title: Blockade of thrombospondin-1-CD47 interactions prevents necrosis of full thickness skin grafts.
abstract: BACKGROUND
  Skin graft survival and healing requires rapid restoration of blood flow to the avascular graft. Failure or delay in the process of graft vascularization is a significant source of morbidity and mortality. One of the primary regulators of blood flow and vessel growth is nitric oxide (NO). The secreted protein thrombospondin-1 (TSP1) limits NO-stimulated blood flow and growth and composite tissue survival to ischemia. We herein demonstrate a role for TSP1 in regulating full thickness skin graft (FTSG) survival.
  
  
  RESULTS
  FTSG consistently fail in wild type C57BL/6 mice but survive in mice lacking TSP1 or its receptor CD47. Ablation of the TSP1 receptor CD36, however, did not improve FTSG survival. Remarkably, wild type FTSG survived on TSP1 null or CD47 null mice, indicating that TSP1 expression in the wound bed is the primary determinant of graft survival. FTSG survival in wild type mice could be moderately improved by increasing NO flux, but graft survival was increased significantly through antibody blocking of TSP1 binding to CD47 or antisense morpholino oligonucleotide suppression of CD47.
  
  
  CONCLUSIONS
  TSP1 through CD47 limits skin graft survival. Blocking TSP1 binding or suppressing CD47 expression drastically increases graft survival. The therapeutic applications of this approach could include burn patients and the broader group of people requiring grafts or tissue flaps for closure and reconstruction of complex wounds of diverse etiologies.
authors.affiliation: Laboratory of Pathology, National Cancer Institute, National Institutes of Health, 10 Center Drive, Bethesda, MD 20892, USA. isenberj@mail.nih.gov
authors.forename: Jeff S
authors.initials: JS
authors.lastname: Isenberg
authors.forename: Loretta K
authors.initials: LK
authors.lastname: Pappan
authors.forename: Martin J
authors.initials: MJ
authors.lastname: Romeo
authors.forename: Mones
authors.initials: M
authors.lastname: Abu-Asab
authors.forename: Maria
authors.initials: M
authors.lastname: Tsokos
authors.forename: David A
authors.initials: DA
authors.lastname: Wink
authors.forename: William A
authors.initials: WA
authors.lastname: Frazier
authors.forename: David D
authors.initials: DD
authors.lastname: Roberts
mesh_terms: D000704:Analysis of Variance; D000818:Animals; D001783:Blood Flow Velocity; D015153:Blotting, Western; D051928:CD47 Antigen / Q000378:metabolism*; D002470:Cell Survival; D004195:Disease Models, Animal; D006085:Graft Survival; D017078:Laser-Doppler Flowmetry; D051379:Mice; D008810:Mice, Inbred C57BL; D018345:Mice, Knockout; D009336:Necrosis / Q000517:prevention & control; D009569:Nitric Oxide / Q000494:pharmacology; D016038:Skin Transplantation; D019700:Thrombospondin 1 / Q000378:metabolism*
chemical_list: D051928:CD47 Antigen; C497895:Cd47 protein, mouse; D019700:Thrombospondin 1; D009569:Nitric Oxide