Increasing donor chimerism and inducing tolerance to islet allografts by post-transplant donor lymphocyte infusion

Am J Transplant. 2006 May;6(5 Pt 1):933-46. doi: 10.1111/j.1600-6143.2006.01283.x.

Abstract

Inducing donor chimerism is the most consistently successful approach to achieve transplant tolerance. We found that a low level of donor chimerism, which was induced by a relatively non-toxic approach, induced donor-specific tolerance to islet allografts in chemically induced diabetic mice. However, a similar level of donor chimerism could not protect donor islet allografts in non-obese diabetic (NOD) mice that spontaneously developed autoimmune diabetes. Rejection of donor islet allografts in diabetic NOD mice with a low level of donor chimerism was mediated by recurrent autoimmunity. We used post-transplant donor lymphocyte infusion (DLI) to increase donor chimerism and to induce tolerance to islet allografts. DLI significantly increased donor chimerism and promoted donor-specific tolerance to islet allografts in diabetic NOD mice. Self-tolerance to islet autoantigens was restored and restoring self-tolerance is mediated by immunoregulation. Thus, our data showed that adoptive immunotherapy with post-transplant DLI after establishing a low level of donor chimerism as a platform enhances donor chimerism, induces donor-specific tolerance to islet allografts and restores self-tolerance in the setting of autoimmune diabetes. Our data also showed that central tolerance is not sufficient to induce tolerance and peripheral tolerance through immunoregulation for restoring self-tolerance is required in the setting of autoimmune diabetes.

Publication types

  • Research Support, N.I.H., Extramural
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adoptive Transfer
  • Animals
  • Blood Glucose / metabolism
  • Diabetes Mellitus, Type 1 / immunology
  • Diabetes Mellitus, Type 1 / surgery
  • Graft Rejection / immunology
  • Graft Survival
  • Islets of Langerhans Transplantation / immunology*
  • Lymphocyte Culture Test, Mixed
  • Lymphocyte Transfusion*
  • Mice
  • Mice, Inbred C57BL
  • Mice, Inbred NOD
  • Prediabetic State
  • Transplantation Chimera*
  • Transplantation Tolerance*
  • Transplantation, Homologous

Substances

  • Blood Glucose