Abstract:
:Chronic graft-versus-host disease (cGVHD) is a leading cause of morbidity and mortality after allogeneic hematopoietic stem cell transplantation. Having shown that germinal center (GC) formation and immunoglobulin deposition are required for multiorgan system cGVHD and associated bronchiolitis obliterans syndrome (BOS) in a murine model, we hypothesized that T follicular helper (Tfh) cells are necessary for cGVHD by supporting GC formation and maintenance. We show that increased frequency of Tfh cells correlated with increased GC B cells, cGVHD, and BOS. Although administering a highly depletionary anti-CD20 monoclonal antibody (mAb) to mice with established cGVHD resulted in peripheral B-cell depletion, B cells remained in the lung, and BOS was not reversed. BOS could be treated by eliminating production of interleukin-21 (IL-21) by donor T cells or IL-21 receptor (IL-21R) signaling of donor B cells. Development of BOS was dependent upon T cells expressing the chemokine receptor CXCR5 to facilitate T-cell trafficking to secondary lymphoid organ follicles. Blocking mAbs for IL-21/IL-21R, inducible T-cell costimulator (ICOS)/ICOS ligand, and CD40L/CD40 hindered GC formation and cGVHD. These data provide novel insights into cGVHD pathogenesis, indicate a role for Tfh cells in these processes, and suggest a new line of therapy using mAbs targeting Tfh cells to reverse cGVHD.
journal_name
Bloodjournal_title
Bloodauthors
Flynn R,Du J,Veenstra RG,Reichenbach DK,Panoskaltsis-Mortari A,Taylor PA,Freeman GJ,Serody JS,Murphy WJ,Munn DH,Sarantopoulos S,Luznik L,Maillard I,Koreth J,Cutler C,Soiffer RJ,Antin JH,Ritz J,Dubovsky JA,Byrd JC,doi
10.1182/blood-2014-03-562231subject
Has Abstractpub_date
2014-06-19 00:00:00pages
3988-98issue
25eissn
0006-4971issn
1528-0020pii
blood-2014-03-562231journal_volume
123pub_type
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