scholarly journals Allelische Subtypisierung und Funktionsanalyse von inhibitorischen NK-Zell-Rezeptoren KIR2DL1 und KIR3DL1 zur Optimierung der Spenderauswahl bei NK-Zell-basierter Immuntherapie

2021 ◽  
Author(s):  
◽  
Yasmin El-Nahry

In Deutschland erkranken pro Jahr bis zu 12.000 Menschen neu an Leukämie. Leukämie ist eine schwere onkologische Erkrankung, bei der reifes Knochenmarkgewebe in Folge von Mutationen unreifer und defekter Vorläuferzellen (leukämischen Blasten) verdrängt wird. Dies führt zu einer zunehmend eingeschränkten Blutbildung. Akute Leukämieformen können unbehandelt innerhalb von wenigen Wochen zum Tode führen und erfordern deshalb eine umgehende Diagnostik sowie einen raschen Therapiebeginn. Heilungschancen bestehen dann, wenn durch die Transplantation von gesunden hämatopoetischen Stammzellen (HSZT) das erkrankte Knochenmark ausreichend ersetzt wird. Leider sind Abstoßungsreaktionen des Spendermaterials (engl.: Graft-versus-Host-Disease, GvHD) keine Seltenheit. Natürliche Killerzellen (NK-Zellen) stellen die kleinste Lymphozytenpopulation im menschlichen Blut dar und werden dem angeborenen Immunsystem zugerechnet. Sie wurden erstmals 1975 durch die Forscher Kiessling, Klein et al. entdeckt.17 Aufgrund ihrer Fähigkeit bestimmte Tumorzellen in vitro zu töten, wächst das Interesse an der Erforschung ihrer aktivierenden und inhibierenden Oberflächenrezeptoren. Die Killer-Zell-Immunoglobulin-ähnlichen Rezeptoren (KIRs) bilden dabei eine besonders diverse NKZell-Rezeptorfamilie. Lokalisiert auf Chromosom 19 liegen bis zu 17 hochpolymorphe KIRGene. Die genetische Ausstattung und Oberflächenexpression variiert von Individuum zu Individuum und bildet die Voraussetzung für die vorhandene Diversität KIR-exprimierender NK-Zellen. NK-Zellen besitzen die Fähigkeit, Gewebezellen in „körpereigen“ oder „fremd“ zu kategorisieren. Inhibitorische Killer-Immunoglobulin-ähnliche Rezeptoren (iKIR) nutzen dazu HLA-Klasse-I-Proteine (MHC-I) auf der Oberfläche gesunder Zellen. Diese schützen sie vor einem zytotoxischen NK-Zell-Angriff. NK-Zellen durchlaufen im Vorfeld einen komplexen Ausbildungssprozess48, an dessen Ende lizensierte Effektorzellen stehen. Diese können mittels gezielter Zytolyse krebstransformierte, zellulär-gestresste, sowie viralinfizierte Zellen im intakten Organismus erkennen und abtöten. Die Spenderauswahl ist ein wichtiger Faktor für den Erfolg einer Stammzelltransplantation. Infundierte Spender NK-Zellen schützen das Transplantat, indem sie als wirksame Effektorzellen verbleibende Leukämiezellen aktiv eliminieren. Diese wünschenswerte Nebenwirkung wird als Graft-versus-Leukämie (GvL)-Effekt bezeichnet. Ruggeri et al. konnte zeigen, dass insbesondere Transplantationsstrategien, die auf KIR-Ligand-Fehlpaarungen (engl.: KIR-HLA-mismatch) basieren, zu weniger Rückfällen, weniger GvHD und einem besseren Gesamtüberleben bei Patienten mit akuter myeloischer Leukämie (AML) nach HSZT führt. Der KIR-HLA-mismatch wird mittlerweile aufgrund ausreichender Datenlage bei der Auswahl passender NK-Zell-Spender berücksichtigt und die Untersuchung auf die An- bzw. Abwesenheit bestimmter KIR-Gene (Haplotypisierung) mittlerweile neben der HLA-Typisierung standardisiert in vielen Instituten durchgeführt. Daneben finden sich immer mehr Hinweise dafür, dass bereits einzelne allelische Polymorphismen innerhalb der KIR-Gene einzelner Spender großen Einfluss auf die Funktionalität ihrer NK-Zellen nehmen. Die allelische Subtypisierung von KIRs stellt aufgrund stetig steigender Zahlen neu entdeckter Allele eine Herausforderung dar. Im Januar 2019 sind für KIR2DL1 bereits 66 Allele beschrieben und für KIR3DL1 sogar 150 Allele in der Immuno Polymorphism Database (IPD) hinterlegt. Die vorliegende Arbeit präsentiert ein praktikables Subtypisierungsverfahren, um allelische Unterschiede innerhalb der Genloci der NK-Zell-Rezeptoren KIR2DL1 und KIR3DL1 zu untersuchen. Für die Experimente wurden NK-Zellen von 20 gesunden Spendern funktionell untersucht und KIR-genetisch analysiert. Ziel war es innerhalb dieser Individuen besonders potente NK-Zellspender zu identifizieren und diese anhand bestimmter Polymorphismen und/ oder der Expression von KIR-Rezeptoren zu charakterisieren. Bei der Subtypisierung der KIR2DL1-Gene konnten 12 verschiedene, bereits bekannte KIR2DL1-Allele bestimmt werden. Die häufigsten Allele waren dabei 2DL1*001, *00201, *00302, *00401 und *00403. 5 der 20 Spender konnten der funktionell hochpotenten R245–Allelgruppe (AS Arginin an Pos. 245) zugeordnet werden. Spender 13 zeigte bei negativer KIR2DL1-SSP eine vermeintlich neue Nullallelvariante, Spender 20 eine neue heterozygote Variante, resultierend in der Kombination eines Arginin mit Alanin (R/A). Bei der allelischer Subtypisierung von KIR3DL1 wurden 25 verschiedene, bereits bekannte KIR3DL1-Allele bei den 20 Spendern bestimmt. Spender 2 zeigt zahlreiche, vorwiegend homozygote Abweichungen von der Referenzfrequenz, insbesondere im Exon 5, und wurde als neue Allelvariante gewertet. Die häufigsten KIR3DL1-Allele waren 3DL1*00101, *002 und *087. Mittels durchflusszytometrischer Messung konnte gezeigt werden, dass das bekannte Nullallel 3DL1*0040101 bei Spender 14 zu keiner Oberflächenexpression des Rezeptors führt215, während Spendern 11 und 16 als Träger des 3DL1*00402 Allels eine Oberflächenexpression von rund 10% präsentierten. Um die Spender NK-Zellen der gebildeten Gruppen funktionell zu testen, wurden die NK-Zellen experimentell mit vier unterschiedlichen transgenen L721.221-Zelllinien stimuliert. Die funktionelle Potenz der gespendeten NK-Zellen wurde mittels eines CD107-Degranulationsassays gemessen. Nach aktuellem Stand sind nur für 53 der 150 KIR3DL1-Allele die allelischen Expressionsmuster untersucht worden. Dies bedeutet im Umkehrschluss, dass für rund 65% der bekannten KIR3DL1-Allele Daten zur Funktionalität fehlen, und damit der größte Anteil der ermittelten Allele von 6 Spendern der unknown-Expression (KIR3DL1u/u) Gruppe zugeordnet wurde. Die Spender 4 und 19 der high-Expressiongruppe (KIR3DL1h/h), sowie Spender 5 und 10 der KIR3DL1u/u-Gruppe mit den Allelen 3DL1*053, *087, *109 und Spender 2 als Träger zweier neuer KIR3DL1-Allele, zeigten in toto die besten funktionellen Ergebnisse in den Experimenten gegen die verwendete B-lymphoblastoide L721.221-Zellinien. Die Ergebnisse der vorliegenden Arbeit zeigen, dass bei der Spenderauswahl für NK-Zellbasierten Immuntherapie neben der Genotypisierung die allelische KIR-Subtypisierung als wertvolles Werkzeug entschiedener berücksichtigt werden sollte. Dafür ist es jedoch notwendig weiter an KIR-Subtypisierung und -Gruppierung Strategien zu arbeiten, um Natürlichen Killerzellen Wege in die klinische Standardpraxis zu bahnen.

Molecules ◽  
2021 ◽  
Vol 26 (14) ◽  
pp. 4237
Author(s):  
Abdellatif Bouazzaoui ◽  
Ahmed A. H. Abdellatif ◽  
Faisal A. Al-Allaf ◽  
Neda M. Bogari ◽  
Mohiuddin M. Taher ◽  
...  

Systemic steroids are used to treat acute graft-versus-host disease (aGVHD) caused by allogenic bone marrow transplantation (allo-BMT); however, their prolonged use results in complications. Hence, new agents for treating aGVHD are required. Recently, a new compound A (CpdA), with anti-inflammatory activity and reduced side effects compared to steroids, has been identified. Here, we aimed to determine whether CpdA can improve the outcome of aGVHD when administered after transplantation in a mouse model (C57BL/6 in B6D2F1). After conditioning with 9Gy total body irradiation, mice were infused with bone marrow (BM) cells and splenocytes from either syngeneic (B6D2F1) or allogeneic (C57BL/6) donors. The animals were subsequently treated (3 days/week) with 7.5 mg/kg CpdA from day +15 to day +28; the controls received 0.9% NaCl. Thereafter, the incidence and severity of aGVHD in aGVHD target organs were analyzed. Survival and clinical scores did not differ significantly; however, CpdA-treated animals showed high cell infiltration in the target organs. In bulk mixed lymphocyte reactions, CpdA treatment reduced the cell proliferation and expression of inflammatory cytokines and chemokines compared to controls, whereas levels of TNF, IL-23, chemokines, and chemokine receptors increased. CpdA significantly reduced proliferation in vitro but increased T cell infiltration in target organs.


Blood ◽  
1992 ◽  
Vol 80 (10) ◽  
pp. 2661-2667
Author(s):  
J Mysliwietz ◽  
S Thierfelder

Abstract A hamster antimouse CD3 monoclonal antibody (MoAb) opened the way to experimental studies on the suppression of allograft rejection and cytokine-related morbidity after treatment with antibodies modulating the CD3/T-cell receptor complex (CD3/TCR). Because earlier attempts to suppress graft-versus-host disease (GVHD) in patients by in vitro treatment of donor marrow with anti-CD3 MoAb had remained inconclusive, we used a rat IgG2b antimouse CD3 MoAb (17A2) with fewer side effects to analyze suppression of GVHD in the mouse model. Detailed phenotyping of blood, spleen, and lymphnode T cells after the injection of 400 micrograms 17A2 in C57BL/6 mice showed 60% CD3 downmodulation and 50% T- cell depletion for spleen cells. Injection of these spleen cells, together with bone marrow cells, in fully mismatched preirradiated CBA mice delayed GVHD by only 6 days. Ex vivo treatment of donor cells with 17A2 was not effective. In contrast, conditioning of marrow recipients with a single injection of 17A2 delayed 50% GVHD mortality by 100 days and prevented GVHD altogether after prolonged treatment, with survivors showing complete chimerism and specific transplantation tolerance. This difference in antibody effect contrasts with earlier experiences with nonmodulating but more strongly T-cell-depleting MoAbs of the same isotype, which prevent GVHD no matter whether applied in vitro or injected into donor or recipient mice. Our data indicate that CD3/TCR reexpression in marrow recipients with no circulating 17A2 is the reason why ex vivo donor cell treatment with anti-CD3 MoAb is comparatively ineffective. Our data, which allow separate evaluation of cell-depleting and cell-modulating antibody activity, help to explain previous clinical failure to suppress GVHD and provide evidence in favor of conditioning the marrow recipient with anti-CD3 MoAb as a therapeutic alternative.


Blood ◽  
2000 ◽  
Vol 95 (12) ◽  
pp. 3693-3701 ◽  
Author(s):  
Ypke V. J. M. van Oosterhout ◽  
Liesbeth van Emst ◽  
Anton V. M. B. Schattenberg ◽  
Wil J. M. Tax ◽  
Dirk J. Ruiter ◽  
...  

Abstract This study evaluated the anti-graft versus host disease (GVHD) potential of a combination of immunotoxins (IT), consisting of a murine CD3 (SPV-T3a) and CD7 (WT1) monoclonal antibody both conjugated to deglycosylated ricin A. In vitro efficacy data demonstrated that these IT act synergistically, resulting in an approximately 99% elimination of activated T cells at 10−8 mol/L (about 1.8 μg/mL). Because most natural killer (NK) cells are CD7+, NK activity was inhibited as well. Apart from the killing mediated by ricin A, binding of SPV-T3a by itself impaired in vitro cytotoxic T-cell cytotoxicity. Flow cytometric analysis revealed that this was due to both modulation of the CD3/T-cell receptor complex and activation-induced cell death. These results warranted evaluation of the IT combination in patients with refractory acute GVHD in an ongoing pilot study. So far, 4 patients have been treated with 3 to 4 infusions of 2 or 4 mg/m2 IT combination, administered intravenously at 48-hour intervals. The T1/2 was 6.7 hours, and peak serum levels ranged from 258 to 3210 ng/mL. Drug-associated side effects were restricted to limited edema, fever, and a modest rise of creatine kinase levels. One patient developed low-titer antibodies against ricin A. Infusions were associated with an immediate drop of circulating T cells, followed by a more gradual but continuing elimination of T/NK cells. One patient mounted an extensive CD8 T-cell response directly after treatment, not accompanied with aggravating GVHD. Two patients showed nearly complete remission of GVHD, despite unresponsiveness to the extensive pretreatment. These findings justify further investigation of the IT combination for treatment of diseases mediated by T cells.


Blood ◽  
1999 ◽  
Vol 93 (9) ◽  
pp. 3140-3147 ◽  
Author(s):  
Joshua A. Grass ◽  
Tamim Wafa ◽  
Aaron Reames ◽  
David Wages ◽  
Laurence Corash ◽  
...  

Abstract Photochemical treatment (PCT) with the psoralen S-59 and long wavelength ultraviolet light (UVA) inactivates high titers of contaminating viruses, bacteria, and leukocytes in human platelet concentrates. The present study evaluated the efficacy of PCT to prevent transfusion-associated graft-versus-host disease (TA-GVHD) in vivo using a well-characterized parent to F1 murine transfusion model. Recipient mice in four treatment groups were transfused with 108 splenic leukocytes. (1) Control group mice received syngeneic splenic leukocyte transfusions; (2) GVHD group mice received untreated allogeneic splenic leukocytes; (3) gamma radiation group mice received gamma irradiated (2,500 cGy) allogeneic splenic leukocytes; and (4) PCT group mice received allogeneic splenic leukocytes treated with 150 μmol/L S-59 and 2.1 J/cm2UVA. Multiple biological and clinical parameters were used to monitor the development of TA-GVHD in recipient mice over a 10-week posttransfusion observation period: peripheral blood cell levels, spleen size, engraftment by donor T cells, thymic cellularity, clinical signs of TA-GVHD (weight loss, activity, posture, fur texture, skin integrity), and histologic lesions of liver, spleen, bone marrow, and skin. Mice in the control group remained healthy and free of detectable disease. Mice in the GVHD group developed clinical and histological lesions of TA-GVHD, including pancytopenia, marked splenomegaly, wasting, engraftment with donor derived T cells, and thymic hypoplasia. In contrast, mice transfused with splenic leukocytes treated with (2,500 cGy) gamma radiation or 150 μmol/L S-59 and 2.1 J/cm2 UVA remained healthy and did not develop detectable TA-GVHD. Using an in vitro T-cell proliferation assay, greater than 105.1 murine T cells were inactivated by PCT. Therefore, in addition to inactivating high levels of pathogenic viruses and bacteria in PC, these data indicate that PCT is an effective alternative to gamma irradiation for prevention of TA-GVHD.


2006 ◽  
Vol 106 (1) ◽  
pp. 82-90 ◽  
Author(s):  
Masaki Kuwatani ◽  
Yoshinori Ikarashi ◽  
Akira Iizuka ◽  
Chihiro Kawakami ◽  
Gary Quinn ◽  
...  

2019 ◽  
Vol 10 (1) ◽  
Author(s):  
Qinjun Zhao ◽  
Leisheng Zhang ◽  
Yimeng Wei ◽  
Hao Yu ◽  
Linglin Zou ◽  
...  

Abstract Background Mesenchymal stem cells are heterogenous populations with hematopoietic supporting and immunomodulating capacities. Enormous studies have focused on their preclinical or clinical therapeutic effects, yet the systematic study of continuous in vitro passages on signatures and functions of UC-MSCs at both the cellular and molecular levels is still lacking. Methods In this study, to systematically evaluate the biological properties of MSCs at various passages, we analyzed biomarker expression, cell proliferation and apoptosis, chromosome karyotype, and tri-lineage differentiation potential. Subsequently, we took advantage of whole-exome sequencing to compare the somatic hypermutation of hUC-MSCs at P3, P6, and P15 including SNV and INDEL mutations. In addition, to explore the safety of the abovementioned hUC-MSCs, we performed metabolic pathway enrichment analysis and in vivo transplantation analysis. Furthermore, we cocultured the abovementioned hUC-MSCs with UCB-CD34+ HSCs to evaluate their hematopoietic supporting capacity in vitro. Finally, we transplanted the cells into acute graft-versus-host disease (aGVHD) mice to further evaluate their therapeutic effect in vivo. Results The hUC-MSCs at P3, P6, and P15 showed similar morphology, biomarker expression, and cytokine secretion. hUC-MSCs at P15 had advantages on adipogenic differentiation and some cytokine secretion such as IL-6 and VEGF, with disadvantages on cell proliferation, apoptosis, and osteogenic and chondrogenic differentiation potential. Based on the SNP data of 334,378 exons and bioinformatic analyses, we found the somatic point mutations could be divided into 96 subsets and formed 30 kinds of signatures but did not show correlation with risk of tumorigenesis, which was confirmed by the in vivo transplantation experiments. However, hUC-MSCs at P15 showed impaired hematologic supporting effect in vitro and declined therapeutic effect on aGVHD in vivo. Conclusions In this study, we systematically evaluated the biological and genetic properties of hUC-MSCs at various passages. Our findings have provided new references for safety and effectiveness assessments, which will provide overwhelming evidence for the safety of hUC-MSCs after continuous in vitro passages both at the cellular and molecular levels for the first time. Taken together, our studies could help understand the controversial effects of disease treatment and benefit the clinical research of UC-MSCs.


Blood ◽  
1990 ◽  
Vol 75 (3) ◽  
pp. 798-805 ◽  
Author(s):  
BR Blazar ◽  
DL Thiele ◽  
DA Vallera

Abstract Incubation of murine bone marrow and splenocytes with the dipeptide methyl ester, L-leucyl-L-leucine methyl ester (Leu-Leu-OMe), which results in the selective depletion of cytotoxic T cells and their precursors, natural killer cells, and monocytes, completely protected 30 recipients of fully allogeneic donor grafts from lethal graft-versus- host disease (GVHD). These results were comparable with those obtained in 30 recipients of anti-Thy 1.2 plus complement (C')-treated donor marrow. However, in contrast to antibody- and C'-dependent T-cell depletion, which reduces the level of donor cell engraftment in our model system, we did not observe such effects using Leu-Leu-OMe marrow pretreatment. As compared with the 24 H-2 typed recipients of anti-Thy 1.2 + C'-treated donor grafts, the 29 H-2 typed recipients of Leu-Leu- OMe-treated donor grafts had significantly (P less than .001) higher percentages of donor cells (mean = 93% v 74%) and significantly (P less than .001) lower percentages of host cells (mean = 6% v 15%) posttransplantation. In vitro limiting dilution assay (LDA) was performed to assess the comparative efficacy of cytolytic T-lymphocyte (CTL) precursor depletion by Leu-Leu-OMe or anti-Thy 1.2 + C' pretreatment. We observed greater levels of CTL precursor depletion in Leu-Leu-OMe treated as compared with anti-Thy 1.2 + C'-treated bone marrow plus spleen cells (BMS) obtained from nontransplanted mice. This suggests that the in vivo results cannot simply be attributed to a less efficacious functional inactivation of cytolytic T-cell precursors by Leu-Leu-OMe treatment as compared with anti-Thy 1.2 + C' treatment. Immunoreconstitution was similar in recipients of Leu-Leu-OMe-treated grafts and anti-Thy 1.2 + C'-treated grafts 100 days posttransplant. In our opinion, Leu-Leu-OMe marrow pretreatment deserves further investigation as a methodology to achieve GVHD prevention without significantly reducing the propensity toward host cell repopulation.


Blood ◽  
1996 ◽  
Vol 87 (4) ◽  
pp. 1232-1237 ◽  
Author(s):  
TA Graubert ◽  
JH Russell ◽  
TJ Ley

A complete molecular description of the syndromes of graft-versus-host disease (GVHD) and graft rejection could have a significant impact on clinical bone marrow transplantation. Recent in vitro experiments (Heusel et al, Cell 76:977, 1994 and Shresta et al, Proc Natl Acad Sci USA 92:5679, 1995) have shown that the putative mediators of these two syndromes, cytotoxic lymphocytes (CTL) and natural killer (NK) cells, respectively, initiate a program of cell death (apoptosis) in susceptible target tissues in a manner critically dependent on the serine protease Granzyme B (gzm B). In the present study, we have analyzed the phenotype of gzm B-deficient mice using experimental transplant models designed to isolate their CD8+ CTL, CD4+ CTL, and NK compartments. We found a significant impairment in class I-dependent GVHD mediated by gzm B -/- CD8+ CTL, whereas class II-dependent GVHD was not altered using gzm B -/- CD4+ effectors. In a hybrid resistance model, gzm B -/- hosts rejected haplo-identical marrow grafts as efficiently as did their wild-type littermates. This result is surprising in light of a severe defect in the ability of gzm B -/- NK cells to induce apoptosis in susceptible targets in vitro. These in vivo data define significant role for gzm B in cytotoxicity mediated by CD8+ CTL, but not by CD4+ CTL. Furthermore, these results do not support a model of hybrid resistance in which NK cells play a pivotal role.


Blood ◽  
1995 ◽  
Vol 85 (9) ◽  
pp. 2607-2618 ◽  
Author(s):  
BR Blazar ◽  
PA Taylor ◽  
A Panoskaltsis-Mortari ◽  
GS Gray ◽  
DA Vallera

We have developed an in vitro system in which C57BL/6 donor splenocytes are exposed to B10.BR host alloantigens in the context of deficient CD28:B7 signaling as a means of preventing graft-versus-host disease (GVHD). Although 54% to 82% of MLR alloresponse was inhibited by cytotoxic T-lymphocyte antigen 4 (CTLA4)-Ig treatment of host stimulator cells, treated splenocytes were still capable of causing GVHD when infused in vivo. By adding anti-leukocyte function antigen 1 (anti-LFA1) antibody to hCTLA4-Ig in vitro to coblock the LFA1:intercellular adhesion molecule (ICAM) signaling, splenic alloresponse was inhibited by > or = 89%, yet GVHD induction capabilities were retained. Because antigen-primed cells might be more susceptible to CD28:B7 blockade, we investigated whether hCTLA4-Ig alone, anti-LFA1 antibody alone, or the combination of both added to donor-antihost in vitro primed cells could reduce GVHD. To facilitate hyporesponsiveness induction and to block B7 and ICAM ligands that are upregulated during GVHD, these reagents were also administered to recipients post-BMT. We have shown that hCTLA4-Ig plus anti-LFA1 antibody is highly effective in preventing GVHD-induced lethality (88% to 100% of treated mice surviving versus 0% to 28% of controls surviving). For optimal prevention, both hCTLA4-Ig and anti-LFA1 must be used in vitro in the context of donor-antihost primed splenocytes and continued in vivo. This in vitro-in vivo combined approach was associated with donor engraftment, and recipients were not globally immunosuppressed. We conclude that blocking both the CD28/B7 and the LFA1:ICAM pathways are critical to effective GVHD prevention and may offer advantages to in vitro donor T-cell removal.


2011 ◽  
Vol 208 (12) ◽  
pp. 2489-2496 ◽  
Author(s):  
Uri Sela ◽  
Peter Olds ◽  
Andrew Park ◽  
Sarah J. Schlesinger ◽  
Ralph M. Steinman

Foxp3+ regulatory T cells (T reg cells) effectively suppress immunity, but it is not determined if antigen-induced T reg cells (iT reg cells) are able to persist under conditions of inflammation and to stably express the transcription factor Foxp3. We used spleen cells to stimulate the mixed leukocyte reaction (MLR) in the presence of transforming growth factor β (TGF-β) and retinoic acid. We found that the CD11chigh dendritic cell fraction was the most potent at inducing high numbers of alloreactive Foxp3+ cells. The induced CD4+CD25+Foxp3+ cells appeared after extensive proliferation. When purified from the MLR, iT reg cells suppressed both primary and secondary MLR in vitro in an antigen-specific manner. After transfer into allogeneic mice, iT reg cells persisted for 6 mo and prevented graft versus host disease (GVHD) caused by co-transferred CD45RBhi T cells. Similar findings were made when iT reg cells were transferred after onset of GVHD. The CNS2 intronic sequence of the Foxp3 gene in the persisting iT reg cells was as demethylated as the corresponding sequence of naturally occurring T reg cells. These results indicate that induced Foxp3+ T reg cells, after proliferating and differentiating into antigen-specific suppressive T cells, can persist for long periods while suppressing a powerful inflammatory disease.


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