The Possible Role of Anti-Neu5Gc as an Obstacle in Xenotransplantation
Open accessAbstract
Seventy to ninety percentage of preformed xenoreactive antibodies in human serum bind to the galactose-α(1,3)-galactose Gal epitope, and the creation of Gal knockout (KO) pigs has eliminated hyperacute rejection as a barrier to xenotransplantation. Now other glycan antigens are barriers to move ahead with xenotransplantation, and the N-glycolyl neuraminic acid, Neu5Gc (or Hanganutziu-Deicher antigen), is also a major pig xenoantigen. Humans have anti-Neu5Gc antibodies. Several data indicate a strong immunogenicity of Neu5Gc in humans that may contribute to an important part in antibody-dependent injury to pig xenografts. Pig islets express Neu5Gc, which reacted with diet-derived human antibodies and mice deleted for Neu5Gc reject pancreatic islets from wild-type counterpart. However, Neu5Gc positive heart were not rejected in Neu5Gc KO mice indicating that the role of Neu5Gc-specific antibodies has to be nuanced and depend of the graft situation parameters (organ/tissue, recipient, implication of other glycan antigens). Recently generated Gal/Neu5Gc KO pigs eliminate the expression of Gal and Neu5Gc, and improve the crossmatch of humans with the pig. This review summarizes the current and recent experimental and (pre)clinical data on the Neu5Gc immunogenicity and emphasize of the potential impact of anti-Neu5Gc antibodies in limiting xenotransplantation in humans.
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Despite detrimental effects of Neu5Gc epitopes on immunogenicity of decellularized heart valves and dermal grafts, neurons are privileged of Neu5Gc expression.
“Despite the detrimental effects of these epitopes on the immunogenicity of decellularized heart valves [137, 138, 142], and dermal grafts, neurons are privileged of Neu5Gc expression [131, 137, 143].”
From Immunogenicity of decellularized extracellular matrix scaffolds: a bottleneck in tissue engineering and regenerative medicine (2023) · cites this paper as [131]
In “Neu5Gc, a Major Non-Gal Glycan Xenoantigen” (page unavailable), the paper says Neu5Gc is absent in mammalian neurons. The “High Titers” section (page unavailable) reports anti-Neu5Gc responses after pig-skin grafts and heart-valve implantation, but describes a contribution to valve deterioration as possible rather than established. Thus the claim overstates the evidence for detrimental effects on heart valves. (LLM, conf=0.84)
Experimental — accuracy not yet measuredData related to non-human primate kidney transplantation into human recipients indicate its privilege from hyperacute rejection and preservation of functionality for at least ten days.
“Data related to non-human primate kidney transplantation into human recipients indicate its privilege from hyperacute rejection and preservation of functionality for at least ten days [131].”
From Immunogenicity of decellularized extracellular matrix scaffolds: a bottleneck in tissue engineering and regenerative medicine (2023) · cites this paper as [131]
The “NHP-to-Human” section reports that 19 of 21 non-human-primate kidneys transplanted into humans remained functional for at least 10 days. It does not establish that these grafts are exempt from hyperacute rejection; it also describes (hyper)acute antibody-mediated rejection in a few NHP-to-human cases. (LLM, conf=0.86)
Experimental — accuracy not yet measuredGrafts taken from non-human primates or α-gal-free pigs still succumb to delayed antibody-mediated rejection, suggesting the presence of antigens other than α-gals within xenogeneic tissues.
“Despite undergoing attenuated immune responses, grafts taken from non-human primates or α-gal-free pigs still succumb to delayed antibody-mediated rejection, suggesting the presence of antigens other than α-gals within xenogeneic tissues [131, 132].”
From Immunogenicity of decellularized extracellular matrix scaffolds: a bottleneck in tissue engineering and regenerative medicine (2023) · cites this paper as [131]
Neu5Gc expression level is a tissue-dependent issue.
“Neu5Gc expression level is a tissue-dependent issue.”
From Immunogenicity of decellularized extracellular matrix scaffolds: a bottleneck in tissue engineering and regenerative medicine (2023) · cites this paper as [131]
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“Consequently, antibodies against Neu5GC, may be produced by humans, leading to hyperacute rejection of the graft containing this antigen [72].”
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IMMUNOBIOLOGICAL BARRIERS TO PIG ORGAN XENOTRANSPLANTATION
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- Authors
- Tector, A. J., Mosser, M., Tector, M., & Bach, J.-M.
- Affiliations
- University of Alabama at Birmingham (US)
- Oniris (FR)
- Corresponding author
- Tector, Alfred Joseph
- Bach, Jean-Marie
- Venue
- Frontiers in Immunology
- Publisher
- Frontiers Media SA
- Published
- 2020-04-15
- Volume
- 11
- Pages
- 622-622
- ISSN
- 1664-3224 (ISSN-L)
- PMC
- PMC7174778
- OpenAlex
- W3016822952
- Cited by
- 60
- References
- 140
- Citations by year
- 2026: 10 · 2025: 7 · 2024: 7 · 2023: 11 · 2022: 15 · 2021: 7 · 2020: 2
- FWCI
- 1.98
- Type
- journal article
- Language
- en
- Open access
- gold
- doi.org
- Licence
- Locations
- Frontiers in Immunology (publishedVersion, cc-by)
- PubMed Central (publishedVersion, cc-by)
- PubMed (publishedVersion)
- HAL (submittedVersion, cc-by)
- DOAJ (DOAJ: Directory of Open Access Journals) (submittedVersion, cc-by-sa)
- Funders
- Agence Nationale de la Recherche (ANR-16-IDEX-0007, ANR-10-IBHU-0005, ANR‐10‐IBHU‐005, ANR-10)
- Institut National de la Recherche Agronomique
- Topics
- Health Sciences › Medicine › Surgery › Xenotransplantation and immune response
- Life Sciences › Biochemistry, Genetics and Molecular Biology › Molecular Biology › Glycosylation and Glycoproteins Research
- Health Sciences › Medicine › Transplantation › Organ and Tissue Transplantation Research
- Keywords
- N-glycolylneuraminic acid, anti-Neu5Gc antibodies, xenotransplantation, pig islets, crossmatch, hyperacute rejection
- MeSH terms
- Animals, Antibodies, Heterophile, Disease Models, Animal, Graft Rejection, Humans, Islets of Langerhans, Neuraminic Acids, Swine, Transplantation, Heterologous, Islets of Langerhans Transplantation, Gene Knockout Techniques, Heterografts
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