Bone marrow-derived cells repopulate the human peritoneal cavity after allogeneic stem cell transplantation

npj gut and liver., vol. 3

Abstract

Abstract In end-stage liver disease, disruption of the gut–liver axis leads to intestinal dysbiosis and impaired barrier function, promoting translocation of bacterial products into the peritoneal cavity and contributing to spontaneous bacterial peritonitis (SBP). The peritoneal cavity harbors a distinct immune landscape dominated by tissue-resident peritoneal macrophages (PMs), which are crucial for pathogen clearance. Severe infections or medical interventions can drastically alter this landscape. While strong evidence from previous studies suggests that PMs originate from infiltrating monocytes, direct experimental proof is still lacking. Here, we studied a patient with allogeneic stem cell transplantation and decompensated cirrhosis. Genetic chimerism enabled tracking of immune cell origin. One year post-transplant, PMs were almost entirely donor-derived yet displayed all features of mature tissue-resident macrophages. A minor fraction of patient-derived small PMs persisted, indicating resilience. Additionally, peritoneal fluid supported macrophage differentiation, underscoring the role of environmental milieu. Our findings provide direct evidence that circulating monocytes can fully replenish PMs.

Authors 13

1. Lamia S. Albesais

   Jena University Hospital

   Affiliation as printed

   Department of Internal Medicine IV, University Hospital Jena, Jena, Germany

2. Michael Rooney

   Jena University Hospital

   Affiliation as printed

   Department of Neuropediatrics, University Hospital Jena, Jena, Germany

3. Stefanie Quickert

   Jena University Hospital

   Affiliation as printed

   Department of Internal Medicine IV, University Hospital Jena, Jena, Germany

4. Benjamin Giszas

   Jena University Hospital

   Affiliation as printed

   Department of Internal Medicine IV, University Hospital Jena, Jena, Germany

5. Juliane Sanft

   Jena University Hospital

   Affiliation as printed

   Institute of Forensic Medicine, University Hospital Jena, Jena, Germany

6. Gita Mall

   Jena University Hospital

   Affiliation as printed

   Institute of Forensic Medicine, University Hospital Jena, Jena, Germany

7. Arndt Steube

   Jena University Hospital

   Affiliation as printed

   Department of Internal Medicine IV, University Hospital Jena, Jena, Germany

8. Philipp Reuken

   Jena University Hospital

   Affiliation as printed

   Department of Internal Medicine IV, University Hospital Jena, Jena, Germany

9. Peter Huppke

   Jena University Hospital

   Affiliation as printed

   Department of Neuropediatrics, University Hospital Jena, Jena, Germany

10. Tino Schenk

    Jena University Hospital

    Affiliation as printed

    Department of Internal Medicine II, University Hospital Jena, Jena, Germany

11. Andreas Stallmach

    Jena University Hospital

    Affiliation as printed

    Department of Internal Medicine IV, University Hospital Jena, Jena, Germany

12. Tony Bruns Aachen Medical Department 3

    Universitätsklinikum Aachen · RWTH Aachen University

    Affiliation as printed

    Medical Department 3, RWTH Aachen University Hospital, Aachen, Germany

13. Sven Stengel corresponding

    Jena University Hospital

    Affiliation as printed

    Department of Internal Medicine IV, University Hospital Jena, Jena, Germany

    Department of Neuropediatrics, University Hospital Jena, Jena, Germany