Graft-versus-host-like disease complicating thymoma: Lack of AIRE expression as a cause of non-hereditary autoimmunity?

G. Johan Offerhaus, Marguerite E.I. Schipper, Audrey J. Lazenby, Elizabeth Montgomery, Folkert H.M. Morsink, Richard J. Bende, Alex R. Musler, Rene A.W. van Lier, Carel J.M. van Noesel

Research output: Contribution to journalArticlepeer-review

37 Scopus citations


Three patients with graft-versus-host-like enterocolonopathy are reported. Their history was remarkable for thymoma and other autoimmune manifestations such as thrombocytopenia, red cell aplasia, interface dermatitis, Sjogren sialadenits, vanishing bile ducts and rheumatoid arthritis. In all patients, microsatellite analysis showed the autologous nature of the lymphocytes in the affected organs ruling out GVHD. In search for mechanisms that could mediate loss of tolerance to self-antigens we found in a panel of thymomas, including those of the three patients, a complete lack of autoimmune regulator (AIRE) and minimal expression of the transcription factor FOXP3 in the intra-tumoral T cells. AIRE is a recently discovered transcription factor which plays a key role in the maintenance of central tolerance and is mutated in the autosomal recessive autoimmune polyendocrinopathy syndrome APS-1. Our observations indicate that thymoma-related autoimmunity can potentially be elicited by an incomplete deletion of 'self'-specific T cells in concert with an insufficient formation of natural Tregs.

Original languageEnglish (US)
Pages (from-to)31-37
Number of pages7
JournalImmunology Letters
Issue number1
StatePublished - Nov 30 2007
Externally publishedYes


  • AIRE
  • Autoimmunity
  • FOXP3
  • Graft-versus-host-disease
  • Microsatellite
  • T-cell development
  • Thymoma

ASJC Scopus subject areas

  • Immunology and Allergy
  • Immunology


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