Manell, Elin
- Department of Clinical Sciences, Swedish University of Agricultural Sciences
- Columbia University
Abstract
Background. Intestinal transplantation (ITx) has the highest rate of rejection among solid organ grafts. We aimed to study the pathophysiology of rejection after ITx but lacked a tool for assessing cellular responses within the graft. Therefore, we developed a novel mixed lymphocyte reaction (MLR) assay to investigate immune responses in the graft. Methods. Intestinal samples were collected, decontaminated, and processed into single-cell suspensions from 9 swine and 2 patients that underwent ITx. Debris was removed using gradient centrifugation. The cells were plated with corresponding stimulator cells and incubated for 6 d before data acquisition and analysis. Results. Tolerant animals showed no anti-donor or anti-recipient responses in their graft mucosa but maintained strong anti-third-party responses, even after weaning immunosuppression. An animal with graft-versus-host disease displayed robust anti-recipient and anti-third-party responses but no anti-donor response. The animals with graft rejection maintained anti-donor responses at all timepoints. Finally, some tolerant animals developed "split tolerance," with anti-donor responses in the peripheral blood but donor-specific hyporesponsiveness in the mucosal MLR, which regulatory T cells depletion suggested was attributable to local regulatory tolerance. When applied to human sample, this mucosal MLR reliably demonstrated self-tolerance with normal anti-third-party responsiveness. Conclusions. The novel mucosal MLR assay presented herein +/- CD25 depletion serves as a useful adjunct for assessing immune responses within the intestinal graft mucosa. This could help elucidate immune responses after ITx in future studies, including our own, and could represent a promising tool for studying ITx tolerance development, guiding immunosuppression strategies, and advancing personalized transplant medicine.
Published in
Transplantation
2025, volume: 109, number: 7, pages: 1175-1183
Publisher: LIPPINCOTT WILLIAMS AND WILKINS
SLU Authors
UKÄ Subject classification
Immunology in the medical area
Publication identifier
- DOI: https://doi.org/10.1097/TP.0000000000005348
Permanent link to this page (URI)
https://res.slu.se/id/publ/143579