Calcineurin deficiency decreases inflammatory lesions in transforming growth factor beta1-deficient mice.

Transforming growth factor (TGF) beta1) is an immunoregulatory cytokine involved in self-tolerance and lymphocyte homeostasis. Tgfb1 knock-out (KO) mice develop severe multi-focal autoimmune inflammatory lesions due to [Ca(2+)]i deregulation in T cells, and die within 3 weeks after birth. Because the calcineurin inhibitor FK506 inhibits the hyperresponsiveness of Tgfb1(-/-) thymocytes, and because calcineurin Abeta (CNAbeta)-deficient mice do not reject allogenic tumours, we have generated Tgfb1(-/-) Cnab(-/-) mice to address whether CNAbeta deficiency prevents T cell activation and inflammation in Tgfb1(-/-) mice. Here we show that in Tgfb1(-/-) Cnab(-/-) mice inflammation is reduced significantly relative to that in Tgfb1(-/-) mice. However, both CD4(+) and CD8(+) T cells in double knock-out (DKO) mice are activated, as revealed by up-regulation of CD11a lymphocyte function-associated antigen-1 (LFA-1), CD44 and CD69 and down-regulation of CD62L. These data suggest that deficiency of CNAbeta decreases inflammatory lesions but does not prevent activation of autoreactive T cells. Also Tgfb1(-/-) T cells can undergo activation in the absence of CNAbeta, probably by using the other isoform of calcineurin (CNAalpha) in a compensatory manner. CNAbeta-deficient T cells undergo spontaneous activation in vivo and are activated upon anti-T cell receptor stimulation in vitro. Understanding the role of calcineurin in T cell regulation should open up new therapeutic opportunities for inflammation and cancer.

Loss of the retinoblastoma tumor suppressor: differential action on transcriptional programs related to cell cycle control and immune function.

Functional inactivation of the retinoblastoma tumor suppressor gene product (RB) is a common event in human cancers. Classically, RB functions to constrain cellular proliferation, and loss of RB is proposed to facilitate the hyperplastic proliferation associated with tumorigenesis. To understand the repertoire of regulatory processes governed by RB, two models of RB loss were utilized to perform microarray analysis. In murine embryonic fibroblasts harboring germline loss of RB, there was a striking deregulation of gene expression, wherein distinct biological pathways were altered. Specifically, genes involved in cell cycle control and classically associated with E2F-dependent gene regulation were upregulated via RB loss. In contrast, a program of gene expression associated with immune function and response to pathogens was significantly downregulated with the loss of RB. To determine the specific influence of RB loss during a defined period and without the possibility of developmental compensation as occurs in embryonic fibroblasts, a second system was employed wherein Rb was acutely knocked out in adult fibroblasts. This model confirmed the distinct regulation of cell cycle and immune modulatory genes through RB loss. Analyses of cis-elements supported the hypothesis that the majority of those genes upregulated with RB loss are regulated via the E2F family of transcription factors. In contrast, those genes whose expression was reduced with the loss of RB harbored different promoter elements. Consistent with these analyses, we found that disruption of E2F-binding function of RB was associated with the upregulation of gene expression. In contrast, cells harboring an RB mutant protein (RB-750F) that retains E2F-binding activity, but is specifically deficient in the association with LXCXE-containing proteins, failed to upregulate these same target genes. However, downregulation of genes involved in immune function was readily observed with disruption of the LXCXE-binding function of RB. Thus, these studies demonstrate that RB plays a significant role in both the positive and negative regulations of transcriptional programs and indicate that loss of RB has distinct biological effects related to both cell cycle control and immune function.

Effect of tuftsin on in vivo development of 3-methylcholanthrene-induced primary fibrosarcoma and Lewis lung carcinoma in mice.

The effect of tuftsin therapy on tumor development was examined in a murine primary fibrosarcoma and the Lewis lung carcinoma systems. Following im injection of 3-methylcholanthrene (CAS: 56-49-5) on day 0, C57BL/10ScSn mice were treated weekly with 3 ip tuftsin injections beginning on day 1 or day 60. Similar patterns of tumor development were observed regardless of whether tuftsin therapy was immediate or delayed. Only modest differences in experimental and control tumor incidences were found upon termination of studies; however, treated animals developed significantly fewer tumors than controls early during the observation periods. Thus mean tumor latent periods varied significantly when therapy began on day 1 (103.6 days in controls vs. 119.1 in treated mice; P = .02) or 2 months later (104.6 days in controls vs. 115.3 in treated mice; P = .01). One day subsequent to intra-footpad implantation of 10(5) Lewis lung carcinoma cells, C57BL/6 mice received at least 10 iv injections of tuftsin and were compared with controls for variations in survival or lung tumor development. The mean survival time in treated mice, 41.2 days, differed sharply from that (30.1 days) in controls (P = .00001). Similar groups of mice varied significantly in mean metastatic lung colony counts when examined on day 30; there were 15.1 colonies in controls and 8.0 in experimental animals (P = .03).

Surgical stress-mediated suppression of murine natural killer cell cytotoxicity.

Natural killer cell-mediated cytotoxicity (NKCC) is one of several possible immune defense mechanisms that may protect against the development of solid-tumor metastases. We have demonstrated that in vitro NKCC can be significantly impaired by both surgical stress and progressive tumor burden. Female C57BL/6 mice received a hindfoot amputation under anesthesia with Nembutal i.p. Twenty-four hr later, amputated and control groups were sacrificed, spleens were harvested, and cytotoxicity assays were performed using 51Cr-labeled Yac-1 lymphoma target cells. In amputated animals, in vitro NKCC was significantly impaired at four effector:target ratios, decreasing by as much as 59%. Nembutal treatment alone caused no significant changes in in vitro NKCC compared to untreated controls. Tumor burden was studied by inoculating the hindfoot pads of C57BL/6 mice with 5 X 10(5) Lewis lung tumor cells. Animal groups were sacrificed 24 hr, 1 week, and 2 weeks after tumor inoculation, and the 51Cr release assay was performed. One day and 1 week of tumor burden mildly stimulated NKCC in vitro; after 2 weeks of tumor burden, when lung metastases were detectable, in vitro NKCC was almost totally suppressed compared with non-tumor-bearing controls. Animals bearing tumor for 1 week and then given amputations showed significantly impaired NKCC in vitro. In vivo, identical animals bearing tumor for 1 week and then given amputations on sacrifice 1 week later were found to have a 71% incidence of lung metastases compared with 38% tumor-bearing unstressed controls. Surgical stress and progressive tumor burden independently and codependently impair NKCC in vitro; this may possibly contribute to the hypermetastatic response observed after surgical stress in this in vivo animal model.

Neutral surface aminopeptidase activity of human tumor cell lines.

Seven human tumor cell lines were studied for their neutral surface aminopeptidase (AP) activity. The activity was shown to exist on all cell lines to varying degrees. The neutral AP activity of the cell lines had similar Km values and were affected by the same inhibitors as those reported for AP's of peripheral blood lymphocytes (PBL, Refs. 1 and 2). However, a difference was seen in the Vmax values of the various cell lines. These values were shown to correlate (r = 0.767, P less than 0.05) with cell surface area.

Degradation of thymopentin by human lymphocytes: evidence for aminopeptidase activity.

Thymopentin (Arg-Lys-Asp-Val-Tyr) was shown to be degraded in vitro by human lymphocytes into two main fragments; the tetrapeptide Lys-Asp-Val-Tyr and the tripeptide Asp-Val-Tyr. Degradation products were identified by HPLC and amino-acid analysis. Analysis of the time-course of degradation revealed a 'stepwise' degradative event beginning at the N-terminal. The degradation of thymopentin after the first 10 min, as well as the formation of the tetrapeptide (5-30 min) were essentially curvilinear. Degradation of the tripeptide, was linear. Upon screening a panel of compounds that inhibit enzymatic activity, bestatin, amastatin and 1,10-phenanthroline were shown to be the most effective. Bestatin and amastatin caused an 85-90% inhibition of thymopentin degrading activity with IC50 values of 7.1 x 10(-6) M and 4.5 x 10(-9) M, respectively. 1,10-Phenanthroline completely inhibited the degradative process with an IC50 of 2 x 10(-4) M. When the tetrapeptide Lys-Asp-Val-Tyr was used as the starting substrate, similar IC50 values were seen for amastatin, bestatin and 1,10-phenanthroline. The importance of divalent metal ions in the degradative event was demonstrated not only by the effect of 1,10-phenanthroline, but also by the ability of Zn2+ and Co2+ to reverse the inhibition of 1,10-phenanthroline (at its IC50) to activities near control values (no inhibitor). These data strongly suggest that an aminopeptidase(s) is responsible for the degradative activity.

Temporal inhibition of calmodulin in the nucleus.

Calmodulin (CaM) acts as a primary mediator of calcium signaling by interacting with target proteins. We have previously shown that nuclear CaM is critical for cell cycle progression using a transgene containing four repeats of a CaM inhibitor peptide and nuclear targeting signals (J. Wang et al., J. Biol. Chem. 270 (1995) 30245 30248; Biochim. Biophys. Acta 1313 (1996) 223-228). To evaluate the role of CaM in the nucleus specifically during S phase of the cell cycle, a motif which stabilizes the mRNA only during S phase was included in the transgene. The CaM inhibitor mRNA transcript contains a self-annealing stem-loop derived from histone H2B at the 3' end. This structure provides stability of the mRNA only during S phase, thereby restricting CaM inhibitor expression to S phase. The inhibitor accumulates in the nucleus, particularly in the nucleoli. Flow cytometric analysis demonstrated that the CaM inhibitor is expressed in S and G2. Transfected cells show growth inhibition and a reduction in DNA synthesis. The CaM inhibitor peptide is a versatile reagent that allows spatial as well as temporal dissection of calmodulin function.

Heat shock response: presence and effects in burn patient neutrophils.

Heat shock proteins (HSPs) are present in neutrophils (PMNs) from critically ill patients. We investigated whether HSPs were present in PMNs from burn patients and whether heat shock contributed to the functional defects observed in burn PMNs. Using both flow cytometry and Western blot techniques it was observed that inducible HSP72 (iHSP72) was present in PMNs and leukocytes from burn patients, especially in patients with inhalation injury. Similar to burn PMNs, and in contrast to normal cells, heat shocked PMNs (43 degrees C incubation) expressed iHSP72 and were unable to increase the expression of CD11b/CD18 in response to pro-inflammatory stimuli. Degranulation after pro-inflammatory stimuli was decreased for both burn- and heat-shocked PMNs when compared to normal controls. In burn PMNs these functional abnormalities were mainly due to decreased quantities of proteins (CD11b, albumin, B12 binding protein, beta-glucuronidase) present within cytoplasmic granules. However, in heat-shocked PMNs the abnormalities were primarily related to abnormal exocytosis. In conclusion, our data show that decreased quantities of cytoplasmic granule proteins and, to a smaller degree, defective exocytosis are involved in the functional abnormalities observed in burn PMNs.

A human natural killer cell-associated antigen defined by monoclonal antibody anti-Leu (NKP-15): functional and two-color flow cytometry analysis.

A monoclonal antibody, anti-Leu 11a (NPK-15), was generated against human large granular lymphocytes (LGL). Anti-Leu 11a reacted with the majority of Percoll gradient-enriched LGL cells, a subpopulation of peripheral blood lymphocytes (PBL) approx (approximately 10-20%), and most granulocytes, but not with a significant number of monocytes, T lymphocytes, or erythrocytes. Cell sorting experiments demonstrated that the Leu 11a+ population encompassed essentially all functional natural killer (NK) cells in the peripheral blood. Two-color flow cytometry analysis of PBL populations stained with anti-Leu 11a and anti-Leu 7 revealed the existence of four distinct populations: Leu 11a-, 7+; Leu 11a+, 7-; Leu 11a+, 7+; and Leu 11a-, 7-. The Leu 11a+ population did not appear to include cells marked with the T cell-associated antigens Leu 1, Leu 2, or Leu 3. The existence of a cell surface antigen common to granulocytes and NK cells, which is capable of distinguishing subpopulations of Leu 7+ cells, provides a useful probe to analyze the nature of the NK lineage.

Neutrophils from burn patients are unable to increase the expression of CD11b/CD18 in response to inflammatory stimuli.

Neutrophils (PMNs) from patients with thermal injury are dysfunctional for the CD11b/CD18-dependent functions of diapedesis, chemotaxis, and phagocytosis. The expression of CD11b/CD18 on normal PMNs is increased after an inflammatory stimulus. We proposed that CD11b/CD18 expression on burn patient PMNs would respond abnormally to inflammatory stimuli. PMNs were obtained from nonseptic burn patients during the second week after thermal injury. PMNs from burn patients incubated with lipopolysaccharide (LPS), N-formyl-methionyl-leucyl-phenylalanine, phorbol myristate acetate, or A23187 did not increase the expression of CD11b/CD18 to the same degree exhibited by normal PMNs. This inability to increase CD11b/CD18 was not due to differences in CD14 receptor expression, LPS binding, or factors present in the serum of burn patients. The upregulation of CD35 also was decreased on burn patient PMNs. Western blot analysis revealed decreased quantities of CD11b protein in burn patient PMNs compared with normal control PMNs. The deficiency in CD11b/CD18 expression after inflammatory stimuli may explain some of the abnormalities observed in burn PMN function.

Regulation of pigmentation in cultured skin substitutes by cytometric sorting of melanocytes and keratinocytes.

Unpredictable pigmentation in cultured skin substitutes (CSS) is an anatomic deficiency after wound treatment and can require years to normalize. Variable numbers of human melanocytes (HM) survive in cultures of human keratinocytes (HK) as demonstrated by focal areas of pigmentation in CSS after healing. The purposes of this study were to deplete HM from HK cultures and to regulate the numbers of HM contained in CSS. A highly pigmented HM cell strain was chosen for these studies to emphasize the differences in light scattering between HK and HM by flow cytometry. Cytometric gates were set with selective cultures of HM and HK and were used to sort a mixed population of HK + 4% HM. After sorting, CSS were prepared from human fibroblasts attached to collagen-glycosaminoglycan sponges combined with cells from the HK + 4% HM (pre-treatment control), the sorted HK (experimental), or sorted HK + 3% HM (post-treatment positive control) subpopulations and grafted to athymic mice. Grafted wounds were assessed for 6 wk by planimetry for area of pigment and by a Minolta Chromameter for color density and hue in situ. Histology and staining of HLA-ABC were performed at 6 wk. Data from percent pigmented area and chromameter measurements identified quantitative and statistically significant decreases in color of healed skin after flow cytometric separation of HK and HM. Therefore, a purified HK subpopulation depleted of HM was isolated by flow cytometry that generated healed skin with reduced pigmentation. These results suggest that HM can be selectively depleted from HK cultures and then added to cultured skin substitutes at specific densities to generate predictable pigmentation for improved function and cosmesis in healed wounds.

Synthesis of interleukin-1 alpha and beta by normal human melanocytes.

Normal human melanocytes and melanoma cells have been reported to produce several cytokines. Previously we demonstrated that neonatal human melanocyte proliferation and tyrosinase activity are inhibited by interleukin-1 alpha, tumor necrosis factor-alpha, and interleukin-6. We have now also shown that interleukin-1 beta induces an inhibiting effect on neonatal melanocyte tyrosinase activity with little effect on melanocyte proliferation. We investigated the ability of neonatal and adult human melanocytes to synthesize interleukin-1 alpha and beta. By immunocytochemistry, using monoclonal antibodies against interleukin-1 alpha and beta, we observed that neonatal and adult melanocytes stain positively for both cytokines. Flow-cytometric analysis revealed that the percentage of melanocytes positive for interleukin-1 alpha was always greater than that for interleukin-1 beta. The ability of neonatal and adult melanocytes to synthesize interleukin-1 alpha and beta was further confirmed using the polymerase chain reaction. These results clearly indicate that human melanocytes synthesize interleukin-1 alpha and beta, and that these cytokines may function as autocrine and/or paracrine regulators of cells in the epidermis.

Altered gene expression in melanocytes exposed to 4-tertiary butyl phenol (4-TBP): upregulation of the A2b adenosine receptor 1.

Exposure to phenolic agents contributes to the development of occupational vitiligo. Proposed as a causative factor for leukoderma in vivo, the para-substituted phenol 4-tertiary butyl phenol was chosen to investigate early cellular events responsible for selective disappearance of melanocytes from the epidermis of individuals sensitive to such agents. To this end, differential display of melanocyte mRNA isolated from three separate cultures was performed following a 12 h exposure of cells to 250 microM 4-tertiary butyl phenol or to vehicle alone. Fragments of cDNA representing differentially expressed messages were cloned and subsequently confirmed by reverse dot blotting. Alignment analysis revealed that the L30 ribosomal protein was upregulated by the treatment, potentially reflecting altered levels of protein synthesis in response to stress. In addition, a gene sequence upregulated following exposure to 4-tertiary butyl phenol was identified as the A2b receptor (a P1 receptor for adenosine). Differential expression of this gene was confirmed in an RNase protection assay. By reverse transcription-polymerase chain reaction, the gene was shown to be expressed in keratinocytes and fibroblasts as well. Flow cytometry confirmed differential expression in melanocytes and fibroblasts, but not in keratinocytes. Interestingly, it has been reported that P1 purinoceptor stimulation can induce apoptosis. This is in concordance with results reported elsewhere demonstrating induction of apoptosis by 4-tertiary butyl phenol in human melanocytes, as well as with morphologic changes observed in this study in cells exposed to 250 microM 4-tertiary butyl phenol for 72 h. In conclusion, differential display is useful to establish melanocyte components involved in the cellular response to phenolic agents.

A simple method for the preparation of antisera specific for murine immunoglobulin heavy chains.

Rabbit antisera were prepared against mouse immunoglobulin mu and gamma chains by immunizing rabbits with their own erythrocytes coated with murine anti-rabbit erythrocyte immunoglobulin. In the preparation of these antisera, we exploited the observation that the primary immune response in C57BL/10ScSn (B10) mice is almost exclusively IgM, while hyperimmune antiserum of A/WySn (A) is mostly IgG. After appropriate absorption with thymocytes and rabbit erythrocytes (Rrbc) coated with B10 or A antiRrbc Ig, the sera were shown to be specific by immunoelectrophoresis, indirect immunofluorescent staining, and complement-mediated cytotoxicity. This technique is simple, requires almost no equipment, and a large quantity of specific antiserum can be prepared quite economically.

Quantitation of phagocytosis by confocal microscopy.

Confocal microscopy is an excellent tool to quantify phagocytosis. Depending on the particle used, phagocytosis can be determined by the simple manual counting of internalized particles. If a fluorescence probe is utilized, an analysis of fluorescence intensity can be used for quantification. The basic procedure can be altered in a number of areas to conform with the scientific needs of the investigator. This includes the use of different particles, cell types, fluorescence dyes, and even the degree of sophistication of the instrumentation. The major pitfall encountered when trying to quantify phagocytosis is the inability to separate external from internal (phagocytosed) particles. If not determined properly, data will be erroneous, usually indicating a much higher degree of phagocytosis than actually occurred.

The synergistic effect of low-dose cyclosporine and fluocinolone acetonide on the survival of rat allogeneic skin grafts.

Both CsA and topical FA can prolong the survival of skin allografts under the proper conditions. This study was performed to determine if there is a synergistic effect between these two compounds. Buf (RT1b) rat split-thickness skin grafts were transplanted onto the backs of Lew (RT1l) rats. The MST for the control group was 9.89 +/- 0.35 days. In rats given oral CsA, 2.5 or 5 mg/kg, daily from the second day of grafting, the MST was 16.0 +/- 1.9 and 13.6 +/- 0.4 days (blood CsA levels were 166 +/- 20 and 640 +/- 32 ng/ml at the time of rejection, respectively. Topical FA applied daily beginning 72 hr after grafting resulted in a MST of 24.1 +/- 3.6 days. When both topical FA and 5 mg/kg oral CsA were used, the allograft survival time was more than 100 days in 4 of 7 animals. When oral CsA 2.5 mg/kg was combined with topical CsA and FA, the allograft rejection was delayed until 50 days postgrafting in four of six animals. The synergistic effects of oral CsA and topical FA is significant, and thus allows for the use of a subtherapeutic dosage of each compound and provides a potentially safe means for prolonging skin allograft survival.

Immunoregulation of transfusion-induced immunosuppression with inhibitors of the arachidonic acid metabolism.

To further define the role of arachidonic acid (AA) metabolites in transfusion-induced immunosuppression (TII), the effects of pharmacological manipulation of AA metabolism were examined in a rodent model. If the prostaglandins of the E series are mediators of TII, as has been recently hypothesized, then inhibition of cyclooxygenase (indomethacin) should abrogate whereas inhibition of lipoxygenase (nordihydroguaiaretic acid [NDGA]), or thromboxane synthetase (4-63557A) could potentiate the transfusion effect. Lewis rats received donor-specific transfusions from Buffalo rats in conjunction with one of the above inhibitors. Two weeks later they received intraabdominal Buffalo heart allografts or were used for one-way mixed lymphocyte reactions. Cyclooxygenase inhibition partially abrogated TII with shortened cardiac allograft survival. Lipoxygenase inhibition augmented TII, with depression of MLR and prolongation of allograft survival. Thromboxane synthetase inhibition had no effect. These results indicate that AA metabolites play a role in TII, and that immunoregulation via pharmacological manipulation of AA metabolism is possible.

Long-term survival of skin allografts in rats treated with topical cyclosporine.

The use of topical cyclosporine (CsA) was studied in skin allografts from Buffalo to Lewis rats. CsA prepared in olive oil and dimethyl sulfoxide was administered in various dosages topically on allografts. Untreated allografts were rejected in 7.4 +/- 1.1 days but survived for 18.6 +/- 0.9, 29.3 +/- 1.8, or 40.6 +/- 2.2 days after 10, 20, or 28 days of topical CsA treatment (10 mg/rat/day), respectively. Long-term graft survival (greater than 100 days) was seen with continuous CsA treatment at 10 mg/rat/day, 10 mg/rat/2 days, and 5 mg/rat/day, as compared with rejection in 13.1 +/- 2.3 and 8.9 +/- 0.9 days with CsA 10 mg/rat/3 days and 5 mg/rat/2 days, respectively. The therapeutic blood level of CsA ranged from 250 to 500 ng/ml. Most grafts were rejected when CsA blood levels fell below 200 ng/ml. Direct administration of topical CsA onto the allografts resulted in longer survival compared with those applied on the normal recipient skin 6 cm distal to the allografts, with both high and low doses. Locally high concentrations of CsA in allografts may play an important role in prolongation of graft survival. Minimal cell infiltration and loss of hair follicles were the main histological features in long-surviving allografts (greater than 120 days).

Dietary omega-3 and omega-9 fatty acids uniquely enhance allograft survival in cyclosporine-treated and donor-specific transfusion-treated rats.

BACKGROUND: Both laboratory and clinical studies have shown that dietary lipids may affect immunologic responses. This study was conducted to compare different classes of long-chain unsaturated fatty acids for their effect on allograft survival in animals receiving a donor-specific transfusion and a short course of low-dose cyclosporine (CsA). METHODS: Heterotopic ACI strain cardiac allografts were transplanted to Lewis strain rat recipients given diets with different lipid composition. In experiment 1, animals received CsA for 14 days and different diets were enriched with lipids with high concentrations of omega-3, omega-6, or omega-9 fatty acids. In experiment 2, animals received CsA for only 8 days and different diets were enriched with corn oil (omega-6), canola oil (omega-3 and omega-9), fish oil (omega-3) or a mixture of sunflower oil and fish oil (omega-3 and omega-9). RESULTS: In experiment 1, animals receiving the diet with 30% sunflower oil had the best allograft survival (200+/-42 days vs. 53+/-8 days for regular chow plus donor-specific transfusion and CsA, P<0.05). In experiment 2, diets containing canola oil (a mixture of omega-3 and omega-9 fatty acids) were associated with the best survival (P=0.0011 vs. regular chow). CONCLUSION: Dietary omega-3 and omega-9 fatty acids both enhanced cardiac allograft survival in a stringent rat strain combination. Canola oil is a convenient oil for administering both alpha-linoleic acid (omega-3) and oleic acid (omega-9) in a palatable form for human consumption. Further investigation of the potential usefulness of lipids in transplant therapy is warranted.

Nutritional immunomodulation leads to enhanced allograft survival in combination with cyclosporine A and rapamycin, but not FK506.

BACKGROUND: Recently, specific immunonutrients were found to increase experimental allograft survival when combined with cyclosporine A (CsA). This study compared the effect on rat cardiac allograft survival when nutritional immunomodulation was used with CsA, rapamycin (Rapa), or tacrolimus (FK506). METHODS: Intra-abdominal ACI to Lewis cardiac allografts were performed and assessed daily by palpation. Study groups included untreated controls and those receiving CsA, Rapa, or FK506. Rats were fed ad libitum with Impact diet (fortified with fish oil, arginine, and RNA) or standard rat food. Further study groups were transplanted that received a donor-specific transfusion in addition to immunosuppression and diet. RESULTS: Allograft survival was extended by combining Impact with CsA (45.3+/-19 days) and Rapa (165.3+/-52 days), but not FK506 (12.4+/-3.2 days). Mean graft survival in the Rapa/Impact group met criteria for functional tolerance. The addition of a donor-specific transfusion did not lead to graft survival advantages over similar groups not receiving a donor-specific transfusion. CONCLUSIONS: The use of immunonutrients improves transplant outcome in animals treated with short courses of CsA and Rapa, but not FK506. These findings highlight the potential differences in the effects of nutritional immunomodulation with different immunosuppressive drugs in the treatment of transplant patients.