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Divito SJ, Aasebø AT, Matos TR, Hsieh PC, Collin M, Elco CP, O'Malley JT, Bækkevold ES, Reims H, Gedde-Dahl T, Hagerstrom M, Hilaire J, Lian JW, Milford EL, Pinkus GS, Ho VT, Soiffer RJ, Kim HT, Mihm MC, Ritz J, Guleria I, Cutler CS, Clark RA, Jahnsen FL, Kupper TS. Peripheral host T cells survive hematopoietic stem cell transplantation and promote graft-versus-host disease. J Clin Invest 2021; 130:4624-4636. [PMID: 32516138 DOI: 10.1172/jci129965] [Citation(s) in RCA: 51] [Impact Index Per Article: 17.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/08/2019] [Accepted: 05/19/2020] [Indexed: 12/12/2022] Open
Abstract
Graft-versus-host disease (GVHD) is a major cause of morbidity and mortality in hematopoietic stem cell transplantation (HSCT). Donor T cells are key mediators in pathogenesis, but a contribution from host T cells has not been explored, as conditioning regimens are believed to deplete host T cells. To evaluate a potential role for host T cells in GVHD, the origin of skin and blood T cells was assessed prospectively in patients after HSCT in the absence of GVHD. While blood contained primarily donor-derived T cells, most T cells in the skin were host derived. We next examined patient skin, colon, and blood during acute GVHD. Host T cells were present in all skin and colon acute GVHD specimens studied, yet were largely absent in blood. We observed acute skin GVHD in the presence of 100% host T cells. Analysis demonstrated that a subset of host T cells in peripheral tissues were proliferating (Ki67+) and producing the proinflammatory cytokines IFN-γ and IL-17 in situ. Comparatively, the majority of antigen-presenting cells (APCs) in tissue in acute GVHD were donor derived, and donor-derived APCs were observed directly adjacent to host T cells. A humanized mouse model demonstrated that host skin-resident T cells could be activated by donor monocytes to generate a GVHD-like dermatitis. Thus, host tissue-resident T cells may play a previously unappreciated pathogenic role in acute GVHD.
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Affiliation(s)
- Sherrie J Divito
- Department of Dermatology, Brigham and Women's Hospital, Boston, Massachusetts, USA
| | - Anders T Aasebø
- Department of Pathology, University of Oslo and Oslo University Hospital-Rikshospitalet, Oslo, Norway
| | - Tiago R Matos
- Department of Dermatology, Brigham and Women's Hospital, Boston, Massachusetts, USA
| | - Pei-Chen Hsieh
- Department of Dermatology, Brigham and Women's Hospital, Boston, Massachusetts, USA
| | - Matthew Collin
- Newcastle University, Translational and Clinical Research Institute, Newcastle upon Tyne, United Kingdom
| | - Christopher P Elco
- Department of Pathology and Laboratory Medicine, Brown University, Providence, Rhode Island, USA
| | - John T O'Malley
- Department of Dermatology, Brigham and Women's Hospital, Boston, Massachusetts, USA
| | - Espen S Bækkevold
- Department of Pathology, University of Oslo and Oslo University Hospital-Rikshospitalet, Oslo, Norway
| | - Henrik Reims
- Department of Pathology, Oslo University Hospital-Rikshospitalet, Oslo, Norway
| | - Tobias Gedde-Dahl
- Department of Hematology, Institute of Clinical Medicine, University of Oslo and Oslo University Hospital-Rikshospitalet, Oslo, Norway
| | | | | | - John W Lian
- Department of Dermatology, Brigham and Women's Hospital, Boston, Massachusetts, USA
| | - Edgar L Milford
- Renal Transplant Program, Division of Renal Medicine, Brigham and Women's Hospital, Boston, Massachusetts, USA
| | | | - Vincent T Ho
- Division of Hematological Malignancies and Stem Cell Transplantation and
| | - Robert J Soiffer
- Division of Hematological Malignancies and Stem Cell Transplantation and
| | - Haesook T Kim
- Department of Data Sciences, Dana-Farber Cancer Institute, Boston, Massachusetts, USA
| | - Martin C Mihm
- Department of Dermatology, Brigham and Women's Hospital, Boston, Massachusetts, USA
| | - Jerome Ritz
- Division of Hematological Malignancies and Stem Cell Transplantation and
| | - Indira Guleria
- Renal Transplant Program, Division of Renal Medicine, Brigham and Women's Hospital, Boston, Massachusetts, USA
| | - Corey S Cutler
- Division of Hematological Malignancies and Stem Cell Transplantation and
| | - Rachael A Clark
- Department of Dermatology, Brigham and Women's Hospital, Boston, Massachusetts, USA
| | - Frode L Jahnsen
- Department of Pathology, University of Oslo and Oslo University Hospital-Rikshospitalet, Oslo, Norway
| | - Thomas S Kupper
- Department of Dermatology, Brigham and Women's Hospital, Boston, Massachusetts, USA
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