Rapamycin and tacrolimus differentially modulate acute graft-versus-host disease in rats after liver transplantation

Liver Transpl. 2010 Mar;16(3):357-63. doi: 10.1002/lt.22003.

Abstract

Acute graft-versus-host disease (aGVHD) is a serious complication of liver transplantation (LTx); it occurs in 1% to 2% of liver allograft recipients. The condition has a poor prognosis and poses major diagnostic and therapeutic challenges. A rat model of aGVHD after LTx has been developed, and a relative decrease in regulatory T (Treg) cells has been shown to be associated with this model. Interest has been expressed in the effects of different immunosuppressive agents on CD4+CD25+Foxp3+ Treg cell homeostasis. Rats with aGVHD after LTx were treated with tacrolimus (FK506), rapamycin (RAPA), or no immunosuppressive drug. Those that received RAPA survived longer (91.4 + or - 8.1 days) than those in the FK506 group (62.3 + or - 13.4 days) or the control group (22.9 + or - 1.2 days). Flow cytometry analysis showed that Treg cells, as a percentage of peripheral blood mononuclear cells (PBMCs), were more abundant in the RAPA group (6.8% + or - 0.8%) than in the FK506 group (1.7% + or - 0.4%) or the control group (2.0% + or - 0.4%). Immunohistochemistry demonstrated more Foxp3+ staining of intestinal cells in the RAPA group than in the FK506 group or the control group. In conclusion, the reduced mortality induced by RAPA in a rat model of aGVHD after LTx was associated with higher percentages of CD4+CD25+Foxp3+ Treg cells in PBMCs in blood and tissues than those occurring after the administration of FK506.

MeSH terms

  • Animals
  • Biopsy
  • CD4 Antigens / metabolism
  • Disease Models, Animal
  • Female
  • Forkhead Transcription Factors / metabolism
  • Graft vs Host Disease / drug therapy*
  • Graft vs Host Disease / immunology
  • Graft vs Host Disease / pathology
  • Homeostasis
  • Immune System / drug effects
  • Immunosuppressive Agents / pharmacology
  • Immunosuppressive Agents / therapeutic use*
  • Interleukin-2 Receptor alpha Subunit / metabolism
  • Liver Transplantation*
  • Male
  • Rats
  • Rats, Inbred Lew
  • Sirolimus / pharmacology
  • Sirolimus / therapeutic use*
  • Skin / pathology
  • T-Lymphocytes, Regulatory / metabolism
  • T-Lymphocytes, Regulatory / pathology
  • Tacrolimus / pharmacology
  • Tacrolimus / therapeutic use*

Substances

  • CD4 Antigens
  • Forkhead Transcription Factors
  • Foxp3 protein, rat
  • Immunosuppressive Agents
  • Interleukin-2 Receptor alpha Subunit
  • Sirolimus
  • Tacrolimus