Donor T-cell-derived GM-CSF drives alloantigen presentation by dendritic cells in the gastrointestinal tract

Blood Adv. 2019 Oct 8;3(19):2859-2865. doi: 10.1182/bloodadvances.2019000053.


Granulocyte-macrophage colony-stimulating factor (GM-CSF) has recently emerged as an important pathogenic cytokine in acute graft-versus-host disease (GVHD), but the nature of the T-cell lineages secreting the cytokine and the mechanisms of action are less clear. Here we used interleukin 17A-fate reporter systems with transcriptional analysis and assays of alloantigen presentation to interrogate the origins of GM-CSF-secreting T cells and the effects of the cytokine on antigen-presenting cell (APC) function after experimental allogeneic stem cell transplantation (SCT). We demonstrated that although GM-CSF-secreting Th17 and non-Th17 cells expanded in the colon over time after SCT, the Th17 lineage expanded to represent 10% to 20% of the GM-CSF secreting T cells at this site by 4 weeks. Donor T-cell-derived GM-CSF expanded alloantigen-presenting donor dendritic cells (DCs) in the colon and lymph nodes. In the mesenteric lymph nodes, GM-CSF-dependent DCs primed donor T cells and amplified acute GVHD in the colon. We thus describe a feed-forward cascade whereby GM-CSF-secreting donor T cells accumulate and drive alloantigen presentation in the colon to amplify GVHD severity. GM-CSF inhibition may be a tractable clinical intervention to limit donor alloantigen presentation and GVHD in the lower gastrointestinal tract.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Animals
  • Dendritic Cells / immunology*
  • Female
  • Gastrointestinal Tract / immunology*
  • Gene Expression / genetics*
  • Granulocyte-Macrophage Colony-Stimulating Factor / immunology*
  • Humans
  • Isoantigens / immunology*
  • Male
  • Mice
  • T-Lymphocytes / metabolism*


  • Isoantigens
  • Granulocyte-Macrophage Colony-Stimulating Factor