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Blood, 15 June 2002, Vol. 99, No. 12, pp. 4601-4609
TRANSPLANTATION
Tolerance induction of alloreactive T cells via ex vivo blockade
of the CD40:CD40L costimulatory pathway results in the generation of
a potent immune regulatory cell
Patricia A. Taylor,
Thea M. Friedman,
Robert Korngold,
Randolph J. Noelle, and
Bruce R. Blazar
From the University of Minnesota Cancer Center and
Department of Pediatrics, Division of Bone Marrow Transplantation,
Minneapolis; Kimmel Cancer Institute, Thomas Jefferson Medical College,
Philadelphia, PA; Department of Microbiology, Dartmouth Medical
College, Hanover, NH.
We previously reported that ex vivo blockade of the CD40:CD40L
costimulatory pathway in primary mixed lymphocyte reaction cultures resulted in profound in vitro secondary hyporesponsiveness and
30-fold or greater protection from graft-versus-host-disease (GVHD)
lethality. Present studies demonstrate that tolerance induction via
costimulatory blockade also results in the generation of a potent
immunoregulatory cell that inhibits both naive and primed alloresponses. The immunoregulatory capacity was dependent upon cell-to-cell contact that prevented the full activation of the naive or
primed cells. The inhibitory effect of tolerized cells did not preclude
the response of naive T cells to nominal protein antigen if antigen was
present at high concentration. However, under suboptimal antigen
concentration, nonspecific inhibition of responses occurred. The
tolerized regulatory cell population maintained a polyclonal T-cell
receptor V repertoire that was broader than in control
primed cultures. These data, the first to demonstrate that tolerance
induction via CD40:CD40L costimulatory blockade results in potent
regulatory function, are relevant to bone-marrow and solid-organ
transplantation. The generation of potent immunoregulatory capacity
during tolerization via CD40:CD40L blockade provides a fail-safe
mechanism to control alloreactive T cells that may have escaped
tolerization. These potent regulatory cells may be clinically
exploitable for the treatment and prevention of GVHD or autoimmunity.

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