IL-6–mediated endothelial injury impairs antiviral humoral immunity after bone marrow transplantation
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Fleming, P
Andoniou, CE
Waltner, OG
Bhise, SS
Martins, JP
McEnroe, BA
Voigt, V
Daly, S
Kuns, RD
Ekwe, AP
Henden, AS
Saldan, A
Olver, S
Varelias, A
et al.
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Abstract
Endothelial function and integrity are compromised after allogeneic bone marrow transplantation (BMT), but how this affects immune responses broadly remains unknown. Using a preclinical model of CMV reactivation after BMT, we found compromised antiviral humoral responses induced by IL-6 signaling. IL-6 signaling in T cells maintained Th1 cells, resulting in sustained IFN-γ secretion, which promoted endothelial cell (EC) injury, loss of the neonatal Fc receptor (FcRn) responsible for IgG recycling, and rapid IgG loss. T cell–specific deletion of IL-6R led to persistence of recipient-derived, CMV-specific IgG and inhibited CMV reactivation. Deletion of IFN-γ in donor T cells also eliminated EC injury and FcRn loss. In a phase III clinical trial, blockade of IL-6R with tocilizumab promoted CMV-specific IgG persistence and significantly attenuated early HCMV reactivation. In sum, IL-6 invoked IFN-γ–dependent EC injury and consequent IgG loss, leading to CMV reactivation. Hence, cytokine inhibition represents a logical strategy to prevent endothelial injury, thereby preserving humoral immunity after immunotherapy.
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Journal of Clinical Investigation
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134
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7
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© 2024, Zhang et al. This is an open access article published under the terms of the Creative Commons Attribution 4.0 International License.
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Zhang, P; Fleming, P; Andoniou, CE; Waltner, OG; Bhise, SS; Martins, JP; McEnroe, BA; Voigt, V; Daly, S; Kuns, RD; Ekwe, AP; Henden, AS; Saldan, A; Olver, S; Varelias, A; et al., IL-6–mediated endothelial injury impairs antiviral humoral immunity after bone marrow transplantation, Journal of Clinical Investigation, 2024, 134 (7), pp. e174184