Insights from computational modeling in inflammation and acute rejection in limb transplantation

PLoS One. 2014 Jun 13;9(6):e99926. doi: 10.1371/journal.pone.0099926. eCollection 2014.

Abstract

Acute skin rejection in vascularized composite allotransplantation (VCA) is the major obstacle for wider adoption in clinical practice. This study utilized computational modeling to identify biomarkers for diagnosis and targets for treatment of skin rejection. Protein levels of 14 inflammatory mediators in skin and muscle biopsies from syngeneic grafts [n = 10], allogeneic transplants without immunosuppression [n = 10] and allografts treated with tacrolimus [n = 10] were assessed by multiplexed analysis technology. Hierarchical Clustering Analysis, Principal Component Analysis, Random Forest Classification and Multinomial Logistic Regression models were used to segregate experimental groups. Based on Random Forest Classification, Multinomial Logistic Regression and Hierarchical Clustering Analysis models, IL-4, TNF-α and IL-12p70 were the best predictors of skin rejection and identified rejection well in advance of histopathological alterations. TNF-α and IL-12p70 were the best predictors of muscle rejection and also preceded histopathological alterations. Principal Component Analysis identified IL-1α, IL-18, IL-1β, and IL-4 as principal drivers of transplant rejection. Thus, inflammatory patterns associated with rejection are specific for the individual tissue and may be superior for early detection and targeted treatment of rejection.

Publication types

  • Research Support, Non-U.S. Gov't
  • Research Support, U.S. Gov't, Non-P.H.S.

MeSH terms

  • Animals
  • Computer Simulation*
  • Extremities / transplantation*
  • Graft Rejection / drug therapy*
  • Graft Survival / drug effects
  • Graft Survival / immunology
  • Immunosuppressive Agents / therapeutic use
  • Interleukin-4 / metabolism
  • Male
  • Rats
  • Skin / immunology
  • Tacrolimus / therapeutic use
  • Transplantation, Homologous
  • Tumor Necrosis Factor-alpha / metabolism

Substances

  • Immunosuppressive Agents
  • Tumor Necrosis Factor-alpha
  • Interleukin-4
  • Tacrolimus

Grants and funding

Funding for this work was provided by the Armed Forces Institute for Advanced Regenerative Medicine Program (TATRC, DOD) Program, Department of Defense grant WX81XWH-07-1-0415, the Austrian Research Fund (Erwin Schrödinger Stipendium), the Austrian Society of Plastic and Reconstructive Surgery and the and the Pennsylvania Department of Health Commonwealth Universal Research Enhancement (CURE) program. The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript.