title: NF-kappaB as a target for the prevention of graft-versus-host disease: comparative efficacy of bortezomib and PS-1145.
abstract: NF-kappaB is a transcription factor that controls the expression of a number of genes important for mediating immune and inflammatory responses. In this study, we examined whether bortezomib and PS-1145, each of which inhibits NF-kappaB, could protect mice from lethal graft-versus-host disease (GVHD), which is characterized by immune activation and proinflammatory cytokine production. When administered within the first 2 days after transplantation, bortezomib and PS-1145 both protected mice from fatal GVHD, did not compromise donor engraftment, and effected marked reduction in the levels of serum cytokines that are normally increased during GVHD. Extending the course of bortezomib administration or delaying the initiation of this agent for as few as 3 days after bone marrow transplantation (BMT), however, significantly exacerbated GVHD-dependent mortality because of severe pathological damage in the colon. In contrast, prolonged administration of PS-1145, which, unlike bortezomib, is a selective inhibitor of NF-kappaB, caused no early toxicity and resulted in more complete protection than that observed with an abbreviated PS-1145 treatment schedule. These results confirm a critical role for NF-kappaB in the pathophysiology of GVHD and indicate that targeted inhibition of NF-kappaB may have a superior therapeutic index and may constitute a viable therapeutic approach to reduce GVHD severity.
authors.affiliation: Bone Marrow Transplant Program and the Department of Medicine, Medical College of Wisconsin, Milwaukee, WI, USA.
authors.forename: Sanja
authors.initials: S
authors.lastname: Vodanovic-Jankovic
authors.forename: Parameswaran
authors.initials: P
authors.lastname: Hari
authors.forename: Paulette
authors.initials: P
authors.lastname: Jacobs
authors.forename: Richard
authors.initials: R
authors.lastname: Komorowski
authors.forename: William R
authors.initials: WR
authors.lastname: Drobyski
mesh_terms: D000818:Animals; D000970:Antineoplastic Agents / Q000627:therapeutic use*; D016026:Bone Marrow Transplantation; D001897:Boronic Acids / Q000627:therapeutic use*; D000069286:Bortezomib; D003106:Colon / Q000187:drug effects / Q000473:pathology; D016207:Cytokines / Q000378:metabolism; D006085:Graft Survival; D006086:Graft vs Host Disease / Q000517:prevention & control*; D006183:H-2 Antigens; D006575:Heterocyclic Compounds, 3-Ring / Q000627:therapeutic use*; D017493:Leukocyte Common Antigens; D051379:Mice; D018345:Mice, Knockout; D016328:NF-kappa B / Q000037:antagonists & inhibitors / Q000378:metabolism*; D011719:Pyrazines / Q000627:therapeutic use*; D011725:Pyridines / Q000627:therapeutic use*; D015996:Survival Rate
chemical_list: D000970:Antineoplastic Agents; D001897:Boronic Acids; D016207:Cytokines; D006183:H-2 Antigens; D006575:Heterocyclic Compounds, 3-Ring; D016328:NF-kappa B; C456319:PS1145; D011719:Pyrazines; D011725:Pyridines; D000069286:Bortezomib; D017493:Leukocyte Common Antigens