During acute graft-versus-host disease (GVHD) the activation of macrophages (Mφ) is mediated by 2 signals, interferon (IFN)-γ and bacteria-derived lipopolysaccharide (LPS). A cascade of inflammatory responses that includes the release of mediators of tissue injury follows Mφ activation. Among the tissues characteristically targeted during acute GVHD are epithelial tissues of the skin and gastrointestinal tract that normally undergo continuous proliferation and are therefore sensitive to cytostatic processes. We have investigated whether Mφ can mediate cytostatic mechanisms capable of interrupting cell proliferation during acute GVHD. GVHD was induced in nonirradiated C57BL/6XAF1 (B6AF1) mice by the injection of 60 × 106 (acute GVHD) or 30 × 106 (nonlethal GVHD) C57BL/6 (B6) lymphoid cells. Mφ from animals undergoing acute GVHD could be triggered by normally insignificant quantities of LPS to mediate a cytostatic effect on target cells, resulting in the complete shutdown of cellular proliferation. The same amounts of LPS had no effect on Mφ from normal or syngeneically transplanted animals. Mφ mediated the release of significant quantities of intracellular iron from target cells undergoing cytostasis. Reversal of cytostasis occurred following inhibition of nitric oxide (NO) production by NG-monomethyl-L-arginine (NMMA). Production of NO by LPS-triggered Mφ reflected the severity of GVHD. NO release increased significantly during acute GVHD but was only transiently increased during nonlethal GVHD. The results provide evidence that, as a result of activation during acute GVHD, Mφ produce NO and induce the release of iron from target cells, resulting in a potent cytostatic effect that inhibits cellular proliferation.
Stimulation of Host NKT Cells by Synthetic Glycolipid Regulates Acute Graft-versus-Host Disease by Inducing Th2 Polarization of Donor T Cells