title: Blockade of very late antigen-4 integrin binding to fibronectin in allograft recipients. II. Treatment with connecting segment-1 peptides prevents chronic rejection by attenuating arteriosclerotic development and suppressing intragraft T cell and macrophage activation.
abstract: BACKGROUND
  Chronic rejection remains the leading obstacle to long-term allograft survival. We have shown that treatment of sensitized rats with rapamycin (RPM) does not prevent progressive chronic-type cardiac allograft failure. Having documented the role of fibronectin (FN) in the allograft rejection cascade, we hypothesized that treatment with synthetic peptides that specifically block adhesive interactions between the connecting segment-1 (CS1)-binding domain of FN and alpha4beta1 integrin on circulating cells may prevent the development of chronic rejection in transplant recipients.
  
  
  RESULTS
  Lewis rats were sensitized with Brown Norway skin grafts (day -7), followed by transplantation of LBNF1 hearts (day 0). Experimental animals were treated with RPM (day -7 to -1; 0.25 mg/kg/day i.p.), or RPM + CS1 peptides (day +7 to +13; 4 mg/kg/day i.v.), and euthanized at day 60. Unlike cardiac allografts in rats undergoing RPM monotherapy, those after adjunctive CS1 peptides had well preserved myocardial architecture and were free of arteriosclerotic lesions. Moreover, reverse transcription-polymerase chain reaction-based intragraft expression of transcripts for CD3, interferon-gamma, interleukin-12, monocyte chemoattractant protein-1, and transforming growth factor-beta were diminished in the CS1 group when compared with levels in the RPM group. The corresponding expression of cytokine proteins, as determined by immunoperoxidase labeling, was also depressed and correlated with decreased infiltration by T cells and macrophages.
  
  
  CONCLUSIONS
  CS1 peptide-facilitated blockage of alpha4beta1-FN interactions prevents the development of chronic rejection and depresses the expression of key T cell- and macrophage-associated cytokines/chemoattractants. Hence, local synthesis of FN is an ongoing feature of, and adhesive FN-alpha4beta1 associations are critical for, the development of chronic transplant rejection.
authors.affiliation: Harvard Medical School, Department of Surgery, Brigham and Women's Hospital, Boston, Massachusetts 02115, USA.
authors.forename: S
authors.initials: S
authors.lastname: Korom
authors.forename: W W
authors.initials: WW
authors.lastname: Hancock
authors.forename: A J
authors.initials: AJ
authors.lastname: Coito
authors.forename: J W
authors.initials: JW
authors.lastname: Kupiec-Weglinski
mesh_terms: D000595:Amino Acid Sequence; D000818:Animals; D015703:Antigens, CD / Q000235:genetics; D001161:Arteriosclerosis / Q000517:prevention & control; D001667:Binding, Competitive; D018932:Chemokine CCL2 / Q000235:genetics; D002908:Chronic Disease; D005353:Fibronectins / Q000737:chemistry / Q000378:metabolism*; D006084:Graft Rejection / Q000628:therapy*; D016027:Heart Transplantation / Q000276:immunology*; D007249:Inflammation / Q000503:physiopathology; D039041:Integrin alpha4beta1; D016023:Integrins / Q000378:metabolism*; D007371:Interferon-gamma / Q000235:genetics; D018664:Interleukin-12 / Q000235:genetics; D008969:Molecular Sequence Data; D010446:Peptide Fragments; D012333:RNA, Messenger / Q000235:genetics; D051381:Rats; D011914:Rats, Inbred BN; D011917:Rats, Inbred Lew; D016201:Receptors, Lymphocyte Homing / Q000378:metabolism*; D016212:Transforming Growth Factor beta / Q000235:genetics
chemical_list: D015703:Antigens, CD; D018932:Chemokine CCL2; D005353:Fibronectins; D039041:Integrin alpha4beta1; D016023:Integrins; D010446:Peptide Fragments; D012333:RNA, Messenger; D016201:Receptors, Lymphocyte Homing; D016212:Transforming Growth Factor beta; D018664:Interleukin-12; D007371:Interferon-gamma