Critical role for CXCR3 chemokine biology in the pathogenesis of bronchiolitis obliterans syndrome

JA Belperio, MP Keane, MD Burdick… - The Journal of …, 2002 - journals.aai.org
JA Belperio, MP Keane, MD Burdick, JP Lynch, YY Xue, K Li, DJ Ross, RM Strieter
The Journal of Immunology, 2002journals.aai.org
Bronchiolitis obliterans syndrome (BOS) is the major limitation to survival post-lung
transplantation and is characterized by a persistent peribronchiolar inflammation that
eventually gives way to airway fibrosis/obliteration. Acute rejection is the main risk factor for
the development of BOS and is characterized by a perivascular/bronchiolar leukocyte
infiltration. The specific mechanism (s) by which these leukocytes are recruited have not
been elucidated. The CXC chemokines (monokine induced by IFN-γ (MIG)/CXC chemokine …
Abstract
Bronchiolitis obliterans syndrome (BOS) is the major limitation to survival post-lung transplantation and is characterized by a persistent peribronchiolar inflammation that eventually gives way to airway fibrosis/obliteration. Acute rejection is the main risk factor for the development of BOS and is characterized by a perivascular/bronchiolar leukocyte infiltration. The specific mechanism (s) by which these leukocytes are recruited have not been elucidated. The CXC chemokines (monokine induced by IFN-γ (MIG)/CXC chemokine ligand (CXCL) 9, IP-10/CXCL10, and IFN-inducible T cell α chemoattractant (ITAC)/CXCL11) act through their shared receptor, CXCR3. Because they are potent leukocyte chemoattractants and are involved in other inflammation/fibroproliferative diseases, we hypothesized that the expression of these chemokines during an allogeneic response promotes the persistent recruitment of mononuclear cells, leading to chronic lung rejection. We found that elevated levels of MIG/CXCL9, IFN-inducible protein 10 (IP-10)/CXCL10, and ITAC/CXCL11 in human bronchoalveolar lavage fluid were associated with the continuum from acute to chronic rejection. Translational studies in a murine model demonstrated increased expression of MIG/CXCL9, IP-10/CXCL10, and ITAC/CXCL11 paralleling the recruitment of CXCR3-expressing mononuclear cells. In vivo neutralization of CXCR3 or its ligands MIG/CXCL9 and IP-10/CXCL10 decreased intragraft recruitment of CXCR3-expressing mononuclear cells and attenuated BOS. This supports the notion that ligand/CXCR3 biology plays an important role in the recruitment of mononuclear cells, a pivotal event in the pathogenesis of BOS.
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