Graft-versus-host disease is enhanced by extracellular ATP activating P2X7R

K Wilhelm, J Ganesan, T Müller, C Dürr, M Grimm… - Nature medicine, 2010 - nature.com
K Wilhelm, J Ganesan, T Müller, C Dürr, M Grimm, A Beilhack, CD Krempl, S Sorichter…
Nature medicine, 2010nature.com
Danger signals released upon cell damage can cause excessive immune-mediated tissue
destruction such as that found in acute graft-versus-host disease (GVHD), allograft rejection
and systemic inflammatory response syndrome. Given that ATP is found in small
concentrations in the extracellular space under physiological conditions, and its receptor
P2X7R is expressed on several immune cell types, ATP could function as a danger signal
when released from dying cells. We observed increased ATP concentrations in the …
Abstract
Danger signals released upon cell damage can cause excessive immune-mediated tissue destruction such as that found in acute graft-versus-host disease (GVHD), allograft rejection and systemic inflammatory response syndrome. Given that ATP is found in small concentrations in the extracellular space under physiological conditions, and its receptor P2X7R is expressed on several immune cell types, ATP could function as a danger signal when released from dying cells. We observed increased ATP concentrations in the peritoneal fluid after total body irradiation, and during the development of GVHD in mice and in humans. Stimulation of antigen-presenting cells (APCs) with ATP led to increased expression of CD80 and CD86 in vitro and in vivo and actuated a cascade of proinflammatory events, including signal transducer and activator of transcription-1 (STAT1) phosphorylation, interferon-γ (IFN-γ) production and donor T cell expansion, whereas regulatory T cell numbers were reduced. P2X7R expression increased when GVHD evolved, rendering APCs more responsive to the detrimental effects of ATP, thereby providing positive feedback signals. ATP neutralization, early P2X7R blockade or genetic deficiency of P2X7R during GVHD development improved survival without immune paralysis. These data have major implications for transplantation medicine, as pharmacological interference with danger signals that act via P2X7R could lead to the development of tolerance without the need for intensive immunosuppression.
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