Skip to main content

Thank you for visiting nature.com. You are using a browser version with limited support for CSS. To obtain the best experience, we recommend you use a more up to date browser (or turn off compatibility mode in Internet Explorer). In the meantime, to ensure continued support, we are displaying the site without styles and JavaScript.

  • Original Article
  • Published:

Graft-Versus-Host Disease

Specific self-antigen-driven immune response in pericardial effusion as an isolated GVHD manifestation

Abstract

Pericardial effusion and cardiac tamponade have been described as GVHD manifestations in the post transplant period. Direct evidence of GVHD-related TCR or B-cell receptor clones in patients with pericardial effusion has never been described. Using several methods, including FACS and spectratyping analysis to assess T- and B-cell clonality and to quantify TCR excision circles to assess newly thymus-derived T cells, we were able to show expansion of oligoclonal T-cell populations and the possible presence of early/premature B cells in the pericardial effusion but not in peripheral mononuclear cells. This may explain the presentation of an isolated GVHD manifestation.

This is a preview of subscription content, access via your institution

Access options

Buy this article

Prices may be subject to local taxes which are calculated during checkout

Figure 1

Similar content being viewed by others

References

  1. Huang H, Manton KG . Newborn screening for severe combined immunodeficiency (SCID): a review. Front Biosci 2005; 10: 1024–1039.

    Article  CAS  PubMed  Google Scholar 

  2. Ivanov V, Faucher C, Bilger K, Vey N, Sainty D, Calmels B et al. Massive ascites of donor T-cell origin in a patient with acute GVHD after a reduced-intensity allograft for CLL. Bone Marrow Transplant 2003; 32: 961–963.

    Article  CAS  PubMed  Google Scholar 

  3. Angelucci E, Mariotti E, Lucarelli G, Baronciani D, Cesaroni P, Durazzi SM et al. Sudden cardiac tamponade after chemotherapy for marrow transplantation in thalassaemia. Lancet 1992; 339: 287–289.

    Article  CAS  PubMed  Google Scholar 

  4. Seber A, Khan SP, Kersey JH . Unexplained effusions: association with allogeneic bone marrow transplantation and acute or chronic graft-versus-host disease. Bone Marrow Transplant 1996; 17: 207–211.

    CAS  PubMed  Google Scholar 

  5. Pérez-Simón JA, Sánchez-Abarca I, Díez-Campelo M, Caballero D, San Miguel J . Chronic graft-versus-host disease: pathogenesis and clinical management. Drugs 2006; 66: 1041–1057.

    Article  PubMed  Google Scholar 

  6. Toren A, Nagler A . Massive pericardial effusion complicating the course of chronic graft-versus-host disease (cGVHD) in a child with acute lymphoblastic leukemia following allogeneic bone marrow transplantation. Bone Marrow Transplant 1997; 20: 805–807.

    Article  CAS  PubMed  Google Scholar 

  7. Rhodes M, Lautz T, Kavanaugh-Mchugh A, Manes B, Calder C, Koyama T et al. Pericardial effusion and cardiac tamponade in pediatric stem cell transplant recipients. Bone Marrow Transplant 2005; 36: 139–144.

    Article  CAS  PubMed  Google Scholar 

  8. Somech R, Somers GR, Chitayat D, Grunebaum E, Atkinson A, Kolomietz E et al. Fatal lung fibrosis associated with immunodeficiency and gonadal dysgenesis in 46XX sisters—a new syndrome. Am J Med Genet A 2008; 146A: 8–14.

    Article  PubMed  Google Scholar 

  9. Saito Y, Matsushima T, Doki N, Tsumita Y, Takizawa M, Yokohama A et al. Pericardial graft vs host disease in a patient with myelodysplastic syndrome following peripheral blood stem cell transplantation. Eur J Haematol 2005; 75: 65–67.

    Article  PubMed  Google Scholar 

  10. Silberstein L, Davies A, Kelsey S, Foran J, Murrell C, D’Cruz D et al. Myositis, polyserositis with a large pericardial effusion and constrictive pericarditis as manifestations of chronic graft-versus-host disease after non-myeloablative peripheral stem cell transplantation and subsequent donor lymphocyte infusion. Bone Marrow Transplant 2001; 27: 231–233.

    Article  CAS  PubMed  Google Scholar 

  11. Oh SJ, Kim JH, Min CK, Chung DH . Role of type II NKT cells in the suppression of graft-versus-host disease. Crit Rev Immunol 2008; 28: 249–267.

    Article  CAS  PubMed  Google Scholar 

  12. Wu L, Van Kaer L . Natural killer T cells and autoimmune disease. Curr Mol Med 2009; 9: 4–14.

    Article  CAS  PubMed  Google Scholar 

  13. O’Keefe CL, Risitano AM, Maciejewski JP . Clinical implications of T cell receptor repertoire analysis after allogeneic stem cell transplantation. Hematology 2004; 9: 189–198.

    Article  PubMed  Google Scholar 

  14. Ye P, Kirschner DE . Measuring emigration of human thymocytes by T-cell receptor excision circles. Crit Rev Immunol 2002; 22: 483–497.

    Article  CAS  PubMed  Google Scholar 

Download references

Author information

Authors and Affiliations

Authors

Corresponding author

Correspondence to R Somech.

Ethics declarations

Competing interests

The authors declare no conflict of interest.

Rights and permissions

Reprints and permissions

About this article

Cite this article

Lev, A., Amariglio, N., Spirer, Z. et al. Specific self-antigen-driven immune response in pericardial effusion as an isolated GVHD manifestation. Bone Marrow Transplant 45, 1084–1087 (2010). https://doi.org/10.1038/bmt.2009.314

Download citation

  • Received:

  • Revised:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1038/bmt.2009.314

Keywords

Search

Quick links