title: Inhibition of endothelial receptor expression and of T-cell ligand activity by mycophenolate mofetil.
abstract: The novel immunosuppressive drug mycophenolate mofetil (CellCept, MMF) blocks DNA-synthesis by the inhibition of the enzyme inosine monophosphate dehydrogenase (IMDH). IMDH is also involved in the synthesis of adhesion receptors which are known to play an important role in the regulation of cell-cell contacts. Therefore, application of MMF might lead to a reduction of cellular infiltrates in the course of transplant rejection. To evaluate the therapeutic value of MMF, we investigated to what extent MMF blocks T-lymphocyte infiltration in vitro with regard to (a) adhesion to endothelial cells, (b) horizontal migration along these cells and (c) penetration through the endothelial cells. The results demonstrated a strong inhibition of both CD4+ and CD8+ T-cell adhesion and penetration by MMF. The ID50 value for CD4+ T-cell adhesion was calculated to be 0.03 microM and the ID50 value for CD4+ T-cell penetration 1.21 microM. MMF did not significantly influence the horizontal migration of T-lymphocytes along the human vascular endothelial cell (HUVEC) borders. FACS-analysis revealed a diminished E-selectin and P-selectin expression on endothelial cell membranes in the presence of MMF. Although MMF did not interfere with the synthesis of T-cell adhesion ligands, the binding activity of lymphocytic leucocyte function associated antigen 1 (LFA-1), very late antigen 4 (VLA-4) and PSGL-1 (P-selectin glycoprotein ligand 1) to immobilized intercellular adhesion molecule 1 (ICAM-1), vascular cell adhesion molecule 1 (VCAM-1) and P-selectin was impaired. Moreover, MMF prevented VLA-4 and PSGL-1 receptor accumulation on the membranes of T-cell pseudopodia. It can be concluded that MMF possesses potent infiltration blocking properties. MMF evoked down-regulation of specific endothelial membrane molecules and the loss of protein localization in the lymphocyte protrusions might be predominantly responsible for the observed blockade of cell adhesion and penetration.
authors.affiliation: Department of General Surgery, Johann Wolfgang Goethe-University, Frankfurt am Main, Germany. Blaheta@em.uni-frankfurt.de
authors.forename: R A
authors.initials: RA
authors.lastname: Blaheta
authors.forename: K
authors.initials: K
authors.lastname: Leckel
authors.forename: B
authors.initials: B
authors.lastname: Wittig
authors.forename: D
authors.initials: D
authors.lastname: Zenker
authors.forename: E
authors.initials: E
authors.lastname: Oppermann
authors.forename: S
authors.initials: S
authors.lastname: Harder
authors.forename: M
authors.initials: M
authors.lastname: Scholz
authors.forename: S
authors.initials: S
authors.lastname: Weber
authors.forename: H
authors.initials: H
authors.lastname: Schuldes
authors.forename: A
authors.initials: A
authors.lastname: Encke
authors.forename: B H
authors.initials: BH
authors.lastname: Markus
mesh_terms: D015496:CD4-Positive T-Lymphocytes / Q000187:drug effects* / Q000378:metabolism; D018414:CD8-Positive T-Lymphocytes / Q000187:drug effects* / Q000378:metabolism; D015815:Cell Adhesion Molecules / Q000096:biosynthesis*; D002478:Cells, Cultured; D019040:E-Selectin / Q000096:biosynthesis; D004730:Endothelium, Vascular / Q000166:cytology; D006801:Humans; D007168:IMP Dehydrogenase / Q000037:antagonists & inhibitors*; D007166:Immunosuppressive Agents / Q000494:pharmacology* / Q000633:toxicity; D039041:Integrin alpha4beta1; D016023:Integrins / Q000378:metabolism; D018799:Intercellular Adhesion Molecule-1 / Q000096:biosynthesis; D016256:Lewis X Antigen / Q000378:metabolism; D008024:Ligands; D016169:Lymphocyte Function-Associated Antigen-1 / Q000378:metabolism; D008562:Membrane Glycoproteins / Q000378:metabolism; D009173:Mycophenolic Acid / Q000031:analogs & derivatives* / Q000494:pharmacology / Q000633:toxicity; D009844:Oligosaccharides / Q000378:metabolism; D019007:P-Selectin / Q000096:biosynthesis; D016201:Receptors, Lymphocyte Homing / Q000378:metabolism*; D000080506:Sialyl Lewis X Antigen; D019010:Vascular Cell Adhesion Molecule-1 / Q000096:biosynthesis
chemical_list: D015815:Cell Adhesion Molecules; D019040:E-Selectin; D007166:Immunosuppressive Agents; D039041:Integrin alpha4beta1; D016023:Integrins; D016256:Lewis X Antigen; D008024:Ligands; D016169:Lymphocyte Function-Associated Antigen-1; D008562:Membrane Glycoproteins; D009844:Oligosaccharides; D019007:P-Selectin; C084882:P-selectin ligand protein; D016201:Receptors, Lymphocyte Homing; D000080506:Sialyl Lewis X Antigen; D019010:Vascular Cell Adhesion Molecule-1; D018799:Intercellular Adhesion Molecule-1; D007168:IMP Dehydrogenase; D009173:Mycophenolic Acid