Belperio John A, Keane Michael P, Burdick Marie D, Lynch Joseph P, Xue Ying Ying, Li Kewang, Ross David J, Strieter Robert M
Department of Medicine, Division of Pulmonary and Critical Care Medicine, University of California, Los Angeles, School of Medicine, Los Angeles, CA 90095, USA.
J Immunol. 2002 Jul 15;169(2):1037-49. doi: 10.4049/jimmunol.169.2.1037.
Bronchiolitis obliterans syndrome (BOS) is the major limitation to survival post-lung transplantation and is characterized by a persistent peribronchiolar inflammation that eventually gives way to airway fibrosis/obliteration. Acute rejection is the main risk factor for the development of BOS and is characterized by a perivascular/bronchiolar leukocyte infiltration. The specific mechanism(s) by which these leukocytes are recruited have not been elucidated. The CXC chemokines (monokine induced by IFN-gamma (MIG)/CXC chemokine ligand (CXCL)9, IP-10/CXCL10, and IFN-inducible T cell alpha chemoattractant (ITAC)/CXCL11) act through their shared receptor, CXCR3. Because they are potent leukocyte chemoattractants and are involved in other inflammation/fibroproliferative diseases, we hypothesized that the expression of these chemokines during an allogeneic response promotes the persistent recruitment of mononuclear cells, leading to chronic lung rejection. We found that elevated levels of MIG/CXCL9, IFN-inducible protein 10 (IP-10)/CXCL10, and ITAC/CXCL11 in human bronchoalveolar lavage fluid were associated with the continuum from acute to chronic rejection. Translational studies in a murine model demonstrated increased expression of MIG/CXCL9, IP-10/CXCL10, and ITAC/CXCL11 paralleling the recruitment of CXCR3-expressing mononuclear cells. In vivo neutralization of CXCR3 or its ligands MIG/CXCL9 and IP-10/CXCL10 decreased intragraft recruitment of CXCR3-expressing mononuclear cells and attenuated BOS. This supports the notion that ligand/CXCR3 biology plays an important role in the recruitment of mononuclear cells, a pivotal event in the pathogenesis of BOS.
闭塞性细支气管炎综合征(BOS)是肺移植术后生存的主要限制因素,其特征为持续性细支气管周围炎症,最终发展为气道纤维化/闭塞。急性排斥反应是BOS发生的主要危险因素,其特征为血管周围/细支气管白细胞浸润。这些白细胞被招募的具体机制尚未阐明。CXC趋化因子(γ干扰素诱导的单核因子(MIG)/CXC趋化因子配体(CXCL)9、干扰素诱导蛋白10(IP-10)/CXCL10和干扰素诱导的T细胞α趋化因子(ITAC)/CXCL11)通过其共同受体CXCR3发挥作用。由于它们是强效白细胞趋化因子,并参与其他炎症/纤维增生性疾病,我们推测这些趋化因子在同种异体反应过程中的表达促进了单核细胞的持续招募,导致慢性肺排斥反应。我们发现,人支气管肺泡灌洗液中MIG/CXCL9、干扰素诱导蛋白10(IP-10)/CXCL10和ITAC/CXCL11水平升高与从急性排斥到慢性排斥的连续过程相关。在小鼠模型中的转化研究表明,MIG/CXCL9、IP-10/CXCL10和ITAC/CXCL11的表达增加与表达CXCR3的单核细胞的招募平行。体内中和CXCR3或其配体MIG/CXCL9和IP-10/CXCL10可减少移植体内表达CXCR3的单核细胞的招募,并减轻BOS。这支持了配体/CXCR3生物学在单核细胞招募中起重要作用的观点,单核细胞招募是BOS发病机制中的关键事件。
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