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T-Lymphocyte Subsets in the Lesional Skin of Allogeneic and Autologous Bone Marrow Transplant Patients

T-Lymphocyte Subsets in the Lesional Skin of Allogeneic and Autologous Bone Marrow Transplant... Abstract • Cutaneous biopsy specimens obtained from bone marrow transplant (BMT) patients, most with graft-vshost disease (GVHD), were analyzed for infiltration by helper, cytotoxic, and suppressor T lymphocytes and natural killer cells. Lesional skin from patients with early mild GVHD and drug reactions showed a CD4/CD8 ratio of 5.0 or more, but later biopsy specimens from patients with acute GVHD and the majority of sections from those with chronic GVHD showed a CD4/CD8 ratio of 0.8 to 3.0 due to increased numbers of presumably cytotoxic cells. Significant numbers of suppressor (CD11 + CD16b-) cells were found in only one patient with severe chronic GVHD. Natural killer cells were not found. Preliminary examination of lesional skin from seven autologous BMT patients showed a similar trend of decreased CD4/CD8 ratios in the three patients with a syndrome that resembled GVHD. Analysis of CD4/CD8 ratios in serial biopsy specimens from patients with GVHD may allow more accurate monitoring of the progression of cutaneous GVHD and may help to elucidate the mechanism of development of the GVHD-like reaction in autologous BMT patients. (Arch Dermatol 1988;124:1795-1801) References 1. Gale RP: Graft-vs-host disease . Immunol Rev 1985;88:193-214.Crossref 2. Sale GE, Lerner KG, Barker EA, et al: The skin biopsy in the diagnosis of acute graft-vs-host disease in man . Am J Pathol 1977;89:621-633. 3. Lampert IA, Janossy G, Suitters AJ, et al: Immunological analysis of the skin in graft vs host disease . Clin Exp Immunol 1982;50:123-131. 4. Lever R, Turbitt M, Mackie R, et al: Prospective study of the histological changes in the skin in patients receiving bone marrow transplants . Br J Dermatol 1986;114:161-170.Crossref 5. Atkinson K, Munro V, Vasak E, et al: Mononuclear cell populations in the skin defined by monoclonal antibodies after HLA-identical sibling marrow transplantation . Br J Dermatol 1986;114:145-160.Crossref 6. Guyotat D, Mauduit G, Chouvet B, et al: A sequential study of histological and immunological changes in the skin after allogeneic bone marrow transplantation . Transplantation 1986;41:340-342.Crossref 7. Kaye VN, Neumann PM, Kersey J, et al: Identity of immune cells in graft-vs-host disease of the skin: Analysis using monoclonal antibodies by indirect immunofluorescence . Am J Pathol 1984;116:436-440. 8. Dreno B, Milpied N, Harousseau JL, et al: Cutaneous immunological studies in diagnosis of acute graft-vs-host disease . Br J Dermatol 1986;114:7-15.Crossref 9. Sloane JP, Thomas JA, Imrie SF, et al: Morphological and immunohistological changes in the skin of allogeneic bone marrow recipients . J Clin Pathol 1984;37:919-930.Crossref 10. Glucksberg H, Storb R, Fefer A, et al: Clinical manifestations of graft-vs-host disease in human recipients of marrow from HL-A-matched sibling donors . Transplantation 1974;18:295-304.Crossref 11. Crider MK, Jansen J, Norins AL, et al: Chemotherapy-induced acral erythema in patients receiving bone marrow transplantation . Arch Dermatol 1986;122:1023-1027.Crossref 12. Lerner KG, Kao GF, Storb R, et al: Histopathology of graft-vs-host reaction (GvHR) in human recipients of marrow from HL-A-matched sibling donors . Transplant Proc 1974;6:367-371. 13. Hamilton BL, Michael J, Bevan MJ, et al: Anti-recipient cytotoxic T lymphocyte precursors are present in the spleens of mice with acute graft vs host disease due to minor histocompatibility antigens . J Immunol 1981;126:621-625. 14. Reinsmoen NL, Kersey JH, Bach FH: Detection of HLA restricted anti-minor histocompatibility antigen(s) reactive cells from skin GVHD lesions . Hum Immunol 1984;11:249-257.Crossref 15. Gebel HM, Kaizer H, Landay AL: Characterization of circulating suppressor T lymphocytes in bone marrow transplant recipients . Transplantation 1987;43:258-263.Crossref 16. Niedecken H, Wehrmann W, Bauer R, et al: Reaction of human keratinocytes with the monoclonal antibody anti-Leu-11: An immunohistologic study . J Am Acad Dermatol 1988;18:504-510.Crossref 17. Rappeport J, Reinherz E, Mihm M, et al: Acute graft-vs-host disease in recipients of bone-marrow transplants from identical twin donors . Lancet 1979;2:717-720.Crossref 18. Gluckman E, Devergie A, Sohier J, et al: Graft-vs-host disease in recipients of syngeneic bone marrow . Lancet 1980;1:253-254. 19. Thien SW, Goldman JM, Galton DG: Acute `graft-vs-host disease' after autografting for chronic granulocytic leukemia in transplantation . Ann Intern Med 1981;94:210-211.Crossref 20. L'Age-Stehr J, Diamantstein T: Induction of autoreactive T lymphocytes and their suppressor cells by cyclophosphamide . Nature 1978;271:663-665.Crossref 21. Belanger R, Tutschka PJ, Beschorner WE, et al: Acute graft-vs-host disease in recipients of syngeneic bone marrow . Exp Hematol 1982;10( (suppl) ):23-32. 22. Gozes Y, Umiel T, Meshorer A, et al: Syngeneic GvH induced in popliteal lymph nodes by spleen cells of old C57BL/6 mice . J Immunol 1978;121:2199-2204. 23. Glazier A, Tutschka PJ, Farmer ER, et al: Graft-vs-host disease in cyclosporin A-treated rats after syngeneic and autologous bone marrow reconstitution . J Exp Med 1983;158:1-8.Crossref 24. Hess AD, Horwitz L, Beschorner WE, et al: Development of graft-vs-host disease-like syndrome in cyclosporine-treated rats after syngeneic bone marrow transplantation: I. Development of cytotoxic T lymphocytes with apparent polyclonal anti-Ia specificity, including autoreactivity . J Exp Med 1985;161:718-730.Crossref 25. Cheney RT, Sprent J: Capacity of cyclosporine to induce autograft-vs-host disease and impair intrathymic T-cell differentiation . Transplant Proc 1985;17:528-531. 26. Hood AF, Vogelsang GB, Black LP, et al: Acute graft-vs-host disease: Development following autologous and syngeneic bone marrow transplantation . Arch Dermatol 1987;123:745-750.Crossref http://www.deepdyve.com/assets/images/DeepDyve-Logo-lg.png Archives of Dermatology American Medical Association

T-Lymphocyte Subsets in the Lesional Skin of Allogeneic and Autologous Bone Marrow Transplant Patients

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References (27)

Publisher
American Medical Association
Copyright
Copyright © 1988 American Medical Association. All Rights Reserved.
ISSN
0003-987X
eISSN
1538-3652
DOI
10.1001/archderm.1988.01670120011002
Publisher site
See Article on Publisher Site

Abstract

Abstract • Cutaneous biopsy specimens obtained from bone marrow transplant (BMT) patients, most with graft-vshost disease (GVHD), were analyzed for infiltration by helper, cytotoxic, and suppressor T lymphocytes and natural killer cells. Lesional skin from patients with early mild GVHD and drug reactions showed a CD4/CD8 ratio of 5.0 or more, but later biopsy specimens from patients with acute GVHD and the majority of sections from those with chronic GVHD showed a CD4/CD8 ratio of 0.8 to 3.0 due to increased numbers of presumably cytotoxic cells. Significant numbers of suppressor (CD11 + CD16b-) cells were found in only one patient with severe chronic GVHD. Natural killer cells were not found. Preliminary examination of lesional skin from seven autologous BMT patients showed a similar trend of decreased CD4/CD8 ratios in the three patients with a syndrome that resembled GVHD. Analysis of CD4/CD8 ratios in serial biopsy specimens from patients with GVHD may allow more accurate monitoring of the progression of cutaneous GVHD and may help to elucidate the mechanism of development of the GVHD-like reaction in autologous BMT patients. (Arch Dermatol 1988;124:1795-1801) References 1. Gale RP: Graft-vs-host disease . Immunol Rev 1985;88:193-214.Crossref 2. Sale GE, Lerner KG, Barker EA, et al: The skin biopsy in the diagnosis of acute graft-vs-host disease in man . Am J Pathol 1977;89:621-633. 3. Lampert IA, Janossy G, Suitters AJ, et al: Immunological analysis of the skin in graft vs host disease . Clin Exp Immunol 1982;50:123-131. 4. Lever R, Turbitt M, Mackie R, et al: Prospective study of the histological changes in the skin in patients receiving bone marrow transplants . Br J Dermatol 1986;114:161-170.Crossref 5. Atkinson K, Munro V, Vasak E, et al: Mononuclear cell populations in the skin defined by monoclonal antibodies after HLA-identical sibling marrow transplantation . Br J Dermatol 1986;114:145-160.Crossref 6. Guyotat D, Mauduit G, Chouvet B, et al: A sequential study of histological and immunological changes in the skin after allogeneic bone marrow transplantation . Transplantation 1986;41:340-342.Crossref 7. Kaye VN, Neumann PM, Kersey J, et al: Identity of immune cells in graft-vs-host disease of the skin: Analysis using monoclonal antibodies by indirect immunofluorescence . Am J Pathol 1984;116:436-440. 8. Dreno B, Milpied N, Harousseau JL, et al: Cutaneous immunological studies in diagnosis of acute graft-vs-host disease . Br J Dermatol 1986;114:7-15.Crossref 9. Sloane JP, Thomas JA, Imrie SF, et al: Morphological and immunohistological changes in the skin of allogeneic bone marrow recipients . J Clin Pathol 1984;37:919-930.Crossref 10. Glucksberg H, Storb R, Fefer A, et al: Clinical manifestations of graft-vs-host disease in human recipients of marrow from HL-A-matched sibling donors . Transplantation 1974;18:295-304.Crossref 11. Crider MK, Jansen J, Norins AL, et al: Chemotherapy-induced acral erythema in patients receiving bone marrow transplantation . Arch Dermatol 1986;122:1023-1027.Crossref 12. Lerner KG, Kao GF, Storb R, et al: Histopathology of graft-vs-host reaction (GvHR) in human recipients of marrow from HL-A-matched sibling donors . Transplant Proc 1974;6:367-371. 13. Hamilton BL, Michael J, Bevan MJ, et al: Anti-recipient cytotoxic T lymphocyte precursors are present in the spleens of mice with acute graft vs host disease due to minor histocompatibility antigens . J Immunol 1981;126:621-625. 14. Reinsmoen NL, Kersey JH, Bach FH: Detection of HLA restricted anti-minor histocompatibility antigen(s) reactive cells from skin GVHD lesions . Hum Immunol 1984;11:249-257.Crossref 15. Gebel HM, Kaizer H, Landay AL: Characterization of circulating suppressor T lymphocytes in bone marrow transplant recipients . Transplantation 1987;43:258-263.Crossref 16. Niedecken H, Wehrmann W, Bauer R, et al: Reaction of human keratinocytes with the monoclonal antibody anti-Leu-11: An immunohistologic study . J Am Acad Dermatol 1988;18:504-510.Crossref 17. Rappeport J, Reinherz E, Mihm M, et al: Acute graft-vs-host disease in recipients of bone-marrow transplants from identical twin donors . Lancet 1979;2:717-720.Crossref 18. Gluckman E, Devergie A, Sohier J, et al: Graft-vs-host disease in recipients of syngeneic bone marrow . Lancet 1980;1:253-254. 19. Thien SW, Goldman JM, Galton DG: Acute `graft-vs-host disease' after autografting for chronic granulocytic leukemia in transplantation . Ann Intern Med 1981;94:210-211.Crossref 20. L'Age-Stehr J, Diamantstein T: Induction of autoreactive T lymphocytes and their suppressor cells by cyclophosphamide . Nature 1978;271:663-665.Crossref 21. Belanger R, Tutschka PJ, Beschorner WE, et al: Acute graft-vs-host disease in recipients of syngeneic bone marrow . Exp Hematol 1982;10( (suppl) ):23-32. 22. Gozes Y, Umiel T, Meshorer A, et al: Syngeneic GvH induced in popliteal lymph nodes by spleen cells of old C57BL/6 mice . J Immunol 1978;121:2199-2204. 23. Glazier A, Tutschka PJ, Farmer ER, et al: Graft-vs-host disease in cyclosporin A-treated rats after syngeneic and autologous bone marrow reconstitution . J Exp Med 1983;158:1-8.Crossref 24. Hess AD, Horwitz L, Beschorner WE, et al: Development of graft-vs-host disease-like syndrome in cyclosporine-treated rats after syngeneic bone marrow transplantation: I. Development of cytotoxic T lymphocytes with apparent polyclonal anti-Ia specificity, including autoreactivity . J Exp Med 1985;161:718-730.Crossref 25. Cheney RT, Sprent J: Capacity of cyclosporine to induce autograft-vs-host disease and impair intrathymic T-cell differentiation . Transplant Proc 1985;17:528-531. 26. Hood AF, Vogelsang GB, Black LP, et al: Acute graft-vs-host disease: Development following autologous and syngeneic bone marrow transplantation . Arch Dermatol 1987;123:745-750.Crossref

Journal

Archives of DermatologyAmerican Medical Association

Published: Dec 1, 1988

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