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  • Distinct roles for major an...
    Mahr, Benedikt; Pilat, Nina; Granofszky, Nicolas; Muckenhuber, Moritz; Unger, Lukas W.; Weijler, Anna M.; Wiletel, Mario; Steiner, Romy; Dorner, Lisa; Regele, Heinz; Wekerle, Thomas

    American journal of transplantation, March 2021, Letnik: 21, Številka: 3
    Journal Article

    Eliminating cytoreductive conditioning from chimerism‐based tolerance protocols would facilitate clinical translation. Here we investigated the impact of major histocompatibility complex (MHC) and minor histocompatibility antigen (MiHA) barriers on mechanisms of tolerance and rejection in this setting. Transient depletion of natural killer (NK) cells at the time of bone marrow (BM) transplantation (BMT) (20 × 106 BALB/c BM cells → C57BL/6 recipients under costimulation blockade CB and rapamycin) prevented BM rejection. Despite persistent levels of mixed chimerism, BMT recipients gradually rejected skin grafts from the same donor strain. Extending NK cell depletion did not improve skin graft survival. However, F1 (C57BL/6×BALB/c) donors, which do not elicit NK cell‐mediated rejection, induced durable chimerism and tolerance. In contrast, if F1 donors with BALB/c background only were used (BALB/c×BALB.B), no tolerance was observed. In the absence of MiHA disparities (B10.D2 donors, MHC‐mismatch only), temporal NK cell depletion established stable chimerism and tolerance. Conversely, MHC identical BM (BALB.B donors, MiHA mismatch only) readily engrafted without NK cell depletion but no skin graft tolerance ensued. Therefore, we conclude that under CB and rapamycin, MHC disparities provoke NK cell‐mediated BM rejection in nonirradiated recipients whereas MiHA disparities do not prevent BM engraftment but impede skin graft tolerance in established mixed chimeras. This article shows that in nonirradiated mice, major histocompatibility antigen barriers are mainly responsible for NK cell–mediated bone marrow rejection under costimulation blockade and rapamycin while minor histocompatibility antigen barriers determine donor skin graft survival. See Sánchez‐Fueyo and Dazzi's editorial on page 919.