Rapamycin, a potent inhibitor of T-cell function, prevents graft rejection in murine recipients of allogeneic T-cell-depleted donor marrow.

We investigated the ability of the macrolide antifungal agent rapamycin (RAPA) to inhibit the rejection of T-cell-depleted (TCD) donor bone marrow (BM) transplanted into major histocompatibility complex (MHC)-disparate irradiated recipients. RAPA (1.5 mg/kg) was administered for 14 days beginning on the day of transplant. In the present study, we have tested RAPA administration in two types of fully allogeneic BM transplantation (BMT) systems in which host T cells mediate the rejection of TCD BM grafts (DBA/1 transplanted into C57BL/6 and BALB/c transplanted into C57BL/6). In both instances, RAPA administration prevented the rejection of the donor graft, accelerated post-BMT hematopoietic recovery, and did not compromise recipient survival. Sequential post-BMT fluorescence-activated cell sorter analysis of the spleen showed that RAPA administration inhibited host CD4+ and CD8+ T-cell expansion that leads to graft rejection. To further investigate the effect of RAPA on T-cell subpopulations, we used two congenic donor mouse stains with isolated MHC class I (bm1) or class II (bm12) mutations. In these studies, we showed that RAPA administration can inhibit MHC class I-restricted CD8+ or class II-restricted CD4+ T-cell-mediated graft rejection without compromising recipient survival. The RAPA-facilitated alloengraftment is multilineage and durable. We have also shown that RAPA speeds hematopoietic recovery post-BMT. We conclude that RAPA represents a new therapeutic modality for promoting alloengraftment and accelerating hematopoietic recovery.