An aberrant NOTCH2-BCR signaling axis in B cells from patients with chronic GVHD

作者:Poe Jonathan C; Jia Wei; Su Hsuan; Anand Sarah; Rose Jeremy J; Tata Prasanthi V; Suthers Amy N; Jones Corbin D; Kuan Pei Fen; Vincent Benjamin G; Serody Jonathan S; Horwitz Mitchell E; Ho Vincent T; Pavletic Steven Z; Hakim Frances T; Owzar Kouros; Zhang Dadong; Blazar Bruce R; Siebel Christian W; Chao Nelson J; Maillard Ivan; Sarantopoulos Stefanie
来源:Blood, 2017, 130(19): 2131-2145.
DOI:10.1182/blood-2017-05-782466

摘要

B-cell receptor (BCR)-activated B cells contribute to pathogenesis in chronic graftversus-host disease (cGVHD), a condition manifested by both B-cell autoreactivity and immune deficiency. We hypothesized that constitutive BCR activation precluded functional B-cell maturation in cGVHD. To address this, we examined BCR-NOTCH2 synergy because NOTCH has been shown to increase BCR responsiveness in normal mouse B cells. We conducted ex vivo activation and signaling assays of 30 primary samples from hematopoietic stem cell transplantation patients with and without cGVHD. Consistent with a molecular link betweenpathways, wefound thatBCR-NOTCHactivation significantly increased the proximal BCR adapter protein BLNK. BCR-NOTCH activation also enabled persistent NOTCH2 surface expression, suggesting a positive feedback loop. Specific NOTCH2 blockade eliminated NOTCH-BCR activation and significantly altered NOTCH downstream targets and B-cell maturation/effector molecules. Examination of the molecular underpinnings of this "NOTCH2-BCR axis" in cGVHD revealed imbalanced expression of the transcription factors IRF4 and IRF8, each critical to B-cell differentiation and fate. All-trans retinoic acid (ATRA) increased IRF4 expression, restored the IRF4-to-IRF8 ratio, abrogated BCR-NOTCH hyperactivation, and reduced NOTCH2 expression in cGVHD B cells without compromising viability. ATRA-treated cGVHD B cells had elevated TLR9 and PAX5, but not BLIMP1 (a gene-expression pattern associated with mature follicular B cells) and also attained increased cytosine guanine dinucleotide responsiveness. Together, we reveal a mechanistic link between NOTCH2 activation and robust BCR responses to otherwise suboptimal amounts of surrogate antigen. Our findings suggest that peripheral B cells in cGVHD patients can be pharmacologically directed from hyperactivation toward maturity.

  • 出版日期2017-11-9