Reconstitution of Interleukin-17–Producing T Helper Cells after Allogeneic Hematopoietic Cell Transplantation  Felix Bahr, Rebekka Wehner, Uwe Platzbecker,

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Reconstitution of Interleukin-17–Producing T Helper Cells after Allogeneic Hematopoietic Cell Transplantation  Felix Bahr, Rebekka Wehner, Uwe Platzbecker, Martin Wermke, Nona Shayegi, Jan Moritz Middeke, Christoph Röllig, Johannes Schetelig, Gerhard Ehninger, Marc Schmitz, Martin Bornhäuser, Sebastian Tuve  Biology of Blood and Marrow Transplantation  Volume 19, Issue 3, Pages 357-365 (March 2013) DOI: 10.1016/j.bbmt.2012.11.018 Copyright © 2013 American Society for Blood and Marrow Transplantation Terms and Conditions

Figure 1 (A) Quantification of IFN-γ– and IL-17A–producing T helper cells using flow cytometry. Gating of IFN-γ−IL-17− (non-Th1/17), IFN-γ+IL-17− (Th1), IFN-γ+IL-17+ (TH1/17), and IFN-γ−IL-17+ (Th17) within the CD3+CD4+ T cell subset using intracellular cytokine staining. A representative flow chart of one patient 42 days after HCT is shown. (B and C) Reconstitution of lymphocytes (B) and CD3+CD4−/CD3+CD4+ T cells (C) after HCT. Data of patients with no complications (n = 29) are shown as dot plots (left panels) and columns (right panels). (Left panels) Dots represent cell counts (GPt/L or MPt/L) in one patient at one time point after HCT. Linear regression curves (trend lines) and R2 values are indicated. (Right panels) Columns show the mean cell counts (± SD) of healthy donors (n = 8) compared with patients (n = 29) at different time periods after HCT. *P < .05, **P < .01, ***P < .001, n.s., not significant. Biology of Blood and Marrow Transplantation 2013 19, 357-365DOI: (10.1016/j.bbmt.2012.11.018) Copyright © 2013 American Society for Blood and Marrow Transplantation Terms and Conditions

Figure 2 Reconstitution of IFN-γ– and IL-17–producing T helper cells after HCT. CD3+CD4+ T cells were quantified according to their production of IFN-γ and IL-17 (Figure 1A). Data of patients with no complications (n = 29) are shown as dot plots (left panels) and columns (right panels). (Left panels) Dots represent cell count (KPt/L) in one patient at one time point after HCT. Linear regression curves (trend lines) and R2 values are indicated. (Right panels) Columns show the mean cell counts (± SD) of healthy donors (n = 8) compared with patients (n = 29) at different time periods after HCT. *P < .05, **P < .01, ***P < .001, n.s., not significant. Biology of Blood and Marrow Transplantation 2013 19, 357-365DOI: (10.1016/j.bbmt.2012.11.018) Copyright © 2013 American Society for Blood and Marrow Transplantation Terms and Conditions

Figure 3 Effect of ATG on the reconstitution of lymphocytes (A), CD3+CD4−/CD3+CD4+ T cells (B), and Th1, Th17, and Th1/17 cells (C). Data of patients with ATG (n = 11) versus time-matched control subjects (n = 29) are shown. Mean quantity (± SD) of lymphocytes, CD3+CD4+/CD3+CD4− T cells, and T helper cells are indicated in GPt/L, MPt/L, or KPt/L at different time periods after HCT. *P < .05, **P < .01, ***P < .001, n.s., not significant. Biology of Blood and Marrow Transplantation 2013 19, 357-365DOI: (10.1016/j.bbmt.2012.11.018) Copyright © 2013 American Society for Blood and Marrow Transplantation Terms and Conditions

Figure 4 Impact of acute GVHD grade I (A-C) and II-IV (D-F) on the frequency of lymphocytes, CD3+CD4−/CD3+CD4+ T cells, and Th1, Th17, and Th1/17 cells. Data of patients with acute GVHD grade I (A-C, n = 6) and grade II-IV (D-F, n = 8) versus time-matched control subjects (n = 22 and n = 24, respectively) are shown. Mean quantity (± SD) of lymphocytes (A and D), CD3+CD4+/CD3+CD4− T cells (B and E), and IL-17/IFN-γ–producing T helper cells (C and F) are indicated in GPt/L, MPt/L, or KPt/L. n.s., not significant. Biology of Blood and Marrow Transplantation 2013 19, 357-365DOI: (10.1016/j.bbmt.2012.11.018) Copyright © 2013 American Society for Blood and Marrow Transplantation Terms and Conditions

Figure 5 Modulation of lymphocyte, CD3+CD4+/CD3+CD4− T cells, and Th1, Th17, and Th1/17 cell counts by CMV reactivation (A-C) and early bacterial infection (D-F). Data of patients with CMV reactivation (A-C, n = 7) and early bacterial infection (D-F, n = 15) versus time-matched control subjects (n = 21 and n = 20, respectively) are shown. Mean quantity (± SD) of lymphocytes (A and D), CD3+CD4+/CD3+CD4− T cells (B and E), and IL-17/IFN-γ–producing T helper cells (C and F) are indicated in GPt/L, MPt/L, or KPt/L. *P < .05, **P < .01, ***P < .001, n.s., not significant. Biology of Blood and Marrow Transplantation 2013 19, 357-365DOI: (10.1016/j.bbmt.2012.11.018) Copyright © 2013 American Society for Blood and Marrow Transplantation Terms and Conditions