Antibodies (Abs) directed at the Gal␣1,3Gal1,4GlcNAc-R (␣Gal) carbohydrate epitope initiate xenograft rejection. Previously, we have shown that bone marrow transplantation (BMT) with lentivirus-mediated gene transfer of porcine ␣1,3 galactosyltransferase (GalT) is able to induce tolerance to ␣Gal-expressing heart grafts following a lethal dose of irradiation. Here we show the first demonstration of permanent survival of ␣Gal ؉ hearts following transplantation with autologous, lentivirus-transduced BM using a nonmyeloablative regimen. Autologous BM from GalT knockout (GalT ؊/؊ ) mice was transduced with a lentiviral vector expressing porcine GalT and transplanted into sublethally irradiated (3 Gy) GalT ؊/؊ mice. Chimerism in the peripheral blood cells (PBCs) remained low but was higher in the BM, especially within the stromal cell population. Mice reconstituted with GalT did not produce anti-␣Gal Abs over time. We immunized these mice with ␣Gal-expressing cells and assessed humoral immune responses. Anti-␣Gal xenoantibodies were not produced in mice reconstituted with GalT, but normal Ab responses to other xenoantigens were detected. Mice reconstituted with GalT accepted ␣Gal ؉ heart grafts over 100 days.
IntroductionThe number of cases of organ transplantation has been increasing, however, the shortage of donor organs is a major problem because the number of donors is limited. Xenotransplantation using nonhuman species as organ donors has received much attention as a possible solution to this problem. Pigs are regarded as the most likely species to serve as donors for clinical xenotransplantation. 1 All mammals except humans, apes, and old-world monkeys express ␣1,3 galactosyltransferase (GalT), hence Gal␣1,3Gal1, 4GlcNac-R (␣Gal) is expressed on most tissues including vascular endothelium. [2][3][4] However, as humans have natural antibodies (Abs) against ␣Gal, it is known that xenotransplantation of pig organs into humans induces hyperacute rejection, acute vascular rejection/ delayed xenograft rejection, and even chronic rejection against ␣Gal. [5][6][7] In pig-to-primate discordant combination, 80% to 90% of antipig xenogeneic Abs are anti-␣Gal Abs. 8 Therefore, overcoming this response is presently the biggest problem facing xenotransplantation.To solve this problem, various approaches have been proposed. [9][10][11][12][13] Mixed hematopoietic chimerism can induce tolerance in allogeneic and xenogeneic models of transplantation. 14,15 Recently, it has been shown that tolerance to ␣Gal can be induced in GalT knockout (GalT Ϫ/Ϫ ) mice that produce anti-␣Gal Abs. Yang et al 16 applied mixed-cell chimerism to achieve permanent acceptance of transplanted organs by injecting bone marrow (BM) from wildtype (WT) donor mice into GalT Ϫ/Ϫ mice conditioned with irradiation and T-cell depletion. Bracy et al 17 have reported use of gene therapy to induce chimerism and tolerance following transplantation of autologous BM cells expressing a retrovirally transduced gene encoding GalT. We have reported that donor hearts...