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2014 ; 124
(13
): 2131-41
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Donor CD4+ Foxp3+ regulatory T cells are necessary for posttransplantation
cyclophosphamide-mediated protection against GVHD in mice
#MMPMID25139358
Ganguly S
; Ross DB
; Panoskaltsis-Mortari A
; Kanakry CG
; Blazar BR
; Levy RB
; Luznik L
Blood
2014[Sep]; 124
(13
): 2131-41
PMID25139358
show ga
Posttransplantation cyclophosphamide (PTCy) is an effective prophylaxis against
graft-versus-host disease (GVHD). However, it is unknown whether PTCy works
singularly by eliminating alloreactive T cells via DNA alkylation or also by
restoring the conventional (Tcon)/regulatory (Treg) T-cell balance. We studied
the role of Tregs in PTCy-mediated GVHD prophylaxis in murine models of
allogeneic blood or marrow transplantation (alloBMT). In 2 distinct MHC-matched
alloBMT models, infusing Treg-depleted allografts abrogated the GVHD-prophylactic
activity of PTCy. Using allografts in which Foxp3(+) Tregs could be selectively
depleted in vivo, either pre- or post-PTCy ablation of donor thymus-derived Tregs
(tTregs) abolished PTCy protection against GVHD. PTCy treatment was associated
with relative preservation of donor Tregs. Experiments using combinations of
Foxp3(-) Tcons and Foxp3(+) Tregs sorted from different Foxp3 reporter mice
indicated that donor Treg persistence after PTCy treatment was predominantly
caused by survival of functional tTregs that retained Treg-specific demethylation
and also induction of peripherally derived Tregs. Finally, adoptive transfer of
tTregs retrieved from PTCy-treated chimeras rescued PTCy-treated, Treg-depleted
recipients from lethal GVHD. Our findings indicate that PTCy-mediated protection
against GVHD is not singularly dependent on depletion of donor alloreactive T
cells but also requires rapidly recovering donor Tregs to initiate and maintain
alloimmune regulation.