Enzymatic remodelling of the carbohydrate surface of a xenogenic cell substantially reduces human antibody binding and complement-mediated cytolysis.

The major obstacle to successful discordant xenotransplantation is the phenomenon of hyperacute rejection (HAR). In the pig-to-primate discordant transplant setting, HAR results from the deposition of high-titre anti-alpha-galactosyl antibodies and complement activation leading to endothelial cell destruction and rapid graft failure. To overcome HAR, we developed an enzymatic carbohydrate remodelling strategy designed to replace expression of the Gal alpha-1,3-Gal xenoepitope on the surface of porcine cells with the non-antigenic universal donor human blood group O antigen, the alpha-1,2-fucosyl lactosamine moiety (H-epitope). Xenogenic cells expressing the human alpha-1,2-fucosyltransferase expressed high levels of the H-epitope and significantly reduced Gal alpha-1,3-Gal expression. As a result, these cells were shown to be resistant to human natural antibody binding and complement-mediated cytolysis.

Ir gene function in an I-A subregion mutant B6.C-H-2bm12.

The B6.C-H2bm12 (bm 12) strain has a mutation in the I-A subregion of the murine H-2 complex and is characterized by a loss of serologically detected Ia antigens and a strong graft rejection and mixed lymphocyte response between parent and mutant. It was presumed that the mutation affected the Ia-1 gene and to determine the relationship of Ia antigens and Ir genes, the immune responses of mutant and parent were compared. The immune responses to poly(L-Tyr,LGlu)-poly(DLAla)--poly(LLys), poly(Phe,Glu)-poly(DLAla)--poly(LLys), and poly(His,Glu)-poly(DLAla)--poly(LLys) in parent and mutant were same, indicating the Ia-1 and the Ir genes for these antigens are not identical. By contrast, although C57BL/6 gave a good response, the mutant strain was unable to generate cytotoxic T lymphocytes to the male-specific H-Y antigen--a response under I-A subregion Ir gene control, which now must be considered to be the Ia-1 gene. In addition, complementary Ir genes in the H-2b haplotype for the H-Y immune response could be detected when the bm12 mutant was used.

B6.C-H-2bm12. A new H-2 mutation in the I region in the mouse.

The B6.C-H-2bm12 mutant is described and evidence is presented for the mutational site occurring in the IA subregion. The mutant is of the gain and loss type as bm12 in equilibrium or formed from C57BL/6 grafts are rejected in 14-16 d. Mapping studies by the gene-complementation method using H-2 recombinant strains place the mutation in the K or IA regions of the H-2 complex and furthermore, the use of this test and the use of other H-2 mutants indicate that H-2Kb is not the site of the mutation, making the IA region the most likely site. Serological analysis with a battery of H-2b, Iab, and other Ia sera, both by cytotoxicity, rosetting, and also by absorption analysis, indicated no alteration in H-2 specificities, particularly in H-2.K33. By contrast, all of the Iab specificities coded for by the IA subregion (Ia.3, 8, 9, 15, and possibly 20) are extensively altered and are either absent or greatly reduced in amount indicating an extensive alteration in the Ia-bearing molecule. The bm12 mutant strongly stimulates the parental C57BL/6 strain in an mixed lymphocyte reaction (MLR), and the reciprocal also occurs, the degree of stimulation being similar to that obtained with K + IA differences originating in another H-2 haplotype and points to the mutation effecting the Lad-1 locus. The presence of an extensive histocompatibility change, a marked alteration in the serologically detected Ia specificities, and a strong MLR, all produced by the one mutation, provides strong evidence for the identity of the Ia-1, Lad-1, and H-2(IA) loci in the IA subregion. The bm12 mutant should be of value in determining the relationship of Ia specificities, Ir genes, and other phenomena effected by the I region.

A novel mechanism of retrovirus inactivation in human serum mediated by anti-alpha-galactosyl natural antibody.

Type C retroviruses endogenous to various nonprimate species can infect human cells in vitro, yet the transmission of these viruses to humans is restricted. This has been attributed to direct binding of the complement component C1q to the viral envelope protein p15E, which leads to classical pathway-mediated virolysis in human serum. Here we report a novel mechanism of complement-mediated type C retrovirus inactivation that is initiated by the binding of "natural antibody" [Ab] (anti-alpha-galactosyl Ab) to the carbohydrate epitope Gal alpha 1-3Gal beta 1-4GlcNAc-R expressed on the retroviral envelope. Complement-mediated inactivation of amphotropic retroviral particles was found to be restricted to human and other Old World primate sera, which parallels the presence of anti-alpha-galactosyl natural Ab. Blockade or depletion of anti-alpha-galactosyl Ab in human serum prevented inactivation of both amphotropic and ecotropic murine retroviruses. Similarly, retrovirus was not killed by New World primate serum except in the presence of exogenous anti-alpha-galactosyl Ab. Enzyme-linked immunosorbent assays revealed that the alpha-galactosyl epitope was expressed on the surface of amphotropic and ecotropic retroviruses, and Western blot analysis further localized this epitope to the retroviral envelope glycoprotein gp70. Finally, down-regulation of this epitope on the surface of murine retroviral particle producer cells rendered them, as well as the particles liberated from these cells, resistant to inactivation by human serum complement. Our data suggest that anti-alpha-galactosyl Ab may provide a barrier for the horizontal transmission of retrovirus from species that express the alpha-galactosyl epitope to humans and to other Old World primates. Further, these data provide a mechanism for the generation of complement-resistant retroviral vectors for in vivo gene therapy applications where exposure to human complement is unavoidable.

Recent advances in xenotransplantation.

The major barrier to clinically successful pig-to-human xenotransplantation is antibody- and complement-dependent hyperacute rejection, known to be due to host anti-Galalpha(1,3)Gal antibodies. Strategies aimed at eliminating hyperacute rejection involve transgenic approaches to eliminate or reduce expression of Galalpha(1,3)Gal or to reduce complement activation; some of these are now in clinical trials in primates. Another important role of Galalpha(1,3)Gal that is becoming more evident is in antibody-dependent and -independent xenograft rejection that is mediated by natural killer cells and monocytes.

Peptide mimics of a tumor antigen induce functional cytotoxic T cells.

The ability to mimic peptide/peptide and/or peptide/carbohydrate structures may be important in generating cross-reactive antibodies for autoimmune and other diseases. We show that the peptide sequence DAHWESWL can mimic the conformation of the unrelated MUC1 peptide SAPDTRPAP(G). Mice immunized with mannan-MUC1-peptides make cytotoxic T lymphocytes (CTLs) and are protected from MUC1+ tumors. We show that the same specific anti-MUC1 responses can be produced by immunizing with the DAHWESWL peptide; furthermore, specific tumor protection is obtained in a manner similar to that with MUC1 immunization. The DAHWESWL peptide immunization leads to CTLs that recognize H2Dd and H2Ld but not H2b or human leukocyte antigens-group A (HLA-A) *0201 presented MUC1 peptides. However, mutation of the DAHWESWL peptide to a more HLA-A*0201-compatible structure with appropriate anchors (DLHWASWV), leads to the production of CTLs in HLA-A*0201 mice.

Serum Ia levels during tumor growth in mice and humans.

Antigen stimulation in mice such as occurs with the rejection of an allogeneic tumor graft caused a substantial rise in serum glycolipid Ia levels. However, mice bearing a measurable syngeneic tumor had no detectable Ia antigens in their sera; this observation was made in several different strains of inbred mice with 5 different tumors. In each instance the serum Ia level fell as the tumor grew progressively, reached zero at about the time the tumor was visible, and remained at this zero level until the mouse died. Similar results were found in humans: Tumor-bearing patients had markedly suppressed serum Ia levels. The mechanism of the fall in serum Ia glycolipid levels is not known, but the measurement of the serum Ia glycolipid content appears to reflect the level of activation of the immune system, and the suppression of serum glycolipid Ia levels found in tumor-bearing mice and patients may have important clinical implications.

Active tyrosine phosphatase in immunoprecipitates of multiple isoforms of Ly-5.

Using tumour cell lines expressing specific isoforms of murine Ly-5 (molecular weights of 180,000, 200,000 and 240,000) we find that all forms of Ly-5 and immuno-affinity purified forms of Ly-5 contain tyrosyl phosphatase activity. These results demonstrate that these isoforms of Ly-5 belong to the same family of functional receptor-linked tyrosine phosphatases as the human leukocyte common antigen. CD45.

Carbohydrate/peptide mimics: effect on MUC1 cancer immunotherapy.

Recent clinical studies with mannan mucin immunotherapeutic agents indicate that patients produce predominantly antibody responses while mice produce a high cytotoxic T lymphocyte response. In studying the reason for the 'immune deviation' occurring in mice to humans from cellular to antibody responses, it has been found that natural anti-Galalpha(1,3)Gal antibodies, present in all humans, react with the mucin component of the agent, providing an example of a carbohydrate-peptide mimic. The immune deviation can be overcome by in vitro sensitization of antigen-presenting cells in the absence of anti-Gal antibodies - at least in mice. The review examines the background of these observations and discusses other peptide carbohydrate mimics and immune deviation

Monoclonal antibodies detect polymorphic determinants shared by I-A and I-E antigens.

Binding data on inbred mouse strains and immunochemical isolation of Ia antigens with subsequent separation on non-reduced/reduced two-dimensional gels provide evidence for the cross-reactivity of monoclonal antibodies with I-A and I-E products. Thus two monoclonal antibodies were found to react with A alpha A beta as well as E alpha E beta dimers. One of these mAbs, K22 -42, reacts with the precursor form of E beta chain of B10.GD mice which is associated with the invariant chain (Ii). This indicates that the respective determinant on E beta is formed prior to association of E beta with E alpha.

Transgenic approaches for the reduction of Galalpha(1,3)Gal for xenotransplantation.

The major barrier to clinically successful xenotransplantation is the lack of effective therapies aimed at eliminating antibody and complement -dependent hyperacute rejection. This review examines transgenic strategies to eliminate or reduce expression of the major pig to human xenoantigen Galalpha(1,3)Gal such that the epitope is no longer recognized by natural human antibodies, by the use of glycosidases and/or glycosyltransferases that can competitively and effectively inhibit the activity of the alpha1,3galactosyltransferase gene and thereby eliminate the xenoantigen Galalpha(1,3)Gal.

Fucosyl transferase (H) transgenic heart transplants to Gal-/- mice.

BACKGROUND: We have previously described the rejection of Gal+ mouse hearts by mice lacking Gala(1,3)Gal (Gal-/-) and demonstrated this to be a model of xenogeneic hyperacute rejection (HAR) which would occur in pig-to-human/primate xenotransplantation, where Gal+ antibody (Ab) and complement (C') mediate HAR. To reduce the amount of Gal present we used fucosyl transferase (H) as a transgene, H transferase competes for the same substrate as Gal transferase and reduces Gal expression by >90%. METHODS: Gal-/- mice received a heart graft from C57BL/6 Gal+ or H transgenic mice and additional Gal Ab and C' provided; HAR was monitored by direct observation for up to 90 min, or by palpation thereafter. When grafts were rejected they were examined macro- and microscopically. RESULTS: H transgenic mice were used as donors to Gal-/- mice; it was found that: 1) C57BL/6 or H transgenic hearts were not rejected by Gal-/- recipients within 90 min in the absence of additional Gal Ab. 2) If additional Gal Ab and C' were provided as fresh normal human serum (NHS), Gal+ (C57BL/6) grafts were rejected by Gal-/- mice in approximately 34 min, whereas H transgenic hearts mostly lasted up to 17 hr, but were then rejected. The histological appearances showed features of both Arthus and Shwartzmann phenomena. 3) Mice hyperimmunized with Gal with anti-Gal titers of >1:20,000, rejected Gal+ grafts in 31 min; the survival was prolonged to 75 min with the H transgenic hearts. CONCLUSION: The presence of the H transgene in donor hearts transplanted to naive Gal-/- mice delays the onset of HAR, but rejection ultimately occurs; if the mice are hyperimmune earlier rejection occurs. The expression of the H transgene alone is insufficient to avoid HAR in the Gal-/- mouse model; the presence of other transgenes and techniques will be required to give an appropriate increase in survival of pig-to-human/primate grafts.

Biochemical studies of pig xenoantigens detected by naturally occurring human antibodies and the galactose alpha(1-3)galactose reactive lectin.

The xenotransplantation of pig organs to humans is now receiving serious consideration because of the shortage of human donors for organ transplants. However, such xenografts would be hyperacutely rejected due to naturally occurring antibodies, present in all human sera, that react with pig antigens on the surface of endothelial cells, leading to complement fixation and the rapid onset of intravascular coagulation. A major target of these human natural antibodies is the terminal nonreducing disaccharide Gal alpha (1,3)Gal, and we now report on the array of molecules that are galactosylated by the alpha 1,3-galactosyltransferase. Pig lymphocytes and endothelial cells (both of which bear Gal alpha(1,3)Gal epitopes) were surface iodinated and the 125I-labeled molecules were precipitated with either human antibodies or the lectin from Griffonia simplicifolia (IB4, which binds to Gal alpha(1,3)Gal epitopes). The precipitated molecules were analyzed by gel electrophoresis and autoradiography. Five major groups of molecules were identified by one-dimensional SDS/PAGE (alpha 220 kDa, beta 160-180 kDa, gamma 120 kDa, delta 64 kDa, epsilon 40 kDa); the beta molecule was different in the 2 cell types (beta 1 of lymphocytes and beta 2 of endothelial cells). Two-dimensional SDS/PAGE analysis revealed that each of these groups of molecules resolved into further species of different charge (presumably due to different glycosylation) and also different molecular mass to give at least 20 different Gal alpha(1,3)Gal+ surface molecules. None of these molecules appeared to be present as disulfide-associated dimers. It is clear that there are many galactosylated molecules on the cell surface; indeed, using longer exposures of the autoradiographs, at least 40 different Gal alpha (1,3)Gal+ molecules could be identified. Several of these molecules are likely to have been identified by others, e.g., the 115-kDa, 125-kDa, and 135-kDa triad identified by Platt. Strategies to overcome hyperacute rejection could include modification or deletion of the alpha 1,3-galactosyltransferase gene, which would simultaneously delete all the Gal alpha(1,3)Gal epitopes on these molecules.

Gal alpha(1,3)Gal is the major xenoepitope expressed on pig endothelial cells recognized by naturally occurring cytotoxic human antibodies.

Hyperacute rejection, mediated by natural antibody, is the major barrier to xenotransplantation. The studies reported herein were aimed at evaluating antibody-mediated cytotoxicity and the role of the Gal alpha(1,3)Gal epitope, which we had previously demonstrated was the major epitope of pig cells detected by naturally occurring human antibodies. Also, we had shown that this epitope could be induced in non-expressing cells by the transfection of a cDNA clone encoding alpha(1,3)galactosyl transferase, the enzyme that produces this epitope. The importance of the Gal alpha(1,3)Gal epitope was supported by (1) sugar inhibition studies; (2) complete absorption of cytotoxic antibodies by melibiose-sepharose columns; and (3) the ability of normal human serum to lyse COS cells after transfection with a cDNA clone encoding alpha(1,3)galactosyl transferase. These findings strongly suggest that the majority of cytotoxic human antibodies that would recognize a xenogeneic graft are directed to the Gal alpha(1,3)Gal epitope.

Reactivity of xenogeneic antihuman Ia antisera with the I-C subregion of the murine major histocompatibility complex. I. Genetic studies.

Several rabbit xenoantisera raised against human serum Ia antigens have been shown to detect murine lymphocyte antigens. The murine system detected was shown to be polymorphic and expressed on B cells and not T cells. Serological analysis of recombinant H-2 strains demonstrated that two of the antisera recognized products of the I-Cd subregion, and one antiserum recognized products of the I-Cb subregion, thus clearly establishing the existence of the I-C subregion in these two haplotypes. However, as the I-Cd subregion is classically described by the Ia.6 specificity present on T cells and xenoantisera detect a product on B cells, the indication is that the I-C region, like I-A and I-J, complex and contains genes coding for specificities on T cells or B cells.

Detection of mouse alloantibodies by rosetting with protein A-coated sheep red blood cells.

Staphylococcal protein A has an affinity for the Fc portion of the IgG molecule of different species and can therefore be used to detect cell-bound immunoglobulin. Using this property, protein A coupled to sheep red blood cells via chromic chloride can detect alloantibodies to mouse H-2, Thy-1, Ly-1, 2, 4, 5, 6, and 7, and Ia antigenic specificities bound to the surface of lymphocytes by the formation of rosettes. In comparison with other rosetting and cytotoxicity assays, the protein A assay shows a greater sensitivity than does cytotoxicity using spleen cells as the target, as does the sheep anti-mouse Ig rosetting assay, whereas cytotoxicity shows greater sensitivity with some antisera on thymocytes. The major advantages of the protein A assay are that constant low reproducible backgrounds are obtained, there is no need to remove surface Ig by capping prior to antiserum treatment, and that viable cells can be recovered.

Human natural killer lymphocytes directly recognize evolutionarily conserved oligosaccharide ligands expressed by xenogeneic tissues.

BACKGROUND: In discordant xenogeneic species combinations, vascularized transplants are hyperacutely rejected, due to binding of xenoreactive natural antibodies (XNA) to selected tissues of the graft, followed by activation of the complement and coagulation cascades. A major epitope recognized by human XNA is the terminal disaccharide Gal alpha(1,3)Gal. Poorly defined, early cell-mediated events also contribute to recognition and rejection of discordant xenografts, and we have suggested a role of natural killer (NK) lymphocytes in this process. METHODS: Human NK cells were used as effectors in functional assays of adhesion to and lysis of xenogeneic discordant endothelial cells in vitro. Adhesion and lysis inhibition experiments were performed using a large panel of carbohydrates, as well as F(ab')2 fragments of human XNA. COS cells transduced with the porcine alpha-galactosyltransferase were also used as targets for NK cell adhesion. RESULTS: We demonstrate that XNA-reactive carbohydrate epitopes expressed by xenogeneic cells, including Gal alpha(1,3)Gal, are also directly recognized by human NK cells. First, selected carbohydrates in solution displace with comparable efficiency both XNA and NK cell binding to xenogeneic endothelium; second, XNA F(ab')2 fragments selectively inhibit human NK cell adhesion to porcine endothelium, but not to human endothelium; third, unstimulated NK lymphocytes adhere selectively to COS-7 cells expressing the porcine glycosyltransferase that encodes the Gal alpha(1,3)Gal epitope. CONCLUSIONS: Collectively, our findings suggest that humoral and cellular components of the natural immune response against heterologous species independently evolved recognition patterns directed against overlapping carbohydrate determinants.

A murine model of antibody-mediated hyperacute rejection by galactose-alpha(1,3)galactose antibodies in Gal o/o mice.

BACKGROUND: In pig-to-primate/human xenografts, hyperacute rejection of primarily vascularized organs usually occurs in 10-60 min and is due to the reaction of the recipients' natural antibodies with antigens expressed on the donor endothelium, the fixation of complement, and ultimately vascular stasis and hemorrhage. Surprisingly, the major target of the natural antibodies is the disaccharide galactose-alpha(1,3)galactose (Gal alpha(1,3)Gal), which is found on many different molecules in pig tissues and reacts with naturally occurring human anti-pig IgM and IgG antibodies. There are a number of strategies to remove/block/alter Gal alpha(1,3)Gal expression in pig tissues, all of which involve the expression of transgenes in pigs. To overcome the difficulty of preclinical studies using primates, we describe a model of hyperacute rejection of heart transplants to Gal o/o mice, which are similar to humans in that they have anti-Gal alpha(1,3)Gal antibodies. METHODS: Gal o/o mice received skin or heart grafts from Gal+ mice or rats, and additional antibody and complement were provided; hyperacute rejection was monitored by observation and histology. RESULTS: Gal alpha(1,3)Gal+ mouse tissues (skin or heart) are not rejected by Gal o/o mice. This was not unexpected, as mice do not utilize alloantibody/complement systems satisfactorily in experimental transplantation studies. However, with the addition of anti-Gal alpha(1,3)Gal antibody and complement, hyperacute rejection of hearts can occur in 10-20 min; it is mediated by IgM, not IgG, antibodies and leads predominantly to tissue hemorrhage. CONCLUSION: Gal alpha(1,3)Gal antigen modification by expression of the H transferase cDNA leads to "indefinite" survival (>120 min) and no hyperacute rejection, which shows that this model is suitable for the study of antibody-mediated rejection of relevance to pig-to-human xenografts.

Reactivity of xenogeneic antihuman Ia antisera with the I-C subregion of the murine major histocompatibility complex. II. Biochemical studies.

The biochemical nature of the cross-reactive antigens on murine B cells, detected with xenogeneic antihuman Ia (H.Ia) sera, were examined. These antigens, coded for by the I-C subregion, were found to be carbohydrate in nature and probably exist as glycolipids on the cell surface. Furthermore, sugar inhibition studies demonstrated that the anti-H.Ia sera recognized identical monosaccharide residues on murine and human B cells.