Effects of reduction in the alpha‐gal antigen on bony union: a model of xenobone graft using GalT knockout mouse

Abstract

Among the bone graft sources used currently, the availability of autografts is limited and allografts are expensive. Therefore, xenobone grafts have drawn attention as a new source of bone grafts, although immunologic rejection issues are unresolved. This study used a GalT knockout mouse model to investigate the effects of reducing the alpha-gal epitope using alpha-galactosidase on the union of porcine xenobone grafts. Sixty-eight alpha-gal knockout C57/BL6 mice and eight wild-type mice were used. The mice were divided into five groups: In group 1 (26 alpha-gal knockout mice), an alpha-galactosidase-treated porcine xenograft was transplanted into the mouse femur to reduce antigenicity, and intramedullary fixation was performed. In group 2 (26 alpha-gal knockout mice), a non-treated porcine xenobone graft was performed. In group 3 (eight alpha-gal knockout C57/BL6 mice), syngenic bone grafts were performed. In group 4 (eight wild-type C57/BL6 mice), syngenic bone grafts were performed. In group 5 (eight C57/BL6 alpha-gal knockout mice), a bone defect model was obtained by maintaining the gap of the osteotomy site. Groups 3, 4, and 5 were used for positive and negative control groups. Qualitative immunohistochemical analysis of the porcine bone was performed to detect the presence of the alpha-gal epitope in groups 1 and 2. The concentration of the anti-alpha-gal antibody was evaluated using a quantitative enzyme-linked immunosorbent assay (ELISA) at the time of sacrifice (3, 4, and 5weeks after the operation). Histologic and radiologic results (Goldberg method) for the bone union were compared. The qualitative immunohistochemical analysis showed that the alpha-gal epitope was reduced when xenobone grafts were treated with alpha-galactosidase. Compared with group 2, group 1 showed a low anti-alpha-gal antibody concentration in the ELISA results. In group 2, the anti-alpha-gal antibody concentration increased with time. Group 1 showed significantly better histologic union than group 2, but the amount of radiologic union was similar in the two groups. Alpha-galactosidase treatment of a porcine xenobone graft can reduce the alpha-gal epitope. This reduction in the antigen could significantly reduce the humoral immune response to the alpha-gal antigen in C57/BL6 alpha-gal knockout mice, leading to significant improvements in histologic union. This study provides a relevant GalT knockout mouse model for detecting the effects of alpha-gal epitope reduction by alpha-galactosidase on the union of porcine xenobone grafts.