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Overexpression of PD-1 on T cells promotes tolerance in cardiac transplantation via ICOS-dependent mechanisms
Thiago J. Borges, Naoka Murakami, Isadora T. Lape, Rodrigo B. Gassen, Kaifeng Liu, Songjie Cai, Joe Daccache, Kassem Safa, Tetsunosuke Shimizu, Shunsuke Ohori, Alison M. Paterson, Paolo Cravedi, Jamil Azzi, Peter T. Sage, Arlene H. Sharpe, Xian C. Li, Leonardo V. Riella
Thiago J. Borges, Naoka Murakami, Isadora T. Lape, Rodrigo B. Gassen, Kaifeng Liu, Songjie Cai, Joe Daccache, Kassem Safa, Tetsunosuke Shimizu, Shunsuke Ohori, Alison M. Paterson, Paolo Cravedi, Jamil Azzi, Peter T. Sage, Arlene H. Sharpe, Xian C. Li, Leonardo V. Riella
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Research Article Immunology Transplantation

Overexpression of PD-1 on T cells promotes tolerance in cardiac transplantation via ICOS-dependent mechanisms

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Abstract

The programmed death 1/programmed death ligand 1 (PD-1/PD-L1) pathway is a potent inhibitory pathway involved in immune regulation and is a potential therapeutic target in transplantation. In this study, we show that overexpression of PD-1 on T cells (PD-1 Tg) promotes allograft tolerance in a fully MHC-mismatched cardiac transplant model when combined with costimulation blockade with CTLA-4–Ig. PD-1 overexpression on T cells also protected against chronic rejection in a single MHC II–mismatched cardiac transplant model, whereas the overexpression still allowed the generation of an effective immune response against an influenza A virus. Notably, Tregs from PD-1 Tg mice were required for tolerance induction and presented greater ICOS expression than those from WT mice. The survival benefit of PD-1 Tg recipients required ICOS signaling and donor PD-L1 expression. These results indicate that modulation of PD-1 expression, in combination with a costimulation blockade, is a promising therapeutic target to promote transplant tolerance.

Authors

Thiago J. Borges, Naoka Murakami, Isadora T. Lape, Rodrigo B. Gassen, Kaifeng Liu, Songjie Cai, Joe Daccache, Kassem Safa, Tetsunosuke Shimizu, Shunsuke Ohori, Alison M. Paterson, Paolo Cravedi, Jamil Azzi, Peter T. Sage, Arlene H. Sharpe, Xian C. Li, Leonardo V. Riella

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Figure 2

A single dose of CTLA-4–Ig induced tolerance in PD-1 Tg recipient and depends on PD-L1 expression by donor cells.

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A single dose of CTLA-4–Ig induced tolerance in PD-1 Tg recipient and de...
(A) Kaplan-Meier curves of allograft survival of fully MHC-mismatched cardiac transplants; BALB/c hearts were transplanted into WT or PD-1 Tg C57BL/6 recipients with or without a single dose of CTLA-4–Ig (250 μg on day 2 after transplant). In the presence of CTLA-4–Ig, allograft survival was significantly prolonged in the PD-1 Tg group, according to log-rank test, when compared with the WT group (n = 6/group). Representative histology of cardiac allografts retrieved from WT or PD-1 Tg mice (treated with sCTLA-4–Ig on day 2) on day 50 after transplant and stained with (B) H&E (magnification, ×20) and (C) elastin (magnification, ×40). PD-1 Tg recipients had a normal tissue architecture, minimal lymphocyte infiltration. and minimal intimal proliferation (n = 6/group; magnification, ×40). (D) Kaplan-Meier curves of allograft survival of PD-L1–KO hearts (BALB/c hearts) transplanted into WT or PD-1 Tg C57BL/6 mice with a single dose of 250 μg of CTLA-4–Ig on day 2. (E) Schematic experimental design of abdominal and cervical heart cotransplantation in PD-1 Tg mice. PD-1 Tg recipients (H-2b) were transplanted with abdominal BALB/c hearts (H-2d) and treated with 250 μg of CTLA-4–Ig at day 2 after transplant. Fifty days later, the same animals were cervically implanted with BALB/c (H-2d; allo), C3H (H-2k; third-party) or B6 (H-2b; syngeneic) hearts (n = 4–8/group). The grafts were assessed by monitoring palpitation for the following 50 days. Cartoon created with BioRender.com. (F) Kaplan-Meier survival curves of the second cardiac grafts for each group. P values determined by log-rank test. Allo, allogeneic; POD, postoperative day; Tx, transplant. *P < 0.05; **P < 0.01; ***P < 0.001.

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