Preemptive HMG-CoA reductase inhibition provides graft-versus-host disease protection by Th-2 polarization while sparing graft-versus-leukemia activity

Blood. 2007 Dec 15;110(13):4588-98. doi: 10.1182/blood-2007-08-106005. Epub 2007 Sep 7.

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.

Publication types

  • Research Support, N.I.H., Extramural
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adoptive Transfer
  • Animals
  • Antigen Presentation / drug effects
  • Atorvastatin
  • Chemoprevention*
  • Cytokines / genetics
  • Graft vs Host Disease / prevention & control*
  • Graft vs Leukemia Effect*
  • Heptanoic Acids
  • Hydroxymethylglutaryl-CoA Reductase Inhibitors / therapeutic use*
  • Mevalonic Acid / metabolism
  • Mice
  • Mice, Knockout
  • Premedication
  • Pyrroles
  • STAT6 Transcription Factor / metabolism
  • Signal Transduction
  • T-Lymphocytes / immunology
  • T-Lymphocytes / transplantation
  • Th2 Cells / cytology*
  • Th2 Cells / immunology

Substances

  • Cytokines
  • Heptanoic Acids
  • Hydroxymethylglutaryl-CoA Reductase Inhibitors
  • Pyrroles
  • STAT6 Transcription Factor
  • Stat6 protein, mouse
  • Atorvastatin
  • Mevalonic Acid