The effect of graft-versus-host disease on skin endothelial and epithelial cell chimerism in stem-cell transplant recipients.
BACKGROUND
Recent evidence indicates that bone marrow-derived cells contribute to endothelial and epithelial cell renewal in recipients of an allogeneic stem-cell transplantation (SCT). Controversy remains on the biological significance of these donor-derived cells.


METHODS
This study investigated the occurrence of endothelial and epithelial cell chimerism in relation to the conditioning regimen, time interval after SCT, and development of acute and chronic graft-versus-host disease (GVHD). Fifty-five skin biopsy samples from 35 female patients transplanted with a male donor were screened for donor-derived endothelial and epithelial cells using in situ hybridization for Y chromosomes in combination with immunohistochemical cell-marking techniques.


RESULTS
Endothelial cell chimerism was found in 25% of the biopsies and increased in time after SCT. Its appearance was increased in patients with acute GVHD more than 2 weeks before biopsy. Epithelial cell chimerism was found in 85% of the biopsies. Appearance of epithelial cell chimerism was not correlated with the time interval after SCT or with tissue damage caused by GVHD.


CONCLUSIONS
From these results, we conclude that donor-derived endothelial cell chimerism results from repair of damaged endothelium and maintenance of vascular homeostasis. In contrast, epithelial cell chimerism follows a more uniform pattern of engraftment, not influenced by tissue damage.
Department of Paediatrics, Division of Immunology, Haematology, Oncology and Bone Marrow Transplantation and Autoimmune Diseases, Leiden University Medical Centre, Leiden, The Netherlands. A.J.Willemze@lumc.nl
Annemieke J
AJ
Willemze
Astrid C
AC
Bakker
Peter A
PA
von dem Borne
Ingeborg M
IM
Bajema
Jaak M
JM
Vossen
D000293:Adolescent; D000328:Adult; D001706:Biopsy; D002648:Child; D002675:Child, Preschool; D042783:Endothelial Cells / Q000473:pathology; D004847:Epithelial Cells / Q000473:pathology; D005260:Female; D006086:Graft vs Host Disease / Q000473:pathology*; D006801:Humans; D007223:Infant; D008297:Male; D008875:Middle Aged; D012867:Skin / Q000473:pathology*; D033581:Stem Cell Transplantation / Q000009:adverse effects*; D018183:Transplantation Chimera; D023001:Transplantation Tolerance; D014184:Transplantation, Homologous; D055815:Young Adult