title: Short course single agent therapy with an LFA-3-IgG1 fusion protein prolongs primate cardiac allograft survival.
abstract: The interaction of T cell costimulatory molecules with their ligands is required for optimal T cell activation. Interference with such interactions can induce antigen unresponsiveness and delay xeno- and allograft rejection. We have previously shown that LFA3TIP, a soluble human lymphocyte function-associated antigen (LFA)-3 construct, binds CD2 and inhibits responses of human T cells in vitro. This study reports the first use of a human fusion protein, LFA3TIP, to significantly prolong primate cardiac allograft survival. Based on our observations that LFA3TIP inhibits baboon allogeneic mixed lymphocyte reactions, we gave baboon recipients of heterotopic cardiac allografts injections of LFA3TIP, 3 mg/kg i.v., for 12 consecutive days, starting 2 days before transplantation. This regimen delayed graft rejection from an average of 10.6 +/- 2.3 days for human IgG-treated controls (n = 5) to an average of 18.0 +/- 5.3 days for LFA3TIP-injected animals (n = 7; P < or = 0.01). Grafts from LFA3TIP-treated animals showed markedly diminished coronary endothelialitis as compared with control animals. LFA3TIP reached peak serum levels of approximately 100 micrograms/ml after 7-9 injections and persisted in the 10-micrograms/ml range for 1 to 2 weeks after the final injection. Despite these blood levels, circulating antibodies to LFA3TIP were not detected in the serum. No renal or hepatic toxicity was noted. The possible mechanism by which LFA3TIP acts to inhibit graft rejection is discussed; success in prolonging graft survival when LFA3TIP is used as a single-agent therapy suggests great potential for this novel therapeutic agent.
authors.affiliation: Department of Surgery, College of Physicians and Surgeons, Columbia University, New York, New York 10032, USA.
authors.forename: R J
authors.initials: RJ
authors.lastname: Kaplon
authors.forename: P S
authors.initials: PS
authors.lastname: Hochman
authors.forename: R E
authors.initials: RE
authors.lastname: Michler
authors.forename: P A
authors.initials: PA
authors.lastname: Kwiatkowski
authors.forename: N M
authors.initials: NM
authors.lastname: Edwards
authors.forename: C L
authors.initials: CL
authors.lastname: Berger
authors.forename: H
authors.initials: H
authors.lastname: Xu
authors.forename: W
authors.initials: W
authors.lastname: Meier
authors.forename: B P
authors.initials: BP
authors.lastname: Wallner
authors.forename: P
authors.initials: P
authors.lastname: Chisholm
authors.forename: C C
authors.initials: CC
authors.lastname: Marboe
mesh_terms: D000818:Animals; D000911:Antibodies, Monoclonal / Q000008:administration & dosage / Q000097:blood / Q000627:therapeutic use; D018801:CD2 Antigens / Q000378:metabolism; D018968:CD58 Antigens / Q000008:administration & dosage / Q000097:blood / Q000627:therapeutic use*; D006084:Graft Rejection / Q000517:prevention & control; D006085:Graft Survival; D016027:Heart Transplantation / Q000009:adverse effects / Q000276:immunology* / Q000473:pathology; D006801:Humans; D007074:Immunoglobulin G / Q000008:administration & dosage / Q000097:blood / Q000627:therapeutic use*; D007167:Immunotherapy; D066298:In Vitro Techniques; D007959:Lymphocyte Culture Test, Mixed; D010215:Papio; D011993:Recombinant Fusion Proteins / Q000008:administration & dosage / Q000097:blood / Q000627:therapeutic use; D013997:Time Factors; D016042:Transplantation, Heterotopic; D014184:Transplantation, Homologous
chemical_list: D000911:Antibodies, Monoclonal; D018801:CD2 Antigens; D018968:CD58 Antigens; D007074:Immunoglobulin G; D011993:Recombinant Fusion Proteins