Gerbitz Armin, Ewing Patricia, Olkiewicz Krystyna, Willmarth Nicole E, Williams Debra, Hildebrandt Gerhard, Wilke Andrea, Liu Chen, Eissner Günther, Andreesen Reinhard, Holler Ernst, Guo Renfeng, Ward Peter A, Cooke Kenneth R
Department of Hematology and Oncology, University of Regensburg, Regensburg, Germany.
Transplantation. 2005 Mar 15;79(5):536-42. doi: 10.1097/01.tp.0000151763.16800.b0.
Idiopathic pneumonia syndrome (IPS) is a frequently fatal complication of allogeneic bone marrow transplantation (BMT). IPS is associated with elevated bronchoalveolar lavage (BAL) fluid levels of tumor necrosis factor-alpha and lipopolysaccharide, both of which are potent activators of endothelial cells (ECs). EC expression of the adhesion molecule CD54 (intercellular adhesion molecule [ICAM]-1) has been shown to be a major regulator of pulmonary inflammation in various experimental models.
Using a well-established murine BMT system in which lung injury and graft-versus-host disease (GvHD) are induced by minor histocompatibility antigenic differences between donor and host, the RNase Protection Assay, mice deficient in ICAM-1 expression, and a monoclonal blocking antibody to ICAM, we evaluated the role of the pulmonary vascular expression of CD54 in the development of IPS.
Enhanced pulmonary vascular expression of ICAM-1 coincided with the development of IPS. When ICAM-1 -/- mice were used as allogeneic BMT recipients, IPS severity (measured by lung histopathology, BAL cellularity, and cytokine expression) was significantly reduced compared with wild-type controls. Similar results were also observed when wild-type recipients were treated with a monoclonal blocking antibody to ICAM-1. Surprisingly, ICAM-1 had differential effects on leukocyte infiltration into GvHD target organs; ICAM-1 deficiency had no impact on intestinal histopathology, whereas ICAM-1-/- BMT recipients had significantly enhanced hepatic injury.
These data demonstrate that although the expression of ICAM-1 is critical for the development of IPS, different mechanisms of leukocyte recruitment are operative in other GvHD target organs.
特发性肺炎综合征(IPS)是异基因骨髓移植(BMT)常见的致命并发症。IPS与支气管肺泡灌洗(BAL)液中肿瘤坏死因子-α和脂多糖水平升高有关,这两种物质都是内皮细胞(ECs)的强效激活剂。在各种实验模型中,粘附分子CD54(细胞间粘附分子[ICAM]-1)的EC表达已被证明是肺部炎症的主要调节因子。
利用一个成熟的小鼠BMT系统,其中肺损伤和移植物抗宿主病(GvHD)由供体和宿主之间的次要组织相容性抗原差异诱导,采用核糖核酸酶保护测定法、ICAM-1表达缺陷的小鼠以及针对ICAM的单克隆阻断抗体,我们评估了CD54的肺血管表达在IPS发生发展中的作用。
ICAM-1肺血管表达增强与IPS的发生同时出现。当将ICAM-1 -/-小鼠用作异基因BMT受体时,与野生型对照相比,IPS严重程度(通过肺组织病理学、BAL细胞计数和细胞因子表达来衡量)显著降低。当野生型受体用针对ICAM-1的单克隆阻断抗体治疗时,也观察到了类似结果。令人惊讶的是,ICAM-1对白细胞浸润到GvHD靶器官有不同影响;ICAM-1缺陷对肠道组织病理学没有影响,而ICAM-1-/- BMT受体的肝损伤明显加重。
这些数据表明,虽然ICAM-1的表达对IPS的发生至关重要,但在其他GvHD靶器官中,白细胞募集的机制不同。