title: Resistance to FasL and tumor necrosis factor-related apoptosis-inducing ligand-mediated apoptosis in Sezary syndrome T-cells associated with impaired death receptor and FLICE-inhibitory protein expression.
abstract: Because of the low proliferative potential of tumor cells in patients with Sézary syndrome (SzS), their accumulation has been suggested to be due to defective regulation of apoptosis. We analyzed the sensitivity to soluble Fas-ligand (FasL) and tumor necrosis factor (TNF)-related apoptosis-inducing ligand (TRAIL), 2 members of the TNF superfamily in peripheral blood leukocytes (PBL) from patients with SzS. Compared with healthy donors, CD4(+) cells from patients with SzS were completely resistant to FasL in 9 of 16 cases. Of these 9 FasL-resistant cases, 4 revealed a loss in Fas (CD95) expression, whereas the remaining 5 exhibited normal or enhanced Fas expression. In the latter 5 cases, the apoptosis inhibitor cFLIP was overexpressed in CD4(+)/CD26(-) tumor cells compared with CD4(+)/CD26(-) cells from Fas-expressing FasL-sensitive patients and healthy donors. Furthermore, resistance to TRAIL and tumor cell-restricted loss of TRAIL-receptor 2 were observed in 16 of 16 SzS PBLs. It is noteworthy that resistance to FasL could be overcome by the use of a hexameric FasL or upon exposure of SzS cells to interferon-alpha (IFN-alpha) or IFN-gamma, the latter by an increase of Fas expression. Our data on primary SzS lymphocytes reveal frequent resistance to apoptosis induced by FasL and TRAIL, which may contribute to their accumulation in patients with SzS and be relevant at a therapeutic level.
authors.affiliation: Department of Dermatology, Zürich University Hospital, Zürich, Switzerland.
authors.forename: Emmanuel
authors.initials: E
authors.lastname: Contassot
authors.forename: Katrin
authors.initials: K
authors.lastname: Kerl
authors.forename: Stéphanie
authors.initials: S
authors.lastname: Roques
authors.forename: Ryan
authors.initials: R
authors.lastname: Shane
authors.forename: Olivier
authors.initials: O
authors.lastname: Gaide
authors.forename: Marc
authors.initials: M
authors.lastname: Dupuis
authors.forename: Alain H
authors.initials: AH
authors.lastname: Rook
authors.forename: Lars E
authors.initials: LE
authors.lastname: French
mesh_terms: D017209:Apoptosis; D053446:CASP8 and FADD-Like Apoptosis Regulating Protein / Q000032:analysis / Q000235:genetics*; D016022:Case-Control Studies; D053222:Fas Ligand Protein / Q000494:pharmacology*; D005786:Gene Expression Regulation; D006801:Humans; D053218:Receptors, Death Domain; D053220:Receptors, TNF-Related Apoptosis-Inducing Ligand / Q000032:analysis*; D012751:Sezary Syndrome / Q000276:immunology / Q000473:pathology*; D012878:Skin Neoplasms / Q000276:immunology / Q000473:pathology*; D013601:T-Lymphocytes / Q000473:pathology*; D053221:TNF-Related Apoptosis-Inducing Ligand / Q000494:pharmacology*
chemical_list: D053446:CASP8 and FADD-Like Apoptosis Regulating Protein; D053222:Fas Ligand Protein; D053218:Receptors, Death Domain; D053220:Receptors, TNF-Related Apoptosis-Inducing Ligand; D053221:TNF-Related Apoptosis-Inducing Ligand; C505639:TNFRSF10B protein, human