Genetically-engineered pig organ transplantation in baboons: immunological and functional studies

基因工程猪器官移植的免疫学研究 和功能研究（PI/PD：大卫K.C.（库珀） 三、会议概况 项目概要/摘要 我们的项目已经培育出了基因工程猪，通过以下方式保护猪的器官免受伤害： 灵长类动物的先天免疫反应从这些猪身上移植的器官， (and潜在的临床适用的）免疫抑制方案，具有显著延长的猪移植物 在狒狒体内存活数月甚至数年。目前的建议旨在确认， 和有效的免疫抑制方案将允许一致的生命功能- 支持猪肾（项目1）和心脏（项目3）6个月或更长时间，以及生命支持 肝脏移植1个月（作为肝脏同种异体移植的桥梁[项目2]）。三个项目的工作 将由4个核心支持。 核心A（猪核心）将提供特定的多基因猪（项目1 - 3），这些猪具有8个或更多的基因， 这将有助于克服剩余的障碍，走向临床试验的操作。核心B （免疫生物学核心）和核心C（组织学核心）将提供以下机制的证据： 正在研究的问题和正在探索的治疗方法。核心D（行政 核心）将提供一个组织结构，以促进拟议项目的成功。 我们的目标包括：（i）探索预防或抑制适应性免疫的方法 通过新的猪遗传学或药理学干预的反应，（ii）预防或减少 （iii）在狒狒中猪肝移植后立即发生血小板减少， 减少移植到狒狒后早期记录的猪器官的快速生长，和（iv） 全面监测移植到狒狒体内后肾脏、肝脏和心脏的功能， 受控免疫应答的存在（即，在相对缺乏免疫应答的情况下）。的 基因改造和改良相结合的机制 免疫抑制方案延长移植物存活将通过免疫学测定进行研究， 组织病理学技术。 项目1和3的成功将使人们能够立即考虑进行有限的肾脏临床试验。 和/或心脏异种移植。项目2的成功将使我们能够立即考虑一个有限的 一种临床试验，其中猪肝被移植作为同种异体移植的维持生命的桥梁。的 因此，这三个项目的总体目标是在这五年的资助期内推进科学， 肾脏和心脏的临床试验可以作为目的疗法（或者，在 心脏，最初可能作为桥接治疗），以及猪肝作为同种异体移植的桥接。

GENETICALLY-ENGINEERED PIG ORGAN TRANSPLANTATION IN BABOONS: IMMUNOLOGICAL AND FUNCTIONAL STUDIES (PI/PD: David K.C. Cooper) OVERVIEW OF THE PROGRAM PROJECT SUMMARY/ABSTRACT Our program has produced genetically-engineered pigs that protect the pig organ from injury by the primate innate immune response. Organs transplanted from these pigs, together with an effective (and potentially clinically-applicable) immunosuppressive regimen, have markedly extended pig graft survival in baboons to months or even years. The current proposal aims to confirm that the combination of a multi-gene pig and an effective immunosuppressive regimen will allow consistent function of life- supporting pig kidneys (Project 1) and hearts (Project 3) for 6 months or longer, and of life-supporting livers for 1 month (to act as a bridge to liver allotransplantation [Project 2]). The work in the 3 Projects will be supported by 4 Cores. Core A (Pig Core) will provide specific multi-gene pigs (to Projects 1-3) that have 8 or more genetic manipulations that will help overcome the remaining barriers to moving towards clinical trials. Core B (Immunobiology Core) and Core C (Histopathology Core) will provide evidence of the mechanisms for the problems being investigated and the therapeutic approaches being explored. Core D (Administrative Core) will provide an organizational structure to facilitate the success of the proposed Projects. Our Aims include (i) exploring methods of preventing or suppressing the adaptive immune response through either novel pig genetics or pharmacologic interventions, (ii) preventing or reducing the thrombocytopenia that immediately follows pig liver transplantation in baboons, (iii) preventing or reducing the rapid growth of pig organs documented early after transplantation into baboons, and (iv) comprehensively monitoring function of the kidney, liver, and heart after transplantation into baboons in the presence of a controlled immune response (i.e., in the relative absence of an immune response). The mechanisms whereby the combination of genetic modification and refinements to the immunosuppressive regimen prolong graft survival will be investigated by immunological assays and histopathology techniques. Success in Projects 1 and 3 would allow immediate consideration of limited clinical trials of kidney and/or heart xenotransplantation. Success in Project 2 would allow immediate consideration of a limited clinical trial in which a pig liver is transplanted as a life-sustaining bridge to allotransplantation. The overall goal of the 3 projects, therefore, is to advance the science during this 5-year period of funding so that clinical trials of kidneys and hearts can be initiated as destination therapies (or, in the case of the heart, possibly initially as a bridging therapy), and of pig livers as bridging to allotransplantation.