Identification of a novel HLA-G + regulatory population in blood: Expansion after allogeneic transplantation and de novo HLA-G expression at graft-versus-host disease sites

Ioanna Lazana, Anastasia Zoudiari, Dimitra Kokkinou, Maria Themeli, Maria Liga, Helen Papadaki, Dionysios Papachristou, Alexandros Spyridonidis

Research output: Contribution to journalArticleAcademicpeer-review

10 Citations (Scopus)


The human leukocyte antigen-G (HLA-G) has been considered to be an important tolerogeneic molecule playing an essential role in maternal-fetal tolerance, which constitutes the perfect example of successful physiological immunotolerance of semi-allografts. In this context, we investigated the putative role of this molecule in the allogeneic hematopoietic cell transplantation setting. Design and Methods The percentage of HLA-G + cells in peripheral blood of healthy donors and allo-transplanted patients was evaluated by flow cytometry. Their immunoregulatory and tolerogeneic properties were investigated in in vitro immunostimulatory and immunosuppression assays. Immunohistochemical analysis for HLA-G expression was performed in skin biopsies from allo-transplanted patients and correlated with the occurrence of graft-versus-host disease. Results We identified a CD14 +HLA-G pos population with an HLA-DR low phenotype and decreased in vitro immunostimulatory capacity circulating in peripheral blood of healthy individuals. Naturally occurring CD14 +HLA-G pos cells suppressed T-cell responses and exerted an immunotolerogenic action on T cells by rendering them hyporesponsive and immunosuppressive in vitro. After allogeneic hematopoietic cell transplantation, HLA-G pos cells increase in blood. Interestingly, besides an increase in CD14 +HLA-G pos cells, there was also a pronounced expansion of CD3 +HLA-G pos cells. Of note, CD3 +HLA-G pos and CD14 +HLA-G pos cells from transplanted patients were suppressive in in vitro lymphoproliferation assays. Furthermore, we found an upregulation of HLA-G expression in skin specimens from transplanted patients that correlated with graft-versus-host disease. Inflammatory cells infiltrating the dermis of transplanted patients were also HLA-G pos. Conclusions We report the presence of naturally occurring HLA-G pos monocytic cells with in vitro suppressive properties. HLA-G expressing regulatory blood cells were found in increased numbers after allogeneic transplantation. Epithelial cells in skin affected by graft-versus-host disease revealed elevated HLA-G expression.

Original languageEnglish
Pages (from-to)1338-1347
Number of pages10
Issue number9
Publication statusPublished - 1 Sept 2012


  • GvHD
  • HLA-G
  • Myeloid suppressor cells

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