Odorico J S, Barker C F, Posselt A M, Naji A
Department of Surgery, Hospital of the University of Pennsylvania, Philadelphia 19104.
Surgery. 1992 Aug;112(2):370-6; discussion 376-7.
Induction of donor-specific tolerance to tissue or organ allografts can readily be achieved by administration of allogeneic bone marrow to neonatal rodents; however, in adult recipients induction of transplantation tolerance by this strategy generally requires intensive cytoablative conditioning. Described here is a novel method of promoting transplantation tolerance that involves inoculation of donor bone marrow into the thymus of transiently immunosuppressed adult recipients.
Prospective Wistar-Furth recipients were inoculated with allogeneic Lewis bone marrow cells (BMCs) either intrathymically or intravenously in conjunction with a single dose of antilymphocyte serum 2 to 3 weeks before receiving donor-strain cardiac allografts. Recipients were monitored for graft survival and examined for presence of hematopoietic chimerism.
Intrathymic but not intravenous inoculation of donor BMCs led to permanent survival of donor-strain cardiac allografts, whereas third-party Dark agouti cardiac allografts were rejected promptly. Persistence of donor chimerism was demonstrated in the thymus of Wistar-Furth recipients of intrathymic Lewis BMCs for as long as 3 weeks after BMC inoculation.
Intrathymic inoculation of BMCs concurrently with a single dose of antilymphocyte serum induces donor-specific unresponsiveness to rat cardiac allografts. The unresponsiveness may be the result of deletion or functional inactivation of alloreactive clones maturing in a thymus bearing donor alloantigen. Intrathymic inoculation of BMCs deserves further evaluation as a possible clinical strategy for the induction of transplantation tolerance.
通过给新生啮齿动物输注同种异体骨髓,可轻易实现对组织或器官异体移植的供体特异性耐受诱导;然而,在成年受体中,采用这种策略诱导移植耐受通常需要强化的细胞清除预处理。本文描述了一种促进移植耐受的新方法,该方法涉及将供体骨髓接种到短暂免疫抑制的成年受体的胸腺中。
在接受供体品系心脏异体移植前2至3周,将同种异体Lewis骨髓细胞(BMC)经胸腺内或静脉内接种到预期的Wistar-Furth受体中,并同时给予单剂量抗淋巴细胞血清。监测受体的移植物存活情况,并检查造血嵌合体的存在情况。
经胸腺内而非静脉内接种供体BMC可导致供体品系心脏异体移植的永久存活,而第三方Dark agouti心脏异体移植则迅速被排斥。在经胸腺内接种Lewis BMC的Wistar-Furth受体的胸腺中,供体嵌合体在BMC接种后长达3周的时间内持续存在。
将BMC经胸腺内接种并同时给予单剂量抗淋巴细胞血清可诱导对大鼠心脏异体移植的供体特异性无反应性。这种无反应性可能是在带有供体同种异体抗原的胸腺中成熟的同种反应性克隆被清除或功能失活的结果。作为一种可能的诱导移植耐受的临床策略,经胸腺内接种BMC值得进一步评估。