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Prepublished online as a Blood First Edition Paper on March 27, 2003; DOI 10.1182/blood-2003-01-0266.
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Blood, 15 July 2003, Vol. 102, No. 2, pp. 429-435
PLENARY PAPERS
Impaired thymic negative selection causes autoimmune graft-versus-host disease
Takanori Teshima,
Pavan Reddy,
Chen Liu,
Debra Williams,
Kenneth R. Cooke, and
James L. M. Ferrara
From the Departments of Internal Medicine and Pediatrics, Division of Hematology/Oncology, Blood & Marrow Stem Cell Transplantation Program, University of Michigan Cancer Center, Ann Arbor; and the Department of Pathology, Immunology & Laboratory Medicine, University of Florida College of Medicine, Gainesville.
Animal models with impaired thymic negative selection do not always cause autoimmune diseases despite the development of an autoreactive T-cell repertoire. We investigated the requirements for the de velopment of systemic autoimmune disease by using bone marrow chimeras that lacked expression of major histocompatibility complex (MHC) class II on thymic antigen-presenting cells (APCs), leading to impaired negative selection. We found that impaired negative selection mediated by absence of MHC class II, but not MHC class I, permitted the development of systemic autoimmune disease that is indistinguishable from acute graft-versus-host disease (GVHD). Thymectomy prevented disease, confirming the causal association of the thymus with its development. Adoptive transfer of CD4+ T cells caused GVHD in secondary hosts only when they were irradiated, and cotransfer of peripheral CD4+ and CD8+ T cells from naive mice prevented the disease. These results demonstrate that impaired thymic negative selection can cause lethal autoimmune disease indistinguishable from acute GVHD in the context of a proinflammatory milieu when peripheral regulatory mechanisms are absent.

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