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Cutting Edge |


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Transplantation Unit, Surgical Services, Massachusetts General Hospital, Boston, MA 02114;
Laboratory of Immunogenetics and Transplantation, Renal Division, Department of Medicine, Brigham and Womens Hospital, Boston, MA 02115;
Division of Rheumatology, Department of Medicine, University of Pennsylvania, Philadelphia, PA 19104; and
Department of Cancer Biology, Harvard School of Public Health; and
¶ Department of Medicine, Harvard Medical School, Boston, MA 02115
To study the role of the direct and indirect pathways in achieving tolerance, we used genetically altered mouse strains in two ways: 1) MHC class II-deficient mice were used as donors of skin and cardiac grafts to eliminate the direct CD4+ T cell response, and 2) B6 II-4+ mice, which are MHC class II-deficient mice expressing an MHC class II transgene only on thymic epithelium, were used as recipients of normal grafts. These mice cannot mount an indirect response. Eliminating the indirect pathway actually made it more difficult to achieve prolonged allograft survival when we used costimulatory blockade than when both pathways were available. Costimulatory blockade was ineffective even when CD4+ T cells from normal animals were transferred into recipients that lacked MHC class II molecules. These results suggest that an active CD4+ response through the indirect pathway is necessary for costimulatory blockade to be effective in prolonging allograft survival.
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