Kim Yong-Mi, Sachs Teviah, Asavaroengchai Wannee, Bronson Roderick, Sykes Megan
Transplantation Biology Research Center, Massachusetts General Hospital, Harvard Medical School, Boston, Massachusetts 02129, USA.
J Clin Invest. 2003 Mar;111(5):659-69. doi: 10.1172/JCI16950.
Graft-versus-host disease (GvHD) mediated by donor T cells recognizing host alloantigens is associated with beneficial graft-versus-tumor effects in recipients of allogeneic hematopoietic cell transplants. Since leukemias and lymphomas reside largely within the lymphohematopoietic system, we have proposed that the desired graft-versus-leukemia or graft-versus-lymphoma effect can be separated from the complication of GvHD by confinement of the graft-versus-host alloresponse to the lymphohematopoietic tissues. Since the new sphingosine-1-phosphate receptor agonist immunosuppressive drug FTY720 leads to trapping of T cells in secondary lymphoid tissues, we evaluated the possibility that this drug could diminish GvHD, a disease involving epithelial target tissues, while permitting a beneficial alloresponse to take place within the lymphohematopoietic system, leading to graft-versus-lymphoma effects. We demonstrate here that FTY720 markedly reduces GvHD in a clinically relevant, haploidentical strain combination, while permitting antitumor effects against a T cell lymphoma of unshared host MHC haplotype to proceed unhindered. These results establish a potential new immunotherapeutic approach to separating graft-versus-leukemia effects from GvHD.
由识别宿主同种异体抗原的供体T细胞介导的移植物抗宿主病(GvHD)与异基因造血细胞移植受者的有益移植物抗肿瘤效应相关。由于白血病和淋巴瘤主要存在于淋巴造血系统中,我们提出,通过将移植物抗宿主同种异体反应限制在淋巴造血组织中,可以将所需的移植物抗白血病或移植物抗淋巴瘤效应与GvHD并发症区分开来。由于新型鞘氨醇-1-磷酸受体激动剂免疫抑制药物FTY720可导致T细胞滞留在二级淋巴组织中,我们评估了这种药物能否减轻GvHD(一种涉及上皮靶组织的疾病),同时允许在淋巴造血系统内发生有益的同种异体反应,从而产生移植物抗淋巴瘤效应的可能性。我们在此证明,FTY720在临床相关的单倍体同基因品系组合中显著降低了GvHD,同时允许对不共享宿主MHC单倍型的T细胞淋巴瘤进行不受阻碍的抗肿瘤效应。这些结果确立了一种将移植物抗白血病效应与GvHD区分开来的潜在新免疫治疗方法。