Neutrophil granulocytes recruited upon translocation of intestinal bacteria enhance graft-versus-host disease via tissue damage

Nat Med. 2014 Jun;20(6):648-54. doi: 10.1038/nm.3517. Epub 2014 May 18.

Abstract

Acute graft-versus-host disease (GVHD) considerably limits wider usage of allogeneic hematopoietic cell transplantation (allo-HCT). Antigen-presenting cells and T cells are populations customarily associated with GVHD pathogenesis. Of note, neutrophils are the largest human white blood cell population. The cells cleave chemokines and produce reactive oxygen species, thereby promoting T cell activation. Therefore, during an allogeneic immune response, neutrophils could amplify tissue damage caused by conditioning regimens. We analyzed neutrophil infiltration of the mouse ileum after allo-HCT by in vivo myeloperoxidase imaging and found that infiltration levels were dependent on the local microbial flora and were not detectable under germ-free conditions. Physical or genetic depletion of neutrophils reduced GVHD-related mortality. The contribution of neutrophils to GVHD severity required reactive oxygen species (ROS) because selective Cybb (encoding cytochrome b-245, beta polypeptide, also known as NOX2) deficiency in neutrophils impairing ROS production led to lower levels of tissue damage, GVHD-related mortality and effector phenotype T cells. Enhanced survival of Bcl-xL transgenic neutrophils increased GVHD severity. In contrast, when we transferred neutrophils lacking Toll-like receptor-2 (TLR2), TLR3, TLR4, TLR7 and TLR9, which are normally less strongly activated by translocating bacteria, into wild-type C57BL/6 mice, GVHD severity was reduced. In humans, severity of intestinal GVHD strongly correlated with levels of neutrophils present in GVHD lesions. This study describes a new potential role for neutrophils in the pathogenesis of GVHD in both mice and humans.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Animals
  • Busulfan
  • Cyclophosphamide
  • Flow Cytometry
  • Freund's Adjuvant
  • Graft vs Host Disease / immunology*
  • Graft vs Host Disease / physiopathology
  • Hematopoietic Stem Cell Transplantation / adverse effects*
  • Histological Techniques
  • Ileum / immunology*
  • Ileum / microbiology
  • Immunohistochemistry
  • Kaplan-Meier Estimate
  • Luciferases
  • Magnetic Resonance Imaging
  • Membrane Glycoproteins / genetics
  • Mice
  • Mice, Inbred C57BL
  • Mice, Knockout
  • Microarray Analysis
  • Microbiota / immunology*
  • NADPH Oxidase 2
  • NADPH Oxidases / genetics
  • Neutrophils / immunology*
  • Peroxidase
  • Reactive Oxygen Species / metabolism

Substances

  • Membrane Glycoproteins
  • Reactive Oxygen Species
  • Cyclophosphamide
  • Freund's Adjuvant
  • Peroxidase
  • Luciferases
  • Cybb protein, mouse
  • NADPH Oxidase 2
  • NADPH Oxidases
  • Busulfan