NDLI: Etoposide selectively ablates activated T cells to control the immunoregulatory disorder hemophagocytic lymphohistiocytosis.

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Etoposide selectively ablates activated T cells to control the immunoregulatory disorder hemophagocytic lymphohistiocytosis.

Content Provider	World Health Organization (WHO)-Global Index Medicus
Author	Jordan, Michael B. Millen, Scott H. Katz, Jonathan D. Johnson, Theodore S. Terrell, Catherine E. Hildeman, David A.
Description	Author Affiliation: Johnson TS ( Cancer Immunology, Inflammation and Tolerance Program, Division of Pediatric Hematology/Oncology, Department of Pediatrics, Georgia Regents University Cancer Center, Georgia Regents University, Augusta, GA 30912)
Abstract	Hemophagocytic lymphohistiocytosis (HLH) is an inborn disorder of immune regulation caused by mutations affecting perforin-dependent cytotoxicity. Defects in this pathway impair negative feedback between cytotoxic lymphocytes and APCs, leading to prolonged and pathologic activation of T cells. Etoposide, a widely used chemotherapeutic drug that inhibits topoisomerase II, is the mainstay of treatment for HLH, although its therapeutic mechanism remains unknown. We used a murine model of HLH, involving lymphocytic choriomeningitis virus infection of perforin-deficient mice, to study the activity and mechanism of etoposide for treating HLH and found that it substantially alleviated all symptoms of murine HLH and allowed prolonged survival. This therapeutic effect was relatively unique among chemotherapeutic agents tested, suggesting distinctive effects on the immune response. We found that the therapeutic mechanism of etoposide in this model system involved potent deletion of activated T cells and efficient suppression of inflammatory cytokine production. This effect was remarkably selective; etoposide did not exert a direct anti-inflammatory effect on macrophages or dendritic cells, and it did not cause deletion of quiescent naive or memory T cells. Finally, etoposide's immunomodulatory effects were similar in wild-type and perforin-deficient animals. Thus, etoposide treats HLH by selectively eliminating pathologic, activated T cells and may have usefulness as a novel immune modulator in a broad array of immunopathologic disorders.
ISSN	00221767
e-ISSN	15506606
DOI	10.4049/jimmunol.1302282
Journal	The Journal of Immunology
Issue Number	1
Volume Number	192
Language	English
Publisher	The American Association of Immunologists
Publisher Date	2014-01-01
Publisher Place	United States
Access Restriction	Open
Subject Keyword	Etoposide Pharmacology Lymphocyte Activation Drug Effects Immunology Lymphohistiocytosis, Hemophagocytic Drug Therapy T-lymphocytes Animals Antigen Presentation Apoptosis Dna-binding Proteins Genetics Dendritic Cells Disease Models, Animal Administration & Dosage Interferon-gamma Biosynthesis Lymphocytic Choriomeningitis Virus Macrophage Activation Macrophages Mice Mice, Knockout Topoisomerase Ii Inhibitors Research Support, N.i.h., Extramural Discipline Immunology
Content Type	Text
Resource Type	Article
Subject	Immunology and Allergy Immunology

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Etoposide selectively ablates activated T cells to control the immunoregulatory disorder hemophagocytic lymphohistiocytosis

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Absence of tapasin alters immunodominance against a lymphocytic choriomeningitis virus polytope.

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The NF-κB regulator Bcl-3 governs dendritic cell antigen presentation functions in adaptive immunity.

CD70 deficiency impairs effector CD8 T cell generation and viral clearance but is dispensable for the recall response to lymphocytic choriomeningitis virus.

Etoposide selectively ablates activated T cells to control the immunoregulatory disorder hemophagocytic lymphohistiocytosis.

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Absence of tapasin alters immunodominance against a lymphocytic choriomeningitis virus polytope.

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Etoposide selectively ablates activated T cells to control the immunoregulatory disorder hemophagocytic lymphohistiocytosis.