title: High levels of interleukin 10 production in vivo are associated with tolerance in SCID patients transplanted with HLA mismatched hematopoietic stem cells.
abstract: Transplantation of HLA mismatched hematopoietic stem cells in patients with severe combined immunodeficiency (SCID) can result in a selective engraftment of T cells of donor origin with complete immunologic reconstitution and in vivo tolerance. The latter may occur in the absence of clonal deletion of donor T lymphocytes able to recognize the host HLA antigens. The activity of these host-reactive T cells is suppressed in vivo, since no graft-vs. -host disease is observed in these human chimeras. Here it is shown that the CD4+ host-reactive T cell clones isolated from a SCID patient transplanted with fetal liver stem cells produce unusually high quantities of interleukin 10 (IL-10) and very low amounts of IL-2 after antigen-specific stimulation in vitro. The specific proliferative responses of the host-reactive T cell clones were considerably enhanced in the presence of neutralizing concentrations of an anti-IL-10 monoclonal antibody, suggesting that high levels of endogenous IL-10 suppress the activity of these cells. These in vitro data correlate with observations made in vivo. Semi-quantitative polymerase chain reaction analysis carried out on freshly isolated peripheral blood mononuclear cells (PBMC) of the patient indicated that the levels of IL-10 messenger RNA (mRNA) expression were strongly enhanced, whereas IL-2 mRNA expression was much lower than that in PBMC of healthy donors. In vivo IL-10 mRNA expression was not only high in the T cells, but also in the non-T cell fraction, indicating that host cells also contributed to the high levels of IL-10 in vivo. Patient-derived monocytes were found to be major IL-10 producers. Although no circulating IL-10 could be detected, freshly isolated monocytes of the patient showed a reduced expression of class II HLA antigens. However, their capacity to stimulate T cells of normal donors in primary mixed lymphocyte cultures was within the normal range. Interestingly, similar high in vivo IL-10 mRNA expressions in the T and non-T cell compartment were also observed in three SCID patients transplanted with fetal liver stem cells and in four SCID patients transplanted with T cell-depleted haploidentical bone marrow stem cells. Taken together, these data indicate that high endogenous IL-10 production is a general phenomenon in SCID patients in whom allogenic stem cell transplantation results in immunologic reconstitution and induction of tolerance. Both donor T cells and host accessory cells contribute to these high levels of IL-10, which would suppress the activity of host-reactive T cell in vivo.
authors.affiliation: Human Immunology Department, DNAX Research Institute, Palo Alto, California 94303-1104.
authors.forename: R
authors.initials: R
authors.lastname: Bacchetta
authors.forename: M
authors.initials: M
authors.lastname: Bigler
authors.forename: J L
authors.initials: JL
authors.lastname: Touraine
authors.forename: R
authors.initials: R
authors.lastname: Parkman
authors.forename: P A
authors.initials: PA
authors.lastname: Tovo
authors.forename: J
authors.initials: J
authors.lastname: Abrams
authors.forename: R
authors.initials: R
authors.lastname: de Waal Malefyt
authors.forename: J E
authors.initials: JE
authors.lastname: de Vries
authors.forename: M G
authors.initials: MG
authors.lastname: Roncarolo
mesh_terms: D001483:Base Sequence; D015496:CD4-Positive T-Lymphocytes / Q000276:immunology; D002455:Cell Division; D002999:Clone Cells; D004247:DNA; D006680:HLA Antigens / Q000276:immunology*; D006684:HLA-DR Antigens / Q000276:immunology; D018380:Hematopoietic Stem Cell Transplantation; D006412:Hematopoietic Stem Cells / Q000276:immunology; D006801:Humans; D007108:Immune Tolerance; D016753:Interleukin-10 / Q000096:biosynthesis*; D007376:Interleukin-2 / Q000096:biosynthesis; D008099:Liver / Q000166:cytology; D008297:Male; D008969:Molecular Sequence Data; D009000:Monocytes / Q000276:immunology; D016133:Polymerase Chain Reaction; D016511:Severe Combined Immunodeficiency / Q000276:immunology* / Q000628:therapy
chemical_list: D006680:HLA Antigens; D006684:HLA-DR Antigens; D007376:Interleukin-2; D016753:Interleukin-10; D004247:DNA