Development of psoriasis after syngeneic bone marrow transplant from psoriatic donor: further evidence for adoptive autoimmunity

Abstract

Transfer of donor immunity has been demonstrated in animal models of both allogeneic and syngeneic bone marrow transplantation (BMT). Clinical case reports have suggested that human autoimmune disease may be similarly transferred. However, it is difficult to completely exclude autoimmune phenomena associated with graft-versus-host disease (GVHD) as previously reported cases are of allogeneic BMT. In addition, the onset of autoimmunity has been distantly related to the timing of the transplant, perhaps because of the immunosuppression used for prophylaxis and treatment of GVHD. We describe a patient in whom the development of psoriasis shortly after receiving syngeneic bone marrow from a psoriatic donor and its recurrence with arthropathy following a second syngeneic BMT provide more direct evidence for the adoptive transfer of human autoimmune disease, probably by T cells.

Resolution of psoriasis following allogeneic bone marrow transplantation for chronic myelogenous leukemia: Case report and review of the literature

“…On the other hand, patients developing psoriasis after a syngeneic BMT from a psoriatic donor have been reported [15,16]. Experimental study in animal models has demonstrated that various autoimmune diseases can be transferred to healthy animals by BMT after total body irradiation [17].…”

Alefacept reduces infiltrating T cells, activated dendritic cells, and inflammatory genes in psoriasis vulgaris

“…Evidence includes identification of clonal populations of T cells in diseased skin (2)(3)(4) and reversal of psoriasiform epidermal hyperplasia as well as other pathologic alterations by T celltargeted therapeutics. Also, psoriasis has erupted as a new disease in recipients of bone marrow transplants from psoriasis donors (5). In experimental xenograft models, ''normal'' skin of psoriasis patients has been converted to psoriasis by injection of superantigen-activated T cells (6), and spontaneous expansion of skin-resident T cells has produced psoriasis (7).…”

Wound Repair Studies Reveal New Insights to Psoriasis

“…This process initiates a pseudo-autoimmune reaction responsible for the psoriasiform outcome (Prinz et al, 1991;Leung et al, 1995;Valdimarsson et al, 2009). Interestingly, psoriasis was shown to be transferrable when the bone marrow of an affected individual was transplanted into a previously unaffected recipient (Snowden & Heaton, 1997). Conversely, psoriasis in a previously affected individual was completely cured after bone marrow ablation prior to transplant (Eedy et al, 1990).…”