Distinct roles for major and minor antigen barriers in chimerism-based tolerance under irradiation-free conditions.

Eliminating cytoreductive conditioning from chimerism-based tolerance protocols would facilitate clinical translation. Here we investigated the impact of major histocompatibility complex (MHC) and minor histocompatibility antigen (MiHA) barriers on mechanisms of tolerance and rejection in this setting. Transient depletion of natural killer (NK) cells at the time of bone marrow (BM) transplantation (BMT) (20 × 106 BALB/c BM cells → C57BL/6 recipients under costimulation blockade [CB] and rapamycin) prevented BM rejection. Despite persistent levels of mixed chimerism, BMT recipients gradually rejected skin grafts from the same donor strain. Extending NK cell depletion did not improve skin graft survival. However, F1 (C57BL/6×BALB/c) donors, which do not elicit NK cell-mediated rejection, induced durable chimerism and tolerance. In contrast, if F1 donors with BALB/c background only were used (BALB/c×BALB.B), no tolerance was observed. In the absence of MiHA disparities (B10.D2 donors, MHC-mismatch only), temporal NK cell depletion established stable chimerism and tolerance. Conversely, MHC identical BM (BALB.B donors, MiHA mismatch only) readily engrafted without NK cell depletion but no skin graft tolerance ensued. Therefore, we conclude that under CB and rapamycin, MHC disparities provoke NK cell-mediated BM rejection in nonirradiated recipients whereas MiHA disparities do not prevent BM engraftment but impede skin graft tolerance in established mixed chimeras.

The importance of improving implementation research for successful interventions and adaptations.

This special issue explores the theoretical underpinnings, triumphs, and challenges of implementing four early childhood education interventions. In doing so, each article highlights the importance of studying the implementation context as part of the evaluation process. This commentary reflects on the entire issue, ultimately arguing that future evaluations must continue to conduct-and improve on-implementation research. Specifically, to understand evaluation findings and scale up or adapt interventions effectively, researchers must examine implementation processes systematically, using both quantitative and qualitative methods. This includes: explaining how interventions were designed, theorizing the relationships between implementation processes and outcomes, defining the implementation phase under study, examining the validity and reliability of implementation measures, and using accessible language in reports.