Stem cell mobilization with G-CSF induces type 17 differentiation and promotes scleroderma

Blood. 2010 Aug 5;116(5):819-28. doi: 10.1182/blood-2009-11-256495. Epub 2010 Apr 30.

Abstract

The recent shift to the use of stem cells mobilized by granulocyte colony-stimulating factor (G-CSF) for hematopoietic transplantation has increased chronic graftversus-host disease (GVHD), although the mechanisms of this are unclear. We have found that G-CSF invokes potent type 17 rather than type 1 or type 2 differentiation. The amplification of interleukin-17 (IL-17) production by G-CSF occurs in both CD4 and CD8 conventional T cells and is dependent on, and downstream of, G-CSF-induced IL-21 signaling. Importantly, donor IL-17A controls the infiltration of macrophages into skin and cutaneous fibrosis, manifesting late after transplantation as scleroderma. Interestingly, donor CD8 T cells were the predominant source of IL-17A after transplantation and could mediate scleroderma independently of CD4 T cells. This study provides a logical explanation for the propensity of allogeneic stem cell transplantation to invoke sclerodermatous GVHD and suggests a therapeutic strategy for intervention.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Animals
  • Bone Marrow Transplantation / adverse effects*
  • CD4-Positive T-Lymphocytes / metabolism*
  • CD8-Positive T-Lymphocytes / metabolism*
  • Cell Differentiation / drug effects
  • Crosses, Genetic
  • Cytokines / biosynthesis
  • Female
  • Fibrosis
  • Graft vs Host Disease / etiology*
  • Hematopoietic Stem Cell Mobilization / adverse effects*
  • Hematopoietic Stem Cell Transplantation / adverse effects*
  • Humans
  • Interleukin-17 / metabolism
  • Interleukin-17 / physiology*
  • Interleukins / physiology*
  • Macrophages / physiology
  • Mice
  • Mice, Inbred BALB C
  • Mice, Inbred DBA
  • Radiation Chimera
  • Scleroderma, Localized / etiology*
  • Signal Transduction
  • Skin / immunology
  • Skin / pathology
  • T-Lymphocyte Subsets / transplantation*
  • Transplantation, Homologous / adverse effects

Substances

  • Cytokines
  • Interleukin-17
  • Interleukins
  • interleukin-21