Extracorporeal Photopheresis Attenuates Murine Graft-versus-Host Disease via Bone Marrow–Derived Interleukin-10 and Preserves Responses to Dendritic Cell.

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Extracorporeal Photopheresis Attenuates Murine Graft-versus-Host Disease via Bone Marrow–Derived Interleukin-10 and Preserves Responses to Dendritic Cell Vaccination Christian M. Capitini, Jessica P.E. Davis, Shannon M. Larabee, Sarah Herby, Nicole M. Nasholm, Terry J. Fry Biology of Blood and Marrow Transplantation Volume 17, Issue 6, Pages 790-799 (June 2011) DOI: 10.1016/j.bbmt.2010.12.712 Copyright © 2011 Terms and Conditions

Figure 1 ECP-treated splenocytes induce apoptosis of lymphocytes in a time-dependent and 8-MOP dose–dependent fashion. A, Splenocytes were treated with 8-MOP, UV light, or both (ECP), and apoptosis was determined by flow cytometric analysis of annexin V over the course of 48 hours. B, Splenocytes were treated with 8-MOP, UV light, or both (ECP), and apoptosis was determined by flow cytometric analysis of annexin V and 7-AAD over the course of 48 hours. C, The rate of apoptosis was ascertained in individual splenic lymphocyte subsets and DCs by flow cytometric analysis of annexin V and 7-AAD over 48 hours. D, Splenocytes were exposed to increasing doses of 8-MOP to determine the minimum concentration that caused maximal apoptosis. Biology of Blood and Marrow Transplantation 2011 17, 790-799DOI: (10.1016/j.bbmt.2010.12.712) Copyright © 2011 Terms and Conditions

Figure 2 ECP-treated splenocytes attenuate GVHD-associated weight loss after TCR BMT, leading to an increase in B220+ cells and Tregs, and are effective regardless of the source of ECP-treated cells. A, C3H.SW recipients received either TCD or TCR B6 BM on day +0, followed by untreated (no ECP) or ECP-treated B6 splenocytes on day +1, and were followed for weight loss (n = 7-8 mice per group). ∗P < .05; ∗∗P < .005. B, Flow cytometric analysis of splenic B220+ cells performed after TCR BMT. C, Flow cytometric analysis of pooled axillary and inguinal lymph nodes for Tregs in mice given UVA-treated splenocytes and mice given ECP-treated splenocytes after TCR BMT. ∗P < .05. D, C3H.SW recipients received TCR B6 BM on day +0, followed by either untreated splenocytes (no ECP) or ECP-treated splenocytes on day +1 from the donor strain (ECP B6), the recipient strain (ECP C3H.SW), or an MHC-matched, mHA-mismatched third party (ECP Balb.b), and followed for weight loss (n = 7-8 mice per group). ∗P < .05. E, C3H.SW recipients received TCR B6 BM on day +0, followed by untreated (no ECP) or ECP-treated MHC-mismatched (C3H.HeNCR ECP) splenocytes on day +1 and followed for weight loss (n = 5 mice per group). ∗P < .05. Biology of Blood and Marrow Transplantation 2011 17, 790-799DOI: (10.1016/j.bbmt.2010.12.712) Copyright © 2011 Terms and Conditions

Figure 3 ECP-treated splenocytes increase in vitro IL-10 production by DCs activated with LPS. Shown are the results of enzyme-linked immunosorbent assay for IL-10 production in supernatants of cultures of B6 mDCs, cocultured with or without ECP-treated B6 splenocytes, activated with increasing concentrations of LPS. ∗P < .05. No IL-10 was detected at an LPS dose of 0.000 μg/mL. Biology of Blood and Marrow Transplantation 2011 17, 790-799DOI: (10.1016/j.bbmt.2010.12.712) Copyright © 2011 Terms and Conditions

Figure 4 ECP-treated splenocytes abrogate CD8+ T cell responses of female mice that did not undergo transplantation to male DC vaccination. A, B6 mice were vaccinated with female or male B6 DCs that had been exposed to ECP-treated splenocytes from varying doses of 8-MOP, after which ELISPOT analysis was performed to quantitate IFN-γ production from UTY-, SMCY-, and DBY-reactive T cells (n = 6-22 mice per group pooled from separate experiments). ∗P < .05; ∗∗P < .01; ∗∗∗P < .001. F, female; NS, not significant. B, Activated B6 DCs were exposed to untreated (no ECP) or ECP-treated B6 splenocytes (ECP) and then examined by flow cytometric analysis for MHC class I and II expression. Biology of Blood and Marrow Transplantation 2011 17, 790-799DOI: (10.1016/j.bbmt.2010.12.712) Copyright © 2011 Terms and Conditions

Figure 5 ECP-treated splenocytes prevent GVHD-associated weight loss when administered before alloreactive T cell infusion, and preserve responses to a male DC vaccine. A, F1 mice were given TCD B6 BM on day +0, followed by B6 DLI on days +14 and +28 to induce GVHD. ECP treatment was given as a separate injection just before DLI infusion as GVHD prophylaxis, and all groups were followed for weight loss (n = 8 mice per group). ∗P < .05; ∗∗P < .01. B, ELISPOT analysis was performed on day +42 to quantitate IFN-γ production from UTY-, SMCY-, and DBY-reactive T cells (n = 6-8 mice per group). ∗∗P < .01; ∗∗∗P < .001. Biology of Blood and Marrow Transplantation 2011 17, 790-799DOI: (10.1016/j.bbmt.2010.12.712) Copyright © 2011 Terms and Conditions

Figure 6 BM-derived IL-10 is necessary for ECP-treated splenocytes to attenuate GVHD-associated weight loss. A, F1 recipients (CD45.1+/CD45.2+) underwent transplantation with TCD B6 (CD45.2+) BM on day +0 and were sacrificed on days +3, +7, +10 and +13 for flow cytometric analysis of CD45.2+CD11c+ reconstitution in the spleen before DLI (n = 3 mice per time point). B, Thymectomized F1 recipients underwent transplantation with TCD B6 wild-type or B6 IL-10-/- BM on day +0 and then treated with DLI (10 × 106 cells) on days +14 and +28. ECP was given as a separate injection to indicated groups just before DLI on days +14 and +28. All groups were followed for weight loss (n = 7 mice per group). Biology of Blood and Marrow Transplantation 2011 17, 790-799DOI: (10.1016/j.bbmt.2010.12.712) Copyright © 2011 Terms and Conditions

Figure S1 B220+ or CD3+ cells in the ECP inocula are not required to prevent GVHD after TCD BMT. F1 recipients received TCD B6 BM on day +0. On days +14 and +28, recipients received either no DLI (no T cells), 10 × 106 DLI only (no ECP), or ECP with whole splenocytes, CD3-depleted splenocytes, or B220-depleted splenocytes, followed by 10 × 106 DLI, and followed for weight loss (n = 7 mice per group). Biology of Blood and Marrow Transplantation 2011 17, 790-799DOI: (10.1016/j.bbmt.2010.12.712) Copyright © 2011 Terms and Conditions

Figure S2 No difference in costimulatory molecule expression by DCs exposed to irradiation versus ECP in vitro was detected. BM-derived DCs were cocultured with untreated, irradiated, or ECP-treated splenocytes and examined for cell surface expression of costimulatory molecules by fluorescence-activated cell sorting analysis. The histograms compare the indicated costimulatory molecule with an isotype control. Biology of Blood and Marrow Transplantation 2011 17, 790-799DOI: (10.1016/j.bbmt.2010.12.712) Copyright © 2011 Terms and Conditions