Transcriptome analysis of GVHD reveals aurora kinase A as a targetable pathway for disease prevention.

Abstract:

:Graft-versus-host disease (GVHD) is the most common complication of hematopoietic stem cell transplant (HCT). However, our understanding of the molecular pathways that cause this disease remains incomplete, leading to inadequate treatment strategies. To address this, we measured the gene expression profile of nonhuman primate (NHP) T cells during acute GVHD. Utilizing microarray technology, we measured the expression profiles of CD3(+) T cells from five cohorts: allogeneic transplant recipients receiving (i) no immunoprophylaxis (No Rx), (ii) sirolimus monotherapy (Siro), (iii) tacrolimus-methotrexate (Tac-Mtx), as well as (iv) autologous transplant recipients (Auto) and (v) healthy controls (HC). This comparison allowed us to identify transcriptomic signatures specific for alloreactive T cells and determine the impact of both mTOR (mechanistic target of rapamycin) and calcineurin inhibition on GVHD. We found that the transcriptional profile of unprophylaxed GVHD was characterized by significant perturbation of pathways regulating T cell proliferation, effector function, and cytokine synthesis. Within these pathways, we discovered potentially druggable targets not previously implicated in GVHD, prominently including aurora kinase A (AURKA). Utilizing a murine GVHD model, we demonstrated that pharmacologic inhibition of AURKA could improve survival. Moreover, we found enrichment of AURKA transcripts both in allo-proliferating T cells and in sorted T cells from patients with clinical GVHD. These data provide a comprehensive elucidation of the T cell transcriptome in primate acute GVHD and suggest that AURKA should be considered a target for preventing GVHD, which, given the many available AURKA inhibitors in clinical development, could be quickly deployed for the prevention of GVHD.

journal_name

Sci Transl Med

authors

Furlan SN,Watkins B,Tkachev V,Flynn R,Cooley S,Ramakrishnan S,Singh K,Giver C,Hamby K,Stempora L,Garrett A,Chen J,Betz KM,Ziegler CG,Tharp GK,Bosinger SE,Promislow DE,Miller JS,Waller EK,Blazar BR,Kean LS

doi

10.1126/scitranslmed.aad3231

subject

Has Abstract

pub_date

2015-11-25 00:00:00

pages

315ra191

issue

315

eissn

1946-6234

issn

1946-6242

pii

7/315/315ra191

journal_volume

7

pub_type

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