The method of surface PEGylation influences leukocyte adhesion and activation.

The influence of different surface modifications with poly(ethyleneglycol) (PEG) layers on the adsorption of fibrinogen and the adhesion and activation of macrophage-like human leukocytes was investigated. Poly(ethylene terephthalate) (PET) was modified using pulsed AC plasma polymerization with two types of starting monomers to generate: 1) a reactive acid surface using maleic anhydride (MAH) as monomer, and 2) a PEG-like surface using diethyleneglycol methyl vinyl ether (DEGVE) as monomer. The MAH surface was used as a reactive platform to graft linear chains of non-fouling mPEG via an intermediate layer of poly(ethyleneimine) (PEI) under lower critical solution temperature (LCST) conditions of the mPEG. The DEGVE monomer is used to create PEG-like layers by use of low power plasma conditions. The ability of the surfaces to resist protein adsorption was investigated quantitatively using (125)I-radiolabeled human fibrinogen, and the conformation of the adsorbed protein was tested using an anti-fibrinogen monoclonal antibody in an enzyme-linked immunosorbent assay. The results showed that PEGylated surfaces adsorbed significantly less (up to 90% less) fibrinogen, and that unfolding of adsorbed fibrinogen was more pronounced on the linear mPEG layers than on the PEG-like plasma polymer surfaces. Adhesion of in-vitro differentiated macrophage-like U937 cells was reduced on both the PEG-like plasma polymer surfaces and the linear mPEG layers compared to the unmodified PET surface, but cells adhering to the PEG-like plasma polymer surfaces secreted less tumor necrosis factor-alpha (TNF-alpha) than cells adhering to the linear mPEG layers. In conclusion, the method for preparing non-fouling surfaces for long-term implanted devices influence surface-induced cellular responses of the host.

Xenotransplantation for brain repair: reduction of porcine donor tissue immunogenicity by treatment with anti-Gal antibodies and complement.

BACKGROUND: Transplantation of embryonic neural tissue is a potential treatment for Parkinson's disease. Because human donor material is in short supply, porcine xenografts are considered a useful alternative. Current immunosuppressive therapies fail, however, to protect intracerebral neural xenografts from host CD4 T lymphocytes. To reduce the immunogenicity of porcine donor tissue, we attempted to remove microglial cells with antibodies against the alpha-galactosyl epitope (Galalpha1,3Galbeta1,4GlcNAc-R), or anti-Gal, and complement, and studied whether this pretreatment can reduce direct and indirect T-cell responses to the tissue. METHODS: Brain tissue from 27-day-old pig embryos was dissociated and treated with human anti-Gal and rabbit complement. The microglial content was analyzed by flow cytometry. [3H]thymidine incorporation in cocultures of the brain cells and purified human CD4 T cells was used to determine direct T-cell responses. Indirect T-cell responses were studied by grafting pretreated and control-pretreated (no anti-Gal) nigral tissue into the lesioned striatum of immunocompetent rats with 6-hydroxydopamine-induced hemiparkinsonism. Amphetamine-induced circling behavior was used to measure graft function. RESULTS: Anti-Gal and complement reduced the microglial content to 11-24% of control and abolished the ability of the brain cells to induce human CD4 T-cell proliferation. Pretreated nigral tissue reduced hemiparkinsonism by more than 50% in five of eight rats at some point during the 10-week follow-up. Rats receiving control-pretreated nigral tissue did not display this degree of improvement. CONCLUSIONS: Pretreatment with anti-Gal and complement can reduce the immunogenicity of porcine neural tissue, and might, therefore, be a valuable alternative or supplement to immunosuppression in neural xenotransplantation.

Neural xenotransplantation: pretreatment of porcine embryonic nigral tissue with anti-Gal antibodies and complement is not toxic for the dopaminergic neurons.

The immunogenicity of porcine tissue is a major obstacle to its use as donor material in xenotransplantation for neurodegenerative diseases. We are currently evaluating a novel strategy for reducing the immunogenicity, in which the alpha-galactosyl epitope (Galalpha1,3Galbeta1,4GlcNAc-R) is used as a target for antibody- and complement-mediated removal of microglia. In the present study, our aim was to determine whether a pretreatment with antibodies against the alpha-galactosyl epitope (anti-Gal) and complement would lyse or otherwise damage dopaminergic neurons in porcine embryonic ventral mesencephalon (VM), the donor tissue for treatment of Parkinson's disease by xenotransplantation. Cell suspensions prepared from VM tissue from 27-day-old pig embryos were incubated with anti-Gal, purified from normal human serum by affinity chromatography, or medium only (control), and subsequently with rabbit complement. After these pretreatments, the cell suspensions were transplanted into the right striatum of 14 adult rats (two groups of 7 animals). The animals were sacrificed 20 days after transplantation, the brains were processed for histology, and the sections were stained for Nissl substance, porcine neurofilament, tyrosine hydroxylase, and rat CD45 to determine graft volume, presence of porcine neurons, content of dopaminergic cells, and leukocyte infiltration, respectively. The VM tissue pretreated with anti-Gal and complement gave rise to dopaminergic grafts that were indistinguishable from those derived from VM tissue given the control pretreatment. In 5 of the 14 animals, the grafts were infiltrated by host leukocytes, but in two of these recipients, the infiltration was only minimal. We conclude that anti-Gal and complement can be applied to porcine embryonic VM tissue without damaging the dopaminergic neurons and their precursors.

Molecular and cellular mechanisms in immune rejection of intracerebral neural transplants.

Restorative transplantation of human embryonic nigral tissue for Parkinson's disease has given encouraging results with functional benefit and minimal signs of rejection in patients receiving standard immunosuppression. Due to the limited availability of human donor material and ethical concerns with its use, porcine tissue is considered an appropriate alternative. In animal studies, neural allo- and xenografts are usually rejected in the brain, emphasizing the necessity of understanding factors underlying survival and rejection of intracerebral neural transplants. Here, we review fundamental mechanisms of allo- and xenograft rejection, and discuss the privileged immune status of the brain, and how we may take advantage of this in order to improve and secure graft survival. Rejection of neural xenografts is expected to be of a cellular nature, like neural allograft rejection, but may also display unique features, and cannot be dealt with using conventional immunosuppressive therapies. The challenge therefore is to improve existing and design new strategies that allow permanent survival of histoincompatible neural grafts, taking advantage of the special immune status of adult CNS and immature donor brain tissue.

Xenotransplantation for CNS repair: immunological barriers and strategies to overcome them.

Neural transplantation holds promise for focal CNS repair. Owing to the shortage of human donor material, which is derived from aborted embryos, and ethical concerns over its use, animal donor tissue is now considered an appropriate alternative. In the USA, individuals suffering from Parkinson's disease, Huntington's disease, focal epilepsy or stroke have already received neural grafts from pig embryos. However, in animal models, neural tissue transplanted between species is usually promptly rejected, even when implanted in the brain. Some of the immunological mechanisms that underlie neural xenograft rejection have recently been elucidated, but others remain to be determined and controlled before individuals with neurological disorders can benefit from xenotransplantation.

The DaNeX study of embryonic mesencephalic, dopaminergic tissue grafted to a minipig model of Parkinson's disease: preliminary findings of effect of MPTP poisoning on striatal dopaminergic markers.

A multicenter study is under way to investigate the efficacy of allografting of embryonic mesencephalic neurons in a pig model of Parkinson's disease. We have first established that a stable parkinsonian syndrome can be established by 1-methyl-4-phenyl-1,2,3,6-tetrahydropyridine (MPTP) intoxication of adult male Göttingen minipigs. We are now using positron emission tomography (PET) methods for testing the physiological responses to MPTP intoxication and the time course of the response to several treatment strategies. We now report preliminary results obtained in 11 pigs employed in the initial phase of the study; the completed study shall ultimately include 30 pigs. Animals were randomly assigned to one of five groups: 1) Control, 2) MPTP intoxication, 3) MPTP intoxication followed by allograft, 4) MPTP intoxication followed by allograft with immunosuppression, and 5) MPTP intoxication followed by allograft with immunosuppression and co-grafting of immortalized HiB5 cells, which had been manipulated to secrete glia cell line-derived neurotrophic factor (GDNF) (approximately 2 ng GDNF/h/10(5) cells). MPTP was administered (1 mg/kg/day, SC) for 7-10 days until the pigs had developed mild parkinsonian symptoms of muscle rigidity, hypokinesia, and impaired coordination, especially of the hind limbs. Approximately 2 weeks after the last MPTP dose, animals received a T1-weighted magnetic resonance imaging (MRI) scan, and a series of dynamic PET recordings. After the first series of PET scans, four grafts of porcine embryonic mesencephalic tissue (E28 days) were placed in each striatum of some MPTP-intoxicated pigs, using MRI-based stereotactic techniques. Immunosuppression of some animals with cyclosporin and prednisolone began just prior to surgery. Two more series of PET scans were performed at 4-month intervals after surgery. After the last scans, pigs were killed and the brains were perfused for unbiased stereological examination of cytological and histochemical markers in striatum and substantial nigra. The behavioral impairment of the animals (the "Parkinson's score") had been evaluated throughout the 8-month period. Kinetic analysis of the first set of PET scans has indicated that the rate constant for the decarboxylation of FDOPA in catecholamine fibers was reduced by 33% in striatum of the mildly parkinsonian pigs. The rate of association of [11C]NS-2214 to catecholamine uptake sites was reduced by 62% in the same groups of pigs. No significant difference was found in the binding potential of [11C]raclopride to the dopamine D2-like receptors in striatum of the MPTP-intoxicated versus control pigs. These preliminary results are suggestive that the activity of DOPA decarboxylase may be upregulated in the partially denervated pig striatum.

Expression of major histocompatibility complex antigens and induction of human T-lymphocyte proliferation by astrocytes and macrophages from porcine fetal brain.

Porcine fetal brain cells are of potential use as donor cells for transplantation therapies of neurodegenerative diseases in humans. Our aim was to determine the immunestimulatory properties of astrocytes and macrophages from porcine fetal brain in vitro. By flow cytometry, freshly isolated porcine fetal brain cells were nonautofluorescent, while primary cultures of these cells, prepared to favor growth of astrocytes and macrophages/microglia, consisted of both an autofluorescent and a nonautofluorescent cell population. The cultured autofluorescent cells had qualities typical of macrophages: CD18 (beta(2) integrin subunit) expression, high granularity, and phagocytic activity. The cultured nonautofluorescent cells stained positive for the astrocyte marker glial fibrillary acidic protein and CD56 (NCAM isoform). While freshly isolated porcine fetal brain cells expressed very low levels of major histocompatibility complex (MHC) class I and no MHC class II antigens, primary culture of these cells resulted in upregulation of MHC class I antigens on astrocytes and macrophages and MHC class II antigens on a subpopulation of the macrophages. Single-cell suspensions prepared from the primary cultures were flow sorted into astrocyte and macrophage populations on the basis of cell granularity and autofluorescence or on the basis of CD56 expression. Pure suspensions (>98%) of astrocytes induced a low proliferative response in human T lymphocytes, as determined by [(3)H]thymidine incorporation after 4 days of coculture. A suspension of 91% macrophages was a strong inducer of human T-cell proliferation, even stronger than allogeneic mononuclear blood cells. For neural xenotransplantation, our findings suggest that depletion of macrophages from the donor-cell suspensions may enhance graft survival by reducing cell-mediated rejection.

Direct cytotoxic response of human lymphocytes to porcine PHA-lymphoblasts and lymphocytes.

Transplantation of cells and organs from pigs to human beings offers potential treatment for medical conditions such as diabetes, kidney and heart failure, and Parkinson's disease. When the antibody-mediated hyperacute rejection barrier is overcome, a xenograft may not be treated as an allograft by the human immune system. Without prior culture with porcine cells, human lymphocytes are cytotoxic to some porcine cells. Our aim was to functionally characterize this direct cytotoxic response to porcine PHA-lymphoblasts and lymphocytes. Peripheral blood mononuclear cells from seven of eight human beings were cytotoxic to porcine PHA-lymphoblasts in bulk chromium-release assays, but not to the porcine lymphocytes from which the PHA-lymphoblasts were derived. The NK cell-sensitive cell line K562 only partly blocked the response to the PHA-lymphoblasts. IL-2-expanded clones of human lymphocytes were able to discriminate between PHA-lymphoblasts from two pigs and unable to lyse K562. When using IL-2 to make the anti-porcine cells proliferate under limiting dilution conditions, the proliferation and/or function of these cells did not conform to single-hit kinetics. All the observations from experiments with cells in bulk cultures and as short-term clones suggest that the direct cytotoxic response of human lymphocytes to porcine cells is heterogeneous and composed of a small population of in vivo-activated T cells as well as NK cells.

Proliferative response of human T lymphocytes to porcine fetal brain cells.

Intracerebral grafting of porcine fetal brain cells is a potential treatment of neurodegenerative disorders in humans. Although it is well known that the survival of fetal pig brain cells in the rat brain requires immunosuppression, the response of human T lymphocytes to fetal pig brain cells is unknown. Here we report on the proliferative response of human T lymphocytes to freshly isolated cells and 14-18 days cultured cells from 28- or 35-day-old porcine fetal brains. After 5 days of mixed lymphocyte-brain cell culture, we observed no or only minor T cell responses to the freshly isolated brain cells, while both CD4 cells and CD8 cells proliferated in response to the cultured brain cells. Pretreatment of the cultured brain cells with heat-inactivated human serum significantly reduced the proliferative T cell response. The data suggest that the porcine fetal brain contains cells that can stimulate the human cellular immune system, and that this stimulation may be reduced by pretreatment of the fetal pig brain cells with human serum.