Research Offers Clues Into T Cell Differentiation in Worsening of Acute Gut GVHD – AJMC.com Managed Markets Network

A new study examining DC-mediated differentiation of alloreactive donor CD4+ T cells during exacerbation of acute gut graft-versus-host disease (GVHD) has led researchers to suggest that the findings could aid in examining T cell differentiation in patients undergoing allogeneic hematopoietic stem cell transplantation (alloSCT).

While alloSCT is a curative therapy for an array of acute leukemias through its graft-versus-leukemia (GVL) effect, the procedure can also cause GVHD when donor T cells damage noncancerous host tissue, including in the gastrointestinal (GI) tract. Previous research has established acute GVHD in the GI tract as the primary cause of both GVHD severity and mortality, and as a result, emphasis is placed on preventing acute gut GVHD while still preserving the GVL effect of alloSCT.

According to the researchers, the key to this is determining the spatial and temporal differences between GVL and GVHD.

Through droplet-based scRNA-Seq and computational modeling, the researchers observed an emergence of pathogenic and regulatory states along a single developmental trajectory in mesenteric lymph nodes (mLNs). Unexpectedly, the researchers also observed a second trajectory with little proliferation or cytokine expression, reduced glycolysis, and high tcf7 expression.

“We previously showed in preclinical models that donor CD4+ T cells are initially activated by recipient nonhematopoietic antigen-presenting cells (APCs) within the gut, including epithelial cells that upregulate class II MHC molecules,” explained the researchers. “Donor-derived colonic DCs also prime donor CD4+ cells in mesenteric lymph nodes (mLNs) and trigger Th cell differentiation, which serves to amplify and exacerbate GVHD.”

From the preclinical
Source…