Cardiac xenografts show reduced survival in the absence of transgenic human thrombomodulin expression in donor pigs.


Journal

Xenotransplantation
ISSN: 1399-3089
Titre abrégé: Xenotransplantation
Pays: Denmark
ID NLM: 9438793

Informations de publication

Date de publication:
03 2019
Historique:
received: 05 12 2017
revised: 20 07 2018
accepted: 10 09 2018
pubmed: 6 10 2018
medline: 27 12 2019
entrez: 6 10 2018
Statut: ppublish

Résumé

A combination of genetic manipulations of donor organs and target-specific immunosuppression is instrumental in achieving long-term cardiac xenograft survival. Recently, results from our preclinical pig-to-baboon heterotopic cardiac xenotransplantation model suggest that a three-pronged approach is successful in extending xenograft survival: (a) α-1,3-galactosyl transferase (Gal) gene knockout in donor pigs (GTKO) to prevent Gal-specific antibody-mediated rejection; (b) transgenic expression of human complement regulatory proteins (hCRP; hCD46) and human thromboregulatory protein thrombomodulin (hTBM) to avoid complement activation and coagulation dysregulation; and (c) effective induction and maintenance of immunomodulation, particularly through co-stimulation blockade of CD40-CD40L pathways with anti-CD40 (2C10R4) monoclonal antibody (mAb). Using this combination of manipulations, we reported significant improvement in cardiac xenograft survival. In this study, we are reporting the survival of cardiac xenotransplantation recipients (n = 3) receiving xenografts from pigs without the expression of hTBM (GTKO.CD46). We observed that all grafts underwent rejection at an early time point (median 70 days) despite utilization of our previously reported successful immunosuppression regimen and effective control of non-Gal antibody response. These results support our hypothesis that transgenic expression of human thrombomodulin in donor pigs confers an independent protective effect for xenograft survival in the setting of a co-stimulation blockade-based immunomodulatory regimen.

Identifiants

pubmed: 30290025
doi: 10.1111/xen.12465
pmc: PMC6450784
mid: NIHMS989381
doi:

Substances chimiques

Immunosuppressive Agents 0
Thrombomodulin 0

Types de publication

Journal Article Research Support, Non-U.S. Gov't

Langues

eng

Sous-ensembles de citation

IM

Pagination

e12465

Subventions

Organisme : NIAID NIH HHS
ID : U19 AI090959
Pays : United States

Informations de copyright

© 2018 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

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Auteurs

Avneesh K Singh (AK)

Cardiothoracic Surgery Research Program/National Heart, Lung and Blood Institute, National Institutes of Health, Bethesda, Maryland.
Department of Surgery, School of Medicine, University of Maryland, Baltimore, Maryland.

Joshua L Chan (JL)

Cardiothoracic Surgery Research Program/National Heart, Lung and Blood Institute, National Institutes of Health, Bethesda, Maryland.

Laura DiChiacchio (L)

Department of Surgery, School of Medicine, University of Maryland, Baltimore, Maryland.

Naomi L Hardy (NL)

Department of Pathology at the University of Maryland Medical Center, University of Maryland, Baltimore, Maryland.

Philip C Corcoran (PC)

Cardiothoracic Surgery Research Program/National Heart, Lung and Blood Institute, National Institutes of Health, Bethesda, Maryland.

Billeta G T Lewis (BGT)

Division of Veterinary Resources, Office of Research Services, National Institutes of Health, Bethesda, Maryland.

Marvin L Thomas (ML)

Division of Veterinary Resources, Office of Research Services, National Institutes of Health, Bethesda, Maryland.

Allen P Burke (AP)

Department of Pathology at the University of Maryland Medical Center, University of Maryland, Baltimore, Maryland.

David Ayares (D)

Revivicor, Inc., Blacksburg, Virginia.

Keith A Horvath (KA)

Cardiothoracic Surgery Research Program/National Heart, Lung and Blood Institute, National Institutes of Health, Bethesda, Maryland.

Muhammad M Mohiuddin (MM)

Cardiothoracic Surgery Research Program/National Heart, Lung and Blood Institute, National Institutes of Health, Bethesda, Maryland.
Department of Surgery, School of Medicine, University of Maryland, Baltimore, Maryland.

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