Characterization of human xenoreactive antibodies in liver failure patients exposed to pig hepatocytes after bioartificial liver treatment - An ex vivo model of pig to human xenotransplantation
A. Baquerizo et al., Characterization of human xenoreactive antibodies in liver failure patients exposed to pig hepatocytes after bioartificial liver treatment - An ex vivo model of pig to human xenotransplantation, TRANSPLANT, 67(1), 1999, pp. 5-18
Background, There are limited experimental data on the nature of the humora
l response elicited in humans against pig antigens, Ttl this study, we have
examined the xenoantibody (XAb) response in eight patients with acute Live
r failure exposed to pig hepatocytes after treatment with the bioartificial
Liver (BAL),
Methods. Patients' plasma samples obtained before and after BAL treatment w
ere tested for IgM and IgG XAbs, IgG subclasses, and XAb cytotoxicity, usin
g enzyme-linked immunosorbent assay and flow-cytometric assays, The charact
erization of pig aortic endothelial cell (PAEC) surface xenoantigens was an
alyzed by immunoprecipitation,
Results. We observed by day 10, a strong anti-pig IgG and IgM XAb response
in patients undergoing two or more BAL treatments, with a significant incre
ase in all the IgG subclasses; in contrast, XAb titers did not change if th
e patients received only one BAL treatment. The majority of the XAbs produc
ed to porcine antigens were primarily specific for the alpha Gal epitope, B
oth IgG and IgM XAbs were cytotoxic to PAECs, and the cytotoxic activity of
IgG was associated with high levels of IgG1 and IgG3 subclasses, known to
be efficient on complement activation. The characterization of porcine surf
ace antigens demonstrated that IgM human XAbs, before and after BAL exposur
e, recognized xenoantigens on PAECs with similar molecular weights, suggest
ing that the same population of XAbs were present in the patients before an
d after exposure to pig antigens,
Conclusions. Repetitive exposure of humans to porcine antigens after BAL tr
eatment, results in a strong IgG and IgM XAb responses that are primarily d
irected against the alpha Gal epitope, These XAbs are cytotoxic to PAECs an
d the IgG toxicity correlates with high IgG1 and IgG3 levels, Our data also
suggest that no new XAb specificity emerges after porcine exposure.