Enhanced de novo alloantibody and antibody-mediated injury in rhesus macaques.

Journal Article (Journal Article)

Chronic allograft rejection is a major impediment to long-term transplant success. Humoral immune responses to alloantigens are a growing clinical problem in transplantation, with mounting evidence associating alloantibodies with the development of chronic rejection. Nearly a third of transplant recipients develop de novo antibodies, for which no established therapies are effective at preventing or eliminating, highlighting the need for a nonhuman primate model of antibody-mediated rejection. In this report, we demonstrate that depletion using anti-CD3 immunotoxin (IT) combined with maintenance immunosuppression that included tacrolimus with or without alefacept reliably prolonged renal allograft survival in rhesus monkeys. In these animals, a preferential skewing toward CD4 repopulation and proliferation was observed, particularly with the addition of alefacept. Furthermore, alefacept-treated animals demonstrated increased alloantibody production (100%) and morphologic features of antibody-mediated injury. In vitro, alefacept was found to enhance CD4 effector memory T cell proliferation. In conclusion, alefacept administration after depletion and with tacrolimus promotes a CD4+memory T cell and alloantibody response, with morphologic changes reflecting antibody-mediated allograft injury. Early and consistent de novo alloantibody production with associated histological changes makes this nonhuman primate model an attractive candidate for evaluating targeted therapeutics.

Full Text

Duke Authors

Cited Authors

  • Page, EK; Page, AJ; Kwun, J; Gibby, AC; Leopardi, F; Jenkins, JB; Strobert, EA; Song, M; Hennigar, RA; Iwakoshi, N; Knechtle, SJ

Published Date

  • September 2012

Published In

Volume / Issue

  • 12 / 9

Start / End Page

  • 2395 - 2405

PubMed ID

  • 22776408

Pubmed Central ID

  • PMC4752112

Electronic International Standard Serial Number (EISSN)

  • 1600-6143

Digital Object Identifier (DOI)

  • 10.1111/j.1600-6143.2012.04074.x


  • eng

Conference Location

  • United States