title: Preemptive HMG-CoA reductase inhibition provides graft-versus-host disease protection by Th-2 polarization while sparing graft-versus-leukemia activity.
abstract: We investigated whether atorvastatin (AT) was capable of protecting animals from acute graft-versus-host disease (aGVHD) across major histocompatibility complex (MHC) mismatch barriers. AT treatment of the donor induced a Th-2 cytokine profile in the adoptively transferred T cells and reduced their in vivo expansion, which translated into significantly reduced aGVHD lethality. Host treatment down-regulated costimulatory molecules and MHC class II expression on recipient antigen-presenting cells (APCs) and enhanced the protective statin effect, without impacting graft-versus-leukemia (GVL) activity. The AT effect was partially reversed in STAT6(-/-) donors and abrogated by L-mevalonate, indicating the relevance of STAT6 signaling and the L-mevalonate pathway for AT-mediated aGVHD protection. AT reduced prenylation levels of GTPases, abolished T-bet expression, and increased c-MAF and GATA-3 protein in vivo. Thus, AT has significant protective impact on aGVHD lethality by Th-2 polarization and inhibition of an uncontrolled Th-1 response while maintaining GVL activity, which is of great clinical relevance given the modest toxicity profile of AT.
authors.affiliation: Division of Blood and Marrow Transplantation, Department of Medicine, Stanford University School of Medicine, Stanford, CA 94305, USA.
authors.forename: Robert
authors.initials: R
authors.lastname: Zeiser
authors.forename: Sawsan
authors.initials: S
authors.lastname: Youssef
authors.forename: Jeanette
authors.initials: J
authors.lastname: Baker
authors.forename: Neeraja
authors.initials: N
authors.lastname: Kambham
authors.forename: Lawrence
authors.initials: L
authors.lastname: Steinman
authors.forename: Robert S
authors.initials: RS
authors.lastname: Negrin
mesh_terms: D019264:Adoptive Transfer; D000818:Animals; D017951:Antigen Presentation / Q000187:drug effects; D000069059:Atorvastatin; D018890:Chemoprevention; D016207:Cytokines / Q000235:genetics; D006086:Graft vs Host Disease / Q000517:prevention & control*; D020544:Graft vs Leukemia Effect; D006538:Heptanoic Acids; D019161:Hydroxymethylglutaryl-CoA Reductase Inhibitors / Q000627:therapeutic use*; D008798:Mevalonic Acid / Q000378:metabolism; D051379:Mice; D018345:Mice, Knockout; D011292:Premedication; D011758:Pyrroles; D050800:STAT6 Transcription Factor / Q000378:metabolism; D015398:Signal Transduction; D013601:T-Lymphocytes / Q000276:immunology / Q000637:transplantation; D018418:Th2 Cells / Q000166:cytology* / Q000276:immunology