Targeting the Canonical Nuclear Factor-κB Pathway with a High-Potency IKK2 Inhibitor Improves Outcomes in a Mouse Model of Idiopathic Pneumonia Syndrome.
Idiopathic pneumonia syndrome (IPS) is a noninfectious inflammatory disorder of the lungs that occurs most often after fully myeloablative allogeneic hematopoietic stem cell transplantation (HSCT). IPS can be severe and is associated with high 1-year mortality rates despite existing therapies. The canonical nuclear factor-(NF) κB signaling pathway has previously been linked to several inflammatory disorders of the lung, including asthma and lung allograft rejection. It has never been specifically targeted as a novel IPS treatment approach, however. Here, we report that the IκB kinase 2 (IKK2) antagonist BAY 65-5811 or "compound A," a highly potent and specific inhibitor of the NF-κB pathway, was able to improve median survival times and recipient oxygenation in a well-described mouse model of IPS. Compound A impaired the production of the proinflammatory chemokines CCL2 and CCL5 within the host lung after transplantation. This resulted in significantly lower numbers of donor lung infiltrating CD4+and CD8+T cells and reduced pulmonary inflammatory cytokine production after allograft. Compound A's beneficial effects appeared to be specific for limiting pulmonary injury, as the drug was unable to improve outcomes in a B6 into B6D2 haplotype-matched murine HSCT model in which recipient mice succumb to lethal acute graft-versus-host disease of the gastrointestinal tract. Collectively, our data suggest that the targeting of the canonical NF-κB pathway with a small molecule IKK2 antagonist may represent an effective and novel therapy for the specific management of acute lung injury that can occur after allogeneic HSCT.
Lineberger Comprehensive Cancer Center, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina.
Kenneth A
KA
Fowler
Department of Medicine, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina.
Corey M
CM
Jania
Department of Medicine, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina.
Stephen L
SL
Tilley
University of Minnesota Cancer Center, Minneapolis, Minnesota.
Angela
A
Panoskaltsis-Mortari
Lineberger Comprehensive Cancer Center, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina.
Albert S
AS
Baldwin
Lineberger Comprehensive Cancer Center, Department of Medicine, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina.
Jonathan S
JS
Serody
Lineberger Comprehensive Cancer Center, Department of Medicine, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina. Electronic address: jcoghill@email.unc.edu.
James M
JM
Coghill
D000818:Animals; D018380:Hematopoietic Stem Cell Transplantation / Q000009:adverse effects*; D051550:I-kappa B Kinase / Q000037:antagonists & inhibitors*; D055370:Lung Injury / Q000188:drug therapy* / Q000209:etiology; D051379:Mice; D058990:Molecular Targeted Therapy / Q000379:methods*; D016328:NF-kappa B / Q000378:metabolism*; D011014:Pneumonia / Q000188:drug therapy*; D016896:Treatment Outcome
D016328:NF-kappa B; D051550:I-kappa B Kinase; C496562:Ikbkb protein, mouse
Chemokines; Graft-versus-host disease; Idiopathic pneumonia syndrome; Lymphocyte trafficking; Nuclear factor-kB pathway