Pulmonary T cell repertoire in patients with graft-versus-host disease following blood and marrow transplantation

Pulmonary inflammation is one of the risk factors associated with blood and marrow transplantation (BMT). To determine the potential role of T cells i n pulmonary complications after transplantation, we analyzed the T-cell rep ertoire expressed in bronchoalveolar lavage fluids from eleven patients wit h graft-versus-host disease following BMT. A reverse transcriptase-polymera se chain reaction was used to amplify rearranged TCR transcripts in unfract ionated, CD4+, and CD8+ T cells from bronchoalveolar lavage fluids. The rel ative expression of TCR variable (V) gene families and the diversity of jun ctional region lengths associated with different AV and BV gene families we re analyzed. Nearly all TCR AV and BV gene families were detected in bronch oalveolar lavage cells from BMT recipients, Oligoclonal patterns of TCR jun ctional region lengths were observed in unfractionated, CD4+, and CD8+ bron choalveolar T cells. The oligoclonal expansion of bronchoalveolar T cells i n patients was confirmed by DNA sequencing. TCRV gene expression is almost completely restored in the lungs of BMT recipients as early as two weeks af ter transplantation. Increased oligoclonality among TCR gene families sugge sts either an incomplete restoration of TCR diversity or an antigen-driven expansion of T cells in the lungs of BMT recipients with graft-versus-host disease, not necessarily related to pulmonary infection. (C) 2001 Wiley-Lis s, Inc.