title: Pretransplant antithymocyte globulin has increased efficacy in controlling donor-reactive memory T cells in mice.
abstract: Antibody-mediated lymphocyte depletion is frequently used as induction therapy in sensitized transplant patients. Although T cells with an effector/memory phenotype remain detectable after lymphoablative therapies in human transplant recipients, the role of preexisting donor-reactive memory in reconstitution of the T cell repertoire and induction of alloimmune responses following lymphoablation is poorly understood. We show in a mouse cardiac transplantation model that antidonor immune responses following treatment with rabbit antimouse thymocyte globulin (mATG) were dominated by T cells derived from the preexisting memory compartment. Administration of mATG 1 week prior to transplantation (pre-TP) was more efficient in targeting preexisting donor-reactive memory T cells, inhibiting overall antidonor T cell responses, and prolonging heart allograft survival than the commonly used treatment at the time of transplantation (peri-TP). The failure of peri-TP mATG to control antidonor memory responses was due to faster recovery of preexisting memory T cells rather than their inefficient depletion. This rapid recovery did not depend on T cell specificity for donor alloantigens suggesting an important role for posttransplant inflammation in this process. Our findings provide insights into the components of the alloimmune response remaining after lymphoablation and may help guide the future use of ATG in sensitized transplant recipients.
authors: Department of Immunology and the Glickman Urological and Kidney Institute, Cleveland Clinic, Cleveland, OH, USA.
authors: K
authors: K
authors: Ayasoufi
authors: H
authors: H
authors: Yu
authors: R
authors: R
authors: Fan
authors: X
authors: X
authors: Wang
authors: J
authors: J
authors: Williams
authors: A
authors: A
authors: Valujskikh
mesh_terms: D019264:Adoptive Transfer; D000818:Animals; D000961:Antilymphocyte Serum / Q000008:administration & dosage* / Q000276:immunology; D005260:Female; D005434:Flow Cytometry; D006084:Graft Rejection / Q000276:immunology* / Q000401:mortality; D006085:Graft Survival / Q000276:immunology*; D006331:Heart Diseases / Q000276:immunology* / Q000628:therapy; D016027:Heart Transplantation / Q000276:immunology*; D006801:Humans; D007156:Immunologic Memory / Q000276:immunology*; D008297:Male; D051379:Mice; D008807:Mice, Inbred BALB C; D008809:Mice, Inbred C3H; D008810:Mice, Inbred C57BL; D008822:Mice, Transgenic; D011817:Rabbits; D015996:Survival Rate; D037182:T-Cell Antigen Receptor Specificity / Q000276:immunology*; D014184:Transplantation, Homologous
chemical_list: D000961:Antilymphocyte Serum