The enzyme indoleamine 2,3-dioxygenase (IDO) converts tryptophan into kynurenine metabolites that suppress effector T-cell function. In this study, we investigated IDO and its metabolite, 3-hydroxyanthranilic acid (3HAA), in regulating lung allograft rejection, using a murine orthotopic lung transplant model with a major mismatch (BALB/c donor and C57BL6 recipient). IDO was overexpressed in murine donor lungs, using an established nonviral (polyethylenimine carrier)-based gene transfer approach, whereas 3HAA was delivered daily via intraperitoneal injection. Increased IDO expression or its metabolite, 3HAA, resulted in a remarkable therapeutic effect with near normal lung function and little acute rejection, approximately A1, compared with A3 in untreated allografts (grading based on International Society for Heart and Lung Transplantation guidelines). We found that a high IDO environment for 7 days in lung allografts resulted in impaired T-cell activation, the production of multiple effector cytokines (IL-2, IL-4, IL-5, IL-6, IFN-g, TNF-a, IL-12, and IL-13), and the generation of effector memory T cells (CD62L lo CD44 hi phenotype). In isolated murine splenocytes, we observed that IDO/3HAA impaired T-cell receptor (TCR)-mediated T-cell activation, and more importantly, a decrease of intracellular calcium, phospholipase C-g1 phosphorylation, and mitochondrial mass was evident. This work further illustrates the potential role of a high IDO environment in lung transplantation, and that the high IDO environment directly impairs TCR activation via the disruption of calcium signaling.Keywords: 3-hydroxyanthranilic acid; lung allograft rejection; nonviral gene transfer Lung transplantation is a well-accepted therapy for patients with endstage lung disease that is not amenable to other medical or surgical therapies. Unfortunately, acute cellular rejection (ACR) is a common complication in lung transplant recipients, despite current immunosuppressive protocols (1). ACR is problematic because it is the major risk factor for the development of bronchiolitis obliterans, believed to be the manifestation of chronic rejection, and ACR necessitates the augmentation of immune suppression, leading to increased mortality and morbidity (2). The difficulties with bronchiolitis obliterans and frequent rejections result in relatively poor outcomes for lung transplantation, compared with the transplants of other solid organs (1).Indoleamine 2,3-dioxygenase (IDO) is an inducible enzyme that promotes tryptophan (Trp) catabolism, and has been shown to involve immune modulating activities (3). By increasing IDO activity, an environment is generated with reduced Trp and an increase in its metabolic products, resulting in the modification of dendritic cell function and the inhibition of T-cell activation and proliferation. Consistent with this concept, our laboratory previously showed that an increase in IDO within rat lung allografts resulted in less rejection, transplant-mediated injury, and impaired CD8 cell function (4-6).In the pre...