Review Article

The Role of NK Cells in Pig-to-Human Xenotransplantation

Table 2

Proven strategies to overcome NK cytotoxicity against pig endothelial cells.

TargetApproachNK sourceEffectReduction (%)Ref

αGal GTIn vitro knockout pEC linesIL2-NK cells, NK92
Fresh NK cells,
Fresh NK cells
No effect CMC
↓ ADCC
↓ nAb/CML
NA
77–90
86
[46, 126]
Gal knockout pigsIL2-NK cells,
Fresh NK cells
Fresh NK cells
No effect in CMC
↓ ADCC
↓ nAb/CML
NA
70
80
[47, 124]
siRNA in pECNK92 cell lineNo effect CMC
↓ ADCC
NA
30–40
[125]

Masking of sugar xenoantigensTransfections of α(1,2)-fucosyltransferase in pECsFresh NK cells↓ CMC47[119]
Treatment of pECs with DXSNK92↓ CMC
inh. C’ deposition
25–47[135]

HLA class I moleculesHLA-E transfection in pECIL2-NK cells↓ CMC15–60[150, 151]
HLA-E transgenic pigsIL2-NK cells↓ CMC
↓ IFNγ production
8–30
40
[15]
HLA-G1 transfection in pECIL2-NK cells, NK92 and NK cell clones↓ CMC
↓ rolling/adhesion
No effect in ADCC
20–45
25–75
NA
[141, 142, 150, 187]
Soluble HLA-G1NK92
Fresh PBMC
↓ CMC
↓ CMC
31–83
24
[145]
HLA-Cw3 transfection in pECNK cell clones↓ CMC12–70[136]
HLA-Cw4 transfection in pECNK cell clones↓ CMC58[139]
HLA-B27 transfection in pECNK cell clones↓ CMC~30[136]

Apoptosis inductionPK15, human FasL transfectionPBL↓ ADCC34–42[108]
PK15, human FasL transfectionPBL,
LAK
↓ ADCC
↓ CMC
54
74
[127]
pEC, human FasL transfectionIL2-NK cellsNo effect CMC
↑ apoptosis NK cells
0[129]
pEC, pig FasL transfectionIL2-NK cells↓ CMC
↓ FasL apoptosis
26
23
[128]

Apoptosis resistanceBcl-2 transfection in PK15PBL↓ FasL apoptosis
↓ ADCC
62
50
[132]
Bcl-2mut transfections in pECIL2-NK cellsNo effect CMC0[110]

ADCC: antibody-dependent cell-mediated cytotoxicity; αGal GT: alpha1,3-galactosyltransferase; C’: complement; CML: complement-mediated lysis, CMC: cell-mediated cytotoxicity; DXS: dextran sulfate; HLA: human leukocyte antigen; IFNγ: interferon gamma; inh.: inhibition; LAK: lymphokine-activated killer; NA: not applicable; nAb: natural antibody; PBL: peripheral blood lymphocytes; PBMC: peripheral blood mononuclear cells; pEC: porcine endothelial cells; PK15: pig kidney cell line; siRNA: short interfering RNA; ↓: reduction.