| Peer-Reviewed

CD3+ T Cell Lineage Specific Maternal Engraftment in Pediatric Patient with Severe Combined Immunodeficiency Disorder

Received: 23 November 2021    Accepted: 15 December 2021    Published: 24 December 2021
Views:       Downloads:
Abstract

Background: Transplacental Maternal Engraftment (TME) is common in patients with Severe Combined Immunodeficiency Disorder (SCID), however only a few are complicated by Graft Versus Host Disease (GVHD) prior to Hematopoietic Cell Transplantation (HCT). Objective: We will discuss a rare case of a SCID patient with complete TME at birth who later developed pre-HCT GVHD secondary to TME. Materials and Methods: Peripheral blood mononuclear cells or sorted cell populations are used for TME monitoring. Chimerism testing/engraftment analysis was performed by PCR based capillary electrophoresis to detect genetic polymorphisms in short tandem repeat loci. Results: SCID was diagnosed on newborn screen and the patient was prematurely born at 33 weeks of gestation. The patient had GVHD secondary to TME, which involved skin, liver, gut and bone marrow along with other clinical symptoms of SCID and treated with tacrolimus and methylprednisolone. The patient was transplanted three months after birth with an HLA identical sibling donor. Partial donor engraftment was seen in myeloid cells followed by B and T cell lineages from day +42 post transplantation. Testing sorted CD4+ and CD8+ T cells at day +42 revealed that the engrafted maternal CD3+ cells were exclusively of CD4+ phenotype, which represented 15% of circulating CD4+ T cells. Conclusion: Based on our findings, we suggest that CD3+ lineage specific T cells, presumably CD4+, might be the main contributor for pre-HCT GVHD secondary to TME.

Published in International Journal of Immunology (Volume 9, Issue 4)
DOI 10.11648/j.iji.20210904.12
Page(s) 73-78
Creative Commons

This is an Open Access article, distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution and reproduction in any medium or format, provided the original work is properly cited.

Copyright

Copyright © The Author(s), 2024. Published by Science Publishing Group

Keywords

Chimerism, Maternal Engraftment, SCID, GVHD, CD3+ T Cell, HCT

References
[1] F. S. Rosen, M. D. Cooper, R. J. P. Wedgwood, The Primary immunodeficiencies (First of two parts), N Egnl J Med 311 (1984) 235-242.
[2] A. Kwan, R. S. Abraham, R. Currier, A. Brower, K. Andruszewski, J. K. Abbott, M. Baker et al, Newborn screening for Severe Combined Immunodeficiency in 11 screening programs in the United States, JAMA 312 (2014) 729-738.
[3] Y. M. Dennis Lo, E. S. F. Lo, N. Watson, L. Noakes, I. L. Sargent, B. Thilaganathan, J. S. Wainscoat, Two-way cell traffic between mother and fetus: Biologic and clinical implications, Blood 88 (1996) 4390-4395.
[4] S. M. Muller, M. Ege, A. Pottharst, A. S. Schulz, K. Schwartz, W. Friedrick, Transplacentally acquired maternal T lymphocytes in Severe Combined Immunodeficiency: a study of 121 patients, Blood 98 (2001) 1847-1851.
[5] J. L. Stephan, V. Vlekova, F. Le Deist, S. Blanche, J. Donadieu, G. De Saint-Basile et al, Severe Combined Immunodeficiency: a retrospective single-center study of clinical presentation and outcome in 117 patients, J Ped 123 (1993) 564-572.
[6] L. F. Thompson, R. D. O’Connor, J. F. Bastian, Phenotype and function of engrafted maternal T cells in patients with Severe Combined Immunodeficiency, J Immunol 133 (1984) 2513-2517.
[7] C. C. Dvorak, M. J. Cowan, B. R. Logan, L. D. Notarangelo, L. M. Griffith, J. M. Puck et al, The natural history of children with Severe Combined Immunodeficiency: Baseline features of the first fifty patients of the primary immune deficiency treatment consortium prospective study 6901, J Clin Immunol 33 (2013) 1156-1164.
[8] K. C. Anderson, H. J. Weinstein, Transfusion-associated graft-versus-host-disease, N Engl J Med 5 (1990) 315-321.
[9] K. S. Denianke, I. J. Frieden, M. J. Cowan, M. L. Williams, T. H. McCalmont, Cutaneous manifestations of maternal engraftment in patients with Severe Combined Immunodeficiency: a clinicopathologic study, Bone Marrow Transplant 28 (2001) 227-233.
[10] M. E. Conley, P. C. Nowell, G. Henle, S. D. Douglas, XX T cells and XY B cells in two patients with Severe Combined Immune Deficiency, Clin Immunol Immunopathol 31 (1984) 87-95.
[11] V. Wahn, S. Yokota, K. L. Meyer, J. W. Janssen, T. E. Hansen-Hagge, C. Knobloch, S. Koletzko, H. Stein et al, Expansion of a maternally derived monoclonal T cell population with CD3+/CD8+/T cell receptor-gamma/delta + phenotype in a child with severe combined immunodeficiency, J Immunol 147 (1999) 2934-2941.
[12] F. Gattaneo, M. Recher, S. Masneri et al, Hypomorphic Janus kinase 3 mutations result in a spectrum of immune defects, including partial maternal T cell engraftment. J Allergy Clin Immunol 131 (2013) 1136-1145.
[13] K. Aleman, J. G. Noordzij, R. de Groot, J. J. van Dongen, N. G. Hartwig, Reviewing Omenn syndrome, Eur J Pediatr 160 (2001) 718-725.
[14] C. Knobloch, S. F. Goldmann, W. Friedrich, Limited T cell receptor diversity of transplacentally acquired maternal T cells in Severe Combined Immunodeficiency, J Immunol, 146 (1991) 4157-4164.
[15] J. R. O’Reilly, C. A. Keever, T. N. Small, J. Brochstein, The use of HLA-nonidentical T cell depleted marrow transplants for correction of Severe Combined Immunodeficiency disease, 1 (1989) 273.
[16] M. S. Pollack, D. Kirkpatrick, N. Kapoor, B. Dupont, R. J. O’Reilly, Identification by HLA typing of intrauterine-derived maternal T cells in four patients with Severe Combined Immunodeficiency, N. Engl. J Medicine 307 (1982) 662-666.
[17] S. Z. Al-Muhsen, Delayed presentation of Severe Combined Immunodeficiency due to prolonged maternal T cell engraftment, Ann Saudi Med 30 (2010) 239-242.
[18] A. Lev, A. J. Simon, L. Trakhtenbrot, I. Goldstein et al, Characterizing T cells in SCID patients presenting with reactive or residual T lymphocytes, Clin Dev Immunol 2012 (2012) 1-9.
[19] A. Lev, A. J. Simon, J. Ben-Ari, D. Takagi et al, Co-existence of clonal expanded autologous and transplacental-acquired maternal T cells recombination activating gene-deficient Severe Combined Immunodeficiency, Clin Exp Immunol 176 (2014) 380-386.
[20] K. Arimoto, N. Kadowaki, T. Ishikawa, T. Ichinohe, T. Uchiyama, Foxp 3 expression in peripheral blood rapidly recovers and lacks correlation with the occurrence of GVHD after allogeneic SCT, Int J Hematol 85 (2007) 154-162.
[21] A. Fischer, Severe Combined Immunodeficiencies, Clin Exp Immunol 122 (2000) 143-149.
[22] M. Ni, L. Wang, M. Yang, B. Neuber, L. Sellner et al, Shaping of CD56bri Natural Killer Cells in patients with Sterioid-Refractory/Resistant aGVHD via extracorporeal photopheresis, Front. Immunol 10 (2019) 1-17.
[23] V. Bekiaris, F. Gaspal, F. M. McConnell, M. Y. Kim et al, NK cells protect secondary lymphoid tissue from cytomegalovirus via a CD30-dependent mechanism, Eur. J. Immunol 39 (2009) 2800-2808.
[24] M. Y. Kim, F. M. C. Gaspal, H. E. Wiggett, F. M. McConnell et al, CD4+CD3- Accessory cells costimulate primed CD4 T cells through OX40 and CD30 at sites where T cells collaborate with B cells, Immunity 18 (2003) 643-654.
[25] D. R. Withers, F. M. Gaspal, E. C. Mackley, C. L. Marriott et al, Cutting edge: Lymphoid tissue inducer cells maintain memory CD4 T cells within secondary lymphoid tissue, J. Immunol 189 (2012) 2094-2098.
[26] V. Bekiaris, J. R. Sedy, M. Rossetti, R. Spreafico et al, Human CD4+CD3- innate like T cells provide a source of TNF and LTab and are elevated in Rheumatoid Arthritis, J. Immunol 191 (2013) 4611-4618.
Cite This Article
  • APA Style

    Gansuvd Balgansuren, Nakita Shelton, Lois Regen, Dana McLendon, Susan Russell, et al. (2021). CD3+ T Cell Lineage Specific Maternal Engraftment in Pediatric Patient with Severe Combined Immunodeficiency Disorder. International Journal of Immunology, 9(4), 73-78. https://doi.org/10.11648/j.iji.20210904.12

    Copy | Download

    ACS Style

    Gansuvd Balgansuren; Nakita Shelton; Lois Regen; Dana McLendon; Susan Russell, et al. CD3+ T Cell Lineage Specific Maternal Engraftment in Pediatric Patient with Severe Combined Immunodeficiency Disorder. Int. J. Immunol. 2021, 9(4), 73-78. doi: 10.11648/j.iji.20210904.12

    Copy | Download

    AMA Style

    Gansuvd Balgansuren, Nakita Shelton, Lois Regen, Dana McLendon, Susan Russell, et al. CD3+ T Cell Lineage Specific Maternal Engraftment in Pediatric Patient with Severe Combined Immunodeficiency Disorder. Int J Immunol. 2021;9(4):73-78. doi: 10.11648/j.iji.20210904.12

    Copy | Download

  • @article{10.11648/j.iji.20210904.12,
      author = {Gansuvd Balgansuren and Nakita Shelton and Lois Regen and Dana McLendon and Susan Russell and Paula Peterson and Ada Ng and Dylan Smith and Debra Cordell and Chris McFarland},
      title = {CD3+ T Cell Lineage Specific Maternal Engraftment in Pediatric Patient with Severe Combined Immunodeficiency Disorder},
      journal = {International Journal of Immunology},
      volume = {9},
      number = {4},
      pages = {73-78},
      doi = {10.11648/j.iji.20210904.12},
      url = {https://doi.org/10.11648/j.iji.20210904.12},
      eprint = {https://article.sciencepublishinggroup.com/pdf/10.11648.j.iji.20210904.12},
      abstract = {Background: Transplacental Maternal Engraftment (TME) is common in patients with Severe Combined Immunodeficiency Disorder (SCID), however only a few are complicated by Graft Versus Host Disease (GVHD) prior to Hematopoietic Cell Transplantation (HCT). Objective: We will discuss a rare case of a SCID patient with complete TME at birth who later developed pre-HCT GVHD secondary to TME. Materials and Methods: Peripheral blood mononuclear cells or sorted cell populations are used for TME monitoring. Chimerism testing/engraftment analysis was performed by PCR based capillary electrophoresis to detect genetic polymorphisms in short tandem repeat loci. Results: SCID was diagnosed on newborn screen and the patient was prematurely born at 33 weeks of gestation. The patient had GVHD secondary to TME, which involved skin, liver, gut and bone marrow along with other clinical symptoms of SCID and treated with tacrolimus and methylprednisolone. The patient was transplanted three months after birth with an HLA identical sibling donor. Partial donor engraftment was seen in myeloid cells followed by B and T cell lineages from day +42 post transplantation. Testing sorted CD4+ and CD8+ T cells at day +42 revealed that the engrafted maternal CD3+ cells were exclusively of CD4+ phenotype, which represented 15% of circulating CD4+ T cells. Conclusion: Based on our findings, we suggest that CD3+ lineage specific T cells, presumably CD4+, might be the main contributor for pre-HCT GVHD secondary to TME.},
     year = {2021}
    }
    

    Copy | Download

  • TY  - JOUR
    T1  - CD3+ T Cell Lineage Specific Maternal Engraftment in Pediatric Patient with Severe Combined Immunodeficiency Disorder
    AU  - Gansuvd Balgansuren
    AU  - Nakita Shelton
    AU  - Lois Regen
    AU  - Dana McLendon
    AU  - Susan Russell
    AU  - Paula Peterson
    AU  - Ada Ng
    AU  - Dylan Smith
    AU  - Debra Cordell
    AU  - Chris McFarland
    Y1  - 2021/12/24
    PY  - 2021
    N1  - https://doi.org/10.11648/j.iji.20210904.12
    DO  - 10.11648/j.iji.20210904.12
    T2  - International Journal of Immunology
    JF  - International Journal of Immunology
    JO  - International Journal of Immunology
    SP  - 73
    EP  - 78
    PB  - Science Publishing Group
    SN  - 2329-1753
    UR  - https://doi.org/10.11648/j.iji.20210904.12
    AB  - Background: Transplacental Maternal Engraftment (TME) is common in patients with Severe Combined Immunodeficiency Disorder (SCID), however only a few are complicated by Graft Versus Host Disease (GVHD) prior to Hematopoietic Cell Transplantation (HCT). Objective: We will discuss a rare case of a SCID patient with complete TME at birth who later developed pre-HCT GVHD secondary to TME. Materials and Methods: Peripheral blood mononuclear cells or sorted cell populations are used for TME monitoring. Chimerism testing/engraftment analysis was performed by PCR based capillary electrophoresis to detect genetic polymorphisms in short tandem repeat loci. Results: SCID was diagnosed on newborn screen and the patient was prematurely born at 33 weeks of gestation. The patient had GVHD secondary to TME, which involved skin, liver, gut and bone marrow along with other clinical symptoms of SCID and treated with tacrolimus and methylprednisolone. The patient was transplanted three months after birth with an HLA identical sibling donor. Partial donor engraftment was seen in myeloid cells followed by B and T cell lineages from day +42 post transplantation. Testing sorted CD4+ and CD8+ T cells at day +42 revealed that the engrafted maternal CD3+ cells were exclusively of CD4+ phenotype, which represented 15% of circulating CD4+ T cells. Conclusion: Based on our findings, we suggest that CD3+ lineage specific T cells, presumably CD4+, might be the main contributor for pre-HCT GVHD secondary to TME.
    VL  - 9
    IS  - 4
    ER  - 

    Copy | Download

Author Information
  • Clinical Immunogenetics Laboratory, Seattle Cancer Care Alliance, Seattle, USA

  • Clinical Immunogenetics Laboratory, Seattle Cancer Care Alliance, Seattle, USA

  • Clinical Immunogenetics Laboratory, Seattle Cancer Care Alliance, Seattle, USA

  • Clinical Immunogenetics Laboratory, Seattle Cancer Care Alliance, Seattle, USA

  • Clinical Immunogenetics Laboratory, Seattle Cancer Care Alliance, Seattle, USA

  • Clinical Immunogenetics Laboratory, Seattle Cancer Care Alliance, Seattle, USA

  • Clinical Immunogenetics Laboratory, Seattle Cancer Care Alliance, Seattle, USA

  • Clinical Immunogenetics Laboratory, Seattle Cancer Care Alliance, Seattle, USA

  • Clinical Immunogenetics Laboratory, Seattle Cancer Care Alliance, Seattle, USA

  • Clinical Immunogenetics Laboratory, Seattle Cancer Care Alliance, Seattle, USA

  • Sections