DR-POSITIVE MATERNAL ENGRAFTED T CELLS IN A SEVERE COMBINED IMMUNODEFICIENCY PATIENT WITHOUT GRAFT-VERSUS-HOST DISEASE

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Abstract
A 2 1/2-yr-old male [human] infant with severe combined immunodeficiency was documented by HLA typing and the presence of a female karyotype in the few spontaneously dividing cells to have an intrauterine-derived maternal lymphocyte graft. The presence of DR antigens on the engrafted maternal E [sheep erythrocyte] rosette-forming T cells was demonstrated by cytotoxicity and immunofluorescence techniques using conventional and monoclonal antihuman DR antisera. These DR antigens were of the same allospecificity, DR4, as the mother''s peripheral blood B cells. The patient''s B cells and monocytes expressed the DR alloantigens DR4 and DR3, corresponding to his genotype. Although fresh maternal lymphocytes react strongly in vitro against patient non-T cells, the engrafted maternal T lymphocytes no longer show this activity. Clinical evidence suggesting mild graft-vs.-host disease was completely resolved by the end of his first year. The presence of the DR-positive maternal cells may reflect the survival of a group of activated suppressor cells mediating graft tolerance of host tissue.