scholarly journals Mycophenolate mofetil increases susceptibility to opportunistic fungal infection independent of lymphocytes

2017 ◽  
Author(s):  
Rory H. Gibson ◽  
Robert J Evans ◽  
Richard Hotham ◽  
Aleksandra Bojarczuk ◽  
Amy Lewis ◽  
...  

AbstractAnti-proliferative agents that target lymphoid cells are common immunosuppressive agents used in the treatment of diverse autoimmune, graft versus host and inflammatory diseases. Mycophenolate mofetil (MMF) is an anti-proliferative agent that targets lymphoid dependence on inosine monophosphate dehydrogenase for the de novo purine synthesis of deoxyguanosine triphosphate (dGTP) for DNA replication. Here we show that MMF has a distinct and specific in vivo effect on macrophages, in the absence of lymphoid cells. This results in increased macrophage cell death that is dependent on the depletion of cellular GTP, independent of DNA synthesis. Furthermore, the macrophage specific effect of MMF treatment causes an increase in susceptibility to the opportunistic fungal infection Cryptococcus neoformans by reducing phagocytosis and increasing the release of intracellular pathogens via macrophage lysis. Our study demonstrates the need for a better mechanistic understanding of immunosuppressive treatments used in clinical practice and of the specific infection risks associated with certain treatment regimens.

2018 ◽  
Author(s):  
Maria Pokrovskii ◽  
Jason A. Hall ◽  
David E. Ochayon ◽  
Ren Yi ◽  
Natalia S. Chaimowitz ◽  
...  

SummaryInnate lymphoid cells (ILCs) can be subdivided into several distinct cytokine-secreting lineages that promote tissue homeostasis and immune defense but also contribute to inflammatory diseases. Accumulating evidence suggests that ILCs, similarly to other immune populations, are capable of phenotypic and functional plasticity in response to infectious or environmental stimuli. Yet the transcriptional circuits that control ILC identity and function are largely unknown. Here we integrate gene expression and chromatin accessibility data to infer transcriptional regulatory networks within intestinal type 1, 2, and 3 ILCs. We predict the “core” sets of transcription-factor (TF) regulators driving each ILC subset identity, among which only a few TFs were previously known. To assist in the interpretation of these networks, TFs were organized into cooperative clusters, or modules that control gene programs with distinct functions. The ILC network reveals extensive alternative-lineage-gene repression, whose regulation may explain reported plasticity between ILC subsets. We validate new roles for c-MAF and BCL6 as regulators affecting the type 1 and type 3 ILC lineages. Manipulation of TF pathways identified here might provide a novel means to selectively regulate ILC effector functions to alleviate inflammatory disease or enhance host tolerance to pathogenic microbes or noxious stimuli. Our results will enable further exploration of ILC biology, while our network approach will be broadly applicable to identifying key cell state regulators in otherin vivocell populations.


2019 ◽  
Vol 216 (12) ◽  
pp. 2763-2777 ◽  
Author(s):  
Lisa Knipfer ◽  
Anja Schulz-Kuhnt ◽  
Markus Kindermann ◽  
Vicky Greif ◽  
Cornelia Symowski ◽  
...  

Group 2 innate lymphoid cells (ILC2s) possess indispensable roles during type 2–mediated inflammatory diseases. Although their physiological and detrimental immune functions seem to depend on the anatomical compartment they reside, their tissue tropism and the molecular and immunological processes regulating the self-renewal of the local pool of ILC2s in the context of inflammation or infection are incompletely understood. Here, we analyzed the role of the CC-chemokine receptor CCR8 for the biological functions of ILC2s. In vitro and in vivo experiments indicated that CCR8 is in comparison to the related molecule CCR4 less important for migration of these cells. However, we found that activated mouse and human ILC2s produce the CCR8 ligand CCL1 and are a major source of CCL1 in vivo. CCL1 signaling to ILC2s regulates their proliferation and supports their capacity to protect against helminthic infections. In summary, we identify a novel chemokine receptor–dependent mechanism by which ILC2s are regulated during type 2 responses.


Blood ◽  
2005 ◽  
Vol 106 (11) ◽  
pp. 5226-5226
Author(s):  
Mark A. Schroeder ◽  
Michael P. Rettig ◽  
Julie K. Ritchey ◽  
John F. DiPersio

Abstract Several immunosuppressive agents are currently being evaluated for their ability to inhibit host immune responses that prevent donor engraftment after reduced intensity allogeneic BMT. Unfortunately, these immunosuppressive agents have the potential to inhibit the beneficial graft-versus-infection and graft-versus-leukemia effects mediated by mature donor T cells that are present in the graft. One potential approach to retain donor T cell function in immunosuppressed recipients after allogeneic BMT is to genetically modify the donor T cells with a drug resistance gene that confers protection from the effects of the immunosuppressive agent. Mycophenolate mofetil (MMF), the morpholino-ethyl ester precursor of the active compound mycophenolic acid (MPA), is an immunosuppressive agent that prevents cell proliferation by inhibiting the enzyme inosine monophosphate dehydrogenase (IMPDH) II and has been used in conjunction with other immunosuppressants to promote donor engraftment and limit graft versus host disease after nonmyeloablative BMT. IMPDH II is the rate-limiting enzyme in de novo guanosine synthesis and is preferentially expressed in activated T and B cells. A number of investigators have identified IMPDH II mutants that have altered MPA binding capacity and normal guanosine synthesis in vitro (BBA2002;1594:27, JBC.1997;272:961, BBA.1994;1217:156). One prototypic mutant (IMPDH*; Thr-333-Ile, Ser-351-Tyr) has been used for in vivo selection of donor T-cells in a canine model (Blood2003;102:3696a) We hypothesized that over expression of IMPDH* in donor T cells would provide resistance to MPA in vitro and MMF in vivo, thus allowing MMF to be used in vivo to inhibit recipient immune responses while maintaining normal donor T cell function. In our initial studies, we transduced murine A20 cells (a B-lymphoblastic leukemia) with retroviral vectors encoding IMPDH or IMPDH* fused to the C-terminus of our previously described CD34/HSV-TK chimeric suicide gene. This strategy enabled us to rapidly and efficiently select genetically modified cells using a well-established CD34 immunoselection technique. Unfortunately, the CD34/TK/IMPDH* fusion protein failed to confer MPA resistance to A20 cells in vitro. To determine whether this failure to confer MPA resistance was caused by fusing IMPDH* to CD34/TK, we generated bicistronic retroviral vectors that expressed either IMPDH or IMPDH* and EGFP using an internal ribosome entry site (IRES). Human Jurkat T cells were efficiently transduced with the bicistronic vectors and GFP+ cells were selected using a MoFlo cell sorter. As before, forced expression of IMPDH* failed to confer MPA resistance to the transduced and selected cells in vitro (IC50 = 0.5uM). Interestingly, chronic selection of transduced Jurkat cells in 1 uM MPA for 2 weeks led to a 4 fold increase in the IC50 (IC50 = 2uM MPA). These studies suggest that the resistance to MPA observed in vivo by others for IMPDH* may not be derived from the aforementioned point mutations in IMPDH but rather to over expression or up-regulation of IMPDH II, which may act as a sink for MPA. Alternatively, differences between species and cell lines, introduction of novel mutations during selection, or alternative salvage pathways may be activated resulting in MPA resistance. We subsequently have generated six additional mutants of the MPA binding site based on in vitro data and x-ray crystallography of the MPA binding site and we have began expressing them in our in vivo model. Analysis of these mutants is ongoing.


2014 ◽  
Vol 2014 ◽  
pp. 1-12 ◽  
Author(s):  
Nazanin Majd ◽  
Kazutaka Sumita ◽  
Hirofumi Yoshino ◽  
Dillon Chen ◽  
Jumpei Terakawa ◽  
...  

Tumor cells adapt to their high metabolic state by increasing energy production. To this end, current efforts in molecular cancer therapeutics have been focused on signaling pathways that modulate cellular metabolism. However, targeting such signaling pathways is challenging due to heterogeneity of tumors and recurrent oncogenic mutations. A critical need remains to develop antitumor drugs that target tumor specific pathways. Here, we discuss an energy metabolic pathway that is preferentially activated in several cancers as a potential target for molecular cancer therapy. In vitro studies have revealed that many cancer cells synthesize guanosine triphosphate (GTP), via the de novo purine nucleotide synthesis pathway by upregulating the rate limiting enzyme of this pathway, inosine monophosphate dehydrogenase (IMPDH). Non-proliferating cells use an alternative purine nucleotide synthesis pathway, the salvage pathway, to synthesize GTP. These observations pose IMPDH as a potential target to suppress tumor cell growth. The IMPDH inhibitor, mycophenolate mofetil (MMF), is an FDA-approved immunosuppressive drug. Accumulating evidence shows that, in addition to its immunosuppressive effects, MMF also has antitumor effects via IMPDH inhibition in vitro and in vivo. Here, we review the literature on IMPDH as related to tumorigenesis and the use of MMF as a potential antitumor drug.


Author(s):  
Shiwen Ni ◽  
Teng Zhang ◽  
Chenmin Zhou ◽  
Min Long ◽  
Xuan Hou ◽  
...  

Inosine monophosphate dehydrogenase (IMPDH), the rate-limiting enzyme catalyzing de novo biosynthesis of guanine nucleotides, aggregates under certain circumstances into a type of non-membranous filamentous macrostructure termed “cytoophidium” or “rod and ring” in several types of cells. However, the biological significance and underlying mechanism of IMPDH assembling into cytoophidium remain elusive. In mouse ovaries, IMPDH is reported to be crucial for the maintenance of oocyte–follicle developmental synchrony by providing GTP substrate for granulosa cell natriuretic peptide C/natriuretic peptide receptor 2 (NPPC/NPR2) system to produce cGMP for sustaining oocyte meiotic arrest. Oocytes and the associated somatic cells in the ovary hence render an exciting model system for exploring the functional significance of formation of IMPDH cytoophidium within the cell. We report here that IMPDH2 cytoophidium forms in vivo in the growing oocytes naturally and in vitro in the cumulus-enclosed oocytes treated with IMPDH inhibitor mycophenolic acid (MPA). Inhibition of IMPDH activity in oocytes and preimplantation embryos compromises oocyte meiotic and developmental competences and the development of embryos beyond the 4-cell stage, respectively. IMPDH cytoopidium also forms in vivo in the granulosa cells of the preovulatory follicles after the surge of luteinizing hormone (LH), which coincides with the resumption of oocyte meiosis and the reduction of IMPDH2 protein expression. In cultured COCs, MPA-treatment causes the simultaneous formation of IMPDH cytoopidium in cumulus cells and the resumption of meiosis in oocytes, which is mediated by the MTOR pathway and is prevented by guanosine supplementation. Therefore, our results indicate that cytoophidia do form in the oocytes and granulosa cells at particular stages of development, which may contribute to the oocyte acquisition of meiotic and developmental competences and the induction of meiosis re-initiation by the LH surge, respectively.


2016 ◽  
Vol 35 (6) ◽  
pp. 712-718 ◽  
Author(s):  
Ling-Ling Jiang ◽  
Mei-Hui Liu ◽  
Jian-Ying Li ◽  
Zhi-Heng He ◽  
Huan Li ◽  
...  

With the increasing use of mycophenolic acid (MPA) in solid organ transplantation, some clinical studies indicate that it is also a human teratogen. However, it is unknown by which mechanism MPA acts as a teratogen. Mycophenolic acid was a selective blocker of de novo purine synthesis, and its immunosuppressive effect is mediated by the inhibition of inosine monophosphate dehydrogenase, which could be a target for MPA-induced toxicity as well. The aim of our study was to examine the direct influence of MPA exposure on zebrafish ( Danio rerio) embryos. Morphological defects including tail curvature and severe pericardial edema in zebrafish embryos caused by MPA (3.7-11.1 µmol/L) were found in a dose-dependent manner. The teratogenic index (25% lethal concentration value (LC25)/no observed adverse effect level ratio) was 16, which indicated MPA as a teratogen. Quantitative polymerase chain reaction analysis revealed that the expression level of impdh1b and impdh2 was significantly reduced by MPA treatment at 8 µmol/L (equals to LC25 level). All the toxic effects could be partially reversed by the addition of 33.3 µmol/L guanosine. Our results indicated that MPA impairs the development of zebrafish embryos via inhibition of impdh activity, which subsequently caused a guanosine nucleotide depletion in vivo.


Blood ◽  
2004 ◽  
Vol 104 (9) ◽  
pp. 2919-2925 ◽  
Author(s):  
Charlotte V. Cox ◽  
Roger S. Evely ◽  
Anthony Oakhill ◽  
Derwood H. Pamphilon ◽  
Nicholas J. Goulden ◽  
...  

Abstract Only some acute lymphoblastic leukemia (ALL) cells are thought to be capable of proliferating to maintain the leukemic clone, and these cells may be the most relevant to target with treatment regimens. We have developed a serum-free suspension culture (SC) system that supported growth of B-ALL cells from 33 patients for up to 6 weeks. ALL cells from 28 cases (85%) were expanded in this system, and growth was superior in SC than in long-term bone marrow culture. To characterize ALL progenitors, cells were sorted for expression of CD34 and CD10 or CD19 and the subfractions assayed in SC and in nonobese diabetic/severe combined immunodeficient (NOD/SCID) mice. Cells capable of long-term proliferation in vitro and NOD/SCID repopulation were derived only from the CD34+/CD10- and CD34+/CD19- subfractions, and these cells could engraft secondary recipients. The engrafted cells had the same immunophenotype and karyotype as was seen at diagnosis, suggesting they had differentiated in vivo. These results demonstrate that ALL cells capable of long-term proliferation in vitro and in vivo are CD34+/CD10-/CD19-. This suggests that cells with a more immature phenotype, rather than committed B-lymphoid cells, may be the targets for transformation in B-ALL.


2005 ◽  
Vol 18 (6) ◽  
pp. 422-431 ◽  
Author(s):  
Yi-Min Ku ◽  
Megan McCartan ◽  
Dean Collier

The use of mycophenolate mofetil (MMF), in combination with cyclosporine (CsA) or tacrolimus (FK) and corticosteroids, has been shown to improve clinical outcomes through significant reduction in the incidence of acute rejection in solid organ transplant patients. A fixed oral dosing regimen of 1 or 1.5 g MMF twice daily received Food and Drug Administration approval in 1995 with no recommendations for concentration monitoring at that time. Subsequent evidence has generated substantial debate on the need of clinical monitoring for MMF. This article summarizes the rationale, evidence, and approaches of clinical monitoring for MMF. Mycophenolic acid (MPA), the active moiety of MMF, noncompetitively inhibits the enzyme inosine monophosphate dehydrogenase (IMPDH), which is the target enzyme for MPA. Pharmacokinetic monitoring, by use of MPA predose or MPA area under the concentration-time curve (AUC) values, and pharmacodynamic monitoring by analysis of inhibition of IMPDH have been evaluated in organ transplant patients. The possibility of drug interactions between other immunosuppressive agents has also received attention recently. The clinical implications of drug interactions are discussed in this article.


2019 ◽  
Vol 21 (Supplement_3) ◽  
pp. iii12-iii12
Author(s):  
A U Ahmed ◽  
J Shireman ◽  
F Atashi ◽  
M Saathoff ◽  
E Ali ◽  
...  

Abstract BACKGROUND A distinguishing characteristic of all cancers is uncontrolled cell division, and they require additional nucleotide bases such as purines, the building blocks of DNA and RNA, to sustain their uncontrolled growth. Purines can be synthesized from scratch by de novo pathway or salvaged by recycling surrounding nucleotides that are released by hydrolytic degradation. Even though the central nervous system (CNS), as well as CNS associated malignancies like glioblastoma (GBM), rely more heavily on the salvage pathway due to its energy efficiency, its precious role in promoting chemoresistance and GBM recurrence is yet to be elucidated. MATERIAL AND METHODS We have examined the role of purine biosynthesis in GBM by using stable isotope tracing analysis as well as utilizing a knockdown (KD) system to investigate its effect on i) DNA damage response during temozolomide (TMZ) therapy, ii) tumor engraftment and iii) therapeutic responses in vivo. RESULTS Through gene expression and protein-protein interaction analysis, we have identified ARL13B, member of ADP-ribosylation factor-like protein family, as a novel regulator of the purine biosynthesis pathway in GBM. ARL13B can physically interacting with the inosine monophosphate dehydrogenase 2 (IMPDH2), a key rate-limiting enzyme for purine biogenesis. Isotope tracer analysis under normal physiological conditions revealed that during TMZ treatment, salvage recycling activity was decreased by 50% while de novo pathway activity remains unchanged. In contrast, TMZ treatment of ARL13B knock-out cells results in a ~50% decrease in de novo pathway activity (p-value=0.004), whereas purine salvage pathway activity is upregulated ~6-fold (p-value <0.0001). ARL13B knockdown cells treated with TMZ show a robust increase in DNA double-strand breaks compared to control cells exposed to TMZ, as demonstrated by gH2X staining. Mice orthotopically engrafted with KD cells experience prolonged survival relative to mice engrafted with unmodified cells. CONCLUSION We propose that ARL13B-IMPDH2 interaction has two consequences: i) augmentation of de novo purine biosynthesis activity, and ii) inhibition of nucleotide recycling. The increasing de novo purine biosynthesis during TMZ therapy helps GBM cells reduce the recycling of nucleotides via the salvage pathway that have been modified as a result of TMZ alkylation. This, in turn, protects the cells from deleterious effects of incorporating modified nucleotides into newly-synthesized DNA while maintaining a supply of purine building blocks to support uncontrolled proliferation. Our results indicate that the interaction of ARL13B-IMPDH2 functions as a purine biosynthesis regulator that could be targeted for increasing efficacy of TMZ treatment of GBM. ​


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