Combined Immunotherapy With Belatacept and BTLA Overexpression Attenuates Acute Rejection Following Kidney Transplantation

BackgroundCostimulatory blockade provides new therapeutic opportunities for ensuring the long-term survival of kidney grafts. The adoption of the novel immunosuppressant Belatacept has been limited, partly due to concerns regarding higher rates and grades of acute rejection in clinical trials. In th...

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Main Authors: Hengcheng Zhang, Zijie Wang, Jiayi Zhang, Zeping Gui, Zhijian Han, Jun Tao, Hao Chen, Li Sun, Shuang Fei, Haiwei Yang, Ruoyun Tan, Anil Chandraker, Min Gu
Format: Article
Language:English
Published: Frontiers Media S.A. 2021-02-01
Series:Frontiers in Immunology
Subjects:
Online Access:https://www.frontiersin.org/articles/10.3389/fimmu.2021.618737/full
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author Hengcheng Zhang
Hengcheng Zhang
Zijie Wang
Jiayi Zhang
Zeping Gui
Zhijian Han
Jun Tao
Hao Chen
Li Sun
Shuang Fei
Haiwei Yang
Ruoyun Tan
Anil Chandraker
Min Gu
author_facet Hengcheng Zhang
Hengcheng Zhang
Zijie Wang
Jiayi Zhang
Zeping Gui
Zhijian Han
Jun Tao
Hao Chen
Li Sun
Shuang Fei
Haiwei Yang
Ruoyun Tan
Anil Chandraker
Min Gu
author_sort Hengcheng Zhang
collection DOAJ
description BackgroundCostimulatory blockade provides new therapeutic opportunities for ensuring the long-term survival of kidney grafts. The adoption of the novel immunosuppressant Belatacept has been limited, partly due to concerns regarding higher rates and grades of acute rejection in clinical trials. In this study, we hypothesized that a combined therapy, Belatacept combined with BTLA overexpression, may effectively attenuate acute rejection after kidney transplantation.Materials and MethodsThe rat kidney transplantation model was used to investigate graft rejection in single and combined therapy. Graft function was analyzed by detecting serum creatinine. Pathological staining was used to observe histological changes in grafts. The expression of T cells was observed by immunohistochemistry and flow cytometry. In vitro, we constructed an antigen-stimulated immune response by mixed lymphocyte culture, treated with or without Belatacept and BTLA-overexpression adenovirus, to observe the proliferation of receptor cells and the expression of cytokines. In addition, western blot and qRT-PCR analyses were performed to evaluate the expression of CTLA-4 and BTLA at various time points during the immune response.ResultsIn rat models, combined therapy reduced the serum creatinine levels and prolonged graft survival compared to single therapy and control groups. Mixed acute rejection was shown in the allogeneic group and inhibited by combination treatment. Belatacept reduced the production of DSA and the deposition of C4d in grafts. Belatacept combined with BTLA overexpression downregulated the secretion of IL-2 and IFN-γ, as well as increasing IL-4 and IL-10 expression. We also found that Belatacept combined with BTLA overexpression inhibited the proliferation of spleen lymphocytes. The duration of the elevated expression levels of CTLA-4 and BTLA differentially affected the immune response.ConclusionBelatacept combined with BTLA overexpression attenuated acute rejection after kidney transplantation and prolonged kidney graft survival, which suggests a new approach for the optimization of early immunosuppression after kidney transplantation.
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spelling doaj.art-d79d1b765e934ed3818cce508178b8f72022-12-21T23:07:11ZengFrontiers Media S.A.Frontiers in Immunology1664-32242021-02-011210.3389/fimmu.2021.618737618737Combined Immunotherapy With Belatacept and BTLA Overexpression Attenuates Acute Rejection Following Kidney TransplantationHengcheng Zhang0Hengcheng Zhang1Zijie Wang2Jiayi Zhang3Zeping Gui4Zhijian Han5Jun Tao6Hao Chen7Li Sun8Shuang Fei9Haiwei Yang10Ruoyun Tan11Anil Chandraker12Min Gu13Department of Urology, The First Affiliated Hospital of Nanjing Medical University, Nanjing, ChinaTransplantation Research Center, Renal Division, Brigham and Women’s Hospital, Harvard Medical School, Boston, MA, United StatesDepartment of Urology, The First Affiliated Hospital of Nanjing Medical University, Nanjing, ChinaDepartment of Urology, The First Affiliated Hospital of Nanjing Medical University, Nanjing, ChinaDepartment of Urology, The First Affiliated Hospital of Nanjing Medical University, Nanjing, ChinaDepartment of Urology, The First Affiliated Hospital of Nanjing Medical University, Nanjing, ChinaDepartment of Urology, The First Affiliated Hospital of Nanjing Medical University, Nanjing, ChinaDepartment of Urology, The First Affiliated Hospital of Nanjing Medical University, Nanjing, ChinaDepartment of Urology, The First Affiliated Hospital of Nanjing Medical University, Nanjing, ChinaDepartment of Urology, The First Affiliated Hospital of Nanjing Medical University, Nanjing, ChinaDepartment of Urology, The First Affiliated Hospital of Nanjing Medical University, Nanjing, ChinaDepartment of Urology, The First Affiliated Hospital of Nanjing Medical University, Nanjing, ChinaTransplantation Research Center, Renal Division, Brigham and Women’s Hospital, Harvard Medical School, Boston, MA, United StatesDepartment of Urology, The First Affiliated Hospital of Nanjing Medical University, Nanjing, ChinaBackgroundCostimulatory blockade provides new therapeutic opportunities for ensuring the long-term survival of kidney grafts. The adoption of the novel immunosuppressant Belatacept has been limited, partly due to concerns regarding higher rates and grades of acute rejection in clinical trials. In this study, we hypothesized that a combined therapy, Belatacept combined with BTLA overexpression, may effectively attenuate acute rejection after kidney transplantation.Materials and MethodsThe rat kidney transplantation model was used to investigate graft rejection in single and combined therapy. Graft function was analyzed by detecting serum creatinine. Pathological staining was used to observe histological changes in grafts. The expression of T cells was observed by immunohistochemistry and flow cytometry. In vitro, we constructed an antigen-stimulated immune response by mixed lymphocyte culture, treated with or without Belatacept and BTLA-overexpression adenovirus, to observe the proliferation of receptor cells and the expression of cytokines. In addition, western blot and qRT-PCR analyses were performed to evaluate the expression of CTLA-4 and BTLA at various time points during the immune response.ResultsIn rat models, combined therapy reduced the serum creatinine levels and prolonged graft survival compared to single therapy and control groups. Mixed acute rejection was shown in the allogeneic group and inhibited by combination treatment. Belatacept reduced the production of DSA and the deposition of C4d in grafts. Belatacept combined with BTLA overexpression downregulated the secretion of IL-2 and IFN-γ, as well as increasing IL-4 and IL-10 expression. We also found that Belatacept combined with BTLA overexpression inhibited the proliferation of spleen lymphocytes. The duration of the elevated expression levels of CTLA-4 and BTLA differentially affected the immune response.ConclusionBelatacept combined with BTLA overexpression attenuated acute rejection after kidney transplantation and prolonged kidney graft survival, which suggests a new approach for the optimization of early immunosuppression after kidney transplantation.https://www.frontiersin.org/articles/10.3389/fimmu.2021.618737/fullkidney transplantationBelataceptacute rejectionBTLACTLA-4immunosuppressant
spellingShingle Hengcheng Zhang
Hengcheng Zhang
Zijie Wang
Jiayi Zhang
Zeping Gui
Zhijian Han
Jun Tao
Hao Chen
Li Sun
Shuang Fei
Haiwei Yang
Ruoyun Tan
Anil Chandraker
Min Gu
Combined Immunotherapy With Belatacept and BTLA Overexpression Attenuates Acute Rejection Following Kidney Transplantation
Frontiers in Immunology
kidney transplantation
Belatacept
acute rejection
BTLA
CTLA-4
immunosuppressant
title Combined Immunotherapy With Belatacept and BTLA Overexpression Attenuates Acute Rejection Following Kidney Transplantation
title_full Combined Immunotherapy With Belatacept and BTLA Overexpression Attenuates Acute Rejection Following Kidney Transplantation
title_fullStr Combined Immunotherapy With Belatacept and BTLA Overexpression Attenuates Acute Rejection Following Kidney Transplantation
title_full_unstemmed Combined Immunotherapy With Belatacept and BTLA Overexpression Attenuates Acute Rejection Following Kidney Transplantation
title_short Combined Immunotherapy With Belatacept and BTLA Overexpression Attenuates Acute Rejection Following Kidney Transplantation
title_sort combined immunotherapy with belatacept and btla overexpression attenuates acute rejection following kidney transplantation
topic kidney transplantation
Belatacept
acute rejection
BTLA
CTLA-4
immunosuppressant
url https://www.frontiersin.org/articles/10.3389/fimmu.2021.618737/full
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