Summary:Recipients of allogeneic bone marrow grafts have clonally expanded CD8 + CD28 − T lymphocytes during the early period after transplantation, which leads to skewing of T cell receptor (TCR) repertoires. Here, we have addressed the question of whether clonal expansion of CD28 − T cells is also observed in CD4 + T lymphocytes after human allogeneic hematopoietic cell transplantation. We found that the fraction of T cells lacking CD28 expression in the CD4 + subset was increased after transplantation, and expanded CD4 + CD28 − T lymphocytes carrying certain TCRBV subfamilies showed limited TCR diversity. In order to further study the ontogeny of CD4 + CD28 − T cells, we analyzed the complementarity-determining region 3 (CDR3) of the TCR- chain of CD4 + CD28 + and CD4 + CD28 − cells. We identified the same T cell clones within both CD4 + CD28 − and CD4 + CD28 + T cell subsets. These results suggest that both subsets are phenotypic variants of the same T cell lineage. Bone Marrow Transplantation (2001) 27, 1095-1100. Keywords: TCR-; CDR3; clone; CD4; CD28The CD28 molecule is a disulfide-linked homodimer expressed on the surface of T cells and it binds to the natural ligand B7 family members, CD80/CD86, expressed on antigen-presenting cells, resulting in costimulation of T cell activation. 1 In humans, all thymocytes and the vast majority of peripheral blood T cells express CD28 at birth. An increase of the proportion of CD8 + T cells lacking CD28 expression has been demonstrated in the aged population, 2 HIV-infected individuals 3,4 and bone marrow transplant recipients. 5,6 In contrast, in healthy individuals, only a few percent of CD4 + T cells lack CD28, 3 and expansion of CD4 + CD28 − T cells is scarcely reported in rheumatoid arthritis patients. 7,8 Correspondence Loss of CD28 expression has recently been implicated in lymphocyte senescence. 9,10 We have previously reported the oligoclonal expansions of CD8 + CD28 − T lymphocytes in recipients of allogeneic bone marrow grafts and the demonstration of identical T cell clones within both CD8 + CD28 − and CD8 + CD28 + T cell subsets. 11 These results suggest that clonally expanded CD8 + CD28 − T cells after allogeneic hematopoietic cell transplantation (HCT) are derived from the CD8 + CD28 + T cell subset, presumably by an antigen-driven mechanism. In the present study, we have addressed the question of whether clonal expansion of CD4 + CD28 − T cells is also observed in recipients of allogeneic hematopoietic cell grafts and whether these cells are the descendents of CD4 + T cells expressing CD28.
Materials and methods
PatientsInformed consent was obtained from the patients before blood samples were collected. All the patients were conditioned with myeloablative chemoradiotherapy, mostly consisting of fractionated total body irradiation (12 Gy in six fractions) and cyclophosphamide (60 mg/kg/day for 2 days), followed by infusion of allogeneic marrow or blood stem cell grafts from HLA-matched donors. All the patients received cyclosporin A and short-term me...