title: Gene therapy-mediated CD40L and CD28 co-stimulatory signaling blockade plus transient anti-xenograft antibody suppression induces long-term acceptance of cardiac xenografts.
abstract: BACKGROUND
  The authors have previously demonstrated that inhibition of CD28 and CD40 ligand (CD40L) co-stimulatory signals by adenovirus-mediated cytotoxic T-lymphocyte-associated (CTL) antigen 4 (A4) immunoglobulin (Ig) and CD40Ig gene therapies induces tolerance or long-term acceptance in rat liver and heart allograft transplantation. In this study, the authors examined whether co-stimulation blockade with a brief course treatment of FK779, a novel leflunomide derivative, would be an ideal strategy for controlling xenograft rejection.
  
  
  METHODS
  Hamster hearts were transplanted into Lewis rats. Adenovirus vector coding (Ad) CD40Ig, CTLA4Ig, or LacZ gene (1 x 10(9) plaque-forming units) was administered intravenously to recipient rats 2 days before or immediately after xenografting. FK779 (10 mg/kg/day) was administered orally to recipients for 7 days beginning on day -1. Graft survival, graft histology, and xenoreactive antibodies were examined.
  
  
  RESULTS
  : Both untreated and AdLacZ-treated control rats rejected cardiac xenografts, with a median survival time (MST) of 3 days. Co-stimulatory blockade alone by AdCTLA4Ig, AdCD40Ig, or both could not overcome such delayed xenograft rejection (DXR) (MST, 3-4 days). Under a short-course FK779 treatment that suppressed T-cell-independent xenoreactive antibodies, administration of AdCD40Ig (MST, 30.5 days) but not AdCTLA4Ig (MST, 9 days) significantly prolonged xenograft survival as compared with the FK779 monotherapy (MST, 7 days). In contrast, DXR and cellular rejection were controlled successfully and all xenografts were accepted for over 100 days when AdCTLA4Ig and AdCD40Ig were administered under FK779 induction therapy. However, chronic rejection was present in all long-term surviving xenografts.
  
  
  CONCLUSIONS
  : Gene therapy-based co-stimulation blockade with FK779 induction treatment seems to be an attractive strategy with which to control xenograft rejection.
authors.affiliation: First Department of Surgery, Hokkaido University School of Medicine, Sapporo 060-8638, Japan.
authors.forename: Nan
authors.initials: N
authors.lastname: Hua
authors.forename: Kenichiro
authors.initials: K
authors.lastname: Yamashita
authors.forename: Taku
authors.initials: T
authors.lastname: Hashimoto
authors.forename: Taro
authors.initials: T
authors.lastname: Masunaga
authors.forename: Miri
authors.initials: M
authors.lastname: Fujita
authors.forename: Hiroyouki
authors.initials: H
authors.lastname: Furukawa
authors.forename: Toshimitsu
authors.initials: T
authors.lastname: Uede
authors.forename: Satoru
authors.initials: S
authors.lastname: Todo
mesh_terms: D000069594:Abatacept; D000818:Animals; D000910:Antibodies, Heterophile / Q000276:immunology*; D018106:CD28 Antigens / Q000235:genetics / Q000276:immunology*; D023201:CD40 Ligand / Q000235:genetics / Q000276:immunology*; D006224:Cricetinae; D015316:Genetic Therapy / Q000379:methods*; D005822:Genetic Vectors; D006085:Graft Survival / Q000276:immunology*; D016027:Heart Transplantation / Q000276:immunology* / Q000473:pathology; D018796:Immunoconjugates / Q000276:immunology; D008099:Liver / Q000276:immunology / Q000473:pathology; D008297:Male; D051381:Rats; D011917:Rats, Inbred Lew; D011994:Recombinant Proteins / Q000276:immunology; D013997:Time Factors; D014183:Transplantation, Heterologous / Q000276:immunology* / Q000473:pathology; D001616:beta-Galactosidase / Q000235:genetics
chemical_list: D000910:Antibodies, Heterophile; D018106:CD28 Antigens; D018796:Immunoconjugates; D011994:Recombinant Proteins; D023201:CD40 Ligand; D000069594:Abatacept; D001616:beta-Galactosidase