当前位置： SCI文献检索 > EBioMedicine期刊下所有文献 > Ex-vivo delivery of monoclonal antibody (Rituximab) to treat human donor lungs prior to transplantation.

Ex-vivo delivery of monoclonal antibody (Rituximab) to treat human donor lungs prior to transplantation.

Abstract：

BACKGROUND:Ex-vivo lung perfusion (EVLP) is an innovative platform for assessing donor lungs in the pre-transplant window. In this study, we demonstrate an extension of its utility by administering the anti-CD20 monoclonal antibody, Rituximab, during EVLP. We hypothesized that this would lead to targeted depletion of allograft B-cells which may provide significant clinical benefit, including the potential to reduce latent Epstein-Barr virus (EBV) and decrease the incidence of post-transplant lymphoproliferative malignancies. METHODS:Twenty human donor lungs rejected for transplantation were placed on EVLP with (n = 10) or without (n = 10) 500 mg of Rituximab. Safety parameters such as lung physiology and inflammatory cytokines were evaluated. We measured the delivery efficacy through flow cytometry, immunohistochemistry and ELISA. An in-vitro culture assay, in the presence of complement, was further conducted to monitor whether B-cell depletion would occur in Rituximab-perfused samples. FINDINGS:Rituximab was successfully delivered to human lungs during EVLP as evidenced by flow cytometric binding assays where lung tissue and lymph node biopsies demonstrated occupied CD20 epitopes after perfusion with the antibody. Lymph nodes from Rituximab perfusions demonstrated a 10.9 fold-reduction in CD20+ staining compared to controls (p = 0.0003). In lung tissue, Rituximab resulted in an 8.75 fold-reduction in CD20+ staining relative to controls (p = 0.0002). This decrease in CD20+ binding illustrates the successful delivery and occupation of epitopes after perfusion with the Rituximab. No apparent safety concerns were seen as exhibited by markers associated with acute cell injury (e.g., proinflammatory cytokines), cell death (e.g., TUNEL staining), or pulmonary physiology. In a post-perfusion tissue culture model, the addition of complement (human serum) resulted in evidence of B-cell depletion consistent with what would be expected with posttransplant activation of bound Rituximab. INTERPRETATION:Our experiments illustrate the potential of EVLP as a platform to deliver monoclonal antibody therapies to treat donor lungs pretransplant with the goal of eliminating a latent virus responsible for considerable morbidity after lung transplantation. FUNDING:Supported by the University Health Network Transplant Center.

journal_name

EBioMedicine

journal_title

EBioMedicine

authors

Ku TJY,Ribeiro RVP,Ferreira VH,Galasso M,Keshavjee S,Kumar D,Cypel M,Humar A

doi

10.1016/j.ebiom.2020.102994

subject

Has Abstract

pub_date

2020-10-01 00:00:00

pages

102994

issn

2352-3964

pii

S2352-3964(20)30370-4

journal_volume

pub_type

杂志文章

在线工具

Ex-vivo delivery of monoclonal antibody (Rituximab) to treat human donor lungs prior to transplantation.