Cytolytic effector mechanisms and gene expression in autologous graft-versus-host disease: distinct roles of perforin and Fas ligand.

Cytolytic effector mechanisms and gene expression in autologous graft-versus-host disease: distinct roles of perforin and Fas ligand.
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自体移植物抗宿主病中的溶细胞效应机制和基因表达:穿孔素和 Fas 配体的不同作用。

DOI:
10.1016/j.bbmt.2003.10.005
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发表时间:
2004
期刊:
Biology of blood and marrow transplantation : journal of the American Society for Blood and Marrow Transplantation.
影响因子:
--
通讯作者:
Hess,AllanD
Hess,AllanD
中科院分区:
--
文献类型:
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作者:
Miura,Yuji;Thoburn,ChristopherJ;Bright,EmilieC;Hess,AllanD

文献摘要

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The administration of cyclosporin A (CsA) after autologous stem cell transplantation (SCT) paradoxically elicits a systemic autoimmune syndrome that resembles graft-versus-host disease (GVHD); this is termed autologous GVHD (autoGVHD). Although dominated by activated CD8+cytotoxic T lymphocytes, the complex cellular reaction also includes CD4+T cells and involves multiple effector mechanisms. To determine the temporal development and relative importance of these mechanisms in autoGVHD, perforin/granzyme, Fas ligand (FasL), interferon-γ (IFN-γ), tumor necrosis factor (TNF)-α, and interleukin-18 gene expression in peripheral blood mononuclear cells was examined in 36 patients treated with CsA after SCT. Quantitative real-time polymerase chain reaction analysis revealed that perforin/granzyme B, TNF-α, and interleukin-18 messenger RNA (mRNA) levels in peripheral blood mononuclear cells from patients in whom autoGVHD developed were markedly higher (and temporally associated with the onset of autoaggression) compared with the levels detected in healthy individuals and in control, non-CsA-treated SCT patients. It is interesting to note that patients in whom autoGVHD did not develop also demonstrated increased mRNA levels for these cytokines: however, expression was substantially lower compared with that in patients with autoGVHD. It is important to note that IFN-γ mRNA levels were selectively increased in CD8+cells only from patients in whom autoGVHD developed. The development of autocytolytic T cells in autoGVHD correlated with increased expression of perforin, IFN-γ, and TNF-α mRNA. Furthermore, enhanced autoreactive T-cell activity and the induction of autoGVHD was also concordant with perforin and TNF-α mRNA upregulation in CD4+cells. Surprisingly, FasL mRNA levels were significantly decreased, with a progressive loss of FasL mRNA expression as autocytolytic activity increased. These findings suggest that IFN-γ/perforin-based CD8+cytotoxic T lymphocytes seem to play a dominant role in autoGVHD and that TNF-α/perforin-based CD4+cells may amplify this autoaggressive syndrome. The FasL pathway may play an important role in the regulation of this immune syndrome.