Posttransplant ischemia-reperfusion injury in transplanted heart is prevented by A minibody to the fifth component of complement

Mariano Ferraresso, Paolo MacOr, Marialuisa Valente, Mila Della Barbera, Fabio D'Amelio, Orietta Borghi, Elena Raschi, Paolo Durigutto, Pierluigi Meroni, Francesco Tedesco

Research output: Contribution to journalArticlepeer-review


BACKGROUND.: Complement activation has been implicated in the development of posttransplant ischemia-reperfusion (I/R) which is responsible for the delayed function of 20% to 30% of grafts. C5a and the terminal complement complex (TCC) are the complement activation products mainly involved in tissue injury caused by I/R. METHODS.: To control activation of the terminal step of the complement activation pathways, we used a neutralizing minibody to C5 containing a human single-chain fragment variable (scFv) linked to the hinge region, CH2, and CH3 domains of rat IgG1. RESULTS.: The minibody acts on C5 inhibiting the release of C5a and the assembly of TCC and depletes circulating C5 in Sprague-Dawley rats with a therapeutic activity of 4 hr. Administration of the minibody to rats 30 min before heart allotransplantation prevented tissue deposition of TCC, apoptosis, and necrosis of the graft and increase in the levels of serum creatine phosphokinase and tumor necrosis factor-α observed in control transplanted rats. CONCLUSIONS.: These data suggest that an anti-C5 therapy is effective in preventing graft injury caused by I/R. A minibody containing the human scFv linked to the hinge region and the CH2 and CH3 domains of human IgG1 is ready for use in clinical transplantation.

Original languageEnglish
Pages (from-to)1445-1451
Number of pages7
Issue number10
Publication statusPublished - Nov 27 2008


  • Complement activation
  • Ischemia/reperfusion injury
  • Organ transplantation.

ASJC Scopus subject areas

  • Transplantation


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