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Blood, 15 May 2005, Vol. 105, No. 10, pp. 4127-4134. Prepublished online as a Blood First Edition Paper on January 27, 2005; DOI 10.1182/blood-2004-05-1726.
Submitted May 5, 2004
Children's Cancer Research Institute, St. Anna Children's Hospital, Vienna, Austria * Corresponding author; email: andreas.heitger{at}ccri.at.
T-cell dysfunction after human hematopoietic stem cell transplantation (HSCT) is generally attributed to intrinsic T-cell defects. Here we show that the characteristic impaired proliferative responses to polyclonal stimulation of post-HSCT PBMC were markedly (four-fold) improved by T-cell enrichment. Conversely, addback of post-HSCT monocytes to these enriched T cells dampened their proliferative responses, suggesting that post-HSCT monocytes effectively mediate T-cell suppression. As a mechanism possibly contributing to monocyte-mediated T-cell suppression, we investigated monocyte tryptophan catabolism by indoleamine 2,3-dioxygenase into kynurenine, which has been implicated in regulating T-cell responses. Compared to controls, all post-HSCT monocyte-containing cell cultures (total PBMC, monocytes, and monocyte/T-cell co-cultures), but not monocyte-depleted populations, secreted elevated amounts of kynurenine. Blockade of tryptophan catabolism improved the proliferative responses. The slightly increased kynurenine release and substantial release of neopterin by unstimulated post-HSCT monocytes suggests that they were in a state of continuous activation. Superimposed on this state, stimulation of these cells caused a striking, additional increase (ten-fold) in kynurenine release, and they triggered marked apoptosis of autologous post-HSCT T-cells. We conclude that the amplified kynurenine release by post-HSCT monocytes, particularly induced upon stimulation, may underlie their suppressor activity that in turn may contribute to the depressed T-cell immune responses after HSCT.
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