Dipeptide boronic acid, a novel proteasome inhibitor, prevents islet-allograft rejection.
BACKGROUND: We have demonstrated previously in vitro that proteasome inhibitors suppress the proliferation, and induce the apoptosis, of activated T cells. This implies that they could be used as a novel category of immunosuppressants to block allograft rejection. Therefore, in this study, dipeptide boronic acid (DPBA) was tested for its effect on mouse islet transplantation. METHODS: First, DPBA was investigated in vitro for its effect on mouse mixed lymphocyte reaction (MLR) and cytotoxic T-lymphocyte (CTL) activity. DPBA was then used in vivo to treat mouse islet-allograft rejection. RESULTS: Both MLR and CTL were dose dependently suppressed by the proteasome inhibitor. A 17-day DPBA regimen resulted in islet-allograft survival in 50% of the recipients for a duration of up to 60 days, whereas the control group without immunosuppressants rejected the islet graft in 7 days. DPBA showed moderate side effects according to blood biochemistry; the function of endogenous islets after treatment appeared normal on glucose challenge. CONCLUSIONS: The proteasome inhibitor could inhibit islet-allograft rejection in mice without serious side effects at therapeutic dose levels. This has opened a new dimension in the development of better immunosuppression regimens for islet transplantation.