title: Effects of leflunomide and deoxyspergualin in the guinea pig-->rat cardiac model of delayed xenograft rejection: suppression of B cell and C-C chemokine responses but not induction of macrophage lectin.
abstract: BACKGROUND
  If complement (C) activation is prevented or the host is C depleted, discordant vascularized xenografts undergo delayed xenograft rejection (DXR), characterized by graft infiltration by macrophages (MO) and natural killer (NK) cells, endothelial cell activation, and widespread fibrin deposition. Given a lack of effect of T cell-directed therapies on development of DXR, we evaluated two novel agents, 15-deoxyspergualin (DSG) and leflunomide (LEF), with reported anti-B-cell and/or anti-MO actions.
  
  
  METHODS
  DSG and LEF were administered to C-depleted, splenectomized rat recipients of guinea pig cardiac xenografts, and their effects on graft survival and production of anti-guinea pig antibodies were determined. Serial intragraft events were studied by immunohistology using monoclonal antibodies to rat leukocytes, cytokines, and novel proteins, including rat MO lectin, which in other systems is important to MO binding, activation, and target cell killing.
  
  
  RESULTS
  Median graft survival was 62 hr in cobra venom factor (CVF)-treated controls versus 108 hr (DSG), 129 hr (LEF), and 120 hr (DSG and LEF; all groups P<0.01 vs. CVF alone). LEF and DSG each decreased (immunoglobulin M [IgM]) or abrogated (IgG) posttransplant production of anti-guinea pig antibodies. Immunohistologic studies showed that each agent also inhibited graft infiltration by NK and T cells, and expression of various cytokines, including the chemokine monocyte chemoattractant protein-1 (MCP-1), but did not affect the tempo or extent of MO infiltration. Consistent with this, the rapid induction of MO lectin postxenografting, and induction of MO lectin by rat MO exposed to guinea pig cells in vitro, were unaffected by therapy with DSG and/or LEF.
  
  
  CONCLUSIONS
  LEF or DSG along with CVF can result in the longest prolongation of xenograft survival yet reported in this model, in conjunction with a dampening of host mononuclear cell responses, including suppression of B cell activation. However, the persistent influx of MO in this model, despite lack of C-, Fc receptor- or apparent chemokine-dependent mechanisms, suggests the presence of additional mechanisms for cell recruitment and activation. It was of importance that, in this regard, although MO depletion is technically difficult and can lead to undesired effects, the demonstration of rapid MO lectin induction postxenografting indicates opportunities for blockade of MO recruitment and functions during DXR by use of anti-MO lectin monoclonal antibodies or administration of competing sugars.
authors.affiliation: Sandoz Center for Immunobiology and Department of Pathology, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, Massachusetts 02215, USA.
authors.forename: W W
authors.initials: WW
authors.lastname: Hancock
authors.forename: T
authors.initials: T
authors.lastname: Miyatake
authors.forename: N
authors.initials: N
authors.lastname: Koyamada
authors.forename: J P
authors.initials: JP
authors.lastname: Kut
authors.forename: M
authors.initials: M
authors.lastname: Soares
authors.forename: M E
authors.initials: ME
authors.lastname: Russell
authors.forename: F H
authors.initials: FH
authors.lastname: Bach
authors.forename: M H
authors.initials: MH
authors.lastname: Sayegh
mesh_terms: D000818:Animals; D000888:Antibodies, Anti-Idiotypic / Q000097:blood; D000911:Antibodies, Monoclonal / Q000276:immunology; D000917:Antibody Formation; D001402:B-Lymphocytes / Q000187:drug effects / Q000276:immunology; D018932:Chemokine CCL2 / Q000096:biosynthesis; D018925:Chemokines / Q000494:pharmacology; D003165:Complement System Proteins / Q000276:immunology; D006084:Graft Rejection / Q000517:prevention & control; D006085:Graft Survival / Q000502:physiology; D006146:Guanidines / Q000494:pharmacology* / Q000627:therapeutic use; D006168:Guinea Pigs; D016027:Heart Transplantation / Q000276:immunology*; D007075:Immunoglobulin M / Q000276:immunology; D007166:Immunosuppressive Agents / Q000494:pharmacology* / Q000627:therapeutic use; D007555:Isoxazoles / Q000494:pharmacology* / Q000627:therapeutic use; D037102:Lectins / Q000096:biosynthesis / Q000276:immunology; D000077339:Leflunomide; D008262:Macrophage Activation / Q000187:drug effects; D008264:Macrophages / Q000737:chemistry / Q000502:physiology; D008297:Male; D051381:Rats; D011914:Rats, Inbred BN; D011917:Rats, Inbred Lew; D017207:Rats, Sprague-Dawley; D014183:Transplantation, Heterologous / Q000276:immunology*; D014184:Transplantation, Homologous / Q000276:immunology
chemical_list: D000888:Antibodies, Anti-Idiotypic; D000911:Antibodies, Monoclonal; D018932:Chemokine CCL2; D018925:Chemokines; D006146:Guanidines; D007075:Immunoglobulin M; D007166:Immunosuppressive Agents; D007555:Isoxazoles; D037102:Lectins; C044203:anti-IgM; D003165:Complement System Proteins; D000077339:Leflunomide; C037258:gusperimus