Adhikary Sam R, Cuthbertson Peter, Nicholson Leigh, Bird Katrina M, Sligar Chloe, Hu Min, O'Connell Philip J, Sluyter Ronald, Alexander Stephen I, Watson Debbie
Illawarra Health and Medical Research Institute, Wollongong, NSW, Australia.
Molecular Horizons and School of Chemistry and Molecular Bioscience, University of Wollongong, Wollongong, NSW, Australia.
Immunology. 2021 Oct;164(2):332-347. doi: 10.1111/imm.13374. Epub 2021 Jun 13.
Graft-versus-host disease (GVHD) is a major complication of allogeneic haematopoietic stem cell transplantation (allo-HSCT) that develops when donor T cells in the graft become reactive against the host. Post-transplant cyclophosphamide (PTCy) is increasingly used in mismatched allo-HSCT, but how PTCy impacts donor T cells and reduces GVHD is unclear. This study aimed to determine the effect of PTCy on reactive human donor T cells and GVHD development in a preclinical humanized mouse model. Immunodeficient NOD-scid-IL2Rγ mice were injected intraperitoneally (i.p.) with 20 × 10 human peripheral blood mononuclear cells stained with carboxyfluorescein succinimidyl ester (CFSE) (day 0). Mice were subsequently injected (i.p.) with PTCy (33 mg kg ) (PTCy-mice) or saline (saline-mice) (days 3 and 4). Mice were assessed for T-cell depletion on day 6 and monitored for GVHD for up to 10 weeks. Flow cytometric analysis of livers at day 6 revealed lower proportions of reactive (CFSE ) human (h) CD3 T cells in PTCy-mice compared with saline-mice. Over 10 weeks, PTCy-mice showed reduced weight loss and clinical GVHD, with prolonged survival and reduced histological liver GVHD compared with saline-mice. PTCy-mice also demonstrated increased splenic hCD4 :hCD8 T-cell ratios and reduced splenic Tregs (hCD4 hCD25 hCD127 ) compared with saline-mice. This study demonstrates that PTCy reduces GVHD in a preclinical humanized mouse model. This corresponded to depletion of reactive human donor T cells, but fewer human Tregs.
移植物抗宿主病(GVHD)是异基因造血干细胞移植(allo-HSCT)的一种主要并发症,当移植物中的供体T细胞对宿主产生反应时就会发生。移植后环磷酰胺(PTCy)越来越多地用于不相合的allo-HSCT,但PTCy如何影响供体T细胞并减少GVHD尚不清楚。本研究旨在确定PTCy对临床前人性化小鼠模型中反应性人类供体T细胞和GVHD发生的影响。免疫缺陷的NOD-scid-IL2Rγ小鼠腹腔内注射(i.p.)用羧基荧光素琥珀酰亚胺酯(CFSE)染色的20×10个人外周血单个核细胞(第0天)。随后小鼠腹腔内注射(i.p.)PTCy(33mg/kg)(PTCy小鼠)或生理盐水(生理盐水小鼠)(第3天和第4天)。在第6天评估小鼠的T细胞清除情况,并监测GVHD长达10周。第6天对肝脏进行流式细胞术分析显示,与生理盐水小鼠相比,PTCy小鼠中反应性(CFSE)人类(h)CD3 T细胞的比例更低。在10周内,与生理盐水小鼠相比,PTCy小鼠体重减轻和临床GVHD减少,生存期延长,肝脏组织学GVHD减轻。与生理盐水小鼠相比,PTCy小鼠还表现出脾脏hCD4:hCD8 T细胞比例增加,脾脏调节性T细胞(hCD4 hCD25 hCD127)减少。本研究表明,在临床前人性化小鼠模型中PTCy可减少GVHD。这与反应性人类供体T细胞的清除有关,但人类调节性T细胞较少。