Hematology, Department of Internal Medicine, Seoul St. Mary's Hospital, The Catholic University of Korea, 222 Banpodae-ro, Seocho-gu, Seoul, 06591, South Korea.
Department of Pathology, Seoul St. Mary's Hospital, The Catholic University of Korea, Seoul, South Korea.
Stem Cell Res Ther. 2020 Jun 26;11(1):254. doi: 10.1186/s13287-020-01768-7.
Human chronic graft-versus-host disease (CGVHD) shares clinical characteristics with a murine sclerodermatous GVHD (Scl-GVHD, B10.D2 → BALB/c) model that is characterized by skin and lung fibrosis. In this study, bone marrow- or adipose tissue-derived human mesenchymal stem cells (hMSCs) were injected into the Scl-GVHD mice to address their therapeutic effect on CGVHD.
Lethally irradiated BALB/c mice were transplanted with B10.D2 T cell-depleted bone marrow with or without spleen cells to generate Scl-GVHD. hMSCs were intravenously treated on days 3, 5, and 7 post-transplantation, and the control antibody or CCL1 blocking antibody was subcutaneously injected according to the same schedule as the hMSCs. Fourteen days after transplantation, the recipient mice were sacrificed, and their skin and lungs were analyzed.
After the early injection of hMSCs after transplantation, the clinical and pathological severity of Scl-GVHD in the skin was significantly attenuated, whereas the pathological score was exacerbated in the lungs. hMSCs had migrated into the lungs, but not into the skin. CD11b monocyte/macrophages and CD4 T cells were markedly decreased in skin tissues, whereas there was an early recruitment of CD11b cells, and subsequently increased infiltration of CD4 T cells, in the lungs. Importantly, hMSCs persistently upregulated the expression of CCL1 in the lungs, but not in the skin. Concurrent treatment of hMSCs with a CCL1-blocking antibody alleviated the severity of the lung histopathology score and fibrosis with the preservation of the cutaneous protective effect against CGVHD. Infiltration of CD3 T cells and CD68 macrophages and upregulation of chemokines were also decreased in lung tissues, along with the recruitment of eosinophils and tissue IgE expression. In the skin, chemokine expression was further reduced after CCL1 blockade.
These data demonstrate that despite a protective effect against Scl-GVHD in the skin, administration of hMSCs exacerbated lung fibrosis associated with eosinophilia and airway inflammation through persistent CCL1 upregulation. CCL1 blockade offers a potential treatment of pulmonary complications induced after treatment with hMSCs.
人类慢性移植物抗宿主病(CGVHD)与一种以皮肤和肺纤维化为特征的小鼠硬皮病移植物抗宿主病(Scl-GVHD,B10.D2→BALB/c)模型具有临床特征。在这项研究中,骨髓或脂肪组织来源的人间充质干细胞(hMSCs)被注射到 Scl-GVHD 小鼠中,以解决其对 CGVHD 的治疗作用。
用 B10.D2 T 细胞耗尽的骨髓和/或脾细胞对致死性照射的 BALB/c 小鼠进行移植,以产生 Scl-GVHD。在移植后第 3、5 和 7 天,静脉内给予 hMSCs 治疗,并根据与 hMSCs 相同的方案,皮下注射对照抗体或 CCL1 阻断抗体。移植后 14 天,处死受者小鼠,分析其皮肤和肺组织。
移植后早期注射 hMSCs 可显著减轻 Scl-GVHD 皮肤的临床和病理严重程度,而肺部的病理评分则加重。hMSCs 已迁移到肺部,但未迁移到皮肤。皮肤组织中 CD11b 单核/巨噬细胞和 CD4 T 细胞明显减少,而肺部则有早期 CD11b 细胞募集,随后 CD4 T 细胞浸润增加。重要的是,hMSCs 持续上调肺部的 CCL1 表达,但在皮肤中没有。hMSCs 与 CCL1 阻断抗体同时治疗可减轻肺组织病理学评分的严重程度和纤维化,同时保持对 CGVHD 的皮肤保护作用。肺部浸润的 CD3 T 细胞和 CD68 巨噬细胞以及趋化因子的表达也减少,同时嗜酸性粒细胞的募集和组织 IgE 表达增加。在皮肤中,阻断 CCL1 后趋化因子的表达进一步降低。
这些数据表明,尽管 hMSCs 对皮肤中的 Scl-GVHD 具有保护作用,但通过持续上调 CCL1,hMSCs 的给药加剧了与嗜酸性粒细胞增多和气道炎症相关的肺纤维化。CCL1 阻断为 hMSCs 治疗后引起的肺部并发症提供了一种潜在的治疗方法。