Reversal of CD8 T-cell-mediated mucocutaneous graft-versus-host-like disease by the JAK inhibitor tofacitinib

J Invest Dermatol. 2014 Apr;134(4):992-1000. doi: 10.1038/jid.2013.476. Epub 2013 Nov 8.

Abstract

The utility of allogeneic hematopoietic stem cell transplantation is limited by graft-versus-host disease (GVHD), a significant cause of morbidity and mortality. Patients with GVHD exhibit cutaneous manifestations with histological features of interface dermatitis followed by scleroderma-like changes. JAK inhibitors represent a class of immunomodulatory drugs that inhibit signaling by multiple cytokines. Herein we report the effects of tofacitinib in a murine model of GVHD. Oral administration of tofacitinib prevented GVHD-like disease manifested by weight loss and mucocutaneous lesions. More importantly, tofacitinib was also effective in reversing established disease. Tofacitinib diminished the expansion and activation of murine CD8 T cells in this model, and had similar effects on IL-2-stimulated human CD8 T cells. Tofacitinib also inhibited the expression of IFN-γ-inducible chemoattractants by keratinocytes, and IFN-γ-inducible cell death of keratinocytes. Tofacitinib may be an effective drug for treatment against CD8 T-cell-mediated mucocutaneous diseases in patients with GVHD.

MeSH terms

  • Administration, Oral
  • Animals
  • Bone Marrow / drug effects
  • CD4-Positive T-Lymphocytes / drug effects
  • CD4-Positive T-Lymphocytes / metabolism
  • CD8-Positive T-Lymphocytes / cytology*
  • CD8-Positive T-Lymphocytes / drug effects*
  • Cell Line, Tumor
  • Cell Proliferation
  • Chemokines / metabolism
  • Cytokines / metabolism
  • Dermatitis / drug therapy*
  • Dermatitis / metabolism
  • Gene Expression Regulation
  • Graft vs Host Disease / drug therapy*
  • Hematopoietic Stem Cell Transplantation
  • Humans
  • Interleukin-2 / metabolism
  • Keratinocytes / drug effects
  • Mice
  • Mice, Inbred C57BL
  • Piperidines / administration & dosage*
  • Protein Kinase Inhibitors / administration & dosage*
  • Pyrimidines / administration & dosage*
  • Pyrroles / administration & dosage*

Substances

  • Chemokines
  • Cytokines
  • Interleukin-2
  • Piperidines
  • Protein Kinase Inhibitors
  • Pyrimidines
  • Pyrroles
  • tofacitinib