Influence of Donor Microbiota on the Severity of Experimental Graft-versus-Host- Disease Isao Tawara, Chen Liu, Hiroya Tamaki, Tomomi Toubai, Yaping Sun,

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Influence of Donor Microbiota on the Severity of Experimental Graft-versus-Host- Disease Isao Tawara, Chen Liu, Hiroya Tamaki, Tomomi Toubai, Yaping Sun, Rebecca Evers, Evelyn Nieves, Nathan Mathewson, Gabriel Nunez, Pavan Reddy Biology of Blood and Marrow Transplantation Volume 19, Issue 1, Pages 164-168 (January 2013) DOI: 10.1016/j.bbmt.2012.09.001 Copyright © 2013 American Society for Blood and Marrow Transplantation Terms and Conditions

Figure 1 GF mouse T cells respond against allogeneic stimulator, similar to SPF mouse T cells in vitro and in vivo. (A) CD90+ T cells were isolated from SPF-B6 mice (left) or GF-B6 mice (right), and frequencies of CD4+FoxP3+ regulatory T cells were analyzed by flow cytometry. (B) Isolated CD90+ T cells from SPF-B6 (filled bar) or GF-B6 (open bar) mice were plated at 4 × 105/well in a 96-well flat-bottomed plate and cocultured with different numbers of syngeneic B6 or allogeneic BALB/c irradiated (30 Gy) spleen cells for 72 hours. 3H-thymidine (1 μCi/well) incorporation during last 6 hours of culture was measured. (C) Cytokine levels in the supernatant of the 66-hour culture was determined by ELISA. (D and E) B6D2F1 recipients were irradiated (11 Gy) on day -1 and injected with allogeneic 5 × 106 SPF-B6 TCDBM cells plus 2 × 106 SPF-B6 CD90+ T cells (solid bar; n = 3 for each time point) or allogeneic 5 × 106 SPF-B6 TCDBM cells plus 2 × 106 GF-B6 CD90+ T cells (open bar; n = 3 for each time point). Spleen cells and sera were collected from recipients on day 7 or day 14. (D) Spleen cells were counted; stained with anti–H-2Kd, -CD4, and -CD8 mAbs; and analyzed by flow cytometry. Donor CD4 and CD8 T cell expansion was determined based on spleen cell count and the percentage of CD4 and CD8 positivity in gated (H-2Kd−) cells. (E) Cytokine levels in the sera were determined by ELISA. Biology of Blood and Marrow Transplantation 2013 19, 164-168DOI: (10.1016/j.bbmt.2012.09.001) Copyright © 2013 American Society for Blood and Marrow Transplantation Terms and Conditions

Figure 2 GF mouse T cells and SPF mouse T cells induce GVHD to a similar extent. (A) BALB/c recipients were irradiated (8 Gy) on day -1 and injected with syngeneic 5 × 106 BALB/c BM cells (▼; n = 3), allogeneic 5 × 106 SPF C57BL/6J (SPF-B6) TCDBM cells plus 5 × 105 SPF-B6 CD90+ T cells (●; n = 6), or allogeneic 5 × 106 SPF-B6 TCDBM cells plus 5 × 105 GF C57BL/6J (GF-B6) CD90+ T cells (○; n = 6). Survival was monitored daily, and GVHD clinical score and body weight change were monitored weekly. (B) B6D2F1 recipients were irradiated (11 Gy) on day -1 and injected with syngeneic 5 × 106 B6D2F1 BM cells (▼; n = 5), allogeneic 5 × 106 SPF-B6 TCDBM cells plus 2 × 106 SPF-B6 CD90+ T cells (●; n = 11), or allogeneic 5 × 106 SPF-B6 TCDBM cells plus 2 × 106 GF-B6 CD90+ T cells (○; n = 11). Survival was monitored daily, and GVHD clinical score and body weight change were monitored weekly. (C) B6D2F1 recipients were irradiated (11 Gy) on day -1 and injected with allogeneic 5 × 106 SPF-B6 TCDBM cells plus 2 × 106 SPF-B6 CD90+ T cells (solid bar; n = 3 for each time point) or allogeneic 5 × 106 SPF-B6 TCDBM cells plus 2 × 106 GF-B6 CD90+ T cells (open bar; n = 3 for each time point). GVHD target tissue (small intestine and liver) were collected from recipients on day 7 or day 14. Histopathological scores were determined for the small intestine (left) and liver (right). (D) Antibiotic treatment of donors does not mitigate GVHD in the recipients. B6 donor mice were treated with a cocktail of oral antibiotics (open circles; n = 10) or autoclaved water alone (solid circles; n = 11), as described in Materials and Methods. The donor T cells were harvested 10-14 days later and transplanted into allogeneic BALB/c or syngeneic B6 animals (inverted triangle) after conditioning with 10 Gy along with TCDBM from SPF B6 donors. P = not significant. ○ versus ●. Combined data from 2 similar experiments are shown. Biology of Blood and Marrow Transplantation 2013 19, 164-168DOI: (10.1016/j.bbmt.2012.09.001) Copyright © 2013 American Society for Blood and Marrow Transplantation Terms and Conditions