Adult Tissue-Derived Stem Cells and Tolerance Induction in Nonhuman Primates for Vascularized Composite Allograft Transplantation-the VCA
Abstract
Amputations and unsalvageable injuries with devastating tissue loss are common in the combat wounded. Reconstructive transplantation inthe civilian setting using vascular composite allotransplants (VCA) composed of multiple tissues (skin, muscle, nerve, bone) incombination with long-term multidrug immunosuppression has been encouraging. However, skin rejection remains a critical complication.We have demonstrated in a murine skin allograft transplantation model that human adipose-derived stromal cells (ASC) when used inconcert with immunological conditioning support engraftment of limited numbers of donor bone marrow cells (dBMCs) across majorhistocompatibility complex (MHC) barriers, and lead to stable multilineage mixed-chimerism and skin allograft tolerance without the needfor long-term immunosuppression. Focus Areas: Immune Rejection-understanding mechanisms of immune rejection, immunomodulation approaches and mechanisms ( e.g., tolerance induction, chimerism), and optimizing immunosuppressive drug regimens. Objectives/Hypothesis: We realize that the implications and potential clinical benefit of the tolerance induction protocol to shown efficacyin a mouse model can only be validated mechanistically in established non-human primate models of allograft transplantation with long-termobservations and evaluations. We hypothesize that ASCs+dBMC therapy may be a pro-tolerogenic cellular therapeutic displaying clinical efficacy for vascular composite allograft (VCA), solid organ, and hematopoietic stem cell transplant applications. This combination would allow for long term graft survival without the need for chronic immunosuppression and the resulting multitude of adverse effects associated with such agents. Specific Aims: (1) To investigate whether ASCs augment chimerism and promote long-term VCA graft survival and (2) To determine whether ASC therapy allows for immunosuppression minimization and development of immunologic tolerance to VCA.
Document Details
- Document Type
- Technical Report
- Publication Date
- Oct 01, 2018
- Accession Number
- AD1071999
Entities
People
- Eric A. Elster
- Jeffery Gimble
- Rolf Barth
- Tom Davis
Organizations
- Henry M. Jackson Foundation for the Advancement of Military Medicine