Department of Anesthesiology, Johns Hopkins University, School of Medicine, Baltimore, MD, USA.
Am J Transplant. 2011 Sep;11(9):1815-24. doi: 10.1111/j.1600-6143.2011.03623.x. Epub 2011 Aug 9.
Acute cellular rejection (ACR) is a common and important clinical complication following lung transplantation. While there is a clinical need for the development of novel therapies to prevent ACR, the regulation of allospecific effector T-cells in this process remains incompletely understood. Using the MHC-mismatched mouse orthotopic lung transplant model, we investigated the short-term role of anti-CD154 mAb therapy alone on allograft pathology and alloimmune T-cell effector responses. Untreated C57BL/6 recipients of BALB/c left lung allografts had high-grade rejection and diminished CD4(+) : CD8(+) graft ratios, marked by predominantly CD8(+) >CD4(+) IFN-γ(+) allospecific effector responses at day 10, compared to isograft controls. Anti-CD154 mAb therapy strikingly abrogated both CD8(+) and CD4(+) alloeffector responses and significantly increased lung allograft CD4(+) : CD8(+) ratios. Examination of graft CD4(+) T-cells revealed significantly increased frequencies of CD4(+) CD25(+) Foxp3(+) regulatory T-cells in the lung allografts of anti-CD154-treated mice and was associated with significant attenuation of ACR compared to untreated controls. Together, these data show that CD154/CD40 costimulation blockade alone is sufficient to abrogate allospecific effector T-cell responses and significantly shifts the lung allograft toward an environment predominated by CD4(+) T regulatory cells in association with an attenuation of ACR.
急性细胞排斥反应 (ACR) 是肺移植后常见且重要的临床并发症。虽然临床需要开发新的疗法来预防 ACR,但在此过程中,对同种特异性效应 T 细胞的调节仍不完全了解。使用 MHC 错配的小鼠原位肺移植模型,我们研究了单独使用抗 CD154 mAb 治疗对同种异体移植物病理和同种免疫效应 T 细胞反应的短期作用。未经治疗的 BALB/c 左肺同种异体移植物的 C57BL/6 受体发生高级别排斥反应,CD4(+) : CD8(+) 移植物比值降低,与同基因对照相比,第 10 天主要表现为 CD8(+) > CD4(+) IFN-γ(+) 同种特异性效应反应。抗 CD154 mAb 治疗显著阻断了 CD8(+) 和 CD4(+) 同种效应反应,并显著增加了肺同种异体移植物的 CD4(+) : CD8(+) 比值。对移植物 CD4(+) T 细胞的检查显示,在抗 CD154 治疗的小鼠肺同种异体移植物中 CD4(+) CD25(+) Foxp3(+) 调节性 T 细胞的频率显著增加,与未治疗的对照组相比,ACR 明显减轻。这些数据表明,单独阻断 CD154/CD40 共刺激可完全阻断同种特异性效应 T 细胞反应,并显著将肺同种异体移植物向以 CD4(+) T 调节细胞为主的环境转移,同时减轻 ACR。