Bacterial products in donor airways prevent the induction of lung transplant tolerance

Satona Tanaka, Jason M. Gauthier, Yuriko Terada, Tsuyoshi Takahashi, Wenjun Li, Kohei Hashimoto, Ryuji Higashikubo, Ramsey R. Hachem, Ankit Bharat, Jon H. Ritter, Ruben G. Nava, Varun Puri, Alexander S. Krupnick, Andrew E. Gelman, Daniel Kreisel

Research output: Contribution to journalArticlepeer-review

9 Scopus citations


Although postoperative bacterial infections can trigger rejection of pulmonary allografts, the impact of bacterial colonization of donor grafts on alloimmune responses to transplanted lungs remains unknown. Here, we tested the hypothesis that bacterial products present within donor grafts at the time of implantation promote lung allograft rejection. Administration of the toll-like receptor 2 (TLR2) agonist Pam3Cys4 to Balb/c wild-type grafts triggered acute cellular rejection after transplantation into B6 wild-type recipients that received perioperative costimulatory blockade. Pam3Cys4-triggered rejection was associated with an expansion of CD8+ T lymphocytes and CD11c+CD11bhiMHC (major histocompatibility complex) class II+ antigen-presenting cells within the transplanted lungs. Rejection was prevented when lungs were transplanted into TLR2-deficient recipients but not when MyD88-deficient donors were used. Adoptive transfer of B6 wild-type monocytes, but not T cells, following transplantation into B6 TLR2-deficient recipients restored the ability of Pam3Cys4 to trigger acute cellular rejection. Thus, we have demonstrated that activation of TLR2 by a bacterial lipopeptide within the donor airways prevents the induction of lung allograft tolerance through a process mediated by recipient-derived monocytes. Our work suggests that donor lungs harboring bacteria may precipitate an inflammatory response that can facilitate allograft rejection.

Original languageEnglish
Pages (from-to)353-361
Number of pages9
JournalAmerican Journal of Transplantation
Issue number1
StatePublished - Jan 2021


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