A critical role for the retinoic acid signaling pathway in the pathophysiology of gastrointestinal graft-versus-host disease

X Chen, J Dodge, R Komorowski… - Blood, The Journal of …, 2013 - ashpublications.org
X Chen, J Dodge, R Komorowski, WR Drobyski
Blood, The Journal of the American Society of Hematology, 2013ashpublications.org
Damage to the gastrointestinal tract during graft-versus-host disease (GVHD) is one of the
major causes of morbidity and mortality in allogeneic hematopoietic stem cell transplant
(HSCT) recipients. In the current study, we identified a critical role for the retinoic acid (RA)
signaling pathway in the induction and propagation of gastrointestinal GVHD. The
administration of exogenous RA significantly increased expression of the gut-homing
molecules, CCR9 and α4β7, on donor T cells in mesenteric lymph nodes, and augmented …
Damage to the gastrointestinal tract during graft-versus-host disease (GVHD) is one of the major causes of morbidity and mortality in allogeneic hematopoietic stem cell transplant (HSCT) recipients. In the current study, we identified a critical role for the retinoic acid (RA) signaling pathway in the induction and propagation of gastrointestinal GVHD. The administration of exogenous RA significantly increased expression of the gut-homing molecules, CCR9 and α4β7, on donor T cells in mesenteric lymph nodes, and augmented the accumulation of proinflammatory CD4+ and CD8+ T cells within the gut mucosa, leading to a selective exacerbation of colonic GVHD and increased overall mortality. Conversely, depletion of RA in recipient mice by vitamin A deprivation resulted in a dramatic reduction of gut-homing molecule expression on donor T cells after HSCT. Significantly, absence of the RA receptor-α on donor T cells markedly attenuated the ability of these cells to cause lethal GVHD. This observation was attributable to a significant reduction in pathological damage within the colon. These findings identify an organ-specific role for RA in GVHD and provide evidence that blockade of the RA signaling pathway may represent a novel strategy for mitigating the severity of colonic GVHD.
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