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2014 ; 123
(25
): 3988-98
Nephropedia Template TP
gab.com Text
Twit Text FOAVip
Twit Text #
English Wikipedia
Increased T follicular helper cells and germinal center B cells are required for
cGVHD and bronchiolitis obliterans
#MMPMID24820310
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
; MacDonald KP
; Hill GR
; Blazar BR
Blood
2014[Jun]; 123
(25
): 3988-98
PMID24820310
show ga
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.