From Ohio, USA:
Could you give me more information on the new transplant discovery made by two military doctors about being able to transplant organs without being a perfect match?
I assume that your question refers to the use of the two proteins CTLA4-IG and 5C8 that were used by two investigators in the navy to prevent rejection of kidney transplants in monkeys. I am afraid I have no scoop to offer you beyond the information in a brief report in the New York Times recently. These studies potentially represent an important step forward in the technology of combating the rejection of transplanted organs; but as the investigators were quick to acknowledge there is much to be done before this approach will be applicable to man.
Meanwhile there has recently been substantial progress in managing this problem. A German group, for instance, has substantially improved the outlook for islet cell allografts in man, by modifications in the post-operative immunosuppressive regimen. Some centers have been able to avoid using the usual anti-rejection drugs by infusing donor stem cells at the time of transplantation. In New Zealand a trial of incubating donor cells in nicotinamide before transplant and giving them to a recipient who is also on nicotinamide has had some initial success.
In another study just reported, the investigators isolated the gene for preproinsulin and introduced this into a retrovirus vector. They then gave the virus into the portal vein of diabetic rats. A significant proportion of the rats subsequently achieved normal blood sugars, converting preproinsulin to insulin in their livers.
Finally, the theme of exogenous protein or more likely protein fragments or peptides being able to modulate the immune response, is currently of great interest. The peptide beta-caso-morphine which is a fragment of A1 beta casein found in the milk of some cows is able to cause diabetes in some strains of mice and the possibility that insulin itself or fragments of the B chain of insulin can prevent the immune destruction of islet tissue is being actively explored.
I hope this adds a little to what was in the paper.
Original posting 12 Aug 97
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