Brasile Lauren, Henry Nicholas, Stubenitsky Bart
1 Research and Development, BREONICS Inc. Watervliet, NY. 2 Plastic Surgery Division, St. Antonius Hospital, Utretch, the Netherlands.
Transplantation. 2017 Feb;101(2):e49-e56. doi: 10.1097/TP.0000000000001537.
We have previously reported on a novel organ-specific immunomodifying therapy that provides protection from early allograft rejection in the absence of systemic immunosuppressive drugs. This novel therapy is a nanobarrier membrane called ImmunoCloak, consisting of a matrix of laminin, proteoglycans, fibronectin, and collagens. The membrane "immunocloaks" the luminal surfaces within the renal vasculature by covering the point of contact between donor vascular endothelial cells and the recipient's immune cells, without adversely affecting renal function. The resulting nonthrombogenic and nonimmunogenic apical surface significantly delays the onset of rejection fivefold over untreated controls. Currently, our focus is to elucidate the mechanisms of protection provided by placement of the membrane.
The mechanisms underlying the protective effect of the ImmunoCloak treatment was evaluated using human peripheral blood mononuclear cells and by testing for antigen presentation by cytokine/chemokine analysis using the Luminex platform, T cell allogeneic responses were measured by flow cytometry, and diapedesis was assessed using transwell plates.
We now report that ImmunoCloak interrupts antigen presentation thereby preventing early T cell activation and interferes with diapedesis. There was significant inhibition in the synthesis of proinflammatory cytokines with a concordant blockade of T cell-mediated responses. The placement of the ImmunoCloak also significantly reduced leukocyte migration through the endothelial cell layer by 93%.
Eliminating the need for nephrotoxic immunosuppressive drugs during the early posttransplant period could help to ameliorate the severity of delayed graft function and could provide a path to using more ischemically damaged renal allografts.
我们之前报道过一种新型的器官特异性免疫调节疗法,该疗法在不使用全身性免疫抑制药物的情况下可预防早期移植排斥反应。这种新型疗法是一种名为免疫斗篷(ImmunoCloak)的纳米屏障膜,由层粘连蛋白、蛋白聚糖、纤连蛋白和胶原蛋白组成的基质构成。该膜通过覆盖供体血管内皮细胞与受体免疫细胞之间的接触点,对肾血管系统内的管腔表面进行“免疫伪装”,而不会对肾功能产生不利影响。由此产生的非血栓形成性和非免疫原性的顶端表面使排斥反应的发生时间比未治疗的对照组显著延迟了五倍。目前,我们的重点是阐明放置该膜所提供的保护机制。
使用人外周血单个核细胞评估免疫斗篷治疗的保护作用机制,并通过Luminex平台进行细胞因子/趋化因子分析来检测抗原呈递,通过流式细胞术测量T细胞同种异体反应,并使用Transwell板评估细胞穿膜迁移。
我们现在报告,免疫斗篷可中断抗原呈递,从而防止早期T细胞激活,并干扰细胞穿膜迁移。促炎细胞因子的合成受到显著抑制,同时T细胞介导的反应也受到相应阻断。免疫斗篷的放置还使白细胞通过内皮细胞层的迁移显著减少了93%。
在移植后的早期阶段消除对肾毒性免疫抑制药物的需求,可能有助于减轻移植肾功能延迟的严重程度,并可能为使用更多缺血性损伤的肾移植提供一条途径。