Combinations of anti-LFA-1, everolimus, anti-CD40 ligand, and allogeneic bone marrow induce central transplantation tolerance through hemopoietic chimerism, including protection from chronic heart allograft rejection

J Immunol. 2004 Dec 1;173(11):7025-36. doi: 10.4049/jimmunol.173.11.7025.

Abstract

Central transplantation tolerance through hemopoietic chimerism initially requires inhibition of allogeneic stem cell or bone marrow (BM) rejection, as previously achieved in murine models by combinations of T cell costimulation blockade. We have evaluated LFA-1 blockade as part of regimens to support mixed hemopoietic chimerism development upon fully allogeneic BALB/c BM transfer to nonirradiated busulfan-treated B6 recipient mice. Combining anti-LFA-1 with anti-CD40 ligand (CD40L) induced high incidences and levels of stable multilineage hemopoietic chimerism comparable to chimerism achieved with anti-CD40L and everolimus (40-O-(2-hydroxyethyl)-rapamycin) under conditions where neither Ab alone was effective. The combination of anti-LFA-1 with everolimus also resulted in high levels of chimerism, albeit with a lower incidence of stability. Inhibition of acute allograft rejection critically depended on chimerism stability, even if maintained at very low levels around 1%, as was the case for some recipients without busulfan conditioning. Chimerism stability correlated with a significant donor BM-dependent loss of host-derived Vbeta11(+) T cells 3 mo after BM transplantation (Tx). Combinations of anti-CD40L with anti-LFA-1 or everolimus also prevented acute rejection of skin allografts transplanted before established chimerism, albeit not independently of allospecific BMTx. All skin and heart allografts transplanted to stable chimeras 3 and 5 mo after BMTx, respectively, were protected from acute rejection. Moreover, this included prevention of heart allograft vascular intimal thickening ("chronic rejection").

Publication types

  • Comparative Study

MeSH terms

  • Adjuvants, Immunologic / administration & dosage
  • Animals
  • Antibodies, Blocking / administration & dosage*
  • Bone Marrow Transplantation / immunology*
  • CD40 Ligand / immunology*
  • Drug Therapy, Combination
  • Female
  • Graft Enhancement, Immunologic / methods
  • Graft Rejection / immunology
  • Graft Rejection / pathology
  • Graft Rejection / prevention & control*
  • Heart Transplantation / immunology*
  • Heart Transplantation / pathology
  • Hematopoiesis / immunology
  • Isoantibodies / biosynthesis
  • Lymphocyte Culture Test, Mixed
  • Lymphocyte Depletion
  • Lymphocyte Function-Associated Antigen-1 / immunology*
  • Mice
  • Mice, Inbred BALB C
  • Mice, Inbred C3H
  • Mice, Inbred C57BL
  • Skin Transplantation / immunology
  • Species Specificity
  • T-Lymphocytes / drug effects
  • T-Lymphocytes / immunology
  • Transplantation Chimera / immunology*
  • Transplantation Tolerance / immunology*

Substances

  • Adjuvants, Immunologic
  • Antibodies, Blocking
  • Isoantibodies
  • Lymphocyte Function-Associated Antigen-1
  • CD40 Ligand