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Publication : Graft-versus-host disease propagation depends on increased intestinal epithelial tight junction permeability.

First Author  Nalle SC Year  2019
Journal  J Clin Invest Volume  129
Issue  2 Pages  902-914
PubMed ID  30667372 Mgi Jnum  J:270472
Mgi Id  MGI:6276400 Doi  10.1172/JCI98554
Citation  Nalle SC, et al. (2019) Graft-versus-host disease propagation depends on increased intestinal epithelial tight junction permeability. J Clin Invest 129(2):902-914
abstractText  Graft-versus-host disease (GVHD) is a complication of hematopoietic stem cell transplantation (HSCT) that affects multiple organs. GVHD-associated intestinal damage can be separated into two distinct phases, initiation and propagation, which correspond to conditioning-induced damage and effector T cell activation and infiltration, respectively. Substantial evidence indicates that intestinal damage induced by pretransplant conditioning is a key driver of GVHD initiation. Here, we aimed to determine the impact of dysregulated intestinal permeability on the subsequent GVHD propagation phase. The initiation phase of GVHD was unchanged in mice lacking long MLCK (MLCK210), an established regulator of epithelial tight junction permeability. However, MLCK210-deficient mice were protected from sustained barrier loss and exhibited limited GVHD propagation, as indicated by reduced histopathology, fewer CD8+ effector T cells in the gut, and improved overall survival. Consistent with these findings, intestinal epithelial MLCK210 expression and enzymatic activity were similarly increased in human and mouse GVHD biopsies. Intestinal epithelial barrier loss mediated by MLCK210 is therefore a key driver of the GVHD propagation. These data suggest that inhibition of MLCK210-dependent barrier regulation may be an effective approach to limiting GVHD progression.
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