Allogeneic Bone Marrow Cell Transplantation Research Articles

Effect of Short PSG Peptides on Inflammatory Markers in Allogeneic Bone Marrow Cell Transplantation in Wistar Rats.

Short linear peptide fragments of placental trophoblastic β1-glycoprotein (PSG) (YECE, YQCE, YVCS, and YACS) were studied in the context of their immunomodulatory effects at the level of inflammatory markers. The original host-versus-graft model was used in male Wistar rats without prior conditioning of recipient bone marrow. A composition of PSG peptide fragments was injected to animals after allogeneic transplantation of bone marrow cells in a dynamic experiment, inflammatory markers α1-acid glycoprotein (AGP, orosomucoid), α2-macroglobulin (α2M) were assayed by ELISA, and biochemical parameters (total protein, glucose, creatinine, and urea) were measured. The levels of α2M and AGP increased in response to allotransplantation, whereas administration of PSG peptides normalized serum α2M levels by the end of the experiment. The decrease in α2M level coincided with the independent effect of PSG peptide administration. The levels of total protein, glucose, creatinine, and urea in rat serum after allotransplantation were reduced throughout the experiment. Administration of PSG peptides contributed to normalization of serum total protein, creatinine, and urea levels by the end of the experiment. Administration of PSG peptides after allogeneic transplantation of bone marrow suspension contributed to normalization of the levels of α2M, total protein, creatinine, and urea, which can be interpreted as an anti-inflammatory effect of these peptides.

Accumulation of Dystrophin-Positive Muscle Fibers and Improvement of Neuromuscular Junctions in mdx Mouse Muscles after Bone Marrow Transplantation under Different Conditions.

Duchenne muscular dystrophy (DMD) is a severe muscular disorder caused by mutations in the dystrophin gene. It leads to respiratory and cardiac failure and premature death at a young age. Although recent studies have greatly deepened the understanding of the primary and secondary pathogenetic mechanisms of DMD, an effective treatment remains elusive. In recent decades, stem cells have emerged as a novel therapeutic product for a variety of diseases. In this study, we investigated nonmyeloablative bone marrow cell (BMC) transplantation as a method of cell therapy for DMD in an mdx mouse model. By using BMC transplantation from GFP-positive mice, we confirmed that BMCs participate in the muscle restoration of mdx mice. We analyzed both syngeneic and allogeneic BMC transplantation under different conditions. Our data indicated that 3 Gy X-ray irradiation with subsequent BMC transplantation improved dystrophin synthesis and the structure of striated muscle fibers (SMFs) in mdx mice as well as decreasing the death rate of SMFs. In addition, we observed the normalization of neuromuscular junctions (NMJs) in mdx mice after nonmyeloablative BMC transplantation. In conclusion, we demonstrated that nonmyeloablative BMC transplantation could be considered a method for DMD treatment.

Effect of Glycodelin on the Cytokine Profile of Rats during Allogeneic Bone Marrow Cell Transplantation

The protein glycodelin (PP14, PAEP) is associated with pregnancy and exhibits pronounced immunotropic properties. We studied the effect of glycodelin on the cytokine profile of blood serum during transplantation a suspension of allogeneic red bone marrow cells to Wistar rats. Recombinant glycodelin was administered to the animals 4 times (14 μg each time). Against the background of bone marrow cell transplantation, the levels of proinflammatory (IL-1α, IL-1β, and IL-18) and regulatory (IL-7, IL-12) cytokines and CSF (M-CSF) increased in blood serum, which indicates a systemic inflammatory response to the allograft. Glycodelin administration against the background of bone marrow cell allotransplantation led to a significant decrease in the proinflammatory cytokine IL-17A on day 21 of the experiment; the concentrations of the other cytokines remained unchanged. In general, glycodelin can suppress the level of IL-17A, a marker of graft rejection, which opens perspectives for its further investigation as a potential drug.

Combined CCR5 and CXCR3 Blockade Attenuates Murine Agvhd through Alternating Donor-Derived T Cell Distribution and Function

Acute graft-versus-host disease (aGVHD) is one of the major complications and a leading cause of death after allogeneic hematopoietic stem cell transplantation (allo-HSCT). Chemokines and their cognate receptors play an important role in directing the migration of donor derived T cells to target organs. Chief among these chemokine receptors are CXCR3 and CCR5. Our previous study found that CCR5 blockade combined with cyclosporine A in a murine model could attenuate the severity of aGVHD in a less extent. This might be due to multiple expression of chemokine receptors on immune cell, only one kind receptor blockade might not completely block the migration of T cells to aGVHD target organs. In this study, we investigated whether combined CCR5 and CXCR3 blockade could further attenuate murine aGVHD, and also explored its immunologic mechanism.BALB/c(H-2Kd)recipients received 8.0 Gy of total body irradiation (60Coγsource) prior to transplantation followed by the infusion of bone marrow cells (BMCs) and splenic cells (SCs) from C57BL/6J(H-2Kb)or CCR5 knockout mice(H-2Kb)to establish an allogeneic bone marrow transplantation model. Body weight change, clinical scores of aGVHD, degree of histopathologic damage and survival rate were dynamically recorded to assess the efficacy of CCR5 and CXCR3 blockade in this transplantation model. Mechanically, donor derived lymphocytes were labeled with fluorescence dye to detect their distribution in vivo. Immunohistochemical analysis for CD4+ and CD8+ were performed on target organs of recipient mice at 7 days post-transplantation. Flow cytometry was used to calculate the absolute number of T cells in target organs, and to detect its proliferation, activation and differentiation in the spleen. ELISA was used to determine the concentration of T cells related cytokines.The results showed that both CCR5 and CXCR3 are enhanced during the aGVHD process. Although transplantation of allogeneic BMCs and SCs induced severe clinical aGVHD with high aGVHD scores (4.67±0.33) and a lethality of 90%, combined CCR5 and CXCR3 blockade attenuated clinical signs of aGVHD, reduced aGVHD scores (1.25±0.25, P< 0.001), reduced aGVHD-induced death (a lethality of 40%, P< 0.05). Compared with aGVHD group, combined CCR5 and CXCR3 blockade reduced liver histologic score (3.3±0.3 versus 1.3±0.3, P< 0.05), lung histologic score (3.6±0.3 versus 1.3±0.3, P< 0.05) and intestine histologic score (3.7±0.3 versus 1.3±0.3, P< 0.05). On days 7 after transplantation, more fluorescent signal emanated from the spleen and from lymph nodes after the use of CCR5 and CXCR3 blockade. Also combined CCR5 and CXCR3 blockade reduced the infiltration of CD4+ and CD8+ T cells into the liver and intestine, and retained part of CD4+ and CD8+ T cells within SLOs. As for the effector function of donor T cells, the results showed that combined CCR5 and CXCR3 blockade dampened T-cell activation, suppressed the percentage of Th1 and Tc1, and induced Treg induction. Additionally, combined CCR5 and CXCR3 blockade altered the concentrations of IFN-γ and IL10. Furthermore, the transplantation of CCR5-/- splenic cells with CXCR3 blockade showed a stronger protection effect on aGVHD.Combined CCR5 and CXCR3 blockade further attenuated aGVHD. aGVHD inhibition was associated with alternated donor T-cell distribution, limited donor T-cell activation and negatively impacted T-cell effector function in vivo. These data suggest that the combined use of CCR5 and CXCR3 blockade might be applicable for aGVHD prophylaxis in clinical settings. DisclosuresNo relevant conflicts of interest to declare.

Haploidentical bone marrow cell reconstruction of tumor-bearing murine host

Objective To investigate the roles of chimerism level after haploidentical bone marrow cell transplantation on graft versus tumor effect (GVT). Methods Thirty BALB/C mice were randomly divided into 3 groups: control group (group C, 10), mixed chimerism group (group A, 10), full donor chimerism group (group B, 10). Five BALB/C mice in group C were only inoculated with Renca cells (2.6 × 106). Ten mice in group A were conditioned with 4 Gy irradiation, followed by infusion by bone marrow cells of CB6F1 mice on the day 1, then inoculated with Renca cells (2. 6 × 106 ) on the day 8. Ten mice in group B were conditioned with 8 Gy irradiation, followed by infusion by bone marrow cells (5 ×106 ) of CB6F1 mice on the day 1, then inoculated with Renca cells ( 2. 6 × 106 ) on the day 8. Tumor growth was monitored every 4 day. In groups A and B, all mice were analyzed by FACScan cytometry on the day 14, 21 and 28 after BMT. Mice were killed at the 32nd day after inoculation with tumor cells and blood of all mice was collected. All tumors were taken out to be weighed. Results The results of chimera showed that engraftments in group A remained mixed donor chimerism and unstable, tended to decrease after 14 days. In group B, full donor chimerism developed, and the chimerism of engraftments remained above 90% and was preserved even after 28 days; The size and tumor growth rate in groups B were reduced as compared with groups A and C (P ＜0. 01 ). The tumor inhibitory rate in groups B was 52%. Conclusion Stable full donor chimerism status after haploidentical allogeneic bone marrow cell transplant is the basis of GVT. Key words: Bone marrow; Cell transplantation; Graft-versus-tumor effect; Chimerism

T helper17 Cells Are Sufficient But Not Necessary to Induce Acute Graft-Versus-Host Disease

T helper (Th)1 cells were considered responsible for the induction of graft-versus-host disease (GVHD), but recently the concept has been challenged. Th17 cells play a critical role in mediating autoimmune diseases, but their role in the pathogenesis of GVHD remains unclear. Herein we compare the ability of in vitro generated Th1 and Th17 cells from C57BL/6 mice to induce GVHD in lethally irradiated BALB/c recipients. Allogeneic Th17 cells had superior expansion and infiltration capabilities in GVHD target organs, which correlated with their increased pathogenicity when compared with naïve or Th1 controls. Th17 cells caused no pathology in the syngeneic recipients, indicating that antigen-activation was required for their pathogenicity. Polarized Th17 cells could not maintain their phenotype in vivo as they produced a significant amount of interferon (IFN)-gamma after being transplanted into allogeneic recipients; however, IFN-gamma was not required for Th17 cell-induced GVHD. Further, we evaluated the pathogenesis of Th17 cells in GVHD by using polyclonal nonprimed CD4T cells in a clinically relevant allogeneic bone marrow transplantation (BMT) setting. We found that disruption of Th17-differentiation alone by targeting RORgammat (Th17-specific transcription factor) had no significant effect on GVHD development. We conclude that Th17 cells are sufficient but not necessary to induce GVHD.

Clinical analysis of six children with aplastic anemia after allogeneic hematopoietic stem cell transplanta-tion

Objective To explore the efficacy of allogeneic hematopeietic stem cell transplantation in children with aplastic anemia. Methods In six children with aplastic anemia, five children received G-CSF primed allogeneic bone marrow plus peripheral stem cell transplantation from HLA-matched siblings, the nucleat- ed cell dose of BM and PBSC transplanted was respectively 4. 61 ( 1.5 ～ 13.2)×108/kg and 9. 36(2. 05 ～ 16. 75 )×108/kg. All five cases used FLU + CTX + ATG as the conditioning regimens. One child received unre-lated HLA-matched bone marrow transplantation, the nucleated cell dose of BM transplanted was 16. 8 x 10S/kg, and used FLU + CTX + TBI as the conditioning regimen. All cases received CSA + MTX + MMF as acute GVHD prophylaxis. Results One child got graft failure and the hematopoiesis recovered at 23 days by itself. The other five children achieved hematopoietic recovery after transplantation. None of them got GVHD after transplanta-tion. One child who had got MAA for four years happened graft rejection,got disease recurrence and finally died of serious infection. Other five children got disease-free survival with a follow-up to Feb 2009. Conclusion AI-logeneic bone marrow plus peripherial stem cell transplantation from HLA-matched siblings could be considered as the preferred treatment for children with aplastic anemia. It is feasible for children with aplastic anemia to re-ceive bone marrow transplant from unrelated HLA-matched donors when the patient was failed in immunosup-pressive therapy and without an available sibling donor. Key words: Hematopeietic stem cell transplantation; Aplastic anemia; Children

Mesenchymal Stem Cell Therapy in a Rat Model for GvHD

Graft-vs-host-disease (GvHD) is an important hindrance for the usage of allogeneic bone marrow cell transplantation (alloBMT) as a treatment strategy for leukemias and other hematopoietic malignancies. Mesenchymal stem cells (MSC) can interact with the immune system and inhibit alloreactive cells. Infusions of MSC into GvHD patients have alleviated disease severity and overall survival and in recent clinical trials.We are studying the immunoregulatory potential of MSC as a putative therapy for GvHD in an experimental animal model. Bone marrow-derived MSC from PVG rats are highly efficient in blocking PVG lymphocytes stimulated by allogeneic BN lymphocytes in mixed lymphocyte reactions. We have found a substantial contribution of indirect (without cell contact) inhibition of allostimulation by MSC in vitro, and have examined some of the possible mediating factors among rat cytokines. In our in vivo model we have transplanted BN host rats with 30×106 PVG donor bone marrow (depleted for T cells), and induced GvHD by injection of 1×106 peripheral T cells from PVG donors two weeks later. We have successfully reversed the lethality of GvHD in a number of diseased animals by pre-emptive and repeated infusions of MSC, improving the overall survival rate by 30%. We are furthermore able to trace injected MSC in vivo, and thereby hope to obtain important information on the migration and behaviour of those cells in the development of GvHD. Additional transplantation experiments to improve the effectiveness of the cellular treatment and test more MSC lines from different MHC-congenic rat strains are underway. Moreover, we will include a rat myelogenic leukemia (BNML) in our GvHD model based on our existing protocols and investigate the long-term outcome of MSC therapy (mortality and disease recurrence) with respect to both graft-versus-leukemia and graft-versus-host immunity.

Elevation of Serum Albumin Levels in Nagase Analbuminemic Rats by Allogeneic Bone Marrow Cell Transplantation

We investigated the feasibility of correcting the congenital absence of albumin in Nagase analbuminemic rats (NARs) by allogeneic bone marrow cell transplantation (BMT). Seven-week-old male NARs were used as recipients, and 6- to 8-week-old male Sprague-Dawley (SD) rats were used as allograft donors. NARs were divided into three groups: a BMT group (n = 10) in which bone marrow cells were infused into the liver; a hepatocyte transplantation (HCT) group (n = 8) in which hepatocytes were transplanted into the liver, and a control group (n = 8) in which PBS was injected into the portal vein. Serum albumin levels were measured as an indicator of the function of the grafted cells, and the phenotypic characteristics of the engrafted cells in the recipient’s liver were assessed with immunohistochemical and immunofluorescence techniques. At 8 weeks after cell transplantation, the serum albumin levels of the BMT group and HCT group were significantly higher than in the control group. The hepatocyte-like cells derived from bone marrow cells expressed albumin in liver of the NARs. According to this result, bone marrow cells can differentiate into hepatocyte-like cells in vivo. The results show that BMT is an effective treatment for congenital analbuminemia in a rat model and suggest that allogeneic BMT can be used as an efficient therapy for hereditary metabolic diseases.

Donor antigen-presenting cells regulate T-cell expansion and antitumor activity after allogeneic bone marrow transplantation.

Delayed immunologic recovery after allogeneic bone marrow transplantation (BMT) represents a major cause of morbidity and mortality that limits the overall success of the transplantation procedure. Recent clinical data suggest that a subset of donor dendritic cells may inhibit the graft-versus-tumor activity of donor T cells. We studied the immunoregulatory activity of donor dendritic cells in allogeneic BMT between major histocompatibility complex-disparate strains of mice. Bone marrow grafts enriched or depleted of CD11b- and CD11b+ dendritic cell subsets by immunomagnetic cell sorting were combined with small numbers of congenic splenic T cells. Recipients of CD11b-depleted bone marrow had significant posttransplantation expansion of donor spleen-derived CD4+ memory T cells compared with recipients of unmanipulated bone marrow. CD11b depletion enhanced the antitumor activity of the splenic donor T cells without producing significant graft-versus-host disease and resulted in long-term survival after a supralethal dose of T-cell leukemia administered after BMT. Expansion of donor spleen-derived T cells was proportional to the number of CD11b- dendritic cells in the bone marrow graft and was associated with increased levels of serum interferon-gamma. Thus, manipulating the content of donor antigen-presenting cells in allogeneic BMT is a novel strategy to activate donor memory T cells and enhance allogeneic graft-versus-leukemia effects with minimal graft-versus-host disease.

Immunotherapy of cancer for the elderly patient: does allogeneic bone marrow transplantation after nonmyeloablative conditioning provide a new option?

The critical role of antigen-specific T cells in cancer immunotherapy has been amply demonstrated. Though success of clinical trials still remains far behind expectations, the continuous improvement in our understanding of the biology of the immune response will provide the basis for optimized cancer vaccines. This review focuses on active therapeutic vaccination after allogeneic bone marrow cell transplantation with nonmyeloablative conditioning. This approach could provide a major breakthrough in cancer immunotherapy, particularly of elderly patients. The senescent immune system, mainly the T-cell compartment, displays reduced responsiveness, and this has to be overcome if therapeutic vaccination is to be of benefit for the patient. Although the defects are quite well characterized, the inducing factors and ways to overcome them are still to be explored in more detail. Many questions also remain to be answered in the field of allogeneic bone marrow transplantation after nonmyeloablative conditioning to optimize this therapeutic setting in cancer immunotherapy. Current considerations to improve engraftment and to reduce graft-versus-host disease while strengthening graft-versus-tumor reactivity will be briefly reviewed. Finally, I will discuss whether tumor-reactive T cells can be "naturally" maintained during the process of T-cell maturation in the allogeneic host. Provided this hypothesis can be substantiated, a T-cell vaccine will meet a pool of virgin T cells in the allogeneically reconstituted host, which are tolerant toward the host but not anergized toward tumor antigens presented by MHC molecules of the host. Inevitably, the problem of the aged immune system would be circumvented.

Immunotherapy of cancer by active vaccination: does allogeneic bone marrow transplantation after non-myeloablative conditioning provide a new option?

The critical role of antigen-specific T cells in cancer immunotherapy has been amply demonstrated in many model systems. Though success of clinical trials still remains far behind expectation, the continuous improvement in our understanding of the biology of the immune response will provide the basis of optimized cancer vaccines and allow for new modalities of cancer treatment. This review focuses on the current status of active therapeutic vaccination and future prospects. The latter will mainly be concerned with allogeneic bone marrow cell transplantation after non-myeloablative conditioning, because it is my belief that this approach could provide a major breakthrough in cancer immunotherapy. Concerning active vaccination protocols the following aspects will be addressed: i) the targets of immunotherapeutic approaches; ii) the response elements needed for raising a therapeutically successful immune reaction; iii) ways to achieve an optimal confrontation of the immune system with the tumor and iv) supportive regimen of immunomodulation. Hazards which one is most frequently confronted with in trials to attack tumors with the inherent weapon of immune defense will only be briefly mentioned. Many question remain to be answered in the field of allogeneic bone marrow transplantation after non-myeloablative conditioning to optimize the therapeutic setting for this likely very powerful tool of cancer therapy. Current considerations to improve engraftment and to reduce graft versus host disease while strengthening graft versus tumor reactivity will be briefly reviewed. Finally, I will discuss whether tumor-reactive T cells can be "naturally" maintained during the process of T cell maturation in the allogeneic host. Provided this hypothesis can be substantiated, a T cell vaccine will meet a pool of virgin T cells in the allogeneically reconstituted host, which are tolerant towards the host, but not anergised towards tumor antigens presented by MHC molecules of the host.

Treatment of mice with anti-CD44 after allogeneic bone marrow cell transplantation is lethal.

Because CD44 is known to be of functional importance in hematopoiesis, we were interested in whether anti-CD44 would interfere with syngeneic or allogeneic bone marrow cell engraftment. Syngeneic and allogeneic grafts were accepted by over 80% of mice. In both the syngeneic and the allogeneic host, homing, repopulation, and regain of immunoreactivity was delayed by anti-CD44 treatment. But in the syngeneic host the overall survival rate was unaltered. Instead, less than 25% of anti-CD44-treated, allogeneically reconstituted mice survived by recovery of the host's hematopoietic system, i.e. graft acceptance was close to 0%. The mice died between 4 and 15 days after engraftment and showed severe alterations of the gut. The high death rate of the allogeneically reconstituted mice was specific for anti-CD44 treatment. It did not depend on an ADCC mechanism, could not be abrogated by depletion of T cells, and was only mitigated by depletion of NK cells. According to the histological appearance of the gut, anti-CD44 strengthens a local (gut-associated) graft versus host reaction, which is not mediated by alphabeta T cells and at least not exclusively by NK cells. Because gut death is one of the major reasons for failure in allogeneic bone marrow transplantation, the model of anti-CD44-induced lethality offers itself to clarify the underlying mechanism.