4.6 Article

Inhibition of αvβ6 Promotes Acute Renal Allograft Rejection in Nonhuman Primates

期刊

AMERICAN JOURNAL OF TRANSPLANTATION
卷 13, 期 12, 页码 3085-3093

出版社

WILEY
DOI: 10.1111/ajt.12467

关键词

Acute rejection; alpha v beta 6; TGF-beta

资金

  1. Biogen Idec, Inc
  2. Yerkes National Primate Research Center [P51RR-00065]
  3. Georgia Research Alliance
  4. NIH [1U01AI079223]

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The integrin v6 activates latent transforming growth factor- (TGF-) within the kidney and may be a target for the prevention of chronic allograft fibrosis after kidney transplantation. However, TGF- also has known immunosuppressive properties that are exploited by calcineurin inhibitors (CNIs); thus, the net benefit of v6 inhibition remains undetermined. To assess the acute impact of interference with v6 on acute rejection, we tested a humanized v6-specific monoclonal antibody (STX-100) in a randomized, double-blinded, placebo-controlled nonhuman primate renal transplantation study to evaluate whether v6 blockade alters the risk of acute rejection during CNI-based immunosuppression. Rhesus monkeys underwent renal allotransplantation under standard CNI-based maintenance immunosuppression; 10 biopsy-confirmed rejection-free animals were randomized to receive weekly STX-100 or placebo. Animals treated with STX-100 experienced significantly decreased rejection-free survival compared to placebo animals (p=0.049). Immunohistochemical analysis confirmed v6 ligand presence, and v6 staining intensity was lower in STX-100-treated animals (p=0.055), indicating an apparent blockade effect of STX-100. LAP, LTBP-1 and TGF- were all decreased in animals that rejected on STX-100 compared to those that rejected on standard immunosuppression alone, suggesting a relevant effect of v6 blockade on local TGF-. These data caution against the use of v6 blockade to achieve TGF- inhibition in kidney transplantation.

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