Petya Chernogorova

Extracellular ATP and adenosine have immunoregulatory roles during inflammation. Elevated extracellular ATP is known to exacerbate GVHD, and the pharmacologic activation of the adenosine A2A receptor is protective. However, the role of endogenous adenosine is unknown. We used gene-targeted mice and a pharmacologic inhibitor to test the role of adenosine generated by CD73/ecto-5'-nucleotidase in GVHD. In allogeneic transplants, both donor and recipient CD73 were protective, with recipient CD73 playing the dominant role. CD73 deficiency led to enhanced T-cell expansion and IFN-γ and IL-6 production, and the migratory capacity of Cd73-/- T cells in vitro was increased. However, the number of regulatory T cells and expression of costimulatory molecules on antigen-presenting cells were unchanged. A2A receptor deficiency led to increased numbers of allogeneic T cells, suggesting that signaling through the A2A receptor via CD73-generated adenosine is a significant part of the mechanism by which CD73 limits the severity of GVHD. Pharmacologic blockade of CD73 also enhanced graft-versus-tumor activity. These data have clinical implications, as both the severity of GVHD and the strength of an alloimmune antitumor response could be manipulated by enhancing or blocking CD73 activity or adenosine receptor signaling depending on the clinical indication.

Thymosin β4 (Tβ4) is a highly conserved G-actin binding polypeptide with multiple intra- and extracellular functions. While stem-cell activation as well as promotion of cell survival and migration by Tβ4 have been investigated in various in vitro and in vivo studies, there are few data on the implications of Tβ4 in brain development. In the present study we analyzed Tβ4 expression in the developing optic tectum of the chicken (Gallus domesticus) and performed in ovo retroviral transduction and plasmid electroporation for overexpression and knockdown of Tβ4. We found marked Tβ4 expression in the tectal plate and in all neuronal layers of later developmental stages, but not in the ventricular zone where neural stem cells reside and divide. Knockdown of Tβ4 inhibited growth of Tβ4-depleted hemispheres, whereas overexpression of Tβ4 led to the production of neuroepithelial folds resembling gyri and sulci, which are not normally present in avian brains. The mechanism yielding enhanced growth of Tβ4 overexpressing hemispheres involved enhanced proliferation, thus indicating an impact of Tβ4 on the neural stem cell and/or progenitor cell population. In summary, we found that due to its effects on proliferation, Tβ4 expression has a large impact on neuroepithelial and macroscopic brain development.

The utility of allogeneic stem cell transplantation for treating hematologic malignancies is enhanced by the graft vs. tumor (GvT) effect, but limited by graft vs. host disease (GvHD). Studies involving the inhibition of CD73 by genetic or pharmacologic means suggest that the levels of CD73-generated adenosine may be manipulated to control GvHD, while maintaining the GvT effect.

Extracellular nucleotides are ubiquitous signalling molecules which modulate distinct physiological and pathological processes. Nucleotide concentrations in the extracellular space are strictly regulated by cell surface enzymes, called ectonucleotidases, which hydrolyze nucleotides to the respective nucleosides. Recent studies suggest that ectonucleotidases play a significant role in inflammation by adjusting the balance between ATP, a widely distributed proinflammatory danger signal, and the anti-inflammatory mediator adenosine. There is increasing evidence for a central role of adenosine in alloantigen-mediated diseases such as solid organ graft rejection and acute graft-versus-host disease (GvHD). Solid organ and hematopoietic cell transplantation are established treatment modalities for a broad spectrum of benign and malignant diseases. Immunological complications based on the recognition of nonself-antigens between donor and recipient like transplant rejection and GvHD are still major challenges which limit the long-term success of transplantation. Studies in the past two decades indicate that purinergic signalling influences the severity of alloimmune responses. This paper focuses on the impact of ectonucleotidases, in particular, NTPDase1/CD39 and ecto-5'-nucleotidase/CD73, on allograft rejection, acute GvHD, and graft-versus-leukemia effect, and on possible clinical implications for the modulation of purinergic signalling after transplantation.

Abstract Abstract 312 Acute graft-versus-host disease (GvHD) limits the success of allogeneic hematopoietic cell transplantation (allo-HCT). We have recently shown that extracellular adenosine triphosphate (ATP) enhances GvHD by activation of the purinergic receptor P2X7R. The abundance of extracellular ATP is regulated by ecto-nucleotidases such as CD39, which dephosphorylate ATP to ADP and AMP. Ecto-5'-nucleotidase (CD73) degrades AMP to adenosine, which can itself exert tolerogenic functions via activation of A2A and/or A2B adenosine receptors (AR). Extracellular ATP and adenosine have immunoregulatory roles under different inflammatory conditions. Deficiency of CD73, the enzyme that metabolizes AMP to adenosine, could therefore have pro- or antiinflammatory activity by reducing adenosine levels in the microenvironment. Currently, the roles of CD73 and adenosine in GvHD are unclear. By using cd73−/− donor or recipient mice and a specific CD73/ecto-5'-nucleotidase inhibitor we observed enhanced GvHD severity when CD73 was genetically deleted or pharmacologically blocked. CD73 was upregulated on CD4+ and CD11c+ cells after irradiation, suggesting an inducible rescue mechanism along with CD39 to counteract ATP accumulation resulting from tissue damage due to the preconditioning treatment. CD73 deficiency led to enhanced T cell expansion and IFN-γ and IL-6 production in GvHD mice. Migratory capacity of cd73−/− T cells was increased, compatible with the ability of adenosine to inhibit transendothelial migration. A2A receptor deficiency led to increased numbers of proliferating allogeneic T cells in allo-HCT recipient mice, suggesting that signaling through the A2A receptor via CD73-generated adenosine is a significant part of the mechanism by which CD73 limits the severity of GvHD. Furthermore, pharmacological blockade of CD73 improved graft-versus-tumor activity in an in vivo B cell leukemia model. In conclusion, we demonstrate that CD73 plays a protective role in GvHD with enhanced disease severity in its absence, while blocking CD73 led to increased graft-versus-tumor effect. These data have potential clinical implications as the alloimmune response could be enhanced by CD73 blocking in patients with residual tumor burden after transplantation. Conversely, immune modulation by addition of CD73 enzyme or an adenosine receptor agonist could improve the outcome of GvHD patients. Disclosures: No relevant conflicts of interest to declare.