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19 protocols using rapamune

1

Immunosuppressive Regimens for Gene Therapy

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For study 1, IS regimens consisted of oral rapamycin (RAPAMUNE; Pfizer, New York, NY, USA; 1 mg/kg daily), azathioprine (Alfa Aesar, Tewksbury, MA, USA; suspended in Ora-Blend; 5 mg/kg every other day), cyclosporin A (CycloSPORINE; Teva Pharmaceuticals USA, Inc., North Wales, PA, USA; 50 mg/kg twice a day), and prednisolone (Pharmaceutical Associates Inc., Greenville, SC, USA; 1 mg/kg daily). In the rapamycin/cyclosporin A group, rapamycin was administered 4 h after the first cyclosporin A treatment to mitigate interactions between the two drugs [68 (link)]. IS regimens began 14 days before vector administration and were tapered from day 85 at 25% per week for 28 days.
For study 2, IS regimens consisted of oral prednisolone (Pharmaceutical Associates Inc.; 1 mg/kg daily), rapamycin (RAPAMUNE; Pfizer; 1 mg/kg daily), and subcutaneous methotrexate (Fresenius Kabi USA LLC, Lake Zurich, IL, USA; 0.4 mg/kg weekly). Rapamycin was dose reduced to maintain a trough level in the blood of ~4–8 ng/mL before vector administration on day 15. Rapamycin levels were measured by liquid chromatography/tandem mass spectrometry in EDTA-treated whole blood at Labcorp Drug Development. IS regimens began 14 days before vector administration. Prednisolone was tapered between days 43 and 71 at 25% per week. Rapamycin and methotrexate were tapered between days 99 and 127 at 25% per week.
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2

Immunosuppression Protocol for Transplant

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Our protocol for immunosuppression has been described elsewhere [20 (link)]. In brief, since 1999, induction therapy consists of an IL2 receptor antagonist (IL2RA) for 6–8 weeks post-transplant in normal-risk recipients and rabbit ATG or alemtuzumab in high-risk recipients (liverfree allografts, presensitized, and re-transplant patients). Maintenance immunosuppression is tacrolimus (Prograf; Astellas, Deerfield, IL) – based and also includes mycophenolate mofetil (Cellcept; Genentech, San Francisco, CA) or sirolimus (Rapamune; Pfizer, Philadelphia, PA). For induction and maintenance, all recipients are given corticosteroids which are typically weaned off in 1–3 years.
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3

RCC Xenograft Models in SCID Mice

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RCC xenograft models were created by injecting 5 ×106 tumour cells (786-O and A498) in 100 μl FBS-free cell culture media subcutaneously in 8-week-old male SCID mice (n = 20 for each cell line). Animals were kept the same as the C57BL/6 mice. The experiment started when tumours reached the palpable size after 2 further inoculations. Then the animals were randomised (simple method) into groups: #1: control IP (saline, IP, n = 5); #2: TAC (Advagraf; Astellas Pharma; 3 mg/kg; IP; n = 5); #3: RAPA (Rapamune; Pfizer; 1 mg/kg; per os; n = 5); #4: control per os (saline; per os; n = 5). Treatments were administered three times a week for 21 days. Tumour growth and the alteration of body weight were registered continuously. After 21-day treatment period, mice were sacrificed. The developed tumours, and kidneys were removed, then prepared for further analyses. The in vivo experiments were conducted according to the guidelines of the Institutional Animal Care Facility and approved by the Institutional Ethical Review Board (PE/EA/801-7/2020 approval date: 16 September 2020) with official permissions (PEI/001/1733-2/2015 approval date: 14 October 2015).
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4

Posttransplant Immunosuppressant Protocol for LDLT

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The posttransplant immunosuppressants protocol is presented in Figure 1. Basiliximab (Simulect; Novartis Pharma AG, Basel, Switzerland) was intravenously administered (20 mg) twice, 6 h after portal vein reperfusion and on post-LDLT day 4. Steroid therapy consisted of intraoperative intravenous methylprednisolone (500 mg) followed by 20 mg/d (switched to oral prednisolone 20 mg/d once the patient could tolerate oral medication), which was tapered down and withdrawn after 3 months if no acute cellular rejection occurred. Patients with stable vital signs and renal function were given tacrolimus (Prograf; Fujisawa, Kerry, Ireland) at a dose to maintain trough levels at 8–10 ng/mL during the first week after LDLT. Mycophenolate mofetil (CellCept; Roche, Humacoa, Puerto Rico) was continuously administered at 1 g/d. Patients with a diagnosis of unfavorable tumor histology or confirmed recurrences were given sirolimus (Rapamune; Pfizer, NY, USA) at a dose to maintain trough levels at 3–8 ng/mL (Figure 1) [14 (link)].
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5

NOD/LtJ Mice Bone Marrow Transplant

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Eight-week-old female NOD/LtJ (H-2Kd/H-2Db) mice received 4.5 Gy total body irradiation (TBI) from X-ray irradiator (X-Rad320; Precision X Ray Inc., Madison, CT, USA) on day −1 (Fig. 1A). On day 0 mice received 25 × 10E+6 C57BL/6 nude (Foxn1nu/J, H-2b) bone marrow cells mixed with 5 × 10E+6 anti-3rd party C57BL/6 (H-2Kb/H2Db) veto Tcm by tail vein injection followed by subcutaneous injections of rapamycin (Rapamune, Pfizer Inc., New York, NY, USA), 12.5 μg/mouse/d, on days −1 to +4.
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6

Sirolimus Treatment in Hamster Vaccination

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Rapamune® (sirolimus 1 mg/ml) was purchased from Pfizer (New York, USA) and kept under conditions specified by the manufacturer. Treatment doses of 0.075 mg/kg in 500 μl of PBS were prepared daily under aseptic conditions [24 (link)]. The S + V group received a daily intraperitoneal dose from day − 1 (one day prior to the first vaccination) for 6 consecutive weeks. The V and C groups of hamsters were handled under the same conditions and were PBS-inoculated.
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7

Rapamycin-Induced DiCre Recombinase Excision

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DiCre recombinase mediated excision of targeted DNA sequences in vivo was achieved by administration of 200 μg Rapamycin (1mg/ml stock, Rapamune, Pfizer) to mice by oral gavage, 24 hours prior to transmission to mosquitoes. In order to achieve excision in the mosquito stages, 10 μg Rapamycin (1 mg/ml stock solution in DMSO, Sigma-Aldrich) was added to 10 ml 10% sucrose solution and used to feed mosquitoes. The Rapamycin dose was refreshed every alternate day along with the sucrose solution.
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8

DiCre-Mediated Gene Excision in Malaria Parasite

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DiCre recombinase mediated excision of targeted DNA sequences in vivo was achieved by a single oral administration of 200μg rapamycin (1mg/ml stock, Rapamune, Pfizer) to mice. Excision of the GFP cassette in blood stage parasites was monitored by flow cytometry using a Guava EasyCyte 6/2L bench cytometer equipped with 488 nm and 532 nm lasers (Millipore) to detect GFP and mCherry, respectively. To analyze parasite development in the mosquito, rapamycin was administered to infected mice 24 hours prior to transmission to mosquitoes, as described [19 (link)]. Midguts were dissected out at day 14 post infection. The haemolymph was collected by flushing the haemocoel with complete DMEM, day 14 to 16 post infection. Salivary gland sporozoites were collected between 21–28 days post feeding from infected mosquitoes, by hand dissection and homogenization of isolated salivary glands in complete DMEM. Live samples (infected mosquito midguts or salivary glands, sporozoites) were mounted in PBS and visualized live using a Zeiss Axio Observer.Z1 fluorescence microscope equipped with a LD Plan-Neofluar 40x/0.6 Corr Ph2 M27 objective. The exposure time was set according to the positive control and maintained for both untreated and rapamycin-treated parasites, in order to allow comparisons. All images were processed with ImageJ for adjustment of contrast.
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9

Evaluating Combination Therapies in Breast Cancer Xenografts

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2.5 × 106 cells of ZR75.1 cells were injected into the breast region of female SCID mice (8 weeks old) subcutaneously to generate xenografts. After the tumour becomes palpable (3–5 weeks), the mice were randomised into five groups. The treatment protocol was the following: (1) control—saline solution intraperitoneal; (2) Rapamune (Pfizer – Budapest, Hungary; active ingredient: rapamycin) by gavage at 3 mg/kg body weight; (3) doxycycline (Merck-Sigma-Aldrich)—5 mg/kg body weight; (4) rapamycin + doxycycline and (5) doxorubicin—(TEVA – Debrecen, Hungary) intravenously at 2 mg/kg body weight. The treatments were administered three times per week for 3 weeks. The body weight and tumour size of mice were assessed and monitored. Tumour volume was calculated using the following equitation: π/6 × (2×  shorter diameter  +  longer diameter)/3)3. At the end of the experiments, the tumour weights of euthanized animals were measured. Then the tumours were removed, fixed in 4% paraformaldehyde and embedded in paraffin for further immunohistochemical stainings.
The in vivo study was carried out in accordance with the approval of the Institutional Animal Care Facility and the Institutional Ethical Review Board (PE/EA/801-7/2020 approval date: 16 September 2020.) with official permissions (PEI/001/1733-2/2015 approval date: 14 October 2015.).
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10

Immunosuppressive Regimen for Transplant

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Transplant recipient received CMV prophylaxis with Valganciclovir (Valcyte, Genentech) at a dose of 12.5 mg/kg once daily for two weeks starting at the day of transplantation and discontinued if CD8 T cell counts were >500 cells/μL. Rapamycin was given orally (2 mg tablets Rapamune, Pfizer) or subcutaneously from a sterile injectable solution (LC Laboratories) at a concentration of 1 mg/mL starting 6 days before transplantation and lasting 20 days. Rapamycin dose was tailored to achieve blood levels of 10–20 ng/mL. Human recombinant IL-2 (Proleukin, Clinigen) at 1 million units/m2 was injected subcutaneously starting 6 days before transplant and lasting 4 days. After any procedure, all animals were given buprenorphine SR which provided 72 hours of analgesia. Animals were observed daily, and if pain was suspected, they were given additional analgesics (meloxicam and/or additional opioids) for comfort.
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