CD4⁺ and CD8⁺ T cells each can utilize a perforin-dependent pathway to mediate lethal graft-versus-host disease in major histocompatibility complex- disparate recipients

Perforin-deficient (-/-) mice were used as T-cell donors for infusion into irradiated major histocompatibility complex (MHC)-disparate recipients to investigate the requirement for perforin-mediated cytolysis during graft- versus-host disease (GVHD) generation. Administration of 5x10⁶ C57BL/6 (H2(b)) perforin -/-splenocytes was significantly less effective in inducing GVHD lethality when given to MHC class I + II disparate B10.BR (H2(k)) recipients, as compared with wild-type (+/+) controls. Perforin expression by donor T cells was not required for GVHD induction because recipients given fivefold higher numbers of perforin -/- donor splenocytes uniformly succumbed to lethal GVHD. Because both CD4⁺ and CD8⁺ donor T cells are required for optimal GVHD lethality in this strain combination, to discern the relative contribution of perforin-mediated cytolysis by CD4⁺ and CD8⁺ T cells, additional studies were performed. For these latter studies, we used a sensitive assay involving the infusion of highly purified CD4⁺ or CD8⁺ T cells into sublethally irradiated MHC class II or I disparate recipients, respectively. As compared with recipients of perforin +/+ T cells, recipients of either CD4⁺ or CD8⁺ perforin -/- T-cell subsets had a significant reduction in GVHD-mediated lethality at T-cell doses that were uniformly lethal. T-cell dose titration studies established that GVHD lethality in recipients of perforin -/- CD4⁺ or CD8⁺ T cells was reduced by approximately threefold. These data are the first to indicate that approaches to limit perforin-mediated cytolysis should be similarly effective in situations in which CD4⁺ or CD8⁺ T cells dominate the GVHD response.