Differential effects of X-irradiation and cyclosporin-A administration on the thymus with respect to the generation of cyclosporin-A-induced autoimmunity.

Cyclosporin A (CsA), a potent inhibitor of T-cell activation, has been shown to have several effects on thymocyte maturation, thymic stromal cells, and the generation of autoreactive T cells. In Lewis rats, the combination of lethal irradiation, syngeneic bone marrow transplantation, and a 4-week course of CsA administration causes the development of an autoimmune disease (CsA-AI) resembling allogeneic graft-versus-host disease. This occurs upon withdrawal of CsA, provided the thymus receives irradiation and is present during CsA treatment. In this study, the separate effects of irradiation or CsA treatment on thymic stromal cells and thymocytes, compared to the combinatory effects, were examined using immunohistochemistry and tricolor flow cytometric analysis. CsA treatment causes an involution of the thymic medulla and a strong reduction of the cell number of thymocytes and stromal cells residing in the medulla. However, within the remaining medullary area, changes in cell distribution and antigen density on these cells were not observed. Irradiation on the other hand causes a strong depletion of thymocytes. The thymocyte population is recovered within 2 weeks and a cortical and medullary region can be distinguished. CsA treatment in combination with irradiation results in a strongly inhibited recovery of the medulla during CsA treatment, whereas the cortex recovers to normal size and morphology. The presence of the medullary IDC and epithelial cells is reduced proportionally to the small size of the medulla. However, the distribution of these stromal cells is normal. During the CsA administration, the thymuses from irradiated and CsA-treated rats are very similar to thymuses from CsA-treated rats. In conclusion, no changes specific for irradiation plus CsA treatment have been observed. Regarding the distribution and size of medullary stromal cells and residing thymocytes, thymuses from irradiated and CsA-treated rats hardly differ from the thymuses from rats treated only with CsA. Therefore, irradiation seems essential in the generation of CsA-AI by eliminating suppressor-cell circuits in the periphery.