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表达 PD-L1 和 IDO 融合蛋白的胰岛同种异体移植物在没有全身免疫抑制的情况下逃避免疫排斥并逆转免疫功能正常小鼠的先前存在的糖尿病。

Islet allografts expressing a PD-L1 and IDO fusion protein evade immune rejection and reverse preexisting diabetes in immunocompetent mice without systemic immunosuppression.

机构信息

Department of Medicine, University of Wisconsin School of Medicine and Public Health, University of Wisconsin-Madison, Madison, Wisconsin, USA.

Department of Medicine, Division of Endocrinology, Diabetes, and Metabolism, University of Wisconsin School of Medicine and Public Health, University of Wisconsin-Madison, Madison, Wisconsin, USA.

出版信息

Am J Transplant. 2022 Nov;22(11):2571-2585. doi: 10.1111/ajt.17162. Epub 2022 Aug 3.

Abstract

Allogeneic islet transplantation is a promising experimental therapy for poorly controlled diabetes. Despite pharmacological immunosuppression, long-term islet engraftment remains elusive. Here, we designed a synthetic fusion transgene coupling PD-L1 and indoleamine dioxygenase [hereafter PIDO] whose constitutive expression prevents immune destruction of genetically engineered islet allograft transplanted in immunocompetent mice. PIDO expressing murine islets maintain robust dynamic insulin secretion in vitro and when transplanted in allogeneic hyperglycemic murine recipients reverse pre-existing streptozotocin-induced and autoimmune diabetes in the absence of pharmacological immunosuppression for more than 50 and 8 weeks, respectively, and is dependent on host CD4 competence. Additionally, PIDO expression in allografts preserves endocrine functional viability of islets and promotes a localized tolerogenic milieu characterized by the suppression of host CD8 T cell and phagocyte recruitment and accumulation of FOXP3 Tregs. Furthermore, in the canine model of xenogeneic islet transplantation, muscle implanted PIDO-expressing porcine islets displayed physiological glucose-responsive insulin secretion competency in euglycemic recipient for up to 20 weeks. In conclusion, the PIDO transgenic technology enables host CD4 T cell-modulated immune evasiveness and long-term functional viability of islet allo- and xenografts in immune-competent recipients without the need for pharmacological immune suppression and would allow for improved outcomes for tissue transplantation.

摘要

同种异体胰岛移植是一种有前途的实验性治疗方法,可用于治疗控制不佳的糖尿病。尽管进行了药物免疫抑制,但长期的胰岛移植仍然难以实现。在这里,我们设计了一种合成融合转基因,将 PD-L1 和吲哚胺 2,3-双加氧酶(简称 PIDO)偶联在一起,其组成型表达可防止免疫破坏在免疫活性小鼠中移植的基因工程胰岛同种异体移植物。表达 PIDO 的鼠胰岛在体外具有强大的动态胰岛素分泌功能,当移植到同种异体高血糖小鼠受体内时,可以在没有药物免疫抑制的情况下分别逆转预先存在的链脲佐菌素诱导的和自身免疫性糖尿病超过 50 和 8 周,并且依赖于宿主 CD4 能力。此外,同种异体移植物中 PIDO 的表达可维持胰岛的内分泌功能活力,并促进局部耐受环境,其特征是抑制宿主 CD8 T 细胞和吞噬细胞募集以及 FOXP3 Treg 的积累。此外,在异种胰岛移植的犬模型中,肌肉植入表达 PIDO 的猪胰岛在接受者血糖正常的情况下可长达 20 周显示出生理性葡萄糖反应性胰岛素分泌能力。总之,PIDO 转基因技术可使宿主 CD4 T 细胞调节的免疫逃避和同种异体和异种胰岛在免疫活性受体内的长期功能活力,而无需药物免疫抑制,从而改善组织移植的结果。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/f52d/9804298/91d86099b118/AJT-22-2571-g001.jpg

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