Abstract: |
Alloreactive donor cytolytic T lymphocytes play a critical role in pathophysiology of acute graft-versus-host disease (GVHD). As GVHD progression involves tumor necrosis factor superfamily receptor activation, and as apoptotic signaling for some tumor necrosis factor superfamily receptors might involve acid sphingomyelinase (ASMase)-mediated ceramide generation, we hypothesized that ASMase deletion would ameliorate GVHD. Using clinically relevant mouse models of acute GVHD in which allogeneic bone marrow and T cells were transplanted into asmase<sup>+/+</sup> and asmase<sup>-/-</sup> hosts, we identify host ASMase as critical for full-blown GVHD. Lack of host ASMase reduced the acute inflammatory phase of GVHD, attenuating cytokine storm, CD8<sup>+</sup> T-cell proliferation/activation, and apoptosis of relevant graft-versus-host target cells (hepatocytes, intestinal, and skin cells). Organ injury was diminished in asmase<sup>-/-</sup> hosts, and morbidity and mortality improved at 90 days after transplantation. Resistance to cytolytic T lymphocyte-induced apoptosis was found at the target cell membrane if hepatocytes lack ASMase, as hepatocyte apoptosis required target cell ceramide generation for formation of ceramide-rich macrodomains, sites concentrating proapoptotic Fas. These studies indicate a requirement for target cell ASMase in evolution of GVHD in liver, small intestines, and skin and provide potential new targets for disease management. © 2009 by The American Society of Hematology. |
Keywords: |
controlled study; survival rate; gene deletion; nonhuman; cd8+ t lymphocyte; lymphocyte proliferation; cd8-positive t-lymphocytes; animal cell; mouse; animals; mice; animal tissue; hepatocytes; apoptosis; fas antigen; animal experiment; animal model; mice, scid; mice, inbred c57bl; skin; disease model; liver; lymphocyte activation; cytokines; acute graft versus host disease; cytotoxic t lymphocyte; t-lymphocytes, cytotoxic; cell membrane; allogeneic hematopoietic stem cell transplantation; cytokine production; target cell; interferon-gamma; liver cell; disease models, animal; bone marrow transplantation; graft vs host disease; intestine, small; intestine cell; t lymphocyte activation; immunopathogenesis; skin cell; ceramide; ceramides; sphingomyelin phosphodiesterase; organ injury; transplantation tolerance; mice, inbred mrl lpr
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