Hematopoietic cell transplantation (HCT) can cure genetic blood disorders through the replacement of defective blood cells by healthy cells. However, life-threatening complications limit the use of HCT therapy in the clinic. Complications in the recipient result from toxic conditioning and from graft-versus-host disease (GVHD), a condition where the donor T-cells attack the recipient (host) tissues. Complete, prolonged depletion of both donor and host T cells permits stable engraftment of donor cells using reduced-intensity conditioning in rodents, without GVHD. However, complete T cell depletion is difficult to achieve in humans and infections, hematopoietic failure, and GVHD remain major complications of clinical HCT. Similar to outcomes in humans, miniature swine develop severe GVHD, infectious complications, or hematopioetic failure following standard clinical myeloablative conditioning and HCT. The investigators recently developed a novel, mild, preclinical protocol for HCT which permits donor cells to engraft without GVHD. Indeed, the treatment of miniature swine with a low-dose of total body irradiation, partial T-cell depletion, and a short course of cyclosporine A has reliably established donor HC engraftment without GVHD despite infusion of a very high dose of T-cell replete haploidentical (e.g., parent-into-child) HCT. Surprisingly, additional treatment with donor leukocyte infusion (DLI), a procedure known to ensure full replacement of HC in engrafted rodents, did not result in full (donor) hematopoietic replacement. The investigators surmise that the persistence of donor and recipient T cells in treated pigs promotes HC engraftment, inhibits GVHD, but also hinders the DLI conversion effect. Indeed, preliminary data suggest that regulatory cells persist in treated animals and inhibit both GVHD and DLI alloreactivity. Thus, the goal of this project is to elucidate the immunological mechanisms responsible for facilitating engraftment without GVHD, and to test new strategies to restore the DLI conversion effect in swine. The investigators hypothesize that immune modulation with regulatory cell involvement promotes engraftment and inhibits GVHD and DLI effects by inactivating donor, recipient, and DLI alloreactive T-cells. This hypothesis will be tested by the following specific aims, to: 1) elucidate the immunological mechanisms controlling GVH and HVG alloreactive T cells in vivo following HCT;and 2) restore the ability of DLI to enhance donor engraftment levels without GVHD through specific immune modulation. This project is innovative in that it investigates approaches for HCT that harness the immunomodulatory capacities of the immune system, rather than immune ablation, to promote better engraftment with fewer complications. The long-term goal of these studies is to translate promising protocols for parent-into-child HCT and DLI to the clinic. Successful translation would provide a cure for many screenable genetic disorders including hemoglobinopathies, lysosomal storage diseases, inherited aplastic anemias, and primary immunodeficiency diseases. If the aims of this application are achieved, these results could have a major impact on clinical HCT approaches.

Public Health Relevance

Toxicities and complications associated with hematopoietic cell transplantation (HCT) currently limit this curative therapy for genetic blood disorders in the clinic. The goal of this application is to understand the immunological mechanisms responsible for facilitating high-level haploidentical (e.g., parent into child) donor hematopoietic cell engraftment without complications. The long-term goal of these studies is to translate promising nontoxic HCT protocols using parental donors to replace diseased blood cells and cure genetic blood disorders in children.

Agency
National Institute of Health (NIH)
Institute
National Institute of Allergy and Infectious Diseases (NIAID)
Type
Research Project (R01)
Project #
5R01AI084657-05
Application #
8420536
Study Section
Special Emphasis Panel (ZHD1-MRG-C (21))
Program Officer
Nabavi, Nasrin N
Project Start
2009-03-15
Project End
2014-02-28
Budget Start
2013-03-01
Budget End
2014-02-28
Support Year
5
Fiscal Year
2013
Total Cost
$395,697
Indirect Cost
$165,373
Name
Massachusetts General Hospital
Department
Type
DUNS #
073130411
City
Boston
State
MA
Country
United States
Zip Code
02199
Lazar, Zsofia; Müllner, Nina; Lucattelli, Monica et al. (2016) NTPDase1/CD39 and aberrant purinergic signalling in the pathogenesis of COPD. Eur Respir J 47:254-63
Madariaga, Maria Lucia L; Shanmugarajah, Kumaran; Michel, Sebastian G et al. (2015) Immunomodulatory Strategies Directed Toward Tolerance of Vascularized Composite Allografts. Transplantation 99:1590-1597
Madariaga, M L; Michel, S G; La Muraglia 2nd, G M et al. (2015) Kidney-induced cardiac allograft tolerance in miniature swine is dependent on MHC-matching of donor cardiac and renal parenchyma. Am J Transplant 15:1580-90
Duran-Struuck, Raimon; Huang, Christene A; Orf, Katherine et al. (2015) Miniature Swine as a Clinically Relevant Model of Graft-Versus-Host Disease. Comp Med 65:429-43
Madariaga, Maria Lucia L; Michel, Sebastian G; La Muraglia 2nd, Glenn M et al. (2015) Recipient-matching of Passenger Leukocytes Prolongs Survival of Donor Lung Allografts in Miniature Swine. Transplantation 99:1372-8
Leonard, D A; Kurtz, J M; Mallard, C et al. (2014) Vascularized composite allograft tolerance across MHC barriers in a large animal model. Am J Transplant 14:343-55
Peraino, Jaclyn Stromp; Schenk, Marian; Zhang, Huiping et al. (2013) A truncated diphtheria toxin based recombinant porcine CTLA-4 fusion toxin. J Immunol Methods 391:103-11
Peraino, Jaclyn Stromp; Zhang, Huiping; Li, Guoying et al. (2013) Molecular basis of cross-species reactivities of human versus porcine CTLA-4. Hum Immunol 74:842-8
Peraino, Jaclyn Stromp; Schenk, Marian; Li, Guoying et al. (2013) Development of a diphtheria toxin-based recombinant porcine IL-2 fusion toxin for depleting porcine CD25+ cells. J Immunol Methods 398-399:33-43
Peraino, Jaclyn Stromp; Hermanrud, Christina E; Springett, Lauren et al. (2012) Expression and characterization of recombinant soluble porcine CD3 ectodomain molecules: mapping the epitope of an anti-porcine CD3 monoclonal antibody 898H2-6-15. Cell Immunol 276:162-7

Showing the most recent 10 out of 22 publications