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Blood, 15 July 2004, Vol. 104, No. 2, pp. 586-593.
Prepublished online as a Blood First Edition Paper on April 6, 2004; DOI 10.1182/blood-2003-12-4259.
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Submitted December 15, 2003
Accepted March 16, 2004
Donor-derived TNF regulates pulmonary chemokine expression and the development of idiopathic pneumonia syndrome after allogeneic bone marrow transplantation
Gerhard C Hildebrandt, Krystyna M Olkiewicz, Leigh A Corrion, Yayi Chang, Shawn G Clouthier, Chen Liu, and Kenneth R Cooke*
Department of Pediatrics, University of Michigan, Ann Arbor, MI, USA
Department of Pathology, University of Michigan, Ann Arbor, MI, USA
Department of Internal Medicine, University of Michigan, Ann Arbor, MI, USA
Department of Pathology, University of Florida School of Medicine, Gainesville, FL, USA
* Corresponding author; email: krcooke{at}med.umich.edu.
Idiopathic pneumonia syndrome (IPS) is a significant cause of mortality after allogeneic bone marrow transplantation (allo-BMT) and TNF is a significant effector molecule in this process. However, the relative contribution of donor- versus host-derived TNF to the development of IPS has not been elucidated. Using a lethally irradiated parent F1 mouse IPS model, we showed that 5 weeks after transplant allo-BMT recipients developed significant lung injury compared to syngeneic controls, which was associated with increased BAL fluid levels of TNF , elevated numbers of donor-derived TNF -secreting T cells and increased pulmonary macrophage production of TNF to LPS stimulation. Allo-BMT with TNF -/- donor cells resulted in significantly reduced IPS severity, whereas utilization of TNF deficient mice as BMT recipients had no effect on IPS. We next determined that TNF secretion from both donor accessory cells (monocytes/macrophages) and T cells significantly contributed to the development of IPS. Importantly, the absence of donor T cell-derived TNF resulted in a significant decrease in inflammatory chemokine production in the lung and near complete abrogation of IPS. Collectively, these data demonstrate that donor TNF is critical to the development of IPS and reveal a heretofore unknown mechanism for T cell-derived TNF in the evolution of this process.

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