达沙替尼诱导的脾脏收缩导致一过性淋巴细胞增多。

Dasatinib-induced spleen contraction leads to transient lymphocytosis.

机构信息

Department of Oncology, Microbiology and Immunology, University of Fribourg, Fribourg, Switzerland.

Department of Immunology, Biomedical Research Institute La Princesa Hospital (IIS-IP), Madrid, Spain.

出版信息

Blood Adv. 2023 Jun 13;7(11):2418-2430. doi: 10.1182/bloodadvances.2022009279.

Abstract

The tyrosine kinase inhibitor dasatinib is approved for Philadelphia chromosome-positive leukemia, including chronic myeloid leukemia (CML). Although effective and well tolerated, patients typically exhibit a transient lymphocytosis after dasatinib uptake. To date, the underlying physiological process linking dasatinib to lymphocytosis remains unknown. Here, we used a small rodent model to examine the mechanism of dasatinib-induced lymphocytosis, focusing on lymphocyte trafficking into and out of secondary lymphoid organs. Our data indicate that lymphocyte homing to lymph nodes and spleen remained unaffected by dasatinib treatment. In contrast, dasatinib promoted lymphocyte egress from spleen with kinetics consistent with the observed lymphocytosis. Unexpectedly, dasatinib-induced lymphocyte egress occurred independently of canonical sphingosine-1-phosphate-mediated egress signals; instead, dasatinib treatment led to a decrease in spleen size, concomitant with increased splenic stromal cell contractility, as measured by myosin light chain phosphorylation. Accordingly, dasatinib-induced lymphocytosis was partially reversed by pharmacological inhibition of the contraction-promoting factor Rho-rho associated kinase. Finally, we uncovered a decrease in spleen size in patients with CML who showed lymphocytosis immediately after dasatinib treatment, and this reduction was proportional to the magnitude of lymphocytosis and dasatinib plasma levels. In summary, our work provides evidence that dasatinib-induced lymphocytosis is a consequence of drug-induced contractility of splenic stromal cells.

摘要

酪氨酸激酶抑制剂达沙替尼获批用于治疗费城染色体阳性白血病,包括慢性髓性白血病(CML)。尽管达沙替尼疗效显著且耐受性良好,但患者在接受达沙替尼治疗后通常会出现短暂的淋巴细胞增多。迄今为止,将达沙替尼与淋巴细胞增多联系起来的潜在生理过程尚不清楚。在这里,我们使用小型啮齿动物模型来研究达沙替尼诱导淋巴细胞增多的机制,重点关注淋巴细胞进出次级淋巴器官的迁移。我们的数据表明,淋巴细胞归巢到淋巴结和脾脏不受达沙替尼治疗的影响。相比之下,达沙替尼促进了淋巴细胞从脾脏的流出,其动力学与观察到的淋巴细胞增多一致。出乎意料的是,达沙替尼诱导的淋巴细胞流出与经典的鞘氨醇 1-磷酸介导的流出信号无关;相反,达沙替尼治疗导致脾脏缩小,同时伴有脾脏基质细胞收缩性增加,如肌球蛋白轻链磷酸化所测量的那样。因此,通过 Rho- Rho 相关激酶收缩促进因子的药理学抑制部分逆转了达沙替尼诱导的淋巴细胞增多。最后,我们发现 CML 患者在接受达沙替尼治疗后立即出现淋巴细胞增多,其脾脏缩小,这与淋巴细胞增多的程度和达沙替尼的血浆水平成正比。总之,我们的工作提供了证据表明,达沙替尼诱导的淋巴细胞增多是药物诱导脾脏基质细胞收缩的结果。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/980e/10238846/5d04e9cbe11b/BLOODA_ADV-2022-009279-fx1.jpg

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