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Blood, 30 April 2009, Vol. 113, No. 18, pp. 4458-4467.
Prepublished online as a Blood First Edition Paper on February 12, 2009; DOI 10.1182/blood-2008-06-165506.


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Submitted June 27, 2008
Accepted January 18, 2009

Host natural killer T cells induce an IL-4 dependent expansion of donor CD4+CD25+Foxp3+ Tregs that protects against graft-versus-host disease

Asha B. Pillai*, Tracy I. George, Suparna Dutt, and Samuel Strober

Department of Medicine, Division of Immunology and Rheumatology, Stanford University School of Medicine, Stanford, CA, United States
Department of Pathology, Stanford University School of Medicine, Stanford, CA, United States

* Corresponding author; email: asha.pillai.md{at}gmail.com.

Though CD4+CD25+ T cells (Tregs) and natural killer T cells (NKT cells) each protect against graft-versus-host disease (GVHD), interactions between these two regulatory cell populations after allogeneic bone marrow transplantation (BMT) have not been studied. We show that host NKT cells can induce an in vivo expansion of donor Tregs that prevents lethal GVHD in mice after conditioning with fractionated lymphoid irradiation (TLI) and anti-T cell antibodies, a regimen which models human GVHD-protective non-myeloablative protocols using TLI and anti-thymocyte globulin (ATG) followed by allogeneic hematopoietic cell transplantation (HCT). GVHD protection was lost in NKT cell-deficient J{alpha}18-/- hosts and IL-4-/- hosts, or when the donor transplant was Treg-depleted. Add-back of donor Tregs or wild-type host NKT cells restored GVHD protection. Donor Treg proliferation was lost in IL-4-/- hosts or when IL-4-/- mice were used as the source of NKT cells for adoptive transfer, indicating that host NKT cell augmentation of donor Treg proliferation after TLI/ATS is IL-4-dependent. Our results demonstrate that host NK T cells and donor Tregs can act synergistically after BMT, and provide a mechanism by which strategies designed to preserve host regulatory cells can augment in vivo donor Treg expansion to regulate GVHD after allogeneic HCT.


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