T helper17 Cells Are Sufficient But Not Necessary to Induce Acute Graft-Versus-Host Disease Cristina Iclozan, Yu Yu, Chen Liu, Yaming Liang, Tangsheng.

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T helper17 Cells Are Sufficient But Not Necessary to Induce Acute Graft-Versus-Host Disease Cristina Iclozan, Yu Yu, Chen Liu, Yaming Liang, Tangsheng Yi, Claudio Anasetti, Xue-Zhong Yu Biology of Blood and Marrow Transplantation Volume 16, Issue 2, Pages 170-178 (February 2010) DOI: 10.1016/j.bbmt.2009.09.023 Copyright © 2010 American Society for Blood and Marrow Transplantation Terms and Conditions

Figure 1 Potency and pathologic injures of Th1 and Th17 cells in GVHD induction. (A) Th1 and Th17 cells were generated from B6 naïve CD4+T cells in vitro as described in Materials and Methods. Intracellular expression of IFN-γ and IL-17 on live CD4+ cells is shown on Th1 and Th17 cells in day 4 after in vitro polarization. Intracellular expressions of IL-4 on both cell populations were <1% (data not shown). Lethally irradiated BALB/c (B-D) or B6 (E) recipients were transplanted with B6 TCD-BM alone, or plus B6 CD4+ naïve (B), Th1 (C), or Th17 (D,E) cells as indicated. Data in graph B and E were from 1 experiment with 5 to 6 mice per group, and data in graph C and D were pooled from 3 to 4 replicate experiments with 10 to 18 mice per group. Biology of Blood and Marrow Transplantation 2010 16, 170-178DOI: (10.1016/j.bbmt.2009.09.023) Copyright © 2010 American Society for Blood and Marrow Transplantation Terms and Conditions

Figure 2 Pathologic injuries caused by Th1 and Th17 cells. Lethally irradiated BALB/c mice were transplanted with B6 TCD-BM alone or together with Th1 or Th17 cells (1×106 each) generated from B6 CD4T cells. Recipient mice were euthanized and organs were harvested 2-3 weeks after BMT. Formalin-fixed tissues were embedded in paraffin, sectioned, and stained with H&E. (A) Representative micrographs are from liver (upper), intestine (middle), and lung (lower) of BM alone, Th1, or Th17 groups (original magnification ×200). (B) Histopathology was assessed by an expert pathologist in a blind fashion. The data are pooled from 2 replicate experiments with 5 to 7 recipients per group. Biology of Blood and Marrow Transplantation 2010 16, 170-178DOI: (10.1016/j.bbmt.2009.09.023) Copyright © 2010 American Society for Blood and Marrow Transplantation Terms and Conditions

Figure 3 Expansion and accumulation of Th1 and Th17 cells in allogeneic recipients. Lethally irradiated BALB/c mice were transplanted with B6 TCD-BM alone (5×106) or together with Th1 or Th17 cells in vitro generated from naïve CD4T cells of Luc-Tg mice on B6 background. One million Th1, Th17, or 0.25×106 Th17 cells per recipient were transplanted. On day 4, 7, 11, and 15 after BMT recipient mice were injected i.p. with luciferin substrate. (A) Animals were imaged from the ventral position for quantification of donor T cells, and 2 representative mice per group are shown. (B) The average of relative signal intensity of 4 to 5 mice per group, and the data represent 1 of 3 replicate experiments. Biology of Blood and Marrow Transplantation 2010 16, 170-178DOI: (10.1016/j.bbmt.2009.09.023) Copyright © 2010 American Society for Blood and Marrow Transplantation Terms and Conditions

Figure 4 Anti-CD3 treatment ameliorates GVHD induced by Th1 cells, but not by Th17 cells. Lethally irradiated BALB/c mice were transplanted with TCD-BM alone or plus polarized Th1 (4×106/mouse) or Th17 cells (2×106/mouse) from B6 donors. Half of the recipient mice received anti-CD3 treatment (20μg/recipient i.p. every other day starting on day 0 for 10 doses). Percentages of survival (A) and body weight change (B) are shown, and 4 to 5 recipients were used in each group. Biology of Blood and Marrow Transplantation 2010 16, 170-178DOI: (10.1016/j.bbmt.2009.09.023) Copyright © 2010 American Society for Blood and Marrow Transplantation Terms and Conditions

Figure 5 Stability of Th1 and Th17 phenotype after restimulation in vitro. Naïve T cells from DO11.10 TCR Tg mice were activated with Ova323-339 peptide under polarizing conditions toward Th1 and Th17 for 4 days as described in Figure 1A. After polarization, phenotypes of DO11.10 Th1 and Th17 cells were confirmed as those in Figure 1A (data not shown). Two weeks after primary stimulation, rested Th1 (empty bars) and Th17 (filled bars) cells at 1×106/mL were restimulated with A20, A20 pulsed with OVA peptide, or OVA-transduced (low level OVA expression) A20 B cell lymphoma at 0.5×106/mL. Culture supernatants were harvested 24hours later and measured for levels of IFN-γ (A) and IL-17 (B). The data represent 1 of 2 replicate experiments. Biology of Blood and Marrow Transplantation 2010 16, 170-178DOI: (10.1016/j.bbmt.2009.09.023) Copyright © 2010 American Society for Blood and Marrow Transplantation Terms and Conditions

Figure 6 Role of IFN-γ in Th17 cells induced GVHD. Lethally irradiated BALB/c mice were transplanted with TCD-BM alone, or plus 2×106/mouse Th17 cells generated from WT mice (A), and 0.5×106/mouse Th17 cells generated from WT or IFN-γ−/− B6 mice, respectively (B,C). (A) After 22 days intracellular expression of IL-17, IFN-γ, and TNF-α were measured. % mean±1 SD of intracellular expression of IFN-γ (upper panel) and TNF-α (lower panel) are shown together with IL-17 on donor CD4+H2b+ cells from recipient spleen and liver. GVHD severity assessed by changes over time in recipient survival (B) and body weight (C) is shown. Data are pooled from 2 experiments with 10 to 12 recipients per group. Biology of Blood and Marrow Transplantation 2010 16, 170-178DOI: (10.1016/j.bbmt.2009.09.023) Copyright © 2010 American Society for Blood and Marrow Transplantation Terms and Conditions

Figure 7 RORγt−/− and WT CD4T cells have comparable ability to induce GVHD. Lethally irradiated BALB/c mice were transplanted with TCD-BM alone or plus purified CD4+T cells (1-2×106/mouse) isolated from WT or RORγt−/− mice on B6 background. Percentages of survival (A) and body weight change (B) are shown. Data cumulate 2 independent experiments with 8 to 9 mice per group. Biology of Blood and Marrow Transplantation 2010 16, 170-178DOI: (10.1016/j.bbmt.2009.09.023) Copyright © 2010 American Society for Blood and Marrow Transplantation Terms and Conditions