CD4(+)CD8(+) T-Lymphocytes in Xenogeneic and Human Graft-versus-Host Disease

Mechanisms driving acute graft-versus-host disease (aGVHD) onset in patients undergoing allogeneic hematopoietic stem cell transplantation (allo-HSCT) are still poorly understood. To provide a detailed characterization of tissue-infiltrating T lymphocytes (TL) and search for eventual site-specific specificities, we developed a xenogeneic model of aGVHD in immunodeficient mice. Phenotypic characterization of xenoreactive T lymphocytes (TL) in diseased mice disclosed a massive infiltration of GVHD target organs by an original CD4(+)CD8(+) TL subset. Immunophenotypic and transcriptional profiling shows that CD4(+)CD8(+) TL comprise a major PD1(+)CD62L(−/+) transitional memory subset (>60%) characterized by low level expression of cytotoxicity-related transcripts. CD4(+)CD8(+) TL produce high IL-10 and IL-13 levels, and low IL-2 and IFN-γ, suggestive of regulatory function. In vivo tracking of genetically labeled CD4(+) or CD8(+) TL subsequently found that CD4(+)CD8(+) TL mainly originate from chronically activated cytotoxic TL (CTL). On the other hand, phenotypic profiling of CD3(+) TL from blood, duodenum or rectal mucosa in a cohort of allo-HSCT patients failed to disclose abnormal expansion of CD4(+)CD8(+) TL independent of aGVHD development. Collectively, our results show that acquisition of surface CD4 by xenoreactive CD8(+) CTL is associated with functional diversion toward a regulatory phenotype, but rule out a central role of this subset in the pathogenesis of aGVHD in allo-HSCT patients.