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Blood, 5 March 2009, Vol. 113, No. 10, pp. 2352-2362. Prepublished online as a Blood First Edition Paper on December 4, 2008; DOI 10.1182/blood-2008-08-175448.
TRANSPLANTATION Interleukin-23 secretion by donor antigen-presenting cells is critical for organ-specific pathology in graft-versus-host disease1 Bone Marrow Transplant Program and Departments of 2 Pediatrics, 3 Medicine, and 4 Pathology, Medical College of Wisconsin, Milwaukee
Damage to the gastrointestinal tract during graft-versus-host disease (GVHD) from the conditioning regimen in conjunction with alloreactive donor T cells plays a pivotal role in the pathogenesis of this disease. In this study, we have identified secretion of interleukin-23 (IL-23) by donor antigen-presenting cells (APCs) as a critical event in the induction of GVHD of the colon linking conditioning regimen-induced mucosal injury and lipopoly-saccharide (LPS) translocation to subsequent proinflammatory cytokine production and GVHD-associated pathologic damage. In the absence of donor APC-derived IL-23 secretion, there is a selective and profound reduction in pathologic damage as well as a marked reduction in LPS and proinflammatory cytokine production in the colon microenvironment. The downstream proinflammatory effects of IL-23 are dependent upon donor-derived secretion of interferon-
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