Department of Surgery, University of Alberta, Edmonton, Alberta, Canada.
Alberta Diabetes and Transplant Institutes, University of Alberta, Edmonton, Alberta, Canada.
Am J Transplant. 2020 Sep;20(9):2356-2365. doi: 10.1111/ajt.15851. Epub 2020 Apr 7.
Mixed hematopoietic chimerism induction as a way to foster tolerance to donor organs in recipients who have been sensitized to donor antigens is challenging. Donor-specific antibodies (DSA) are a dominant barrier toward successful donor bone marrow engraftment. Although desensitization methods are routinely used in recipients with allosensitization for allogeneic bone marrow transplantation, engraftment is frequently unsuccessful. To overcome the barrier of prior sensitization we tested enzymatic desensitization of donor-specific IgG using imlifidase and endoglycosidase of Streptococcus pyogenes (EndoS), which both partially block the function of DSA in mice, as a novel approach to improve murine bone marrow engraftment in primed hosts. We found that EndoS was capable of inhibiting antibody-mediated killing of donor cells in vivo. Furthermore, the effect of EndoS depended on the titer of DSA and the genetic background of the recipients. In combination with imlifidase, EndoS improved the survival of donor bone marrow cells. Together with cyclophosphamide, bortezomib, T cell depletion, and nonlethal irradiation, imlifidase in combination with EndoS allowed allogeneic bone marrow engraftment in sensitized recipients. We conclude that enzymatic inactivation of DSA, using the combination of imlifidase and EndoS, can be used for inducing donor hematopoietic chimerism in allosensitized recipient mice in combination with other desensitization strategies.
混合造血嵌合体诱导作为一种促进对已对供体抗原致敏的受者对供体器官耐受的方法具有挑战性。供体特异性抗体(DSA)是成功进行供体骨髓移植的主要障碍。尽管在同种异体骨髓移植中对同种致敏的受者常规使用脱敏方法,但植入通常不成功。为了克服先前致敏的障碍,我们使用链球菌(EndoS)的 imlifidase 和内切糖苷酶对供体特异性 IgG 进行酶促脱敏,这两种方法都部分阻断了 DSA 在小鼠中的功能,作为一种提高预先致敏宿主中鼠骨髓植入的新方法。我们发现 EndoS 能够抑制体内抗体介导的供体细胞杀伤。此外,EndoS 的作用取决于 DSA 的滴度和受者的遗传背景。与 imlifidase 联合使用时,EndoS 可提高供体骨髓细胞的存活率。与环磷酰胺、硼替佐米、T 细胞耗竭和非致死性照射联合使用时,imlifidase 联合 EndoS 允许在致敏受者中进行同种异体骨髓移植。我们得出结论,使用 imlifidase 和 EndoS 的组合对 DSA 进行酶失活可以与其他脱敏策略一起用于诱导同种致敏受者中的供体造血嵌合体。
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