Immunoregulatory T Cells : New Therapeutics for Graft-Versus-Host Disease

CD4 CD25 immunoregulatory T cells play a pivotal role in preventing organ-specific autoimmune diseases and in tolerance induction to allogeneic organ transplants. We investigated whether these cells could also control graft-versus-host disease (GVHD), the main complication after allogeneic hematopoietic stem cell transplantation (HSCT). Here, we show that the few CD4 CD25 T cells naturally present in the transplant regulate GVHD because their removal from the graft dramatically accelerates this disease. Furthermore, the addition of freshly isolated CD4 CD25 T cells at time of grafting significantly delays or even prevents GVHD. Ex vivo–expanded CD4 CD25 regulatory T cells obtained after stimulation by allogeneic recipient-type antigen-presenting cells can also modulate GVHD. Thus, CD4 CD25 regulatory T cells represent a new therapeutic tool for controlling GVHD in allogeneic HSCT. More generally, these results outline the tremendous potential of regulatory T cells as therapeutics.

[1]  I. Weissman,et al.  Down-regulation of homing receptors after T cell activation. , 1988, Journal of immunology.

[2]  T. Mak,et al.  Immunologic Self-Tolerance Maintained by Cd25+Cd4+Regulatory T Cells Constitutively Expressing Cytotoxic T Lymphocyte–Associated Antigen 4 , 2000, The Journal of experimental medicine.

[3]  J. Bluestone,et al.  B7/CD28 costimulation is essential for the homeostasis of the CD4+CD25+ immunoregulatory T cells that control autoimmune diabetes. , 2000, Immunity.

[4]  E. Shevach,et al.  CD4+CD25+ T cells inhibit both the induction and effector function of autoreactive T cells and represent a unique lineage of immunoregulatory cells. , 1998, Journal of immunology.

[5]  D. Mason,et al.  CD25 Is a Marker for CD4+ Thymocytes That Prevent Autoimmune Diabetes in Rats, But Peripheral T Cells with This Function Are Found in Both CD25+ and CD25− Subpopulations1 , 2000, The Journal of Immunology.

[6]  D. Mason,et al.  Regulatory T Cells in the Control of Autoimmunity: the Essential Role of  Transforming Growth Factor β and Interleukin 4 in the Prevention of Autoimmune Thyroiditis in Rats by Peripheral CD4+CD45RC− Cells and CD4+CD8− Thymocytes , 1999, The Journal of experimental medicine.

[7]  D. Klatzmann,et al.  Immunological defects after suicide gene therapy of experimental graft-versus-host disease. , 1999, Human gene therapy.

[8]  J. Bluestone,et al.  Suppressor T cells – they’re back and critical for regulation of autoimmunity! , 2001, Immunological reviews.

[9]  Fiona Powrie,et al.  An Essential Role for Interleukin 10 in the Function of Regulatory T Cells That Inhibit Intestinal Inflammation , 1999, The Journal of experimental medicine.

[10]  A. Enk,et al.  Identification and Functional Characterization of Human Cd4+Cd25+ T Cells with Regulatory Properties Isolated from Peripheral Blood , 2001, The Journal of experimental medicine.

[11]  R. Coffman,et al.  A critical role for transforming growth factor-beta but not interleukin 4 in the suppression of T helper type 1-mediated colitis by CD45RB(low) CD4+ T cells , 1996, The Journal of experimental medicine.

[12]  D. Klatzmann,et al.  Would suicide gene therapy solve the 'T-cell dilemma' of allogeneic bone marrow transplantation? , 1999, Immunology today.

[13]  W. Strober,et al.  Cell Contact–Dependent Immunosuppression by Cd4+Cd25+Regulatory T Cells Is Mediated by Cell Surface–Bound Transforming Growth Factor β , 2001, The Journal of experimental medicine.

[14]  R Storb,et al.  Bone-marrow transplantation (first of two parts). , 1975, The New England journal of medicine.

[15]  S. Sakaguchi Regulatory T cells , 2006, Springer Seminars in Immunopathology.

[16]  A. Rimm,et al.  Graft-versus-leukemia reactions after bone marrow transplantation. , 1990, Blood.

[17]  M. Roncarolo,et al.  Human Cd25+Cd4+ T Regulatory Cells Suppress Naive and Memory T Cell Proliferation and Can Be Expanded in Vitro without Loss of Function , 2001, The Journal of experimental medicine.

[18]  H. Deeg,et al.  Effects of in vitro depletion of T cells in HLA-identical allogeneic marrow grafts. , 1985, Blood.

[19]  Ethan M. Shevach,et al.  Suppressor Effector Function of CD4+CD25+ Immunoregulatory T Cells Is Antigen Nonspecific , 2000, The Journal of Immunology.

[20]  L. Adorini,et al.  Regulatory T Cells Induced by 1α,25-Dihydroxyvitamin D3 and Mycophenolate Mofetil Treatment Mediate Transplantation Tolerance1 , 2001, The Journal of Immunology.

[21]  M. Toda,et al.  Immunologic self-tolerance maintained by activated T cells expressing IL-2 receptor alpha-chains (CD25). Breakdown of a single mechanism of self-tolerance causes various autoimmune diseases. , 1995, Journal of immunology.

[22]  H. Deeg,et al.  Methotrexate and cyclosporine versus cyclosporine alone for prophylaxis of graft-versus-host disease in patients given HLA-identical marrow grafts for leukemia: long-term follow-up of a controlled trial. , 1989, Blood.

[23]  H. Hall,et al.  CD4+CD25+ regulatory T cells down‐regulate co‐stimulatory molecules on antigen‐presenting cells , 2000, European journal of immunology.

[24]  R. Noelle,et al.  Cd4+Cd25+ Immune Regulatory Cells Are Required for Induction of Tolerance to Alloantigen via Costimulatory Blockade , 2001, The Journal of experimental medicine.

[25]  C. Mackall,et al.  Thymic aging and T‐cell regeneration , 1997, Immunological reviews.

[26]  F. Powrie,et al.  IL-10 Is Required for Regulatory T Cells to Mediate Tolerance to Alloantigens In Vivo1 , 2001, The Journal of Immunology.

[27]  M. Toda,et al.  Immunologic self-tolerance maintained by CD25+CD4+ naturally anergic and suppressive T cells: induction of autoimmune disease by breaking their anergic/suppressive state. , 1998, International immunology.