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Imaging alloreactive T cells provides early warning of organ transplant rejection
Toshihito Hirai, Aaron T. Mayer, Tomomi W. Nobashi, Po-Yu Lin, Zunyu Xiao, Tomokatsu Udagawa, Kinya Seo, Federico Simonetta, Jeanette Baker, Alan G. Cheng, Robert S. Negrin, Sanjiv S. Gambhir
Toshihito Hirai, Aaron T. Mayer, Tomomi W. Nobashi, Po-Yu Lin, Zunyu Xiao, Tomokatsu Udagawa, Kinya Seo, Federico Simonetta, Jeanette Baker, Alan G. Cheng, Robert S. Negrin, Sanjiv S. Gambhir
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Resource and Technical Advance Immunology Transplantation

Imaging alloreactive T cells provides early warning of organ transplant rejection

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Abstract

Diagnosis of organ transplant rejection relies upon biopsy approaches to confirm alloreactive T cell infiltration in the graft. Immune molecular monitoring is under investigation to screen for rejection, though these techniques have suffered from low specificity and lack of spatial information. ImmunoPET utilizing antibodies conjugated to radioisotopes has the potential to improve early and accurate detection of graft rejection. ImmunoPET is capable of noninvasively visualizing the dynamic distribution of cells expressing specific immune markers in the entire body over time. In this work, we identify and characterize OX40 as a surrogate biomarker for alloreactive T cells in organ transplant rejection and monitor its expression by utilizing immunoPET. In a dual murine heart transplant model that has both syngeneic and allogeneic hearts engrafted in bilateral ear pinna on the recipients, OX40 immunoPET clearly depicted alloreactive T cells in the allograft and draining lymph node that were not observed in their respective isograft counterparts. OX40 immunoPET signals also reflected the subject’s immunosuppression level with tacrolimus in this study. OX40 immunoPET is a promising approach that may bridge molecular monitoring and morphological assessment for improved transplant rejection diagnosis.

Authors

Toshihito Hirai, Aaron T. Mayer, Tomomi W. Nobashi, Po-Yu Lin, Zunyu Xiao, Tomokatsu Udagawa, Kinya Seo, Federico Simonetta, Jeanette Baker, Alan G. Cheng, Robert S. Negrin, Sanjiv S. Gambhir

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Figure 2

OX40 identifies an alloreactive CD4+ T cell subset in the graft and draining lymph node.

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OX40 identifies an alloreactive CD4+ T cell subset in the graft and drai...
(A) Quantification of T cell subsets in allo- or isografts at d6 (n = 4), d9 (n = 5) ,and d12 (n = 5) after transplantation. (B) t-SNE representations of concatenated single-cell cytometry data from allo- and isografts across all time points. Top, colors/clusters represent distribution of indicated cell phenotype. Bottom,distribution of OX40-expressing cells. (C) Subset t-SNE plots for allo- or isografts at d6, d9, or d12. Red indicates OX40-expressing cells. Arrows indicate 2 primary clusters associated with OX40 expression. (D) Quantification of the number of OX40+ cells. (E) Correlation of OX40 with T cell phenotype. Color and circle size provide a graphical representation of r2 correlation value. (F) Relative difference in the number of cells of each T cell phenotype between allograft and isograft on d9. The y axis represents fold change (Allo/Iso). (G) Fluorescent intensity (MFI) and frequency of OX40 expression on principle CD4 T cell subsets in allo- or isografts over time. (H) Representative biaxial cytometry plots of OX40 versus Foxp3 expression in allo- or isografts. (I) The proportion of Foxp3–CD4+ (red), Foxp3+CD4+ (orange), and CD8+ T cell (yellow) phenotype among total graft-infiltrating T cells. Sections with shaded lines represents OX40+ cell frequency in each population. Each compartment represents average proportion of n = 4–5 samples for indicated time point. (J) Immunofluorescent microscopy images depicting infiltration of CD4+ T cells (red) and Foxp3+ cells (green) in areas surrounding and within allo- and isografts at d9. High-magnification images are of indicated insets. (K) Quantification of Foxp3+CD4+ (top) and total CD4+ (bottom) cell count within grafts per 200μm2 (n = 3) on d9. *P < 0.05, **P < 0.01, ***P < 0.001 calculated with Mann-Whitney U test between allograft and isograft. All data are representative of at least 2 independent experiments.

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