This is a competitive renewal application to further characterize the molecular and cellular facets of host immunity in high-risk corneal transplants, performed in inflamed host beds and distinguished by their rapid rejection. The goal of our grant, which has been supported since 2000, is to gain new insights into the mechanisms that distinguish high-risk vs. low-risk transplant immunity. Our work has identified Foxp3hi regulatory T cell (Treg) function as being critical for allotolerance and graft survival. Our overarching hypothesis is that the high-risk graft is characterized by a microenvironment which abrogates the tolerogenic potential of Tregs, rendering them incapable of protecting the allograft against immune- mediated attack. This is supported by our data from transgenic mice demonstrating that in high-risk grafted hosts some Tregs lose Foxp3 expression and convert into `exTreg' that express interferon-gamma (IFN?), an inflammatory cytokine which can exert damage on graft tissue. We thus propose to pursue the following three specific aims:
In Aim 1, we will determine the function of Tregs in protecting graft endothelial cells against effector T cell-mediated (Aim 1A) and inflammatory cytokine-mediated (Aim 1B) attack.
In Aim 2 we plan to explore the function of different Treg phenotypes in regulating corneal angiogenesis, an entirely novel area. Surprisingly, we have found that Foxp3-/lo Tregs, which have limited immunosuppressive function, are potently anti-angiogenic. We will quantify the expression of different VEGF species and the anti-angiogenic cytokine IFN? by Tregs derived from low-risk and high-risk grafted hosts, hypothesizing that a high IFN?/VEGF ratio determines Treg angiostatic function.
In Aim 3 we test the hypothesis that exTregs not only have defective immunoregulatory function, but actually effect graft rejection, a wholly novel concept.
In Aim 3 A we will determine the capacity of exTreg to induce graft loss, and in Aim 3B we will determine the cytokine cues that induce Treg conversion to exTregs, devising strategies for preventing this conversion and thus promoting graft tolerance. Our study design relies on using the core expertise of our laboratory along with use of well-characterized mouse models of corneal transplantation in conjunction with in vitro immunological and cell proliferation assays and use of a double transgenic mouse that permits us to monitor the differentiation of Tregs to exTregs. The overall health relevance of this research is that corneal grafting represents the number one form of transplantation performed in the United States. However, while most high-risk corneal transplant patients rapidly reject their grafts, there has been no significant change in the management of high-risk transplants for decades. Thus, the long-term objective of our project is to use data derived from our studies to develop new strategies to promote graft acceptance without the use of systemic immunosuppressive regimens that place grafted recipients at significant risk of serious morbidities.

Public Health Relevance

High-risk corneal transplantation, performed in inflamed host graft beds, is characterized by swift and often irreversible immune rejection. While tens of thousands of these are performed annually on a global basis, there has been no significant change in the poor outcome of high-risk grafts for decades. This grant proposes to study the function of regulatory T cells in the development of immunity to high-risk corneal transplants and develop novel strategies to promote tolerance and long-term survival of these grafts without use of toxic immunosuppressive medications.

Agency
National Institute of Health (NIH)
Institute
National Eye Institute (NEI)
Type
Research Project (R01)
Project #
2R01EY012963-18
Application #
9314151
Study Section
Special Emphasis Panel (ZRG1)
Program Officer
Mckie, George Ann
Project Start
2000-08-01
Project End
2021-07-31
Budget Start
2017-08-01
Budget End
2018-07-31
Support Year
18
Fiscal Year
2017
Total Cost
Indirect Cost
Name
Schepens Eye Research Institute
Department
Type
DUNS #
073826000
City
Boston
State
MA
Country
United States
Zip Code
02114
Foulsham, William; Coco, Giulia; Amouzegar, Afsaneh et al. (2018) When Clarity Is Crucial: Regulating Ocular Surface Immunity. Trends Immunol 39:288-301
Hua, Jing; Inomata, Takenori; Chen, Yihe et al. (2018) Pathological conversion of regulatory T cells is associated with loss of allotolerance. Sci Rep 8:7059
Tahvildari, Maryam; Amouzegar, Afsaneh; Foulsham, William et al. (2018) Therapeutic approaches for induction of tolerance and immune quiescence in corneal allotransplantation. Cell Mol Life Sci 75:1509-1520
Inomata, Takenori; Hua, Jing; Nakao, Takeshi et al. (2018) Corneal Tissue From Dry Eye Donors Leads to Enhanced Graft Rejection. Cornea 37:95-101
Hos, Deniz; Bukowiecki, Anne; Horstmann, Jens et al. (2017) Transient Ingrowth of Lymphatic Vessels into the Physiologically Avascular Cornea Regulates Corneal Edema and Transparency. Sci Rep 7:7227
Di Zazzo, Antonio; Kheirkhah, Ahmad; Abud, Tulio B et al. (2017) Management of high-risk corneal transplantation. Surv Ophthalmol 62:816-827
Di Zazzo, Antonio; Tahvildari, Maryam; Subbarayal, Brinda et al. (2017) Proangiogenic Function of T Cells in Corneal Transplantation. Transplantation 101:778-785
Inomata, Takenori; Mashaghi, Alireza; Hong, Jiaxu et al. (2017) Scaling and maintenance of corneal thickness during aging. PLoS One 12:e0185694
Tahvildari, Maryam; Emami-Naeini, Parisa; Omoto, Masahiro et al. (2017) Treatment of donor corneal tissue with immunomodulatory cytokines: a novel strategy to promote graft survival in high-risk corneal transplantation. Sci Rep 7:971
Inomata, Takenori; Mashaghi, Alireza; Di Zazzo, Antonio et al. (2017) Kinetics of Angiogenic Responses in Corneal Transplantation. Cornea 36:491-496

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