title: Alterations in chemokine receptor CCR5 expression on blood dendritic cells correlate with acute graft-versus-host disease.
abstract: BACKGROUND
  Dendritic cells (DC) are important in the development of acute graft-versus-host disease (GVHD) after allogeneic hemopoietic cell transplantation (alloHCT). The trafficking of immature DC from blood to GVHD target organs is likely to be regulated by chemokine receptors.
  
  
  METHODS
  We performed flow cytometry to document the expression of chemokine receptors on circulating DC and correlated the findings after alloHCT with occurrence of acute GVHD.
  
  
  RESULTS
  In normal individuals, plasmacytoid DC (pDC) expressed high levels of CCR5, whereas the major CD16 myeloid DC subpopulation lacked CCR5. However, its expression on CD16 cells was induced by culture in allogeneic mixed lymphocyte reaction supernatant, an effect largely mediated by interferon-γ. CCR5 was expressed on a significant proportion of CD16 DC in 42 alloHCT patients, whereas it was down-regulated on pDC. The maximum percentage of CCR5CD16 DC, at any time after transplantation, correlated with acute GVHD, whereas the minimum CCR5 on pDC showed a similar correlation. Before developing signs of GVHD, the maximum percentage CCR5CD16 DC was higher in patients with GVHD grades II to IV than in GVHD grades 0 and I, whereas the minimum percentage CCR5 on pDC was lower in GVHD grades II to IV than in GVHD grades 0 and I. CCR5 levels more than 20.5% on CD16 myeloid DC and less than 22.6% on CD123 pDC correlated with subsequent GVHD grades II to IV with high sensitivities and specificities.
  
  
  CONCLUSIONS
  These observations may reflect DC activation and altered homing during the alloimmune response and could allow early diagnosis and therapeutic intervention before the clinical diagnosis of GVHD.
authors.affiliation: 1 Flow Cytometry Unit, Institute of Clinical Pathology and Medical Research, Westmead Hospital, Westmead, New South Wales, Australia. 2 Dendritic Cell Biology and Therapeutics Group, ANZAC Medical Research Institute, Concord, New South Wales, Australia. 3 Blood and Marrow Transplant Service, Westmead Hospital, Westmead, New South Wales, Australia. 4 Address correspondence to: Kenneth F. Bradstock, M.B., B.S., P.hD., Haematology Department Westmead Hospital, Darcy Rd, Westmead, New South Wales, Australia 2145.
authors.forename: Kifah
authors.initials: K
authors.lastname: Shahin
authors.forename: Mary
authors.initials: M
authors.lastname: Sartor
authors.forename: Derek N J
authors.initials: DN
authors.lastname: Hart
authors.forename: Kenneth F
authors.initials: KF
authors.lastname: Bradstock
mesh_terms: D000208:Acute Disease; D000293:Adolescent; D000328:Adult; D000368:Aged; D003713:Dendritic Cells / Q000276:immunology* / Q000378:metabolism; D005260:Female; D005434:Flow Cytometry; D058851:GPI-Linked Proteins / Q000276:immunology / Q000378:metabolism; D006086:Graft vs Host Disease / Q000276:immunology* / Q000378:metabolism; D018380:Hematopoietic Stem Cell Transplantation / Q000009:adverse effects*; D006801:Humans; D008297:Male; D008875:Middle Aged; D011183:Postoperative Complications / Q000276:immunology* / Q000378:metabolism; D019713:Receptors, CCR5 / Q000276:immunology* / Q000378:metabolism; D017452:Receptors, IgG / Q000276:immunology / Q000378:metabolism; D014184:Transplantation, Homologous; D055815:Young Adult
chemical_list: C584933:CCR5 protein, human; C428200:FCGR3B protein, human; D058851:GPI-Linked Proteins; D019713:Receptors, CCR5; D017452:Receptors, IgG