Department of Microbiology and Immunology.
Department of Surgery, and.
JCI Insight. 2024 Apr 11;9(9):e165936. doi: 10.1172/jci.insight.165936.
Allogeneic hematopoietic stem cell transplantation (aHSCT) can cure patients with otherwise fatal leukemias and lymphomas. However, the benefits of aHSCT are limited by graft-versus-host disease (GVHD). Minnelide, a water-soluble analog of triptolide, has demonstrated potent antiinflammatory and antitumor activity in several preclinical models and has proven both safe and efficacious in clinical trials for advanced gastrointestinal malignancies. Here, we tested the effectiveness of Minnelide in preventing acute GVHD as compared with posttransplant cyclophosphamide (PTCy). Strikingly, we found Minnelide improved survival, weight loss, and clinical scores in an MHC-mismatched model of aHSCT. These benefits were also apparent in minor MHC-matched aHSCT and xenogeneic HSCT models. Minnelide was comparable to PTCy in terms of survival, GVHD clinical score, and colonic length. Notably, in addition to decreased donor T cell infiltration early after aHSCT, several regulatory cell populations, including Tregs, ILC2s, and myeloid-derived stem cells in the colon were increased, which together may account for Minnelide's GVHD suppression after aHSCT. Importantly, Minnelide's GVHD prevention was accompanied by preservation of graft-versus-tumor activity. As Minnelide possesses anti-acute myeloid leukemia (anti-AML) activity and is being applied in clinical trials, together with the present findings, we conclude that this compound might provide a new approach for patients with AML undergoing aHSCT.
异基因造血干细胞移植 (aHSCT) 可治愈 otherwise fatal 的白血病和淋巴瘤患者。然而,aHSCT 的益处受到移植物抗宿主病 (GVHD) 的限制。米内利德是雷公藤红素的水溶性类似物,在几种临床前模型中表现出强大的抗炎和抗肿瘤活性,并已在晚期胃肠道恶性肿瘤的临床试验中被证明安全有效。在这里,我们测试了 Minnelide 预防急性 GVHD 的效果与移植后环磷酰胺 (PTCy) 相比。令人惊讶的是,我们发现 Minnelide 在 MHC 不匹配的 aHSCT 模型中改善了存活率、体重减轻和临床评分。这些益处在 MHC 匹配较小的 aHSCT 和异种 HSCT 模型中也很明显。Minnelide 在存活率、GVHD 临床评分和结肠长度方面与 PTCy 相当。值得注意的是,除了 aHSCT 后早期供体 T 细胞浸润减少外,几种调节性细胞群体,包括 Tregs、ILC2s 和结肠中的髓系来源的干细胞,也增加了,这可能共同解释了 Minnelide 在 aHSCT 后的 GVHD 抑制作用。重要的是,Minnelide 的 GVHD 预防伴随着移植物抗肿瘤活性的保留。由于 Minnelide 具有抗急性髓细胞白血病 (anti-AML) 活性,并正在临床试验中应用,结合本研究结果,我们得出结论,该化合物可能为接受 aHSCT 的 AML 患者提供一种新的治疗方法。
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