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Blood, 15 February 2005, Vol. 105, No. 4, pp. 1828-1836.
Prepublished online as a Blood First Edition Paper on October 19, 2004; DOI 10.1182/blood-2004-08-3213.
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Submitted August 19, 2004
Accepted October 8, 2004
Donor CD4+CD25+ T cells promote engraftment and tolerance following MHC mismatched hematopoietic cell transplantation
Alan M Hanash and Robert B Levy*
Department of Microbiology and Immunology, University of Miami School of Medicine, Miami, FL, USA
* Corresponding author; email: rlevy{at}med.miami.edu.
Allogeneic bone marrow transplantation (BMT) is a potentially curative treatment for both inherited and acquired diseases of the hematopoietic compartment; however, its wider use is limited by the frequent and severe outcome of graft vs. host disease (GVHD). Unfortunately, efforts to reduce GVHD by removing donor T-cells have resulted in poor engraftment and elevated disease recurrence. Alternative cell populations capable of supporting allogeneic hematopoietic stem/progenitor cell engraftment without inducing GVHD could increase numbers of potential recipients while broadening the pool of acceptable donors. Although unfractionated CD4+ T cells have not been shown to be an efficient facilitating population, CD4+CD25+ regulatory (T-reg) cells were examined for their capacity to support allogeneic hematopoietic engraftment. In a murine fully MHC-mismatched BMT model, co-transplantation of donor B6 T-regs into sublethally conditioned BALB/c recipients supported significantly greater lineage committed and multi-potential donor progenitors in recipient spleens one week post-transplant and significantly increased long-term multi-lineage donor chimerism. Donor engraftment occurred without GVHD-related weight loss or lethality and was associated with tolerance to donor and host antigens by in vitro and in vivo analyses. Donor CD4+CD25+ T cells may therefore represent a potential alternative to unfractionated T cells for promotion of allogeneic engraftment in clinical hematopoietic cell.

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