Combined effects of calcineurin inhibitors or sirolimus with anti-CD40L mAb on alloengraftment under nonmyeloablative conditions

Blood. 2002 Nov 1;100(9):3400-7. doi: 10.1182/blood-2002-03-0872.

Abstract

The immunosuppressive drugs, cyclosporine A (CsA), tacrolimus, or sirolimus, were analyzed as single agents and in combination with anti-CD40L monoclonal antibody (mAb) for their effects on alloengraftment in mice conditioned with minimal total body irradiation (TBI). Whereas anti-CD40L mAb facilitated chimerism, neither sirolimus nor CsA resulted in substantial alloengraftment. However, sirolimus was synergistic with anti-CD40L mAb for inducing donor chimerism. Contrary to expectations, CsA, a T-cell receptor (TCR) signaling inhibitor, did not abrogate anti-CD40L mAb-facilitated engraftment but rather increased engraftment in anti-CD40L mAb-treated mice. Although tacrolimus alone or with anti-CD40L mAb resulted in similar levels of donor chimerism, donor T-cell reconstitution was very low in tacrolimus-treated mice. At 1 week after transplantation, CsA decreased thymic numbers more profoundly than sirolimus or tacrolimus in anti-CD40L mAb-treated recipients. In contrast, only sirolimus resulted in a decrease in host splenic T-cell numbers in anti-CD40L mAb-treated recipients. Importantly, sirolimus and anti-CD40L mAb induced profound donor tolerance with 100% acceptance of donor skin grafts placed early after bone marrow transplantation (BMT). In contrast, anti-CD40L mAb alone or in combination with CsA resulted in 12% or less donor skin graft acceptance early (1 month) and 60% or less later (3 months) after BMT. These data have clinical relevance and indicate that immunosuppressive pharmacologic agents enhance anti-CD40L mAb-facilitated alloengraftment and tolerance induction under nonmyeloablative conditioning.

Publication types

  • Comparative Study
  • Research Support, U.S. Gov't, P.H.S.

MeSH terms

  • Animals
  • Antibodies, Monoclonal / pharmacology*
  • Antibodies, Monoclonal / therapeutic use
  • Apoptosis / drug effects
  • Bone Marrow Transplantation*
  • CD40 Ligand / immunology*
  • Calcineurin Inhibitors*
  • Cyclosporine / pharmacology*
  • Cyclosporine / therapeutic use
  • Drug Evaluation, Preclinical
  • Drug Synergism
  • Female
  • Graft Survival / drug effects*
  • Graft vs Host Disease / prevention & control
  • Immune Tolerance
  • Immunosuppressive Agents / pharmacology*
  • Immunosuppressive Agents / therapeutic use
  • Lymphocyte Count
  • Mice
  • Mice, Inbred BALB C
  • Mice, Inbred C57BL
  • Radiation Chimera
  • Sirolimus / pharmacology*
  • Sirolimus / therapeutic use
  • Skin Transplantation / immunology
  • Specific Pathogen-Free Organisms
  • T-Lymphocyte Subsets / drug effects
  • Tacrolimus / pharmacology*
  • Tacrolimus / therapeutic use
  • Transplantation Conditioning / methods*
  • Transplantation, Homologous
  • Whole-Body Irradiation

Substances

  • Antibodies, Monoclonal
  • Calcineurin Inhibitors
  • Immunosuppressive Agents
  • CD40 Ligand
  • Cyclosporine
  • Sirolimus
  • Tacrolimus