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  • Proinflammatory Dual Recept...
    Balakrishnan, Amritha; Gloude, Nicholas; Sasik, Roman; Ball, Edward D.; Morris, Gerald P.

    Biology of blood and marrow transplantation, 11/2017, Volume: 23, Issue: 11
    Journal Article

    •T cells naturally expressing 2 T cell receptors are increased in patients with chronic graft-versus-host disease•Dual T cell receptor cells are highly activated in chronic graft-versus-host disease, indicating a pathogenic role•Dual T cell receptor cells in chronic graft-versus-host disease are Tbet+, suggesting proinflammatory function•Dual T cell receptor cells may link post–hematopoietic stem cell transplantation T cell development and chronic graft-versus-host disease Defective post-transplantation thymopoiesis is associated with chronic graft-versus-host disease (GVHD), a multiorgan pathology affecting up to 80% of patients after allogeneic hematopoietic stem cell transplantation (HSCT). Previous work demonstrated that the subset of T cells expressing 2 T cell receptors (TCRs) is predisposed to alloreactivity, driving selective and disproportionate activity in acute GVHD in both mouse models and HSCT patients. Here we investigate a potential role for this pathogenic T cell subset in chronic GVHD (cGVHD). HSCT patients with cGVHD demonstrated increased numbers of dual TCR cells in circulation. These dual receptor cells had an activated phenotype, indicating an active role in cGVHD. Notably, single-cell RNA sequencing identified the increased dual TCR cells in cGVHD as predominantly expressing Tbet, indicative of a proinflammatory phenotype. These results identify dual TCR cells as specific mediators of pathogenic inflammation underlying cGVHD and highlight Tbet-driven T cell function as a potential pathway for potential therapeutic targeting.