title: Pneumocystis carinii infection sensitizes lung to radiation-induced injury after syngeneic marrow transplantation: role of CD4+ T cells.
abstract: A murine model of bone marrow transplant (BMT)-related lung injury was developed to study how infection sensitizes lung to the damaging effects of total body irradiation (TBI) at infectious and TBI doses that individually do not cause injury. Mice infected with Pneumocystis carinii exhibited an asymptomatic, rapid, and transient influx of eosinophils and T cells in bronchoalveolar lavage fluid (BALF). In contrast, mice infected with P. carinii 7 days before receiving TBI and syngeneic BMT (P. carinii/TBI mice) exhibited severe pulmonary dysfunction, surfactant aggregate depletion, and surfactant activity reductions at 17 days post-BMT. BALF from P. carinii/TBI mice contained a disproportionate initial influx of CD4(+) T cells (CD4(+):CD8(+) ratio of 2.7) that correlated with progressive lung injury (from 8 to 17 days post-BMT). Levels of TNF-alpha in BALF were significantly increased in P. carinii/TBI mice compared with mice given either insult alone, with peak values found at 11 days post-BMT. In vivo depletion of CD4(+) T cells in P. carinii/TBI mice abrogated pulmonary dysfunction and reduced TNF-alpha levels in BALF, whereas depletion of CD8(+) T cells did not affect lung compliance or TNF-alpha. Lung injury was not attributable to direct P. carinii damage, since CD4-depleted P. carinii/TBI mice that exhibited no injury had higher average lung P. carinii burdens than either mice given P. carinii alone or undepleted P. carinii/TBI mice. Together, these results indicate that P. carinii infection can sensitize the lung to subsequent TBI-mediated lung injury via a process dependent on non-alloreactive CD4(+) T cells.
authors.affiliation: Division of Hematology/Oncology/Bone Marrow Transplant, Department of Pediatrics, University of Rochester Medical Center, 601 Elmwood Ave., Rochester, NY 14642, USA. lauren_bruckner@urmc.rochester.edu
authors.forename: Lauren
authors.initials: L
authors.lastname: Bruckner
authors.forename: Francis
authors.initials: F
authors.lastname: Gigliotti
authors.forename: Terry
authors.initials: T
authors.lastname: Wright
authors.forename: Allen
authors.initials: A
authors.lastname: Harmsen
authors.forename: Robert H
authors.initials: RH
authors.lastname: Notter
authors.forename: Patricia
authors.initials: P
authors.lastname: Chess
authors.forename: Zhengdong
authors.initials: Z
authors.lastname: Wang
authors.forename: Jack
authors.initials: J
authors.lastname: Finkelstein
mesh_terms: D000818:Animals; D016026:Bone Marrow Transplantation / Q000276:immunology*; D015496:CD4-Positive T-Lymphocytes / Q000276:immunology*; D008212:Lymphocyte Depletion; D017710:Lymphocyte Transfusion; D051379:Mice; D008810:Mice, Inbred C57BL; D016513:Mice, SCID; D016720:Pneumocystis Infections / Q000503:physiopathology* / Q000628:therapy*; D011832:Radiation Injuries / Q000503:physiopathology*; D012128:Respiratory Distress Syndrome / Q000209:etiology*; D014185:Transplantation, Isogeneic