Department of Immunology, Weizmann Institute of Science, Rehovot, Israel.
Blood. 2013 Feb 14;121(7):1220-8. doi: 10.1182/blood-2012-07-441493. Epub 2012 Dec 5.
Transplantation of T cell-depleted BM (TDBM) under mild conditioning, associated with minimal toxicity and reduced risk of GVHD, offers an attractive therapeutic option for patients with nonmalignant hematologic disorders and can mediate immune tolerance to subsequent organ transplantation. However, overcoming TDBM rejection after reduced conditioning remains a challenge. Here, we address this barrier using donorderived central memory CD8(+) T cells (Tcms), directed against third-party antigens. Our results show that fully allogeneic or (hostXdonor)F1-Tcm, support donor chimerism (> 6 months) in sublethally irradiated (5.5Gy) mice, without GVHD symptoms. Chimerism under yet lower irradiation (4.5Gy) was achieved by combining Tcm with short-term administration of low-dose Rapamycin. Importantly, this chimerism resulted in successful donor skin acceptance, whereas third-party skin was rejected. Tracking of host anti-donor T cells (HADTCs), that mediate TDBMT rejection, in a novel bioluminescence-imaging model revealed that Tcms both induce accumulation and eradicate HADTCs in the LNs,concomitant with their elimination from other organs, including the BM. Further analysis with 2-photon microcopy revealed that Tcms form conjugates with HADTCs, resulting in decelerated and confined movement of HADTCs within the LNs in an antigen-specific manner. Thus, anti-third-party Tcms support TDBMT engraftment under reduced-conditioning through lymph-node sequestration and deletion of HADTCs, offering a novel and potentially safe approach for attaining stable hematopoietic chimerism.
在轻度条件下进行 T 细胞耗竭的 BM(TDBM)移植,具有低毒性和降低移植物抗宿主病(GVHD)风险的特点,为非恶性血液病患者提供了一种有吸引力的治疗选择,并能介导对随后的器官移植的免疫耐受。然而,克服减少条件后的 TDBM 排斥仍然是一个挑战。在这里,我们使用针对第三方抗原的供体来源的中央记忆 CD8(+) T 细胞(Tcms)来解决这个障碍。我们的结果表明,完全同种异体或(宿主 X 供体)F1-Tcm 支持亚致死性照射(5.5Gy)小鼠中的供体嵌合(>6 个月),而没有 GVHD 症状。通过将 Tcm 与短期低剂量 Rapamycin 联合使用,可以在更低的照射(4.5Gy)下实现嵌合。重要的是,这种嵌合导致了成功的供体皮肤接受,而第三方皮肤被排斥。在一种新的生物发光成像模型中跟踪介导 TDBMT 排斥的宿主抗供体 T 细胞(HADTCs)表明,Tcms 既诱导 HADTCs 在 LNs 中的积累,又消除它们从其他器官(包括 BM)中的消除。用 2 光子显微镜进行的进一步分析表明,Tcms 与 HADTCs 形成共轭,导致 HADTCs 在 LNs 内以抗原特异性方式减速和受限运动。因此,抗第三方 Tcms 通过淋巴结隔离和 HADTCs 的删除来支持 TDBMT 植入,为实现稳定的造血嵌合提供了一种新的、潜在安全的方法。