Acute graft versus host disease (aGVHD) affects more than 40% of patients undergoing haematopoietic stem cell transplantation. aGVHD occurs after transplantation of donor haematopoietic cells into hosts incapable of rejecting the donor cells, when donor T cells attack host tissue. Despite extensive efforts, aGVHD remains problematic to prevent and difficult to control. Current therapies to prevent aGVHD induce profound immunosuppression, leaving patients at increased risk of infection and leukaemic relapse. Dendritic cells (DC) are professional antigen presenting cells of haematopoietic origin and are the primary stimulators of the immune system, uniquely being able to activate naïve T cells. A growing body of evidence suggests that DC are responsible for the stimulation of the donor T cells which cause aGVHD. I have used a model of aGVHD which utilizes conditioned severe combined immunodeficient mice transplanted with human peripheral blood mononuclear cells (PBMC). In this model human CD4+ T cells appear to be responsible for an aGVHD-like syndrome which results in death 15-30 days post transplant. I have shown, using in vitro depletion of individual populations, that other subpopulations of human PBMC did not affect the survival of the mice. I have also demonstrated that human DC are required for the induction of aGVHD in the majority of mice. This novel finding validated the use of this model to test the primary hypothesis; that antibody mediated depletion of DC would prevent aGVHD. The murine IgM monoclonal antibody (Mab), CMRF-44 Mab, is specific for an unknown molecule expressed on the surface of activated human DC. Previous work had shown that when mixed lymphocyte reaction stimulator cells were depleted of CMRF-44+ cells, there was a significant reduction in the proliferation of responder cells. Here I tested the efficacy of CMRF-44 as a therapy for the prevention of aGVHD in the model. CMRF-44 Mab did not improve survival of mice treated with human PBMC, despite recent data showing that CMRF-44 expression on DC was predictive of aGVHD in patients. In vitro depletion of CMRF-44+ cells from human PBMC prior to transplantation also did not reduce incidence of aGVHD. An alternate target for the depletion of human DC was CD83 which is also expressed on the surface of activated human DC. I generated a rabbit polyclonal antibody using a human CD83 fusion protein, which was then affinity purified in a multi-step process which yielded only antibody specific for human CD83. Treatment with this antibody greatly improved survival of transplanted mice. Further experiments showed that anti-CD83 treatment did not abrogate human leucocytes including CD8+ memory T cells suggesting that a therapy using an anti-CD83 antibody has the potential to prevent aGVHD without the immunosuppression associated with current anti-aGVHD therapies. The work described here has validated the use of a human mouse chimeric model as an in vivo assay of human DC function and shown that targeting CD83 has the potential to reduce the incidence of clinical aGVHD whilst preserving donor memory T cells.

γδ T cells belong to the T cell lineage however they possess some innate like properties. γδ T cells recognize non-peptidic microbial and stress induced self antigens in a non-MHC restricted manner and are proposed to bridge the gap between innate and adaptive immunity. Dendritic epidermal T cells are a prototypic population of intraepithelial γδ T cells in murine skin. Found in the basal layer of epidermis in close contact with Langerhans cells and keratinocytes DETC facilitate vital immunological and physiological processes e.g. wound healing, homeostasis, tumour surveillance and regulation of inflammation. The purpose of this thesis was to elucidate whether γδ T cells and in particular DETC play a role in generation of adaptive immune responses to foreign cutaneous antigen (OVA) in the context of skin grafts. Skin grafting has long been established as a means to test cutaneous and epithelial immunity. To answer this question, γδ T cell knock-out mice (TCRδ-/-), transgenic K5mOva mice and a skin grafting model were used. It is shown in this study that in the absence of γδ in the skin and not in the circulation there is a lower rejection rate of OVA expressing skin grafts. This phenomenon is observed in both freshly placed and well healed grafts. To understand which part of the immune response is affected by the absence of γδ T cells the priming and effector phases of the immune response was examined in TCRδ-/- mice. The priming phase was studied using two approaches: the first approach was to test priming to maximal doses of subcutaneous antigen in conjunction with an adjuvant and the second approach involved testing priming to an antigen in the context of skin grafts (graft priming). Using ELISPOTs and CFSE proliferation assays we found that while administration of OVA in conjunction with an adjuvant (QuilA) via the subcutaneous route results in sufficient priming in γδ T cell knockout mice, cross priming to OVA in the context of - freshly placed and well healed skin grafts is impaired in TCRδ-/- mice. By immunizing TCRδ-/- mice prior to skin grafting or by transferring in vitro primed OT-I cells to RAG-/- mice grafted with K5mOVA or TCRδ-/-OVA skin it was shown that 100% of all OVA grafts are rejected regardless of presence or absence of γδ T cells, concluding that effector phase of the immune response is not affected in this model. The inability of DETC to perform the role of cross presentation leads to the hypothesis that DETC indirectly enhance this process by affecting professional antigen presenting cells (APC) of the skin. Based on the contribution of DETC to wound healing it was hypothesized that the migration of dendritic cells (DCs) from the skin grafts to the lymph nodes may be affected. When this hypothesis was tested using hapten sensitization and congenically marked skin grafts it was shown that migration of DCs from skin grafts is not affected by the absence of DETC. In another hypothesis the co-stimulatory markers CD40 and CD86 were examined on migrating DCs found in the skin draining lymph nodes of grafted mice and it was shown that expression levels of those molecules were lower on DCs from TCRδ-/- grafted mice compared to C57BL/6 control mice. In addition using cytometric bead array, we show that the cytokine milieu in TCRδ-/- skin and skin draining lymph nodes is different from that of wildtype C57 skin and this disparate cytokine profile may be contributing to the less efficient cross priming and graft rejection in TCRδ-/- mice.

Diss. (sammanfattning) Stockholm : Karolinska institutet, 2005. / Härtill 5 uppsatser.

Diss. (sammanfattning) Stockholm : Karol. inst., 2004. / Härtill 5 uppsatser.

Diss. (sammanfattning) Stockholm : Karol. inst., 2004. / Härtill 4 uppsatser.

Diss. (sammanfattning) Stockholm : Karol. inst., 2003. / Härtill 5 uppsatser.

Diss. (sammanfattning) Stockholm : Karol. inst., 2003. / Härtill 5 uppsatser.

Diss. (sammanfattning) Uppsala : Univ., 2003. / Härtill 5 uppsatser.

Thesis (PhD) -- University of Western Sydney, 2002. / "A candidate for the degree of Doctor of Philosophy." "A thesis submitted in the School of Science, Food and Horticulture, University of Western Sydney." "June 2002" Bibliography: leaves 303 - 305.

Thesis (Ph.D.)--University of Wollongong, 2005. / Typescript. Includes bibliographical references.