A novel in vivo regulatory role of P-glycoprotein in alloimmunity |
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Authors: | Atsushi Izawa Natasha Y Frank Takuya Ueno Shona S Pendse Martin Grimm Ana Maria Waaga-Gasser Markus H Frank |
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Institution: | a Transplantation Research Center, Children’s Hospital Boston and Brigham & Women’s Hospital, Harvard Medical School, Boston, MA, USA b Department of Medicine, VA Boston Healthcare System, Boston, MA, USA c Division of Genetics, Brigham & Women’s Hospital, Harvard Medical School, Boston, MA, USA d Department of Surgery, University of Würzburg Medical School, Würzburg, Germany e Department of Dermatology, Brigham & Women’s Hospital, Harvard Medical School, Boston, MA, USA |
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Abstract: | P-glycoprotein (P-gp) is required for adaptive immunity through defined functions in T cell activation and antigen presenting cell (APC) maturation. The potential role of P-gp as an in vivo regulator of alloimmunity is currently unknown. Here we show that P-gp blockade prolongs graft survival in a murine heterotopic cardiac allotransplantation model through in vivo inhibition of the T helper 1 (Th1) cytokine IFN-γ and the Th2 product IL-4, and via downregulation of the APC-expressed positive costimulatory molecule CD80. In vitro, the P-gp antagonist PSC833, a non-calcineurin-inhibitory cyclosporine A analogue, specifically inhibited cellular efflux of the P-gp substrate rhodamine-123 in wild-type CD3+ T cells and MHC class II+ APCs but not their P-gp knockout counterparts that lacked rhodamine-123 efflux capacity. Additionally, P-gp blockade significantly inhibited murine alloimmune T cell activation in a dose-dependent fashion. In vivo, P-gp blockade significantly prolonged graft survival in Balb/c recipients of C57BL/6 cardiac allografts from 8.5 ± 0.5 to 11.7 ± 0.5 days (P < 0.01), similar in magnitude to the effects of monotherapy with cyclosporine A. Moreover, P-gp blockade, compared to controls, attenuated intragraft expression of CD3 and CD80, but not CD86, and inhibited IFN-γ and IL-4 production (P < 0.05). In the setting of systemic CD86 inhibition, P-gp blockade suppressed IFN-γ and IL-4 production significantly further (to 98% and 89% inhibition, respectively) compared to either P-gp or anti-CD86 blockade alone, and markedly prolonged allograft survival compared to anti-CD86 blockade alone (40.5 ± 4.6 versus 22.5 ± 2.6 days, respectively, P < 0.01). Our findings define a novel in vivo regulatory role of P-gp in alloimmunity and identify P-gp as a potential therapeutic target in allotransplantation. |
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Keywords: | P-glycoprotein Immunity Transplantation T cell Antigen presenting cell CD86 |
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