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Neutralizing BAFF/APRIL With Atacicept Prevents Early DSA Formation and AMR Development in T Cell Depletion Induced Nonhuman Primate AMR Model
Author(s) -
Kwun J.,
Page E.,
Hong J. J.,
Gibby A.,
Yoon J.,
Farris A. B.,
Villinger F.,
Knechtle S.
Publication year - 2015
Publication title -
american journal of transplantation
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 2.89
H-Index - 188
eISSN - 1600-6143
pISSN - 1600-6135
DOI - 10.1111/ajt.13045
Subject(s) - medicine , b cell activating factor , immunology , neutralizing antibody , regimen , blockade , antibody , alemtuzumab , transplantation , gastroenterology , b cell , receptor
Depletional strategies directed toward achieving tolerance induction in organ transplantation have been associated with an increased incidence and risk of antibody‐mediated rejection (AMR) and graft injury. Our clinical data suggest correlation of increased serum B cell activating factor/survival factor (BAFF) with increased risk of antibody‐mediated rejection in alemtuzumab treated patients. In the present study, we tested the ability of BAFF blockade (TACI‐Ig) in a nonhuman primate AMR model to prevent alloantibody production and prolong allograft survival. Three animals received the AMR inducing regimen (CD3‐IT/alefacept/tacrolimus) with TACI‐Ig (atacicept), compared to five control animals treated with the AMR inducing regimen only. TACI‐Ig treatment lead to decreased levels of DSA in treated animals at 2 and 4 weeks posttransplantation (p < 0.05). In addition, peripheral B cell numbers were significantly lower at 6 weeks posttransplantation. However, it provided only a marginal increase in graft survival (59 ± 22 vs. 102 ± 47 days; p = 0.11). Histological analysis revealed a substantial reduction in findings typically associated with humoral rejection with atacicept treatment. More T cell rejection findings were observed with increased graft T cell infiltration in atacicept treatment, likely secondary to the graft prolongation. We show that BAFF/APRIL blockade using concomitant TACI‐Ig treatment reduced the humoral portion of rejection in our depletion‐induced preclinical AMR model.