Brain Advance Access published online on February 25, 2004
Brain, doi:10.1093/brain/awh117
© 2004 by Guarantors of Brain
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Article
1 Multiple Sclerosis Research Unit, Department of Neurology and Baylor Multiple Sclerosis Center, Houston, Texas, USA
* Corresponding author. E-mail: jzang{at}bcm.tmc.edu.
Received 4 November 2003
; revised 16 December 2003
; accepted 18 December 2003
Multiple sclerosis is thought to involve aberrant immune responses to myelin autoantigens. Haemato poietic stem-cell transplantation (HSCT) is in clinical trials for progressive multiple sclerosis based on the rationale that it destroys aberrant immune system, while recapitulation of lymphocyte ontogeny might alter the immune system and slow down disease progression. This study was undertaken to analyse characteristics of the T-cell receptor (TCR) repertoire, serum cytokine profile and the T-cell responses to myelin basic protein (MBP) in the reconstituted immune system in progressive multiple sclerosis. The study revealed that, following autologous HSCT, the T-cell immunity recovered in two distinctive phases. The first phase was characterized by limited T-cell immunity as a result of selective expansion of pre-existing T cells commonly expressing the TCR
Keywords: haematopoietic stem-cell transplantation; multiple sclerosis; myelin basic protein; T-cell receptor
Characteristics of T-cell receptor repertoire and myelin-reactive T cells reconstituted from autologous haematopoietic stem-cell grafts in multiple sclerosis
2 Gene and Cell Therapy Center, Department of Medicine, Baylor College of Medicine, Houston, Texas , USA
3 Department of Pathology, Baylor College of Medicine, Houston, Texas , USA
4 Multiple Sclerosis Research Unit, Department of Neurology and Baylor Multiple Sclerosis Center, Houston, Texas, USA; Department of Immunology, Baylor College of Medicine, Houston, Texas 77030, USA; Department of Neurology, Baylor College of Medicine, 6501 Fannin Street, NB302, Houston, TX 77030, USA
chain variable region (TCR BV) 20 and increased serum cytokine production during the first several months. The second phase of T-cell reconstitution coincided with increased thymic T-cell output 9-12 months after HSCT. T cells reconstituted from stem-cell grafts had the distinctive properties of comprehensive T-cell immunity and a broad TCR repertoire. T cells recognizing MBP were initially depleted by immunoablation and rapidly expanded from the reconstituted T-cell repertoire in 12 months. The reconstituted MBP-reactive T cells exhibited a broader epitope recognition repertoire while maintaining the same skewed reactivity pattern compared with that seen at baseline. The findings have important implications in the understanding of the role of HSCT as a potential treatment for multiple sclerosis.![]()
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