Production of Four-Gene (GTKO/hCD55/hTBM/hCD39)-Edited Donor Pigs and Kidney Xenotransplantation
Chang Yang
Yunnan Province Key Laboratory for Porcine Gene Editing and Xenotransplantation, Yunnan Agricultural University, Kunming, China
Yunnan Province Xenotransplantation Research Engineering Center, Yunnan Agricultural University, Kunming, China
Faculty of Animal Science and Technology, Yunnan Agricultural University, Kunming, China
Search for more papers by this authorYunfang Wei
Yunnan Province Key Laboratory for Porcine Gene Editing and Xenotransplantation, Yunnan Agricultural University, Kunming, China
Yunnan Province Xenotransplantation Research Engineering Center, Yunnan Agricultural University, Kunming, China
Faculty of Animal Science and Technology, Yunnan Agricultural University, Kunming, China
Search for more papers by this authorXinglong Li
Yunnan Province Key Laboratory for Porcine Gene Editing and Xenotransplantation, Yunnan Agricultural University, Kunming, China
Yunnan Province Xenotransplantation Research Engineering Center, Yunnan Agricultural University, Kunming, China
Faculty of Animal Science and Technology, Yunnan Agricultural University, Kunming, China
Search for more papers by this authorKaixiang Xu
Yunnan Province Key Laboratory for Porcine Gene Editing and Xenotransplantation, Yunnan Agricultural University, Kunming, China
Yunnan Province Xenotransplantation Research Engineering Center, Yunnan Agricultural University, Kunming, China
College of Veterinary Medicine, Yunnan Agricultural University, Kunming, China
Search for more papers by this authorXiaoying Huo
Yunnan Province Key Laboratory for Porcine Gene Editing and Xenotransplantation, Yunnan Agricultural University, Kunming, China
Yunnan Province Xenotransplantation Research Engineering Center, Yunnan Agricultural University, Kunming, China
College of Veterinary Medicine, Yunnan Agricultural University, Kunming, China
Search for more papers by this authorGang Chen
Institute of Organ Transplantation, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
Search for more papers by this authorHeng Zhao
Yunnan Province Key Laboratory for Porcine Gene Editing and Xenotransplantation, Yunnan Agricultural University, Kunming, China
Yunnan Province Xenotransplantation Research Engineering Center, Yunnan Agricultural University, Kunming, China
College of Veterinary Medicine, Yunnan Agricultural University, Kunming, China
Search for more papers by this authorJiaoxiang Wang
Yunnan Province Key Laboratory for Porcine Gene Editing and Xenotransplantation, Yunnan Agricultural University, Kunming, China
Yunnan Province Xenotransplantation Research Engineering Center, Yunnan Agricultural University, Kunming, China
Faculty of Animal Science and Technology, Yunnan Agricultural University, Kunming, China
Search for more papers by this authorTaiyun Wei
Yunnan Province Key Laboratory for Porcine Gene Editing and Xenotransplantation, Yunnan Agricultural University, Kunming, China
Yunnan Province Xenotransplantation Research Engineering Center, Yunnan Agricultural University, Kunming, China
Search for more papers by this authorYubo Qing
Yunnan Province Key Laboratory for Porcine Gene Editing and Xenotransplantation, Yunnan Agricultural University, Kunming, China
Yunnan Province Xenotransplantation Research Engineering Center, Yunnan Agricultural University, Kunming, China
College of Veterinary Medicine, Yunnan Agricultural University, Kunming, China
Search for more papers by this authorJianxiong Guo
Yunnan Province Key Laboratory for Porcine Gene Editing and Xenotransplantation, Yunnan Agricultural University, Kunming, China
Yunnan Province Xenotransplantation Research Engineering Center, Yunnan Agricultural University, Kunming, China
Search for more papers by this authorHongfang Zhao
Yunnan Province Key Laboratory for Porcine Gene Editing and Xenotransplantation, Yunnan Agricultural University, Kunming, China
Yunnan Province Xenotransplantation Research Engineering Center, Yunnan Agricultural University, Kunming, China
Faculty of Animal Science and Technology, Yunnan Agricultural University, Kunming, China
Search for more papers by this authorXiong Zhang
Yunnan Province Key Laboratory for Porcine Gene Editing and Xenotransplantation, Yunnan Agricultural University, Kunming, China
Yunnan Province Xenotransplantation Research Engineering Center, Yunnan Agricultural University, Kunming, China
Faculty of Animal Science and Technology, Yunnan Agricultural University, Kunming, China
Search for more papers by this authorDeling Jiao
Yunnan Province Key Laboratory for Porcine Gene Editing and Xenotransplantation, Yunnan Agricultural University, Kunming, China
Yunnan Province Xenotransplantation Research Engineering Center, Yunnan Agricultural University, Kunming, China
College of Veterinary Medicine, Yunnan Agricultural University, Kunming, China
Search for more papers by this authorZhe Xiong
Yunnan Province Key Laboratory for Porcine Gene Editing and Xenotransplantation, Yunnan Agricultural University, Kunming, China
Yunnan Province Xenotransplantation Research Engineering Center, Yunnan Agricultural University, Kunming, China
Search for more papers by this authorMuhammad Ameen Jamal
Yunnan Province Key Laboratory for Porcine Gene Editing and Xenotransplantation, Yunnan Agricultural University, Kunming, China
Yunnan Province Xenotransplantation Research Engineering Center, Yunnan Agricultural University, Kunming, China
Search for more papers by this authorCorresponding Author
Hong-Ye Zhao
Yunnan Province Key Laboratory for Porcine Gene Editing and Xenotransplantation, Yunnan Agricultural University, Kunming, China
Yunnan Province Xenotransplantation Research Engineering Center, Yunnan Agricultural University, Kunming, China
College of Veterinary Medicine, Yunnan Agricultural University, Kunming, China
Correspondence: Hong-Ye Zhao ([email protected]) | Hong-Jiang Wei ([email protected])
Search for more papers by this authorCorresponding Author
Hong-Jiang Wei
Yunnan Province Key Laboratory for Porcine Gene Editing and Xenotransplantation, Yunnan Agricultural University, Kunming, China
Yunnan Province Xenotransplantation Research Engineering Center, Yunnan Agricultural University, Kunming, China
College of Veterinary Medicine, Yunnan Agricultural University, Kunming, China
Correspondence: Hong-Ye Zhao ([email protected]) | Hong-Jiang Wei ([email protected])
Search for more papers by this authorChang Yang
Yunnan Province Key Laboratory for Porcine Gene Editing and Xenotransplantation, Yunnan Agricultural University, Kunming, China
Yunnan Province Xenotransplantation Research Engineering Center, Yunnan Agricultural University, Kunming, China
Faculty of Animal Science and Technology, Yunnan Agricultural University, Kunming, China
Search for more papers by this authorYunfang Wei
Yunnan Province Key Laboratory for Porcine Gene Editing and Xenotransplantation, Yunnan Agricultural University, Kunming, China
Yunnan Province Xenotransplantation Research Engineering Center, Yunnan Agricultural University, Kunming, China
Faculty of Animal Science and Technology, Yunnan Agricultural University, Kunming, China
Search for more papers by this authorXinglong Li
Yunnan Province Key Laboratory for Porcine Gene Editing and Xenotransplantation, Yunnan Agricultural University, Kunming, China
Yunnan Province Xenotransplantation Research Engineering Center, Yunnan Agricultural University, Kunming, China
Faculty of Animal Science and Technology, Yunnan Agricultural University, Kunming, China
Search for more papers by this authorKaixiang Xu
Yunnan Province Key Laboratory for Porcine Gene Editing and Xenotransplantation, Yunnan Agricultural University, Kunming, China
Yunnan Province Xenotransplantation Research Engineering Center, Yunnan Agricultural University, Kunming, China
College of Veterinary Medicine, Yunnan Agricultural University, Kunming, China
Search for more papers by this authorXiaoying Huo
Yunnan Province Key Laboratory for Porcine Gene Editing and Xenotransplantation, Yunnan Agricultural University, Kunming, China
Yunnan Province Xenotransplantation Research Engineering Center, Yunnan Agricultural University, Kunming, China
College of Veterinary Medicine, Yunnan Agricultural University, Kunming, China
Search for more papers by this authorGang Chen
Institute of Organ Transplantation, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
Search for more papers by this authorHeng Zhao
Yunnan Province Key Laboratory for Porcine Gene Editing and Xenotransplantation, Yunnan Agricultural University, Kunming, China
Yunnan Province Xenotransplantation Research Engineering Center, Yunnan Agricultural University, Kunming, China
College of Veterinary Medicine, Yunnan Agricultural University, Kunming, China
Search for more papers by this authorJiaoxiang Wang
Yunnan Province Key Laboratory for Porcine Gene Editing and Xenotransplantation, Yunnan Agricultural University, Kunming, China
Yunnan Province Xenotransplantation Research Engineering Center, Yunnan Agricultural University, Kunming, China
Faculty of Animal Science and Technology, Yunnan Agricultural University, Kunming, China
Search for more papers by this authorTaiyun Wei
Yunnan Province Key Laboratory for Porcine Gene Editing and Xenotransplantation, Yunnan Agricultural University, Kunming, China
Yunnan Province Xenotransplantation Research Engineering Center, Yunnan Agricultural University, Kunming, China
Search for more papers by this authorYubo Qing
Yunnan Province Key Laboratory for Porcine Gene Editing and Xenotransplantation, Yunnan Agricultural University, Kunming, China
Yunnan Province Xenotransplantation Research Engineering Center, Yunnan Agricultural University, Kunming, China
College of Veterinary Medicine, Yunnan Agricultural University, Kunming, China
Search for more papers by this authorJianxiong Guo
Yunnan Province Key Laboratory for Porcine Gene Editing and Xenotransplantation, Yunnan Agricultural University, Kunming, China
Yunnan Province Xenotransplantation Research Engineering Center, Yunnan Agricultural University, Kunming, China
Search for more papers by this authorHongfang Zhao
Yunnan Province Key Laboratory for Porcine Gene Editing and Xenotransplantation, Yunnan Agricultural University, Kunming, China
Yunnan Province Xenotransplantation Research Engineering Center, Yunnan Agricultural University, Kunming, China
Faculty of Animal Science and Technology, Yunnan Agricultural University, Kunming, China
Search for more papers by this authorXiong Zhang
Yunnan Province Key Laboratory for Porcine Gene Editing and Xenotransplantation, Yunnan Agricultural University, Kunming, China
Yunnan Province Xenotransplantation Research Engineering Center, Yunnan Agricultural University, Kunming, China
Faculty of Animal Science and Technology, Yunnan Agricultural University, Kunming, China
Search for more papers by this authorDeling Jiao
Yunnan Province Key Laboratory for Porcine Gene Editing and Xenotransplantation, Yunnan Agricultural University, Kunming, China
Yunnan Province Xenotransplantation Research Engineering Center, Yunnan Agricultural University, Kunming, China
College of Veterinary Medicine, Yunnan Agricultural University, Kunming, China
Search for more papers by this authorZhe Xiong
Yunnan Province Key Laboratory for Porcine Gene Editing and Xenotransplantation, Yunnan Agricultural University, Kunming, China
Yunnan Province Xenotransplantation Research Engineering Center, Yunnan Agricultural University, Kunming, China
Search for more papers by this authorMuhammad Ameen Jamal
Yunnan Province Key Laboratory for Porcine Gene Editing and Xenotransplantation, Yunnan Agricultural University, Kunming, China
Yunnan Province Xenotransplantation Research Engineering Center, Yunnan Agricultural University, Kunming, China
Search for more papers by this authorCorresponding Author
Hong-Ye Zhao
Yunnan Province Key Laboratory for Porcine Gene Editing and Xenotransplantation, Yunnan Agricultural University, Kunming, China
Yunnan Province Xenotransplantation Research Engineering Center, Yunnan Agricultural University, Kunming, China
College of Veterinary Medicine, Yunnan Agricultural University, Kunming, China
Correspondence: Hong-Ye Zhao ([email protected]) | Hong-Jiang Wei ([email protected])
Search for more papers by this authorCorresponding Author
Hong-Jiang Wei
Yunnan Province Key Laboratory for Porcine Gene Editing and Xenotransplantation, Yunnan Agricultural University, Kunming, China
Yunnan Province Xenotransplantation Research Engineering Center, Yunnan Agricultural University, Kunming, China
College of Veterinary Medicine, Yunnan Agricultural University, Kunming, China
Correspondence: Hong-Ye Zhao ([email protected]) | Hong-Jiang Wei ([email protected])
Search for more papers by this authorChang Yang, Yunfang Wei, and Xinglong Li are first co-authors.
Funding: This work was supported by the National Key R&D Program of China (Grant No. 2019YFA0110700) and the Major Science and Technology Project of Yunnan Province (Grant No. 202102AA310047).
ABSTRACT
Background
The number of multigene-modified donor pigs for xenotransplantation is increasing with the advent of gene-editing technologies. However, it remains unclear which gene combination is suitable for specific organ transplantation.
Methods
In this study, we utilized CRISPR/Cas9 gene editing technology, piggyBac transposon system, and somatic cell cloning to construct GTKO/hCD55/hTBM/hCD39 four-gene-edited cloned (GEC) pigs and performed kidney transplantation from pig to rhesus monkey to evaluate the effectiveness of these GEC pigs.
Results
First, 107 cell colonies were obtained through drug selection, of which seven were 4-GE colonies. Two colonies were selected for somatic cell nuclear transfer (SCNT), resulting in seven fetuses, of which four were GGTA1 biallelic knockout. Out of these four, two fetuses had higher expression of hCD55, hTBM, and hCD39. Therefore, these two fetuses were selected for two consecutive rounds of cloning, resulting in 97 live piglets. After phenotype identification, the GGTA1 gene of these pigs was inactivated, and hCD55, hTBM, and hCD39 were expressed in cells and multiple tissues. Furthermore, the numbers of monkey IgM and IgG binding to the peripheral blood mononuclear cells (PBMCs) of the 4-GEC pigs were markedly reduced. Moreover, 4-GEC porcine PBMCs had greater survival rates than those from wild-type pigs through complement-mediated cytolysis assays. In pig-to-monkey kidney xenotransplantation, the kidney xenograft successfully survived for 11 days. All physiological and biochemical indicators were normal, and no hyperacute rejection or coagulation abnormalities were found after transplantation.
Conclusion
These results indicate that the GTKO/hCD55/hTBM/hCD39 four-gene modification effectively alleviates immune rejection, and the pig kidney can functionally support the recipient monkey's life.
Conflicts of Interest
The authors declare no conflicts of interest.
Open Research
Data Availability Statement
The dataset supporting the conclusions of this article is included within the article and its additional file.
Supporting Information
Filename | Description |
---|---|
xen12881-sup-0001-FigureS1.tif998.5 KB | Figure S1 Immunosuppressive regimen |
xen12881-sup-0002-FigureS2.tif1.2 MB | Figure S2 Erythrocyte indexes and electrolytes in recipient monkey. A. The numbers of red blood cells. B-C. Hematocrit (B) and hemoglobin concentration (C). D-I. The concentration of sodium (Na) (D), chlorine (Cl) (E), calcium (Ca) (F), magnesium (Mg) (G), phosphorus (P) (H) and potassium (K) (I) in the serum of recipient monkey. |
xen12881-sup-0003-FigureS3.tif1.1 MB | Figure S3 The liver function indexes of recipient monkey. A-I. The levels of total protein (TP) (A), ailbumin (ALB) (B), total bilirubin (TBIL) (C), direct bilirubin (DBIL) (D), alkaline phosphatase (ALP) (E), total bile acid (TBA) (F), aspartate transaminase (AST) (G), adenosine deaminase (ADA) (H) and alanine transaminase (ALT) (I). |
xen12881-sup-0004-FigureS4.tif4.2 MB | Figure S4 Silence of hCD55 expression might be due to methylation. A. The protein expression of αGal, hCD55, hTBM and hCD39 gene in GEC porcine kidney tissue was confirmed by immunofluorescence, in which no hCD55 was detected (scale bar = 50 µm). B. Correspondingly, high methylation level in CpG island of hCD55 coding DNA. Each row repsents a repeat. |
xen12881-sup-0005-TablesS1-S2.docx116.5 KB | Supporting Information |
xen12881-sup-0006-SuppMat.doc56.5 KB | Supporting Information |
Please note: The publisher is not responsible for the content or functionality of any supporting information supplied by the authors. Any queries (other than missing content) should be directed to the corresponding author for the article.
References
- 1B. P. Griffith, C. E. Goerlich, A. K. Singh, et al., “Genetically Modified Porcine-to-Human Cardiac Xenotransplantation,” New England Journal of Medicine 387 (2022): 35–44.
- 2B. M. Kuehn, “Pig-to-Human Xenotransplants Take Another Step Forward,” Kidney News 15 (2023): 7–8.
- 3S. Mallapaty and M. Kozlov, “First Pig Kidney Transplant in a Person: What It Means for the Future,” Nature 628 (2024): 13–14.
- 4K. Yamada, K. Yazawa, A. Shimizu, et al., “Marked Prolongation of Porcine Renal Xenograft Survival in Baboons Through the Use of Alpha1,3-Galactosyltransferase Gene-Knockout Donors and the Cotransplantation of Vascularized Thymic Tissue,” Nature Medicine 11 (2005): 32–34.
- 5H. Kim, H. K. Chee, J. Yang, et al., “Outcomes of Alpha 1,3-GT-Knockout Porcine Heart Transplants Into a Preclinical Nonhuman Primate Model,” Transplantation Proceedings 45 (2013): 3085–3091.
- 6R. A. Montgomery, J. M. Stern, B. E. Lonze, et al., “Results of Two Cases of Pig-to-Human Kidney Xenotransplantation,” New England Journal of Medicine 386 (2022): 1889–1898.
- 7G. L. Puga Yung, R. Rieben, L. Buhler, H. J. Schuurman, and J. Seebach, “Xenotransplantation: Where Do We Stand in 2016?,” Swiss Medical Weekly 147 (2017): w14403.
- 8D. K. C. Cooper, H. Hara, H. Iwase, et al., “Justification of Specific Genetic Modifications in Pigs for Clinical Organ Xenotransplantation,” Xenotransplantation 26 (2019): e12516.
- 9S. C. Kim, D. V. Mathews, C. P. Breeden, et al., “Long-Term Survival of Pig-to-Rhesus Macaque Renal Xenografts is Dependent on CD4 T Cell Depletion,” American Journal of Transplantation 19 (2019): 2174–2185.
- 10L. Higginbotham, D. Mathews, C. A. Breeden, et al., “Pre-Transplant Antibody Screening and Anti-CD154 Costimulation Blockade Promote Long-Term Xenograft Survival in a Pig-to-Primate Kidney Transplant Model,” Xenotransplantation 22 (2015): 221–230.
- 11Y. Hisadome, D. L. Eisenson, M. R. Santillan, H. Iwase, and K. Yamada, “Pretransplant Screening for Prevention of Hyperacute Graft Loss in Pig-to-Primate Kidney Xenotransplantation,” Transplantation 108, no. 8 (2024): 1749–1759, https://doi.org/10.1097/TP.0000000000004958.
- 12C. C. Lin, D. K. C. Cooper, and A. Dorling, “Coagulation Dysregulation as a Barrier to Xenotransplantation in the Primate,” Transplant Immunology 21 (2009): 75–80.
- 13J. C. Roussel, C. J. Moran, E. J. Salvaris, H. H. Nandurkar, A. J. F. d'Apice, and P. J. Cowan, “Pig Thrombomodulin Binds Human Thrombin But Is a Poor Cofactor for Activation of Human Protein C and TAFI,” American Journal of Transplantation 8 (2008): 1101–1112.
- 14B. Petersen, W. Ramackers, A. Tiede, et al., “Pigs Transgenic for Human Thrombomodulin Have Elevated Production of Activated Protein C,” Xenotransplantation 16 (2009): 486–495.
- 15K. Watanabe-Kusunoki, D. Nakazawa, A. Ishizu, and T. Atsumi, “Thrombomodulin as a Physiological Modulator of Intravascular Injury,” Frontiers in Immunology 11 (2020): 575890.
- 16Y. M. Kanthi, N. R. Sutton, and D. J. Pinsky, “CD39: Interface Between Vascular Thrombosis and Inflammation,” Current Atherosclerosis Reports 16 (2014): 425.
- 17A. B. Adams, S. C. Kim, G. R. Martens, et al., “Xenoantigen Deletion and Chemical Immunosuppression Can Prolong Renal Xenograft Survival,” Annals of Surgery 268 (2018): 564–573.
- 18H. Iwase, H. Liu, M. Wijkstrom, et al., “Pig Kidney Graft Survival in a Baboon for 136 Days: Longest Life-Supporting Organ Graft Survival to Date,” Xenotransplantation 22 (2015): 302–309.
- 19M. M. Mohiuddin, A. K. Singh, P. C. Corcoran, et al., “Chimeric 2C10R4 Anti-CD40 Antibody Therapy is Critical for Long-Term Survival of GTKO.HCD46.HTBM Pig-to-Primate Cardiac Xenograft,” Nature Communications 7 (2016): 11138.
- 20H. Wei, Y. Qing, W. Pan, et al., “Comparison of the Efficiency of Banna Miniature Inbred Pig Somatic Cell Nuclear Transfer Among Different Donor Cells,” PLoS ONE 8 (2013): e57728.
- 21L. Lai, D. Kolber-Simonds, K.-W. Park, et al., “Production of α-1,3-Galactosyltransferase Knockout Pigs by Nuclear Transfer Cloning,” Science 295 (2002): 1089–1092.
- 22C. G. A. Mcgregor, D. Ricci, N. Miyagi, et al., “Human CD55 Expression Blocks Hyperacute Rejection and Restricts Complement Activation in Gal Knockout Cardiac Xenografts,” Transplantation 93 (2012): 686.
- 23N. Ko, J. Shim, H.-J. Kim, et al., “A Desirable Transgenic Strategy Using GGTA1 Endogenous Promoter-Mediated Knock-in for Xenotransplantation Model,” Scientific Reports 12 (2022): 9611.
- 24S. Ding, X. Wu, G. Li, M. Han, Y. Zhuang, and T. Xu, “Efficient Transposition of the piggyBac (PB) Transposon in Mammalian Cells and Mice,” Cell 122 (2005): 473–483.
- 25H. Zhao, W. Ye, J. Guo, et al., “Development of RAG2-/-IL2Rγ-/Y Immune Deficient FAH-Knockout Miniature Pig,” Frontiers in Immunology 13 (2022): 950194.
- 26K. Xu, H. Yu, S. Chen, et al., “Production of Triple-Gene (GGTA1, B2M and CIITA)-Modified Donor Pigs for Xenotransplantation,” Frontiers in Veterinary Science 9 (2022): 848833.
- 27K. J. Eilertsen, R. A. Power, L. L. Harkins, and P. Misica, “Targeting Cellular Memory to Reprogram the Epigenome, Restore Potential, and Improve Somatic Cell Nuclear Transfer,” Animal Reproduction Science 98 (2007): 129–146.
- 28C. C. Lin, M. Ezzelarab, R. Shapiro, et al., “Recipient Tissue Factor Expression Is Associated With Consumptive Coagulopathy in Pig-to-Primate Kidney Xenotransplantation,” American Journal of Transplantation 10 (2010): 1556–1568.
- 29G. Chen, H. Qian, T. Starzl, et al., “Acute Rejection is Associated With Antibodies to Non-Gal Antigens in Baboons Using Gal-Knockout Pig Kidneys,” Nature Medicine 11 (2005): 1295–1298.
- 30D. K. C. Cooper, V. Satyananda, B. Ekser, et al., “Progress in Pig-to-Non-Human Primate Transplantation Models (1998–2013): A Comprehensive Review of the Literature,” Xenotransplantation 21 (2014): 397–419.
- 31A. Shimizu, K. Yamada, S. C. Robson, D. H. Sachs, and R. B. Colvin, “Pathologic Characteristics of Transplanted Kidney Xenografts,” Journal of the American Society of Nephrology 23 (2012): 225–235.
- 32D. Ma, T. Hirose, G. Lassiter, et al., “Kidney Transplantation From Triple-Knockout Pigs Expressing Multiple Human Proteins in Cynomolgus Macaques,” American Journal of Transplantation 22 (2022): 46–57.
- 33H. N. Suh, J. Y. Lee, H. J. Kang, et al., “A Comparison Between GalT−/−; hCD39; hCD55 and GalT−/−; hCD39; hCD46; hCD55; TBM Pig Kidneys Transplanted in Nonhuman Primates,” Cell Transplantation 33 (2024): 09636897231217382.