Nepomuceno Ronald R, Balatoni Cynthia E, Natkunam Yaso, Snow Andrew L, Krams Sheri M, Martinez Olivia M
Department of Surgery, Stanford University School of Medicine, 1201 Welch Road, Stanford, CA 94305, USA.
Cancer Res. 2003 Aug 1;63(15):4472-80.
EBV-infected B-cell lymphomas are a potentially life-threatening complication in bone marrow and solid organ transplant recipients. Immunosuppressive drugs required to prevent allograft rejection also impair anti-EBV T-cell immunity, thereby increasing the risk of EBV-associated disease. Here we demonstrate that the immunosuppressant rapamycin (RAPA) has a strong antiproliferative effect in vitro on B-cell lines derived from organ transplant recipients with EBV-associated posttransplant lymphoproliferative disorder (PTLD). Furthermore, RAPA significantly inhibits or delays the growth of solid tumors established from EBV-infected B-cell lines in a xenogeneic mouse model of PTLD. RAPA acts via cell cycle arrest, induction of apoptosis, and, most importantly, inhibition of interleukin 10 secretion, a necessary autocrine growth factor. The reduced interleukin 10 production is accompanied by corresponding decreases in the constitutive activation of the growth-promoting transcription factors signal transducer and activator of transcription 1 and 3. Thus, RAPA can limit B-cell lymphoma growth while simultaneously providing immunosuppression to prevent graft rejection in patients who are otherwise at risk for EBV-associated PTLD. Moreover, these findings may have application to other EBV-associated malignancies.
EBV感染的B细胞淋巴瘤是骨髓和实体器官移植受者中一种潜在的危及生命的并发症。预防同种异体移植排斥所需的免疫抑制药物也会损害抗EBV T细胞免疫,从而增加EBV相关疾病的风险。在此,我们证明免疫抑制剂雷帕霉素(RAPA)在体外对源自患有EBV相关移植后淋巴细胞增生性疾病(PTLD)的器官移植受者的B细胞系具有强大的抗增殖作用。此外,在PTLD的异种小鼠模型中,RAPA显著抑制或延缓了由EBV感染的B细胞系形成的实体瘤的生长。RAPA通过细胞周期阻滞、诱导凋亡发挥作用,最重要的是,抑制白细胞介素10的分泌,白细胞介素10是一种必要的自分泌生长因子。白细胞介素10产生的减少伴随着促进生长的转录因子信号转导和转录激活因子1和3的组成性激活相应降低。因此,RAPA可以限制B细胞淋巴瘤的生长,同时为有EBV相关PTLD风险的患者提供免疫抑制以预防移植排斥。此外,这些发现可能适用于其他EBV相关的恶性肿瘤。