LFA-1-specific therapy prolongs allograft survival in rhesus macaques

J Clin Invest. 2010 Dec;120(12):4520-31. doi: 10.1172/JCI43895. Epub 2010 Nov 22.

Abstract

Outcomes in transplantation have been limited by suboptimal long-term graft survival and toxicities associated with current immunosuppressive approaches. T cell costimulation blockade has shown promise as an alternative strategy to avoid the side effects of conventional immunosuppressive therapies, but targeting CD28-mediated costimulation alone has proven insufficient to prevent graft rejection in primates. Donor-specific memory T (TM) cells have been implicated in costimulation blockade-resistant transplant rejection, due to their enhanced effector function and decreased reliance on costimulatory signaling. Thus, we have tested a potential strategy to overcome TM cell-driven rejection by targeting molecules preferentially expressed on these cells, such as the adhesion molecule lymphocyte function-associated antigen 1 (LFA-1). Here, we show that short-term treatment (i.e., induction therapy) with the LFA-1-specific antibody TS-1/22 in combination with either basiliximab (an IL-2Rα-specific mAb) and sirolimus (a mammalian target of rapamycin inhibitor) or belatacept (a high-affinity variant of the CD28 costimulation-blocker CTLA4Ig) prolonged islet allograft survival in nonhuman primates relative to control treatments. Moreover, TS-1/22 masked LFA-1 on TM cells in vivo and inhibited the generation of alloproliferative and cytokine-producing effector T cells that expressed high levels of LFA-1 in vitro. These results support the use of LFA-1-specific induction therapy to neutralize costimulation blockade-resistant populations of T cells and further evaluation of LFA-1-specific therapeutics for use in transplantation.

Publication types

  • Research Support, N.I.H., Extramural
  • Research Support, U.S. Gov't, Non-P.H.S.

MeSH terms

  • Animals
  • Antibodies, Monoclonal / therapeutic use*
  • Antibodies, Neutralizing / therapeutic use*
  • Cell Differentiation / immunology
  • Diabetes Mellitus, Experimental / immunology
  • Diabetes Mellitus, Experimental / pathology
  • Diabetes Mellitus, Experimental / therapy
  • Graft Survival / immunology*
  • Humans
  • Immunologic Memory
  • Immunosuppression Therapy / methods
  • Islets of Langerhans Transplantation / immunology
  • Islets of Langerhans Transplantation / pathology
  • Lymphocyte Function-Associated Antigen-1 / immunology*
  • Lymphocyte Function-Associated Antigen-1 / metabolism
  • Macaca mulatta
  • T-Lymphocyte Subsets / cytology
  • T-Lymphocyte Subsets / immunology
  • Tissue Donors
  • Transplantation, Homologous

Substances

  • Antibodies, Monoclonal
  • Antibodies, Neutralizing
  • Lymphocyte Function-Associated Antigen-1