title: Effect of triple costimulation blockade on islet allograft survival in sensitized mice.
abstract: BACKGROUND
  Islet allograft rejection in sensitized recipients is difficult to control by costimulation blockade using anti-CD154 and cytotoxic T-lymphocyte antigen-4 immunoglobulin (CTLA4Ig). Because leukocyte function antigen (LFA) 1 is highly expressed on memory T cells, adding an LFA-1 blockade may inhibit memory T-cell activities. We examined the effects on islet allograft survival of triple costimulation blockade in presensitized recipient mice.
  
  
  METHODS
  C57BL/6 mice were sensitized by transplantation under the kidney capsule or intraperitoneal injection of Balb/c islets. Four weeks after transplantation, sensitization was confirmed by flow-cytometric detection of alloreactive antibodies. Diabetes was induced by a single intravenous injection of streptozotocin. Recipients were transplanted with 200 Balb/c islets under the right kidney capsule. Graft function was assessed by daily blood glucose and body weight records. Transplanted animals were divided into 3 treatment groups: group 1, control antibody; group 2, anti-CD154 and CTLA-4 Ig double therapy; group 3, anti-CD154, CTLA4Ig, and anti-LFA-1 triple therapy. Injections were administered every second day from day -2 to day 8.
  
  
  RESULTS
  Naïve mice rejected islet allografts between days 7 and 29 (mean 16 +/- 6 d; n = 5), sensitized mice in group 1 between days 0 and 14 (mean 7 +/- 5 d; n = 8), in group 2 between days 4 and 16 (mean 8 +/- 4 d; n = 7), and in group 3 between days 4 and 26 (mean 11 +/- 7 d; n = 10).
  
  
  CONCLUSIONS
  Triple costimulation blockade with anti-CD154, CTLA4Ig, and anti-LFA-1 was not sufficient to improve islet allograft survival in sensitized recipients.
authors.affiliation: Department of Laboratory Medicine, Division of Clinical Immunology and Transfusion Medicine, Karolinska Institutet, Stockholm, Sweden.
authors.forename: R
authors.initials: R
authors.lastname: Diab
authors.forename: T
authors.initials: T
authors.lastname: Iwata
authors.forename: M
authors.initials: M
authors.lastname: Corbascio
authors.forename: A
authors.initials: A
authors.lastname: Tibell
authors.forename: H
authors.initials: H
authors.lastname: Ekberg
authors.forename: J
authors.initials: J
authors.lastname: Holgersson
authors.forename: M
authors.initials: M
authors.lastname: Kumagai-Braesch
mesh_terms: D000818:Animals; D015703:Antigens, CD / Q000276:immunology; D001786:Blood Glucose / Q000378:metabolism; D060908:CTLA-4 Antigen; D003921:Diabetes Mellitus, Experimental / Q000097:blood / Q000601:surgery*; D006084:Graft Rejection / Q000097:blood; D006085:Graft Survival / Q000502:physiology*; D007074:Immunoglobulin G / Q000276:immunology; D016381:Islets of Langerhans Transplantation / Q000276:immunology / Q000473:pathology / Q000502:physiology*; D051379:Mice; D008807:Mice, Inbred BALB C; D008810:Mice, Inbred C57BL; D012086:Reoperation; D014184:Transplantation, Homologous / Q000276:immunology / Q000473:pathology / Q000502:physiology*
chemical_list: D015703:Antigens, CD; D001786:Blood Glucose; D060908:CTLA-4 Antigen; C556707:Ctla4 protein, mouse; D007074:Immunoglobulin G