title: Long-term persistence of oligoclonal serum IgM repertoires in patients treated with allogeneic bone marrow transplantation (BMT).
abstract: Immunoglobulin gene rearrangements in patients treated with BMT have restricted repertoire diversity. Clonal variability remains low for 3 months and reconstitution of the humoral immune system appears to follow a wave-like pattern. In the present study we analysed serum IgM and IgG repertoires in 44 patients from 1 week to 3 years after transplantation. We applied a quantitative immunoblot technique in combination with a newly developed method for estimation of repertoire diversity in complex mixtures of antibodies. Our results demonstrate that 60% of BMT patients have severely reduced diversity in the IgM repertoire during and after the first year post-BMT, compared with healthy controls. In contrast, the majority of patients have a polyclonal IgG repertoire, similar to that of healthy controls. Serum IgM repertoires remain oligoclonal even though the serum concentration of total IgM is within normal range around 6 months post-BMT. During the first years after transplantation IgM as well as IgG repertoires are less diverse in patients receiving a BM graft from a sibling donor compared with those receiving a graft from an HLA-matched unrelated donor. Patients in the latter group show a higher incidence of infections and minor antigen mismatches which may promote the development of a diverse immunoglobulin repertoire post-BMT.
authors.affiliation: Department of Immunology, Division of Clinical Immunology, Karolinskia Institutet, Hudinge, Sweden.
authors.forename: I N
authors.initials: IN
authors.lastname: Björk
authors.forename: C
authors.initials: C
authors.lastname: Brissac
authors.forename: M
authors.initials: M
authors.lastname: Remberger
authors.forename: J
authors.initials: J
authors.lastname: Mattsson
authors.forename: S
authors.initials: S
authors.lastname: Klaesson
authors.forename: O
authors.initials: O
authors.lastname: Ringdén
authors.forename: J
authors.initials: J
authors.lastname: Stewart
authors.forename: I
authors.initials: I
authors.lastname: Lundkvist
mesh_terms: D000328:Adult; D000916:Antibody Diversity; D016026:Bone Marrow Transplantation / Q000276:immunology*; D016022:Case-Control Studies; D006085:Graft Survival; D006801:Humans; D007074:Immunoglobulin G / Q000097:blood; D007075:Immunoglobulin M / Q000097:blood*; D019520:Living Donors; D008875:Middle Aged; D009679:Nuclear Family; D013997:Time Factors; D014184:Transplantation, Homologous
chemical_list: D007074:Immunoglobulin G; D007075:Immunoglobulin M