital, Boston, MA
| | - R Scott
- Division of Transplantation, Department of Surgery, Massachusetts General Hospital, Boston, MA
| | - L Kojima
- Division of Transplantation, Department of Surgery, Massachusetts General Hospital, Boston, MA
| | - L Washburn
- Division of Transplantation, Department of Surgery, Massachusetts General Hospital, Boston, MA
| | - L Liu
- Division of Transplantation, Department of Surgery, Massachusetts General Hospital, Boston, MA
| | - W-H Liu
- Division of Transplantation, Department of Surgery, Massachusetts General Hospital, Boston, MA
| | - H Tector
- Division of Transplantation, Department of Surgery, Massachusetts General Hospital, Boston, MA
| | - J Lei
- Division of Transplantation, Department of Surgery, Massachusetts General Hospital, Boston, MA
| | - H Yeh
- Division of Transplantation, Department of Surgery, Massachusetts General Hospital, Boston, MA
| | - J I Kim
- Division of Transplantation, Department of Surgery, Massachusetts General Hospital, Boston, MA
| | - J F Markmann
- Division of Transplantation, Department of Surgery, Massachusetts General Hospital, Boston, MA
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44
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Schlößer HA, Thelen M, Dieplinger G, von Bergwelt-Baildon A, Garcia-Marquez M, Reuter S, Shimabukuro-Vornhagen A, Wennhold K, Haustein N, Buchner D, Heiermann N, Kleinert R, Wahba R, Ditt V, Kurschat C, Cingöz T, Becker J, Stippel DL, von Bergwelt-Baildon M. Prospective Analyses of Circulating B Cell Subsets in ABO-Compatible and ABO-Incompatible Kidney Transplant Recipients. Am J Transplant 2017; 17:542-550. [PMID: 27529836 DOI: 10.1111/ajt.14013] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/16/2016] [Revised: 07/24/2016] [Accepted: 08/09/2016] [Indexed: 01/25/2023]
Abstract
Immunosuppressive strategies applied in renal transplantation traditionally focus on T cell inhibition. B cells were mainly examined in the context of antibody-mediated rejection, whereas the impact of antibody-independent B cell functions has only recently entered the field of transplantation. Similar to T cells, distinct B cell subsets can enhance or inhibit immune responses. In this study, we prospectively analyzed the evolution of B cell subsets in the peripheral blood of AB0-compatible (n = 27) and AB0-incompatible (n = 10) renal transplant recipients. Activated B cells were transiently decreased and plasmablasts were permanently decreased in patients without signs of rejection throughout the first year. In patients with histologically confirmed renal allograft rejection, activated B cells and plasmablasts were significantly elevated on day 365. Rituximab treatment in AB0-incompatible patients resulted in long-lasting B cell depletion and in a naïve phenotype of repopulating B cells 1 year following transplantation. Acute allograft rejection was correlated with an increase of activated B cells and plasmablasts and with a significant reduction of regulatory B cell subsets. Our study demonstrates the remarkable effects of standard immunosuppression on circulating B cell subsets. Furthermore, the B cell compartment was significantly altered in rejecting patients. A specific targeting of deleterious B cell subsets could be of clinical benefit in renal transplantation.
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Affiliation(s)
- H A Schlößer
- Department of General, Visceral and Cancer Surgery, University of Cologne, Köln, Germany.,Cologne Interventional Immunology, University of Cologne, Köln, Germany.,Cologne Transplant Center, University of Cologne, Köln, Germany
| | - M Thelen
- Cologne Interventional Immunology, University of Cologne, Köln, Germany
| | - G Dieplinger
- Department of General, Visceral and Cancer Surgery, University of Cologne, Köln, Germany.,Cologne Transplant Center, University of Cologne, Köln, Germany
| | - A von Bergwelt-Baildon
- Cologne Transplant Center, University of Cologne, Köln, Germany.,Department of Internal Medicine II, University of Cologne, Köln, Germany
| | - M Garcia-Marquez
- Cologne Interventional Immunology, University of Cologne, Köln, Germany
| | - S Reuter
- Cologne Interventional Immunology, University of Cologne, Köln, Germany
| | - A Shimabukuro-Vornhagen
- Cologne Interventional Immunology, University of Cologne, Köln, Germany.,Cologne Transplant Center, University of Cologne, Köln, Germany
| | - K Wennhold
- Cologne Interventional Immunology, University of Cologne, Köln, Germany
| | - N Haustein
- Cologne Interventional Immunology, University of Cologne, Köln, Germany
| | - D Buchner
- Department of General, Visceral and Cancer Surgery, University of Cologne, Köln, Germany.,Cologne Transplant Center, University of Cologne, Köln, Germany
| | - N Heiermann
- Department of General, Visceral and Cancer Surgery, University of Cologne, Köln, Germany.,Cologne Transplant Center, University of Cologne, Köln, Germany
| | - R Kleinert
- Department of General, Visceral and Cancer Surgery, University of Cologne, Köln, Germany.,Cologne Transplant Center, University of Cologne, Köln, Germany
| | - R Wahba
- Department of General, Visceral and Cancer Surgery, University of Cologne, Köln, Germany.,Cologne Transplant Center, University of Cologne, Köln, Germany
| | - V Ditt
- Institute for Clinical Transfusion Medicine, Merheim Medical Center Cologne, Köln, Germany
| | - C Kurschat
- Cologne Transplant Center, University of Cologne, Köln, Germany.,Department of Internal Medicine II, University of Cologne, Köln, Germany
| | - T Cingöz
- Cologne Transplant Center, University of Cologne, Köln, Germany.,Department of Internal Medicine II, University of Cologne, Köln, Germany
| | - J Becker
- Cologne Transplant Center, University of Cologne, Köln, Germany.,Institute of Pathology, University of Cologne, Köln, Germany
| | - D L Stippel
- Department of General, Visceral and Cancer Surgery, University of Cologne, Köln, Germany.,Cologne Transplant Center, University of Cologne, Köln, Germany
| | - M von Bergwelt-Baildon
- Cologne Interventional Immunology, University of Cologne, Köln, Germany.,Department of Internal Medicine I, University of Cologne, Köln, Germany
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45
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Tasaki M, Saito K, Nakagawa Y, Imai N, Ito Y, Aoki T, Kamimura M, Narita I, Tomita Y, Takahashi K. Acquired Downregulation of Donor-Specific Antibody Production After ABO-Incompatible Kidney Transplantation. Am J Transplant 2017; 17:115-128. [PMID: 27343838 DOI: 10.1111/ajt.13937] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/17/2015] [Revised: 05/31/2016] [Accepted: 06/21/2016] [Indexed: 01/25/2023]
Abstract
The mechanism of long-term B cell immunity against donor blood group antigens in recipients who undergo ABO-incompatible (ABOi) living-donor kidney transplantation (LKTx) is unknown. To address this question, we evaluated serial anti-A and anti-B antibody titers in 50 adult recipients. Donor-specific antibody titers remained low (≤1:4) in 42 recipients (84%). However, antibodies against nondonor blood group antigens were continuously produced in recipients with blood type O. We stimulated recipients' peripheral blood mononuclear cells in vitro to investigate whether B cells produced antibodies against donor blood group antigens in the absence of graft adsorption in vivo. Antibodies in cell culture supernatant were measured using specific enzyme-linked immunosorbent assays (ELISAs). Thirty-five healthy volunteers and 57 recipients who underwent ABO-compatible LKTx served as controls. Antibody production in vitro against donor blood group antigens by cells from ABOi LKTx patients was lower than in the control groups. Immunoglobulin deposits were undetectable in biopsies of grafts of eight recipients with low antibody titers (≤1:4) after ABOi LKTx. One patient with blood type A1 who received a second ABOi LKTx from a type B donor did not produce B-specific antibodies. These findings suggest diminished donor-specific antibody production function in the setting of adult ABOi LKTx.
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Affiliation(s)
- M Tasaki
- Division of Urology, Department of Regenerative & Transplant Medicine, Niigata Graduate School of Medical and Dental Sciences, Niigata, Japan
| | - K Saito
- Division of Urology, Department of Regenerative & Transplant Medicine, Niigata Graduate School of Medical and Dental Sciences, Niigata, Japan
| | - Y Nakagawa
- Division of Urology, Department of Regenerative & Transplant Medicine, Niigata Graduate School of Medical and Dental Sciences, Niigata, Japan
| | - N Imai
- Division of Clinical Nephrology and Rheumatology, Graduate School of Medical and Dental Sciences, Niigata University, Niigata, Japan
| | - Y Ito
- Division of Clinical Nephrology and Rheumatology, Graduate School of Medical and Dental Sciences, Niigata University, Niigata, Japan
| | - T Aoki
- Division of Transfusion Medicine and Regenerative Medicine, Bioscience Medical Center, Niigata University Medical and Dental Hospital, Niigata, Japan
| | - M Kamimura
- Division of Transfusion Medicine and Regenerative Medicine, Bioscience Medical Center, Niigata University Medical and Dental Hospital, Niigata, Japan
| | - I Narita
- Division of Clinical Nephrology and Rheumatology, Graduate School of Medical and Dental Sciences, Niigata University, Niigata, Japan
| | - Y Tomita
- Division of Urology, Department of Regenerative & Transplant Medicine, Niigata Graduate School of Medical and Dental Sciences, Niigata, Japan
| | - K Takahashi
- Division of Urology, Department of Regenerative & Transplant Medicine, Niigata Graduate School of Medical and Dental Sciences, Niigata, Japan.,Niigata Prefecture Organ Transplant Promotion Foundation, Tokyo, Japan
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46
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Huibers MMH, Gareau AJ, Beerthuijzen JMT, Siera-de Koning E, van Kuik J, Kamburova EG, Vink A, de Jonge N, Lee TDG, Otten HG, de Weger RA. Donor-Specific Antibodies Are Produced Locally in Ectopic Lymphoid Structures in Cardiac Allografts. Am J Transplant 2017; 17:246-254. [PMID: 27428759 DOI: 10.1111/ajt.13969] [Citation(s) in RCA: 27] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/19/2016] [Revised: 06/17/2016] [Accepted: 07/10/2016] [Indexed: 01/25/2023]
Abstract
Cardiac allograft vasculopathy (CAV) is a transplant pathology, limiting graft survival after heart transplantation. CAV arteries are surrounded by ectopic lymphoid structures (ELS) containing B cells and plasma cells. The aim of this study was to characterize the antigenic targets of antibodies produced in ELS. Coronary arteries and surrounding epicardial tissue from 56 transplant recipients were collected during autopsy. Immunofluorescence was used to identify antibody-producing plasma cells. Immunoglobulin levels in tissue lysates were measured by enzyme-linked immunosorbent assay and analyzed for donor-specific HLA antibodies by Luminex assay. Cytokine and receptor expression levels were quantified using quantitative polymerase chain reaction. Plasma cells in ELS were polyclonal and produced IgG and/or IgM antibodies. In epicardial tissue, IgG (p < 0.05) and IgM levels were higher in transplant patients with larger ELS than smaller ELS. In 4 of 21 (19%) patients with ELS, donor-specific HLA type II antibodies were detected locally. Cytokine and receptor expression (CXCR3, interferon γ and TGF-β) was higher in large ELS in the epicardial tissue than in other vessel wall layers, suggesting active recruitment and proliferation of T and B lymphocytes. ELS exhibited active plasma cells producing locally manufactured antibodies that, in some cases, were directed against the donor HLA, potentially mediating rejection with major consequences for the graft.
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Affiliation(s)
- M M H Huibers
- Department of Pathology, University Medical Center Utrecht, Utrecht, the Netherlands
| | - A J Gareau
- Department of Internal Medicine, University of Manitoba, Winnipeg, Canada
| | - J M T Beerthuijzen
- Department of Pathology, University Medical Center Utrecht, Utrecht, the Netherlands
| | - E Siera-de Koning
- Department of Pathology, University Medical Center Utrecht, Utrecht, the Netherlands
| | - J van Kuik
- Department of Pathology, University Medical Center Utrecht, Utrecht, the Netherlands
| | - E G Kamburova
- Laboratory of Translational Immunology, University Medical Center Utrecht, Utrecht, the Netherlands
| | - A Vink
- Department of Pathology, University Medical Center Utrecht, Utrecht, the Netherlands
| | - N de Jonge
- Department of Cardiology, University Medical Center Utrecht, Utrecht, the Netherlands
| | - T D G Lee
- Department of Pathology, Dalhousie University, Halifax, Canada.,Department of Surgery, Dalhousie University, Halifax, Canada.,Department of Microbiology and Immunology, Dalhousie University, Halifax, Canada
| | - H G Otten
- Laboratory of Translational Immunology, University Medical Center Utrecht, Utrecht, the Netherlands
| | - R A de Weger
- Department of Pathology, University Medical Center Utrecht, Utrecht, the Netherlands
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47
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Bigot J, Pilon C, Matignon M, Grondin C, Leibler C, Aissat A, Pirenne F, Cohen JL, Grimbert P. Transcriptomic Signature of the CD24 hi CD38 hi Transitional B Cells Associated With an Immunoregulatory Phenotype in Renal Transplant Recipients. Am J Transplant 2016; 16:3430-3442. [PMID: 27273606 DOI: 10.1111/ajt.13904] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/24/2015] [Revised: 05/25/2016] [Accepted: 05/27/2016] [Indexed: 01/25/2023]
Abstract
The role of B cells after transplant regarding allograft rejection or tolerance has become a topic of major interest. Recently, in renal transplant recipients, a B cell signature characterized by the overexpression of CD19+ CD38hi CD24hi transitional B cells has been observed in operationally tolerant patients and in belatacept-treated patients with significantly lower incidence of donor-specific antibodies. The phenotypic and functional characterization of these transitional B cells is far from exhaustive. We present the first transcriptomic and phenotypic analysis associated with this cell phenotype. Three populations were studied and compared: (i) transitional CD24hi CD38hi , (ii) CD24+ CD38- , and (iii) CD24int CD38int B cells. Transcriptome bioinformatic analysis revealed a particular signature for the CD24hi CD38hi population. Phenotypic analysis showed that CD24hi CD38hi transitional B cells also expressed CD9, CD10, CD1b and inducible T cell costimulator ligand (ICOS-L) markers. In addition, we found enrichment of IL-10+ cells among CD24hi CD38hi cells expressing ICOS-L and CD1b, the latter showing regulatory properties. Renal transplant recipients treated with belatacept exhibited significant expression of CD1b. Our results show that transitional CD24hi CD38hi B cells exhibit a distinct and specific profile, and this could be helpful for understanding of immune-regulatory mechanisms and immune monitoring in the field of organ transplant and autoimmune disease.
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Affiliation(s)
- J Bigot
- Université Paris-Est Créteil, Faculté de Médecine, Créteil, France.,Institut Mondor de Recherche Biomédicale (IMRB), INSERM U955, Equipe 21, Créteil, France
| | - C Pilon
- Université Paris-Est Créteil, Faculté de Médecine, Créteil, France.,Institut Mondor de Recherche Biomédicale (IMRB), INSERM U955, Equipe 21, Créteil, France.,AP-HP, Groupe Hospitalier Henri-Mondor Albert-Chenevier, CIC-BT-504, Créteil, France
| | - M Matignon
- Université Paris-Est Créteil, Faculté de Médecine, Créteil, France.,Institut Mondor de Recherche Biomédicale (IMRB), INSERM U955, Equipe 21, Créteil, France.,AP-HP, Groupe Hospitalier Henri-Mondor Albert-Chenevier, Service de Néphrologie, Créteil, France
| | - C Grondin
- Université Paris-Est Créteil, Faculté de Médecine, Créteil, France.,Institut Mondor de Recherche Biomédicale (IMRB), INSERM U955, Equipe 21, Créteil, France
| | - C Leibler
- Université Paris-Est Créteil, Faculté de Médecine, Créteil, France.,Institut Mondor de Recherche Biomédicale (IMRB), INSERM U955, Equipe 21, Créteil, France.,AP-HP, Groupe Hospitalier Henri-Mondor Albert-Chenevier, Service de Néphrologie, Créteil, France
| | - A Aissat
- Université Paris-Est Créteil, Faculté de Médecine, Créteil, France.,Institut Mondor de Recherche Biomédicale (IMRB), INSERM U955, Equipe 5, Créteil, France.,AP-HP, Groupe Hospitalier Henri-Mondor Albert-Chenevier, Service Hospitalier, Créteil, France
| | - F Pirenne
- Université Paris-Est Créteil, Faculté de Médecine, Créteil, France.,Institut Mondor de Recherche Biomédicale (IMRB), INSERM U955, Equipe 2, Créteil, France.,Etablissement Français du Sang, Ile-de-France Mondor, Créteil, France
| | - J L Cohen
- Université Paris-Est Créteil, Faculté de Médecine, Créteil, France.,Institut Mondor de Recherche Biomédicale (IMRB), INSERM U955, Equipe 21, Créteil, France.,AP-HP, Groupe Hospitalier Henri-Mondor Albert-Chenevier, CIC-BT-504, Créteil, France
| | - P Grimbert
- Université Paris-Est Créteil, Faculté de Médecine, Créteil, France.,Institut Mondor de Recherche Biomédicale (IMRB), INSERM U955, Equipe 21, Créteil, France.,AP-HP, Groupe Hospitalier Henri-Mondor Albert-Chenevier, CIC-BT-504, Créteil, France.,AP-HP, Groupe Hospitalier Henri-Mondor Albert-Chenevier, Service de Néphrologie, Créteil, France
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48
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Young JS, Chen J, Miller ML, Vu V, Tian C, Moon JJ, Alegre ML, Sciammas R, Chong AS. Delayed Cytotoxic T Lymphocyte-Associated Protein 4-Immunoglobulin Treatment Reverses Ongoing Alloantibody Responses and Rescues Allografts From Acute Rejection. Am J Transplant 2016; 16:2312-23. [PMID: 26928966 PMCID: PMC4956497 DOI: 10.1111/ajt.13761] [Citation(s) in RCA: 42] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/21/2015] [Revised: 02/18/2016] [Accepted: 02/21/2016] [Indexed: 01/25/2023]
Abstract
Antibody-mediated rejection has emerged as the leading cause of late graft loss in kidney transplant recipients, and inhibition of donor-specific antibody production should lead to improved transplant outcomes. The fusion protein cytotoxic T lymphocyte-associated protein 4-immunoglobulin (CTLA4-Ig) blocks T cell activation and consequently inhibits T-dependent B cell antibody production, and the current paradigm is that CTLA4-Ig is effective with naïve T cells and less so with activated or memory T cells. In this study, we used a mouse model of allosensitization to investigate the efficacy of continuous CTLA4-Ig treatment, initiated 7 or 14 days after sensitization, for inhibiting ongoing allospecific B cell responses. Delayed treatment with CTLA4-Ig collapsed the allospecific germinal center B cell response and inhibited alloantibody production. Using adoptively transferred T cell receptor transgenic T cells and a novel approach to track endogenous graft-specific T cells, we demonstrate that delayed CTLA4-Ig minimally inhibited graft-specific CD4(+) and T follicular helper responses. Remarkably, delaying CTLA4-Ig until day 6 after transplantation in a fully mismatched heart transplant model inhibited alloantibody production and prevented acute rejection, whereas transferred hyperimmune sera reversed the effects of delayed CTLA4-Ig. Collectively, our studies revealed the unexpected efficacy of CTLA4-Ig for inhibiting ongoing B cell responses even when the graft-specific T cell response was robustly established.
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Affiliation(s)
- James S. Young
- Section of Transplantation, Department of Surgery, The University of Chicago, Chicago, IL
| | - Jianjun Chen
- Section of Transplantation, Department of Surgery, The University of Chicago, Chicago, IL
| | - Michelle L. Miller
- Section of Rheumatology, Department of Medicine, The University of Chicago, Chicago, IL
| | - Vinh Vu
- Section of Transplantation, Department of Surgery, The University of Chicago, Chicago, IL
| | - Changtai Tian
- Section of Transplantation, Department of Surgery, The University of Chicago, Chicago, IL
| | - James J. Moon
- Center for Immunology and Inflammatory Diseases, and Division of Pulmonary and Critical Care Medicine, Massachusetts General Hospital; and Harvard Medical School, Boston, MA
| | - Maria-Luisa Alegre
- Section of Rheumatology, Department of Medicine, The University of Chicago, Chicago, IL
| | - Roger Sciammas
- Section of Transplantation, Department of Surgery, The University of Chicago, Chicago, IL
| | - Anita S. Chong
- Section of Transplantation, Department of Surgery, The University of Chicago, Chicago, IL
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49
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Mujtaba MA, Komocsar WJ, Nantz E, Samaniego MD, Henson SL, Hague JA, Lobashevsky AL, Higgins NG, Czader M, Book BK, Anderson MD, Pescovitz MD, Taber TE. Effect of Treatment With Tabalumab, a B Cell-Activating Factor Inhibitor, on Highly Sensitized Patients With End-Stage Renal Disease Awaiting Transplantation. Am J Transplant 2016; 16:1266-75. [PMID: 26780484 DOI: 10.1111/ajt.13557] [Citation(s) in RCA: 25] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/22/2015] [Revised: 09/23/2015] [Accepted: 09/28/2015] [Indexed: 01/25/2023]
Abstract
B cell-activation factor (BAFF) is critical for B cell maturation. Inhibition of BAFF represents an appealing target for desensitization of sensitized end-stage renal disease (ESRD) patients. We conducted a Phase 2a, single-arm, open-label exploratory study investigating the effect of tabalumab (BAFF inhibitor) in patients with ESRD and calculated panel reactive antibodies (cPRAs) >50%. The treatment period duration was 24 weeks. Eighteen patients received tabalumab, at doses of 240-mg subcutaneous (SC) at Week 0 followed by 120-mg SC monthly for 5 additional months. Patients were followed for an additional 52 weeks. Immunopharmacologic effects were characterized through analysis of blood for HLA antibodies, BAFF concentrations, immunoglobulins, T and B cell subsets, as well as pre- and posttreatment tonsil and bone marrow biopsies. Significant reductions in cPRAs were observed at Weeks 16 (p = 0.043) and 36 (p = 0.004); however, absolute reductions were small (<5%). Expected pharmacologic changes in B cell subsets and immunoglobulin reductions were observed. Two tabalumab-related serious adverse events occurred (pneumonia, worsening of peripheral neuropathy), while the most common other adverse events were injection-site pain and hypotension. Three patients received matched deceased donor transplants during follow-up. Treatment with a BAFF inhibitor resulted in statistically significant, but not clinically meaningful reduction in the cPRA from baseline (NCT01200290, Clinicaltrials.gov).
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Affiliation(s)
- M A Mujtaba
- Division of Nephrology, University of Texas Medical Branch, Galveston, TX
| | - W J Komocsar
- Bio-Medicines Business Unit, Eli Lilly and Company, Indianapolis, IN
| | - E Nantz
- Bio-Medicines Business Unit, Eli Lilly and Company, Indianapolis, IN
| | - M D Samaniego
- Department of Internal Medicine-Nephrology, University of Michigan Health System, Ann Arbor, MI
| | - S L Henson
- Department of Surgery, Indiana University School of Medicine, Indianapolis, IN
| | - J A Hague
- Clinical Trial Management, Eli Lilly and Company, Indianapolis, IN
| | - A L Lobashevsky
- Transplant Immunology, Indiana University Health, Indianapolis, IN
| | - N G Higgins
- Transplant Immunology, Indiana University Health, Indianapolis, IN
| | - M Czader
- Department of Pathology and Laboratory Medicine, Indiana University School of Medicine, Indianapolis, IN
| | - B K Book
- Department of Surgery, Indiana University School of Medicine, Indianapolis, IN
| | - M D Anderson
- Department of Medicine-Nephrology, Indiana University School of Medicine, Indianapolis, IN
| | | | - T E Taber
- Department of Medicine-Nephrology, Indiana University School of Medicine, Indianapolis, IN
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Tsai DE, Reshef R. Shaping the Molecular Landscape of Posttransplantation Lymphoproliferative Disorders. Am J Transplant 2016; 16:379-80. [PMID: 26780686 DOI: 10.1111/ajt.13559] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/23/2015] [Accepted: 10/02/2015] [Indexed: 01/25/2023]
Affiliation(s)
- D E Tsai
- Division of Hematology and Oncology, Abramson Cancer Center, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA
| | - R Reshef
- Division of Hematology and Oncology and Columbia Center for Translational Immunology, Department of Medicine, Columbia University Medical Center, New York, NY
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