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Blood, Vol. 96 No. 3 (August 1), 2000:
pp. 834-839
CHEMOKINES
Induction of monocyte- and T-cell-attracting chemokines in the
lung during the generation of idiopathic pneumonia syndrome
following allogeneic murine bone marrow transplantation
Angela Panoskaltsis-Mortari,
Robert M. Strieter,
John R. Hermanson,
Konstantin V. Fegeding,
William J. Murphy,
Catherine L. Farrell,
David L. Lacey, and
Bruce R. Blazar
From the University of Minnesota Cancer Center and Department of
Pediatrics, Division of Hematology, Oncology, Blood and Marrow
Transplant Program, University of Minnesota, Minneapolis, MN;
Department of Medicine, Division of Pulmonary and Critical Care
Medicine, UCLA School of Medicine, Los Angeles, CA; Department of
Pathology, Walter Reed Army Institute, Washington, DC;
SAIC Frederick, NCI-FCRDC, Frederick, MD; and
Amgen Inc, Thousand Oaks, CA.
 |
Abstract |
Idiopathic pneumonia syndrome (IPS) is a significant complication
following bone marrow transplantation (BMT). We have developed a murine
model in which severe IPS is induced by pre-BMT conditioning and
allogeneic T cells and is characterized by the recruitment of host
monocytes and donor T cells into the lung by day 7 post-BMT. Chemokines
regulate cellular recruitment and the migration of cells into
inflammatory lesions. In this study, we examined the profiles of
chemokines produced locally in the lung (parenchyma and bronchoalveolar
lavage fluid) and systemically (serum) during the generation of IPS in
the peri-BMT period. Protein and messenger RNA (mRNA) levels of CC
chemokines (monocyte/lymphocyte attractants), especially monocyte
chemoattractant protein (MCP)-1, macrophage inflammatory protein
(MIP)-1 , RANTES (regulated upon activation normal T-cell expressed
and secreted), and C10, were preferentially induced in the lung by day
7 postallogeneic BMT. In addition, there was an increase in mRNA for
IP-10 (a monocyte and Th1-cell chemoattractant). The CXC chemokines
MIP-2 and KC, known neutrophil attractants, were moderately elevated.
For the most part, these increases in chemokines were dependent on the
coinfusion of allogeneic T cells with the BM inoculum. Ribonuclease
protection assay and in situ hybridization analyses post-BMT showed
that the lung was a major producer of MCP-1, a potent inducer of
monocyte chemotaxis. Increases in MCP-1 levels in the lung preceded
host APC influx whereas MIP-1 levels accompanied donor T-cell
infiltration. In summary, we have shown that monocyte- and
T-cell-attracting chemokines are associated with monocyte and
T-cell recruitment during IPS.
(Blood. 2000;96:834-839)
© 2000 by The American Society of Hematology.
 |
Introduction |
Our laboratory has focused upon the early peri-bone
marrow transplant (BMT) inflammatory events that lead to the generation of idiopathic pneumonia syndrome (IPS), a significant cause of mortality following BMT.1 The risk of developing IPS is
associated with the intensity of the conditioning regimens and the
severity of graft-versus-host disease (GVHD).2-5 We
reported, in our murine IPS model, that the severity of IPS and
exaccerbation of host macrophage activation in the lung in the early
post-BMT period were dependent on allogeneic T cells and potentiated by
preconditioning with cyclophosphamide (Cy).6 The
manifestations of lung injury included epithelial cell injury,
increased wet and dry weights, decreased specific lung compliance and
lung capacity, and an influx of host monocytes and allogeneic T
cells.6 The frequency of cells expressing T-cell
costimulatory B7 molecules increased in the lung, as did the frequency
of cells expressing messenger RNA (mRNA) for transforming growth
factor- (a monocyte chemoattractant) and the cytolysin
granzyme B.6,7 In addition, we reported that lung
dysfunction post-BMT in mice was associated with increased bronchoalveolar lavage (BAL) levels of nitrite, lactate dehydrogenase, and protein, all indices of lung injury.8 Allogeneic T
cells stimulate nitric oxide production whereas Cy stimulates the
production of superoxide, the combination of which forms a
tissue-damaging oxidant, peroxynitrite.8 Because all the
above manifestations were seen during the first week post-BMT, the need
for early intervention to circumvent the lung damage critical to the
generation of IPS was implicated.
Chemokines are small (8 to 14 kd) proteins that can regulate leukocyte
functioning and migration during inflammation. Chemokines are
categorized based on the presence and position of the conserved cysteine residues.9,10 Most chemokines belong either to the CXC ( ), CC ( ), or C ( ) family. Although there are
redundancies, as with cytokines, members of the family (CXC)
generally are chemotactic for polymorphonuclear cells (neutrophils,
eosinophils, and basophils); members of the family (CC) are
chemotactic for mononuclear cells such as monocytes and lymphocytes;
and the family (C) are chemotactic for lymphocytes.9
Following tissue injury, the up-regulation of adhesion molecules on
endothelial surfaces causes tethering and rolling of circulating
leukocytes.11 These cells are then activated by chemokines
immobilized on the luminal surface of endothelium, resulting in
cytoskeletal remodeling, flattening of the cell with firmer adhesion
via cell-surface integrins, and subsequent diapedesis and extravasation
into the tissue.12,13 Chemokines then continue to act as
migratory signals, guiding inflammatory cells to the site of injury.
The cellular specificity depends on the presence of chemokine receptors
on the cell surface (termed CXCRs, CCRs).9
It is not known whether chemokines produced locally in the lung, as
opposed to systemic circulating levels, are increased in conditions
that generate IPS and whether these chemokines increase in concordance
with the influx of inflammatory cells. This would help to further
define the mechanism(s) leading to the inflammatory cell influx and
activation leading to lung injury and the generation of IPS following
allogeneic BMT. Ultimately, treatments to interfere with chemokine
signaling and thus hinder the infiltration process in the early
post-BMT period may prove to be beneficial. The purpose of this study
was to define the potential chemokines responsible for leukocyte
recruitment into the lung leading to IPS injury. The chemokine
production profile was examined in distinct lung compartments, ie,
alveolar space, lung parenchyma, and systemic blood circulation, in
relation to pre-BMT conditioning and allo-BMT infusion on these
IPS-inducing inflammatory events in the lung in the early post-BMT period.
 |
Materials and methods |
Mice
B10.BR (H2k) and C57BL/6 (H2b) mice were
purchased from Jackson Laboratories (Bar Harbor, ME). Mice were housed
in microisolator cages in the specific pathogen-free facility of the
University of Minnesota and cared for according to the Research Animal
Resources guidelines of our institution. For BMT, donors were
8 to 12 weeks of age, and recipients were used at 8 to 10 weeks of age.
Pre-BMT treatment and conditioning
B10.BR mice received phosphate-buffered saline (PBS) or Cy (Cytoxan,
Bristol Myers Squibb, Seattle, WA), 120 mg/kg per day intraperitoneally, as a conditioning regimen pre-BMT on days 3 and 2. All mice were lethally irradiated on the day before BMT (7.5 Gy total body irradiation [TBI]) by x-ray at a dose rate of 0.41 Gy/min as described.14
Bone marrow transplantation
Our BMT protocol has been described previously.15
Briefly, donor C57BL/6 BM was T-cell depleted with anti-Thy 1.2 monoclonal antibody (clone 30-H-12, rat IgG2b, kindly
provided by Dr David Sachs, Cambridge, MA) plus complement
(Nieffenegger, Woodland, CA). Recipient mice were transplanted via
caudal vein with 20 × 106 T-cell-depleted C57BL/6
(H-2b) marrow with or without 15 × 106
natural killer (NK) cell-depleted (PK136, anti-NK1.1 plus complement) spleen cells (BMS) as a source of IPS-causing T cells.
Bronchoalveolar lavage
Mice were euthanized with sodium pentobarbitol, and the thoracic
cavity was partially dissected. The trachea was cannulated with a
19-gauge needle and infused with 0.5 mL of PBS and withdrawn. This was
repeated 2 more times, and a total of 1.5 mL BAL fluid was collected
per mouse. BAL fluid was centrifuged at 4°C for 10 minutes at
1000g to pellet the cells and stored at 80°C. The BAL fluid was analyzed for chemokine levels in the same manner used for
serum (see "Chemokine level determination").
Frozen tissue preparation
Following euthanasia on day 3 post-BMT, the thoracic cavity was
partially dissected, and a mixture of 0.5 mL Optimal Cutting Temperature compound (OCT, Miles, Elkhart, IN) with PBS (3:1) was
infused via the trachea into lungs. Lung tissue was snap-frozen in
liquid nitrogen and stored at 80°C.
In situ hybridization
Cryosections (4 µm) were hybridized with digoxigenin-labeled
antisense RNA probes. The corresponding ribonucleotide sequences used
were 237 to 749 for monocyte chemoattractant protein (MCP)-1, 229 to
667 for macrophage inflammatory protein (MIP)-1 , 234 to 550 for
MIP-1 , 761 to 987 for MIP-2, 179 to 467 for TCA-3, and 83 to 421 for
RANTES (regulated upon activation normal T-cell expressed and
secreted). Immunologic detection of digoxigenin-labeled RNA duplexes was accomplished with antidigoxigenin antibody
(alkaline-phosphatase conjugated; Boehringer Mannheim, Indianapolis,
IN) and fluorescent substrate using the ELF-97 system (excites at 370 nm and emits at 515 nm; Molecular Probes, Eugene, OR). Stained tissue
was analyzed on an Olympus BX50 WI microscope with multiphoton confocal
MRC-1024 imaging (Bio-Rad, Hercules, CA) using LaserSharp
v3.1 software (Bio-Rad).
Serum collection
At the time of sacrifice (days 0, 3, and 7 post-BMT), blood was
collected by cardiac puncture, placed immediately at 4°C, the serum
separated at 4°C, and stored at 80°C.
Lung protein extracts
At the time of sacrifice (days 0, 3, and 7 post-BMT),
after exsanguination and BAL, the left lung was
homogenized in 1 mL PBS containing protease inhibitor cocktail
(Boehringer Mannheim) and centrifuged at 3000 rpm for 10 minutes. The
supernatant was filtered through a 1.2-µm syringe filter and stored
at 80°C until assayed.
Chemokine level determination
Serum, BAL, and lung protein extract levels of MIP-1 , MIP-1 ,
MCP-1, MIP-2, eotaxin, KC, RANTES, and C10 were determined by sandwich enzyme-linked immunosorbent assay (ELISA) as previously described16,17 (sensitivity, 25 pg/mL) or using commercial kits (R & D Systems, Minneapolis, MN; sensitivity, 1.5 to 3 pg/mL).
Ribonuclease protection assay
Total lung RNA was isolated18 and hybridized with
antisense RNA probes labeled with 32P-UTP using the mCK-5
chemokine template set from Pharmingen (San Diego, CA). The RNA
duplexes were run on premade polyacrylamide gels (Novex, San Diego, CA)
and autoradiographs scanned on a Bio-Rad GS700 with densitometry using
Molecular Analyst. In some experiments, independent ribonuclease
protection assay (RPA) analyses on the same samples were done for
chemokines not represented in the mCK-5 template. The corresponding
ribonucleotide sequences used were 112 to 241 for KC and 960 to 1143 for C10. Cyclophilin was used as a control to normalize mRNA levels.
Following ribonuclease treatment (RPA II kit, Ambion, Austin, TX), RNA
duplexes were run on 6% polyacrylamide gels. Following overnight
exposure, autoradiographs were scanned on a PhosphorImager and band
densities determined using ImageQuant software (Molecular Dynamics,
Sunnyvale, CA).
Statistical analysis
Data were analyzed by ANOVA or the Student t test.
Probability values less than or equal to .05 were considered
statistically significant. P values more than .05 and less than
.1 were considered a statistical trend.
 |
Results |
Preferential elevation of monocyte- and T-cell-attracting
chemokines in different lung compartments following allogeneic BMT is
predominantly T-cell dependent
One of our central hypotheses is that the chemokine production that
occurs during the early phase of chemoradiotherapy-induced injury is
essential for the recruitment of leukocytes into the lung. Because the
chemokine-receptor interactions necessary for IPS injury are unknown, a
kinetic analysis of chemokine production was performed. The 3 time
points selected corresponded to the 3 distinct phases of early tissue
injury and cellular recruitment in this model: day 0 (post-chemoradiotherapy, predonor cell infusion), day 3 (end of first
wave of host monocyte recruitment), and day 7 (donor CD4+
and CD8+ T-cell and host monocyte recruitment, severe
inflammation and destruction). Particular attention was devoted to the
analysis of chemokines known to be important to the recruitment of
monocytes (eg, MCP-1) and T cells (MIP-1 , MIP-1 , RANTES). Due to
the potential importance of such data and the virtual absence of data
regarding the role of chemokines in either IPS or GVH responses, we
measured the levels of members of both the CC (MCP-1, MIP-1 ,
MIP-1 , RANTES, eotaxin, C10) and CXC (MIP-2, KC) chemokine families
in 3 physically defined compartments of the lung, namely parenchyma
(lung protein extracts), alveolar space (BAL fluid), and circulating
serum in an allogeneic BMT setting.
To induce IPS, B10.BR recipients were conditioned with TBI with or
without Cy and infused with C57BL/6 BM with or without spleen cells as
described in "Materials and methods." On day 0 of BMT (1 day
post-TBI and prior to BM/BMS infusion), we did not find elevations in
any of the CC chemokines we examined in the lung compartments
(parenchyma and BAL fluid, data not shown) as assessed by ELISA,
consistent with the lack of inflammatory cell infiltrates in the lung
at this time point. The only CC chemokine elevated in the serum of
TBI-conditioned mice was MCP-1 (6.5-fold increase vs normals,
P = .001, data not shown). Cy treatment potentiated the
increase in serum MCP-1 levels (9.1-fold vs normals,
P = .000 05; and 1.6-fold vs TBI alone, P = .03;
data not shown).
Regarding the day 3 and day 7 post-BMT time points examined, the more
significant findings were seen for day 7 post-BMT consistent with the
striking cellular recruitment seen at this time point. Figure
1A shows that significant increases in 3 CC
chemokines known to increase monocyte and T-cell migration were seen in
all 3 compartments as measured by ELISA: MCP-1, MIP-1 , and RANTES (except RANTES in parenchyma). In general, the highest levels of these
3 chemokines were seen in the Cy/TBI/BMS groups that had the most
severe degree of cellular infiltration and tissue injury in the
lung.6 Potentiation by Cy was seen for MCP-1 in BAL fluid
(P < .0007, BMS/Cy vs BMS). Figure 1B illustrates that
T-cell-dependent increases for the CC chemokine eotaxin (major chemoattractant for eosinophils) were observed only in the BAL and
serum. Cy potentiated the level of eotaxin to some degree in the BAL
(P = .01, BMS/Cy vs BMS). T-cell-dependent increases for
MIP-1 (a monocyte chemoattractant) were not observed. In fact,
MIP-1 levels were unchanged in the lung (parenchyma and BAL) and
were actually decreased in the serum compared with control mice
regardless of treatment group. Figure 1B also shows that there was a
T-cell-dependent increase in the level of C10 (monocyte and lymphocyte
attractant) in lung parenchyma, BAL fluid, and serum. Cy and BMS,
interestingly, induced a synergistic increase in C10, and this
synergism was only seen in the 2 lung compartments. Overall, the
T-cell-dependent increase of CC chemokines is consistent with our
previous observations of the donor T-cell infiltration and the
allogeneic T-cell-dependent second wave of host monocytic influx in
the lung at this day 7 post-BMT time point.6


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| Fig 1.
Expression of CC chemokines in lung parenchyma, BAL
fluid, and serum on day 7 postallogeneic BMT as assessed by ELISA.
B10.BR recipient mice were preconditioned with TBI (7.5 Gy, day
1) with or without Cy (120 mg/kg per day, days 3,
2) as indicated and given C57BL/6 BM without (BM) or with
15 × 106 spleen cells (BMS) on the day of BMT (day
0). Lung protein extracts were obtained after exsanguination and BAL.
(A ) Expression of MCP-1, MIP-1 , and RANTES. (B) Expression of
eotaxin, MIP-1 , and C10. Mean values ± SD are indicated for 12 mice per group pooled from 2 experiments (except for RANTES and
MIP-1 , n = 6 per group). *P < .05 vs control
unmanipulated B10.BR mice; > 106 means all samples
measured off-scale in the assay.
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Because neutrophils make up approximately 20% of the pulmonary
infiltrate by day 7 post-BMT in our model, we examined the profiles of
CXC chemokines that are known to increase neutrophil migration. On day
0, the only CXC chemokine elevated in TBI-conditioned mice was KC in
the BAL fluid (4.6-fold vs normals, P = .002, data not
shown). Cy treatment caused an increase in serum KC levels (1.8-fold vs
normals, P = .03; and 1.8-fold vs TBI alone,
P = .01; data not shown).
Day 7 post-BMT levels were elevated in a T-cell-dependent manner for
MIP-2 and, to a lesser extent, KC (data not shown), indicating that
MIP-2 and KC may be involved in the migration of neutrophils into the
lung during IPS generation post-BMT.
Lung tissue is a major source of T-cell- and monocyte-attracting
chemokines post-BMT
To better understand the relationship(s) between chemokine
production and IPS generation post-BMT, we sought to determine whether
the lung itself was a source of chemokines that may be responsible for
the infiltration of inflammatory cells. As illustrated by RPA analysis
of lung tissue homogenates from day 7 post-BMT (Figure
2), messages for CC chemokines lymphotactin
(Ltn), RANTES, eotaxin, MIP-1 , MIP-1 , MCP-1, and TCA-3 were
significantly elevated in mice with severe IPS (ie, BMS plus Cy). In
addition, the CXC chemokines MIP-2 and IP-10 were elevated in these
same mice. To determine the relative abundance of these chemokines and
their possible relevance to the T-cell-dependent lung injury seen in our model, densitometry was performed. Figure
3 shows that the CCchemokines Ltn,
MIP-1 , MCP-1, and TCA-3 and the CXC chemokine IP-10 were
significantly elevated above control in mice receiving allogeneic T cells. The CC chemokines RANTES, eotaxin, and MIP-1 and
the CXC MIP-2 also were significantly elevated in these mice, but these
chemokines were also significantly elevated, albeit to a lesser degree,
in mice not given allogeneic T cells. In separate RPA analyses, we also
saw a significant increase in mRNA for C10 in BMS-plus-Cy
mice (4.6-fold increase vs control, P < .05, data not shown). KC was transcribed at very low levels (not shown), but
because different housekeeping genes were used to control RNA input, we
are unable to make a direct comparison to the other chemokines. In
summary, a predominant T-cell- and monocyte-attracting chemokine mRNA
profile was induced in the lungs of mice exhibiting IPS injury on day 7 post-BMT consistent with our protein data and with the predominant
monocyte and lymphocyte infiltrate we initally described for our IPS
model.

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| Fig 2.
Expression of chemokines in lung parenchyma on day 7 post-allogeneic BMT.
B10.BR recipient mice were preconditioned with TBI (7.5 Gy, day
1) with or without Cy (120 mg/kg per day, days 3,
2) as indicated and given C57BL/6 BM without (BM) or with
15 × 106 spleen cells (BMS) on the day of BMT (day
0). Lung tissue total RNA (obtained after exsanguination and BAL of
lungs) on day 7 post-BMT was analyzed by RPA as described in
"Materials and methods" using the CK5 template from Pharmingen.
One of 3 representative experiments is shown. Densitometry data are
shown in Figure 3.
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| Fig 3.
IPS is associated with elevations in chemokines known to
chemoattract monocytes and T cells.
Densitometry readings of RPA blots are shown.
T-cell-dependent increases for Ltn, MIP-1 , MIP-1 , RANTES, IP-10,
MCP-1, and TCA-3 were significantly elevated in mice receiving
allogeneic splenocytes. Data (densitometry readings) are normalized to
L32 mRNA levels and expressed as mean chemokine/L32 ± SD (n = 3
per group). *P < .05 vs control unmanipulated B10.BR
control mice.
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The production of MCP-1 in the lung in response to injury is
associated with the initial recruitment of monocytes post-BMT
Because the first wave of monocyte recruitment into the lung is
evident by day 3 post-BMT, studies were performed to confirm the expression of MCP-1 mRNA in the lung during this initial monocyte recruitment phase, prior to substantial donor T-cell migration. In situ
hybridization analysis of cryosections of lungs taken on day 3 post-BMT
confirmed the presence of MCP-1 mRNA-producing cells in the lung
(Figure 4). Increased staining for MCP-1
mRNA in the BMS groups was seen for endothelial, bronchial epithelium, and alveolar cells, consistent with known sources of
MCP-1.9 Therefore, it appears that the lung itself is
responsible for the production of the MCP-1 chemotactic gradient. At
this day 3 post-BMT time point, staining for MIP-1 , MIP-2, RANTES,
and TCA-3 was not different from control consistent with our protein data for this time point (not shown). Therefore, of the chemokines we
studied by in situ hybridization, we found only MCP-1 transcription to
be induced in the lung at least by day 3 post-BMT, and this closely
parallels the monocyte influx we previously demonstrated consistent
with the target cell specificity of MCP-1.

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| Fig 4.
MCP-1 mRNA transcription in the lung increases
postirradiation and is potentiated by the presence of allogeneic T
cells as assessed by in situ hybridization.
B10.BR recipient mice were preconditioned with TBI (day 1) and
given C57BL/6 BM with 15 × 106 spleen cells (BMS)
on the day of BMT (day 0). Lung tissues were harvested on day 3 post-BMT and cryosections hybridized with antisense digoxigenin-labeled
riboprobe for MCP-1. Stained tissue (using the ELF-97 alkaline
phosphatase substrate) was analyzed on an Olympus BX50 WI microscope
under a 20 × objective lens with multiphoton confocal MRC-1024
imaging (tissue excited at 370 nm and emission collected at 515 nm).
Light field images (stained by hematoxylin and eosin) were also
photographed under a 20 × objective lens. Solid arrow indicates
pulmonary arteriole; a, alveolar duct; b, bronchiole. Note the
increased staining of vessel endothelium, bronchiolar epithelium, and
alveolar cells in the BMS group.
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Increases in MCP-1 levels in the lung precede host
antigen-presenting cell (APC) influx whereas MIP-1 levels accompany
donor T-cell infiltration
To better understand the association between the induction of the CC
chemokines MCP-1 and MIP-1 in the lung and the presence of
inflammatory infiltrate, the levels of these chemokines in lung protein
extracts were compared with the frequencies of the predominant classes
of infiltrating cells, namely the host monocytes and donor T cells, on
a kinetic basis. Figure 5 shows that, in BMS mice conditioned with Cy/TBI that exhibit the most severe IPS
injury, the increase of MCP-1 (as measured by ELISA) in the lung
precedes the increase in host monocytes (APCs) as assessed by host
major histocompatibility complex class II expression.6 The
increase in MCP-1 did not correlate with the influx of other cell types
such as neutrophils or T cells. In contrast, the levels of MIP-1
appeared to accompany the presence of infiltrating donor T cells,
suggesting either that there is a short time lag between MIP-1
increase (from resident cells) and the recruitment of T cells or that
the infiltrating T cells themselves are producing MIP-1 .

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| Fig 5.
Comparison of MCP-1 and MIP-1 levels in the lung with
frequencies of host monocytes and donor T cells.
indicates host monocytes; , donor T cells. B10.BR recipient mice
were preconditioned with TBI (7.5 Gy, day 1) and Cy (120 mg/kg
per day, days 3, 2) and given C57BL/6 BM with
15 × 106 spleen cells (BMS) on the day of BMT (day
0). Chemokine levels in picograms per milliliter of BAL fluid (in
shaded box) were determined by ELISA of lung protein extracts as
described in "Materials and methods" from mice killed on day
3 (prior to Cy administration), day 0 (prior to BMT), day 3, and
day 7 after BMT. Frequencies of host monocytes and donor T cells (as a
percentage of total nucleated cells) were determined by
immunohistochemical staining of lung cryosections using biotinylated
monoclonal antibodies as described previously.6
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 |
Discussion |
This is the first comprehensive analysis of chemokines produced
locally, in the lung, and systemically, during the generation of IPS in
the peri-BMT period in our established murine model. Collectively, the
data indicate that severe IPS injury is associated with increases of
chemokines in the lung compartments. We found an induction of CC
chemokines (especially MCP-1, MIP-1 , RANTES, and C10) and a CXC
chemokine (IP-10) that attract T cells and monocytes in the lung by day
7 post-BMT. These increases, for the most part, were
dependent on the coinfusion of allogeneic T cells with the BM inoculum.
In contrast, CXC chemokines that attract neutrophils were only
moderately elevated compared with normal. The inflammatory pattern
observed correlates with the chemokine data and is consistent with our
previous findings on the composition of the cellular infiltrate of the
lung at this time point, ie, a predominance of monocytes and T cells,
the target cells of CC chemokines.
On Day 0 at the time of BMT, we found an approximate 6.5-fold increased
level of MCP-1 in the serum that is probably relevant in mobilizing
monocytes into the circulation. MCP-1 is produced by many cell types,
including endothelial cells, epithelial cells, smooth muscle cells,
fibroblasts, lymphocytes, eosinophils, monocytes, and macrophages
(peritoneal and alveolar)19,20 and is considered to be
essential for monocyte recruitment21 probably by
up-regulation of adhesion molecules on monocytes.22,23
Damage to cells by irradiation causes the release of intracellular
contents and acute-phase reactants. The increase in serum MCP-1 was
potentiated by Cy increasing values by about 4-fold. This is probably
due to the greater damage caused by the Cy/TBI combination and may be
the cause of the Cy-mediated acceleration of the monocyte infiltration
post-BMT.6 Monocytes preferentially use the chemokine
receptor CCR2 for MCP-1-mediated migration,24 and we did
find an increase in CCR2 mRNA in the lungs of IPS mice (data not
shown). On day 7 post-BMT, there was a T-cell-dependent increase in
the MCP-1 levels in the serum. This increase coincides with increases
in the serum levels of the cytokines interleukin-1 , tumor necrosis
factor- , and interferon- ,6 combinations of which can
stimulate production of MCP-1 in endothelial cells.25 MCP-1
was highest in the mice with the most significant host monocyte influx.
We determined, by both RPA and in situ hybridization analyses of mRNA,
that the lung parenchyma and epithelium is a major source of MCP-1 as
least as early as day 3 post-BMT. RPA analysis showed that MCP-1 mRNA
transcription in the lung is significantly induced by irradiation and
is further potentiated by allogeneic T cells. We found that MCP-1
protein levels in lung parenchyma and BAL continued to increase only in
mice receiving allogeneic T cells (with potentiation of this effect by
Cy only in BAL fluid). These data imply that there is a
T-cell-dependent posttranscriptional regulation of MCP-1 in the lung.
The increase of MCP-1 (as measured by ELISA) in the lung preceded the
increase in host monocytes (APCs). These data support the hypothesis
that MCP-1 produced in the lung by resident cells is responsible for
generating the MCP-1 chemotactic gradient for the recruitment of host
monocytes to the lung post-BMT.
MIP-1 , a CD8+ T-cell chemoattractant in vivo, was
elevated in a T-dependent manner and to the greatest extent in the lung parencyma and BAL fluid under conditions that resulted in the highest
influx of CD8+ T cells into the lung. The importance of
donor T-cell-derived MIP-1 for the generation of GVHD has been
recently reported for the lungs, liver, and intestine but only across
the class I major histocompatibility complex barrier.26
This is consistent with the preferential migration of CD8+
T cells in response to MIP-1 .27,28 It is likely, in our
IPS model, that MIP-1 is being produced by the donor T cells because the lung and BAL levels of MIP-1 did not rise significantly until day 7 post-BMT, concomitant with the influx of donor CD8+ T
cells; however, we cannot exclude the posssibility that host alveolar
macrophages may be producing MIP-1 , as has been described for
bleomycin-induced lung injury in rodents.29 Also, other cells can make MIP-1 , including monocytes, neutrophils, fibroblasts, and bronchiolar epithelium. It has been shown that MIP-1 can decrease interleukin-4 production,30 and that may be a
contributing factor skewing the CD4 response to a Th1-mediated one,
because we have seen significant levels of interferon- in the BAL
fluid of IPS mice. Th1 cells express CCR531,32 and
therefore can respond to MIP-1 and RANTES,33 both of
which were elevated in BAL fluid post-BMT. The increase in mRNA for
IP-10 (a monocyte and Th1-cell chemoattractant) in the lungs of mice
with IPS may be relevant, because it is induced by
interferon- ,34 which we also find elevated in
IPS.6,7,35 In addition, we found an increase in the
expression of CCR5 mRNA in the lungs of mice with IPS consistent with
the influx of inflammatory Th1 cells (data not shown).
The CC chemokine C10 was also increased in a T-dependent manner in the
lungs, BAL fluid, and sera post-BMT. The function of C10 is unknown,
but it is presumed to play a role in hematopoiesis, because it is
produced by cells newly derived from bone marrow36 and it
is chemotactic for CD4+ T cells, B cells, monocytes, and NK
cells. It is unique not only because of its genetic
structure37 but also in that it is not induced by
lipopolysaccharide stimulation and is distinctly
regulated, requiring de novo protein synthesis for its
induction.38 Recent evidence indicates that C10 is a
chemoattractant for eosinophils,39 but eosinophil
recruitment is not a characterisitc of our IPS model and, in addition,
we could not demonstrate the presence in the lung of mRNA for CCR3
found on eosinophils (data not shown). The role of C10 in our IPS model
remains unknown.
The demonstration of increases in chemokines that attract monocytes and
T cells in the lungs and airway space post-BMT raises the question of
whether these chemokines regulate GVHD responses in other GVHD target
organs. This comprehensive analysis of the chemokines induced in the
peri-BMT period will be beneficial in the development of strategies to
circumvent the inflammatory events leading to GVHD and IPS.
 |
Acknowledgments |
The expert technical assistance of Naomi Fujioka, Marie Burdick,
Sheila Scully, Alana Eli, Stacey Hermanson, Chris Lees, Erika Estevez,
Nhien Bui, and Kelly Coffey is greatly appreciated. We thank Jerry
Sedgewick and John Oja from the BioImaging Processing Lab at the
University of Minnesota for help with microscopy imaging. We also thank
Dr Patricia A. Taylor for helpful discussions.
 |
Footnotes |
Submitted November 10, 1999; accepted March 29, 2000.
Supported by National Institutes of Health (grant HL 55209), the
Minnesota Medical Foundation, and the Viking Children's Fund.
Reprints: Angela Panoskaltsis-Mortari, University of Minnesota,
Dept of Pediatrics, Division of Heme/Onc/Blood and Marrow Transplant
Program, Box 366 Mayo, 420 Delaware St SE, Minneapolis, MN 55455;
e-mail: panos001{at}tc.umn.edu.
The publication costs of this
article were defrayed in part by
page charge payment. Therefore,
and solely to indicate this fact,
this article is hereby marked
"advertisement"
in accordance with 18 U.S.C.
section 1734.
 |
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