Wang Hao, Hosiawa Karoline A, Garcia Bertha, Shum Jeffrey B, Dutartre Patrick, Kelvin David J, Zhong Robert
Multi-Organ Transplant Program, London Health Sciences Centre, Ontario, Canada.
Transplantation. 2003 May 15;75(9):1475-81. doi: 10.1097/01.TP.0000057245.59998.95.
We previously reported that Lewis rat hearts transplanted into BALB/c mice developed typical acute vascular rejection (AVR). The present study was undertaken to determine the efficacy of LF15-0195, a new analogue of 15-deoxyspergualin, in the prevention of AVR and to determine whether a combination of LF15-0195 and CD45RB monoclonal antibody (mAb) would have a synergistic effect in prolonging xenograft survival.
We transplanted 2-week-old Lewis rat hearts into BALB/c mice, followed by experimental immunosuppressive regimens. Control groups were either untreated or treated with mAb monotherapy (100 microg/mouse, days -1 to 7, intravenously). Experimental groups were either treated with LF15-0195 (2 mg/kg, days -1 to 14, subcutaneously) or with LF15-0195 combined with mAb at monotherapeutic doses.
Heart xenografts in both untreated and mAb-treated BALB/c recipients were rejected at 6.0+/-0.7 days and 8.5+/-1.3 days, respectively, with typical features of AVR, characterized by hemorrhage, fibrin deposition, thrombosis, and massive accumulations of anti-rat IgG and IgM. Serum xenoreactive antibodies (xAbs) were also markedly elevated in these animals. In contrast, LF15-0195 monotherapy significantly prolonged graft survival to 19.3+/-0.7 days. Notably, xAbs were significantly decreased and graft rejection was of a cell-mediated nature instead of AVR. When mAb was combined with LF15-0195, graft survival was further increased to 65.2+/-9.1 days. Antibody production and T-cell infiltration were significantly inhibited at terminal stages of graft survival. Sequential studies on days 6 and 14 demonstrated that LF15-0195, either alone or combined with mAb, completely inhibited antibody production. However, intragraft infiltration by Mac-1+ cells in LF15-0195-treated recipients was similar to that of untreated recipients.
LF15-0195 effectively attenuated AVR by markedly inhibiting antidonor xAb production. Treatment with a combination of LF15-0195 and CD45RB mAb also significantly reduced T-cell infiltration and should be studied further to evaluate its efficacy in nonhuman primate subjects.
我们之前报道过,将Lewis大鼠心脏移植到BALB/c小鼠体内会发生典型的急性血管排斥反应(AVR)。本研究旨在确定15-脱氧精胍菌素的新类似物LF15-0195在预防AVR方面的疗效,并确定LF15-0195与CD45RB单克隆抗体(mAb)联合使用是否会在延长异种移植物存活时间方面产生协同作用。
我们将2周龄的Lewis大鼠心脏移植到BALB/c小鼠体内,随后采用实验性免疫抑制方案。对照组要么不进行治疗,要么采用单克隆抗体单一疗法(100微克/小鼠,第-1天至第7天,静脉注射)。实验组要么用LF15-0195治疗(2毫克/千克,第-1天至第14天,皮下注射),要么用LF15-0195与单克隆抗体的单一治疗剂量联合治疗。
在未治疗和接受单克隆抗体治疗的BALB/c受体中,心脏异种移植物分别在6.0±0.7天和8.5±1.3天被排斥,具有AVR的典型特征,表现为出血、纤维蛋白沉积、血栓形成以及抗大鼠IgG和IgM的大量积聚。这些动物的血清异种反应性抗体(xAbs)也显著升高。相比之下,LF15-0195单一疗法显著延长了移植物存活时间至19.3±0.7天。值得注意的是,xAbs显著降低,移植物排斥反应是细胞介导的性质而非AVR。当单克隆抗体与LF15-0195联合使用时,移植物存活时间进一步延长至65.2±9.1天。在移植物存活的末期,抗体产生和T细胞浸润受到显著抑制。在第6天和第14天的序贯研究表明,LF15-0195单独使用或与单克隆抗体联合使用时,完全抑制了抗体产生。然而,接受LF15-0195治疗的受体中Mac-1+细胞在移植物内的浸润情况与未治疗的受体相似。
LF15-0195通过显著抑制抗供体xAb的产生有效减轻了AVR。LF15-0195与CD45RB单克隆抗体联合治疗也显著减少了T细胞浸润,应进一步研究以评估其在非人类灵长类动物中的疗效。