Smith C V, Suzuki T, Guzzetta P C, Nakajima K, Sundt T M, Mixon A, Spitzer T R, Eckhaus M A, Sachs D H
Transplantation Biology Research Center, Massachusetts General Hospital, Boston 02129.
Transplantation. 1993 Sep;56(3):541-9.
Studies of the myeloablative regimens capable of permitting successful BMT across MHC barriers in miniature swine have been performed. To minimize graft-versus-host disease (GVHD), engraftment was studied in the F1-->P combination (i.e., MHC homozygous ["parental"] swine receiving bone marrow from one-haplotype matched MHC heterozygous ["F1"] donors). Animals given total body irradiation (TBI) up to 1100 cGy, 10 cGy/min, in a single dose failed to engraft. Increasing the dose rate led to unacceptable extramedullary toxicity without improving engraftment. Eleven different fractionated TBI regimens were tested in this F1-->parent model. At all of the dose rates tested, a total dose of less than 1000 cGy was insufficient for engraftment, and a total dose of 1400 cGy led to unacceptable toxicity. Between these extremes, a window was defined in which engraftment could be obtained without unacceptable extramedullary toxicity utilizing 2 equally divided fractions of TBI delivered 24 hr apart. The addition of 50 mg/kg cyclophosphamide i.v. to fractionated TBI (1150 cGy total dose [500 + 650]) also permitted engraftment, with decreased incidence of interstitial pneumonitis as compared to fractionated TBI (1300 cGy total dose [650 x 2]). Both of these regimens were also confirmed to permit engraftment between heterozygous donors and recipients sharing a single common haplotype ("F1-->F1"). The regimen of 1300 cGy (650 x 2) also permitted engraftment in completely MHC mismatched BMT, but with subsequent death from GVHD. These studies of the myeloablative regimens permitting engraftment across defined MHC barriers in miniature swine provide a basis for further studies of allogenic BMT and GVHD in this large animal preclinical model.
已开展了关于能够使小型猪成功跨越主要组织相容性复合体(MHC)屏障进行骨髓移植(BMT)的清髓方案的研究。为尽量减少移植物抗宿主病(GVHD),在F1→P组合(即MHC纯合子["亲代"]猪接受来自单倍型匹配的MHC杂合子["F1"]供体的骨髓)中研究了植入情况。接受单次剂量全身照射(TBI)达1100 cGy、10 cGy/分钟的动物未能实现植入。提高剂量率导致出现不可接受的髓外毒性,且未改善植入情况。在这个F1→亲代模型中测试了11种不同的分次TBI方案。在所有测试的剂量率下,总剂量低于1000 cGy不足以实现植入,而总剂量1400 cGy会导致不可接受的毒性。在这两个极端情况之间,确定了一个范围,在该范围内,通过间隔24小时给予2个等份的TBI可实现植入且无不可接受的髓外毒性。静脉注射50 mg/kg环磷酰胺并联合分次TBI(总剂量1150 cGy [500 + 650])也可实现植入,与分次TBI(总剂量1300 cGy [650×2])相比,间质性肺炎的发生率降低。这两种方案也均被证实可使共享单个共同单倍型的杂合子供体和受体之间实现植入("F1→F1")。1300 cGy(650×2)的方案也可使完全MHC不匹配的BMT实现植入,但随后会死于GVHD。这些关于允许小型猪跨越特定MHC屏障实现植入的清髓方案的研究为在这个大型动物临床前模型中进一步研究同种异体BMT和GVHD提供了基础。