Ischemia-reperfusion injury in transplantation: novel cytoprotection strategies

描述（由申请人提供）：供体器官的缺血/再灌注损伤（IRI）大大增强了移植物的免疫原性，增加了急性和慢性同种异体移植排斥反应的发生率。IRI越严重的移植物长期存活率也越低。因此，IRI仍然是当今移植的主要障碍，但目前尚无针对移植后IRI的标准治疗方法。因此，在当前的移植时代，研究导致开发新的策略来减轻IRI的影响是非常必要的。我们的总体假设是，移植物中的IRI激活了异体移植物衍生的树突状细胞（ADDC），后者成为先天免疫和异体免疫之间的关键纽带，最终增强了移植物的异体性。ADDC是最有效的抗原提呈细胞。我们实验室使用各种转基因模型的大量初步数据导致了新的观察，即预防这种损伤可以降低缺血器官的免疫原性并促进移植。该项目的总体目标是：1)研究IRI通过增加ADDC的同种异体性来增强同种异体移植物免疫原性的机制；2)确定新的保护策略来减少IRI，最终目标是促进同种异体移植物的长期接受。在AIM 1中，我们将研究通过IRI连接先天免疫和同种免疫激活ADDC的机制。我们将使用T regs和同种异体反应性转基因小鼠来研究缺血/抗缺血策略是否以及如何影响T regs和同种异体反应性T细胞的产生。在AIM 2中，我们将探讨缺血诱导的TLR2/TLR4激活导致更高的DC异源刺激能力和运输特性的机制。我们将确定缺血DC中NFkB上游和TLR4和TLR2下游的关键信号分子，重点关注MyD88和TRIF。缺血DC将评估其细胞因子细化谱、异源刺激能力和趋化因子依赖于体外和体内运输模式。器官短缺已成为阻碍全球器官移植成功的主要障碍，促使临床医生扩大接受边缘器官的标准，因为边缘器官更容易发生IRI。我们提出的综合研究将为iri诱导的先天免疫和同种免疫激活的病理生理学提供高度创新的数据和见解。本研究将确定新的治疗靶点，并在供体管理领域提出新的策略和创新，以减轻IRI的有害影响，这是当前移植时代迫切需要的。我们相信，在丰富的初步数据、创新的方法、复杂的模型以及研究者的承诺和专业知识的支持下，这项研究具有实现既定目标的所有必要因素。本研究结果可以很容易地转化为临床实践，并对减轻临床移植中IRI的负担产生重大影响。

DESCRIPTION (provided by applicant): Ischemia/reperfusion injury (IRI) to donor organs substantially enhances the immunogenicity of grafts and increases the rate of acute and chronic allograft rejection. Grafts with more severe IRI also have significantly worse long-term survival. Thus, IRI remains the major obstacle in transplantation today, but there are currently no standard treatments for IRI post-transplantation. Therefore, studies which lead to the development of novel strategies to attenuate the effects of IRI are much needed in the current era of transplantation. Our overall hypothesis is that IRI in the graft activates allograft derived dendritic cells (ADDC) which become the critical link between the innate immunity and alloimmunity, ultimately enhancing the allogenicity of the graft. ADDC are the most potent antigen-presenting cells. Extensive preliminary data from our laboratory using various transgenic models have led to the novel observation that preventing this injury could diminish the immunogenicity of ischemic organs and promote engraftment. The overarching goals of this project are: 1) to investigate the mechanisms by which IRI enhances the immunogenicity of allografts by increasing the allogenicity of ADDC, and 2) to identify novel protective strategies to minimize IRI, with the ultimate goal of promoting long-term allograft acceptance. In AIM 1, we will examine the mechanisms by which activated ADDC by IRI link innate and alloimmunity. We will employ T reg and alloreactive transgenic mice to study whether and how the ischemia/anti-ischemic strategy affects the generation of T regs vs. alloreactive T cells. In AIM 2, we will explore the mechanisms by which ischemia-induced TLR2/TLR4 activation results in higher DC allostimulatory capacity and trafficking properties. We will identify the key signaling molecules in ischemic DC upstream of NFkB and downstream of TLR4 and TLR2, with particular focus on MyD88 and TRIF. Ischemic DC will be evaluated for their cytokine elaboration profiles, allostimulatory capacity, and chemokine dependent in vitro and in vivo trafficking patterns. The organ shortage has become a major obstacle hampering the success of organ transplantation worldwide, prompting clinicians to expand their criteria for the acceptance of marginal organs, which are more susceptible to IRI. Our proposed comprehensive studies will provide highly innovative data and insights into the pathophysiology of IRI-induced activation of innate and alloimmunity. This research will identify novel therapeutic targets and set forth novel strategies and innovations in the areas of donor management to attenuate the deleterious effects of IRI which are urgently needed in the current era of transplantation. We believe that this research, supported by the wealth of preliminary data, innovative approaches, sophisticated models and the commitment and expertise of the investigators, has all the necessary elements to achieve the stated goals. The findings from this proposal could be easily translated into clinical practice and have a significant impact on reducing the burden of IRI in clinical transplantation.