Department of Hematology, Hemostasis, Oncology and Stem Cell Transplantation, Hannover Medical School, 30625 Hannover, Germany.
Institute of Immunology, Hannover Medical School, 30625 Hannover, Germany.
Int J Mol Sci. 2022 Sep 18;23(18):10914. doi: 10.3390/ijms231810914.
Donor lymphocyte infusion (DLI) can (re-)induce durable remission in relapsing patients after allogeneic hematopoietic stem-cell transplantation (alloHSCT). However, DLI harbors the risk of increased non-relapse mortality due to the co-occurrence of graft-versus-host disease (GVHD). GVHD onset may be caused or accompanied by changes in the clonal T-cell receptor (TCR) repertoire. To investigate this, we analyzed T cells in a cohort of 21 patients receiving DLI after alloHSCT. We performed deep T-cell receptor β (TRB) sequencing of sorted CD4+CD25+CD127low regulatory T cells (Treg cells) and CD4+ conventional T cells (Tcon cells) in order to track longitudinal changes in the TCR repertoire. GVHD following DLI was associated with less diverse but clonally expanded CD4+CD25+CD127low Treg and CD4+ Tcon TCR repertoires, while patients without GVHD exhibited healthy-like repertoire properties. Moreover, the diversification of the repertoires upon GVHD treatment was linked to steroid-sensitive GVHD, whereas decreased diversity was observed in steroid-refractory GVHD. Finally, the unbiased sample analysis revealed that the healthy-like attributes of the CD4+CD25+CD127low Treg TCR repertoire were associated with reduced GVHD incidence. In conclusion, CD4+CD25+CD127low Treg and CD4+ Tcon TRB repertoire dynamics may provide a helpful real-time tool to improve the diagnosis and monitoring of treatment in GVHD following DLI.
供者淋巴细胞输注(DLI)可在异基因造血干细胞移植(alloHSCT)后复发的患者中(重新)诱导持久缓解。然而,DLI 存在由于移植物抗宿主病(GVHD)的同时发生而导致非复发死亡率增加的风险。GVHD 的发生可能是由于或伴随着克隆 T 细胞受体(TCR)库的变化。为了研究这一点,我们分析了接受 alloHSCT 后接受 DLI 的 21 例患者的 T 细胞。我们对分选的 CD4+CD25+CD127low 调节性 T 细胞(Treg 细胞)和 CD4+常规 T 细胞(Tcon 细胞)进行了深度 TCRβ(TRB)测序,以跟踪 TCR 库的纵向变化。DLI 后的 GVHD 与更不多样化但克隆性扩增的 CD4+CD25+CD127low Treg 和 CD4+Tcon TCR 库相关,而无 GVHD 的患者表现出健康样的库特征。此外,GVHD 治疗后库的多样化与皮质类固醇敏感的 GVHD 相关,而皮质类固醇难治性 GVHD 则观察到多样性降低。最后,无偏样本分析表明,CD4+CD25+CD127low Treg TCR 库的健康样特征与降低的 GVHD 发生率相关。总之,CD4+CD25+CD127low Treg 和 CD4+Tcon TRB 库动力学可能提供一种有用的实时工具,以改善 DLI 后 GVHD 的诊断和监测。