Research Group
- Dr. Anne M. VanBuskirk, Principal Investigator
- Ms. Julie Dierksheide, Research Associate
Location
- Ohio State University, Columbus, USA
Title
- Cytokine Inhibition of CTL Reactivation and Post-Transplant Lymphoproliferative Disorder
Post-transplant lymphoproliferative disorder (PTLD) is an aggressive B cell
malignancy afflicting approximately 2-7% of all transplant patients, with
50-90% mortality. Most PTLDs are B cell lymphomas
associated with Epstein-Barr virus (EBV). Primary EBV infection and viral load
in the post-transplant period are significant risk factors, but many aspects of
PTLD remain poorly defined. Most adults harbor a
latent EBV infection controlled by EBV-reactive cellular immune responses,
which also prevent PTLD. However, immunosuppressive therapy necessary to
prevent graft rejection results in defective immune surveillance, including a
drop in EBV-specific CTL activity. The precise mechanism(s) by which the
anti-EBV immune response fails is not clear, nor is it clear why only some
transplant patients develop PTLD, although immune factors are thought to be
important. One key mediator is IFNg, which contains an AàT
polymorphism at residue 847. The T allele is associated with high cytokine
production. We recently reported that the A/A genotype for IFNg is
expressed more frequently in PTLD than in non-PTLD patients, and have now
confirmed that observation using the SCID-Hu PBL
mouse model. These data suggest that low IFNg is a
factor in PTLD. Exciting preliminary data indicate that the A
allele of the IFNg genotype is associated with an ability of TGFβ to inhibit CTL activity. Exogenous IFNg can
overcome this inhibition. We also have data that indicate the inhibition occurs
via the APC. We therefore hypothesize that TGFβ
induced by immunosuppressive therapy inhibits EBV CTL in PBL with the A/A, but
not the T/T, IFNg genotype, by altering APC function. We are
uniquely able to investigate TGFβ-mediated CTL
inhibition due to our bank of genotyped PBL donors and HLA-matched tumor cells. These PBL and matched tumor
lines will be used to characterize the TGFβ-mediated
inhibition and begin to dissect its mechanism. These results will increase our
understanding of PTLD by addressing mechanisms of CTL inhibition by TGFβ and the association of CTL inhibition with
cytokine genotype. These results may also provide information on potential
therapeutic targets to treat or prevent PTLD.