Nakamura T, Nakao T, Yoshimura N, Ashihara E
Department of Transplantation and Regenerative Surgery, Graduate School of Medical Science, Kyoto Prefectural University of Medicine, Kamigyo-Ku, Kyoto-Prefecture, Japan.
Department of Clinical and Translational Physiology, Kyoto Pharmaceutical University, Yamashina-ku, Kyoto, Japan.
Am J Transplant. 2015 Sep;15(9):2364-77. doi: 10.1111/ajt.13276. Epub 2015 May 5.
Mammalian target of rapamycin (mTOR) inhibitors are the main immunosuppressive drugs for organ transplant recipients. Nevertheless, the mechanisms by which mTOR inhibitors induce immunosuppression is not fully understood. Myeloid-derived suppressor cells (MDSCs) maintain host immunity; however, the relationship between mTOR inhibitors and MDSCs is unclear. Here, the results from a murine cardiac transplantation model revealed that rapamycin treatment (3 mg/kg, intraperitoneally on postoperative days 0, 2, 4, and 6) led to the recruitment of MDSCs and increased their expression of inducible nitric oxide synthase (iNOS). Immunohistochemical analysis revealed that rapamycin induced the migration of iNOS-expressing MDSCs into the subintimal space within the allograft vessels, resulting in a significant prolongation of graft survival compared with that in the untreated group (67 days vs. 7 days, respectively). These effects were counterbalanced by the administration of an anti-Gr-1, which reduced allograft survival to 21 days. Moreover, adoptive transcoronary arterial transfer of MDSCs from rapamycin-treated recipients prolonged allograft survival; this increase was reversed by the anti-Gr-1 antibody. Finally, co-administration of rapamycin and a mitogen-activated protein kinase kinase (MEK) inhibitor trametinib reversed rapamycin-mediated MDSC recruitment. Thus, the mTOR and Raf/MEK/extracellular signal regulated kinase (ERK) signaling pathways appear to play an important role in MDSC expansion.
雷帕霉素哺乳动物靶点(mTOR)抑制剂是器官移植受者的主要免疫抑制药物。然而,mTOR抑制剂诱导免疫抑制的机制尚未完全明确。髓系来源的抑制性细胞(MDSCs)维持宿主免疫;然而,mTOR抑制剂与MDSCs之间的关系尚不清楚。在此,小鼠心脏移植模型的结果显示,雷帕霉素治疗(3mg/kg,于术后第0、2、4和6天腹腔注射)导致MDSCs募集并增加其诱导型一氧化氮合酶(iNOS)的表达。免疫组织化学分析显示,雷帕霉素诱导表达iNOS的MDSCs迁移至同种异体移植血管的内膜下间隙,与未治疗组相比,显著延长了移植物存活时间(分别为67天和7天)。给予抗Gr-1可抵消这些作用,使同种异体移植物存活时间缩短至21天。此外,经冠状动脉移植来自雷帕霉素治疗受体的MDSCs可延长同种异体移植物存活时间;抗Gr-1抗体可逆转这种延长。最后,雷帕霉素与丝裂原活化蛋白激酶激酶(MEK)抑制剂曲美替尼联合给药可逆转雷帕霉素介导的MDSCs募集。因此,mTOR和Raf/MEK/细胞外信号调节激酶(ERK)信号通路似乎在MDSCs扩增中起重要作用。