Induction of natural killer T cell-dependent alloreactivity by administration of granulocyte colony-stimulating factor after bone marrow transplantation

Nat Med. 2009 Apr;15(4):436-41. doi: 10.1038/nm.1948. Epub 2009 Mar 29.

Abstract

Granulocyte colony-stimulating factor (G-CSF) is often used to hasten neutrophil recovery after allogeneic bone marrow transplantation (BMT), but the clinical and immunological consequences evoked remain unclear. We examined the effect of G-CSF administration after transplantation in mouse models and found that exposure to either standard G-CSF or pegylated-G-CSF soon after BMT substantially increased graft-versus-host disease (GVHD). This effect was dependent on total body irradiation (TBI) rendering host dendritic cells (DCs) responsive to G-CSF by upregulating their expression of the G-CSF receptor. Stimulation of host DCs by G-CSF subsequently unleashed a cascade of events characterized by donor natural killer T cell (NKT cell) activation, interferon-gamma secretion and CD40-dependent amplification of donor cytotoxic T lymphocyte function during the effector phase of GVHD. Crucially, the detrimental effects of G-CSF were only present when it was administered after TBI conditioning and at a time when residual host antigen presenting cells were still present, perhaps explaining the conflicting and somewhat controversial clinical studies from the large European and North American BMT registries. These data have major implications for the use of G-CSF in disease states where NKT cell activation may have effects on outcome.

MeSH terms

  • Animals
  • Bone Marrow Transplantation / immunology*
  • CD8-Positive T-Lymphocytes / immunology
  • Dendritic Cells / drug effects
  • Dendritic Cells / immunology
  • Graft vs Host Disease / immunology
  • Granulocyte Colony-Stimulating Factor / therapeutic use*
  • Humans
  • Interferon-gamma / physiology
  • Killer Cells, Natural / immunology*
  • Lymphocyte Activation / drug effects
  • Lymphocyte Transfusion
  • Mice
  • Mice, Inbred C57BL
  • Mice, Inbred Strains
  • Models, Animal
  • Neutrophils / drug effects
  • Neutrophils / physiology*
  • T-Lymphocytes / transplantation
  • Transplantation, Homologous / immunology
  • Whole-Body Irradiation

Substances

  • Granulocyte Colony-Stimulating Factor
  • Interferon-gamma