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B lymphocyte–directed immunotherapy promotes long-term islet allograft survival in nonhuman primates

Abstract

We found that an induction immunotherapy regimen consisting of rabbit anti-thymocyte globulin (Thymoglobulin) and the monoclonal antibody to CD20 rituximab (Rituxan) promoted long-term islet allograft survival in cynomolgus macaques maintained on rapamycin monotherapy. B lymphocyte reconstitution after rituximab-mediated depletion was characterized by a preponderance of immature and transitional cells, whose persistence was associated with long-term islet allograft survival. Development of donor-specific alloantibodies was abrogated only in the setting of continued rapamycin monotherapy.

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Figure 1: Metabolic, histological and immunological characterization of representative cynomolgus monkey islet allograft recipients.

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Acknowledgements

This work was supported by grants from the Juvenile Diabetes Research Foundation (4-2005-351) and the US National Institutes of Health (AI065356 to A.N. and DK64603 to H.N.). The authors wish to thank M.P. Cancro, A. Jeganathan, M.A. Leonard, R. Mozaffari, N. Noorchashm, L. Rolf and B. Wolf for their helpful input.

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Authors and Affiliations

Authors

Contributions

C.L. conducted the islet isolations, transplantation, drug administration and immune monitoring of the nonhuman primates with the assistance of Z.W., E.V., M.Y. and T.G. A.N. designed and supervised the experiments. J.A.S. and E.L.P. performed flow cytometric analysis. M.N. and J.B. performed in vitro T and B cell assays. S.Y.R. performed the in vitro mixed lymphocyte reaction assay. M.R.R. performed the in vivo metabolic β cell assays. J.E.T. performed the C4d immunohistochemical analysis. B.K. performed histochemical analysis of tissue biopsies. M.E.P. performed the anti-tetanus responses. Data analysis and manuscript preparation were carried out by C.L., H.N. and A.N. C.F.B. assisted with crucial editing of the manuscript.

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Correspondence to Ali Naji.

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Supplementary Methods and Supplementary Figs. 1–8 (PDF 8120 kb)

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Liu, C., Noorchashm, H., Sutter, J. et al. B lymphocyte–directed immunotherapy promotes long-term islet allograft survival in nonhuman primates. Nat Med 13, 1295–1298 (2007). https://doi.org/10.1038/nm1673

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