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The role of beta-defensins in allogeneic transplantation

Fachliche Zuordnung Allgemein- und Viszeralchirurgie
Förderung Förderung von 2010 bis 2018
Projektkennung Deutsche Forschungsgemeinschaft (DFG) - Projektnummer 160225957
 
Erstellungsjahr 2018

Zusammenfassung der Projektergebnisse

Based on our initial hypothesis that antimicrobial peptides (AMPs) play a crucial role in the development of GvHD we have shown that AMPs namely beta-defensins are indicators of enhanced inflammatory and pro-angiogenic reactions. Furthermore, when expressed systemically AMPs perpetuate pro-inflammatory signalling pathways both in vitro and in vivo. We have elucidated the molecular mechanisms how beta-defensins enhance these inflammatory and pro-angiogenic reactions and further identified the respective host receptors which belong to the Gi-protein coupled receptor family. Based on the identification of Reg3α, another AMP produced by Paneth cells of the small intestine, as a specific biomarker of intestinal GvHD we have generated Reg3 transgenic mice in order to characterize Reg3α functions in our experimental models. Interestingly, the analysis of Reg3α transgenic mice revealed that these mice have a strongly altered gut microbial composition accompanied by a loss of microbial diversity compared to wildtype control mice. The alterations of the gut microbial composition is further depicted by strongly reduced levels of short chain fatty acids (e.g. acetate and butyrate). In order to test whether the composition/diversity of the intestinal microbiota plays a major role in the pathophysiology of GvHD we determined in a translational approach the composition of the intestinal microbiome in patients receiving allogeneic SCT. The results revealed a loss of bacterial diversity and an increase in enterococci after initiation of antibiotic prophylaxis; however, these changes were significantly stronger in those patients who developed or actually suffered from gastrointestinal GvHD. In addition, the levels of the bacterial metabolite 3-indoxylsulfate are strongly reduced in patients with active GvHD as a consequence of the loss of bacterial diversity. A possible role of the urinary metabolite 3-indoxyl-sulfate as an indirect biomarker for the loss of microbial diversity in patients undergoing allogeneic SCT is currently under investigation. Furthermore, we have extended our translational studies by analyzing the local induction of Reg3α in samples from patients after allogeneic SCT. The relative expression of endogenous Paneth cell-derived AMPs, as well as Reg3α serum levels were analyzed in relation to acute gastrointestinal GvHD in 200 patients undergoing allogeneic SCT. Our results demonstrate that the relative expression of Paneth cell-derived AMPs is significantly higher in the small intestine in the absence of GvHD. Acute stages of GvHD was associated with reduced expression of endogenousAMPs. Severe GvHD also correlated with higher serum concentrations of Reg3α and low levels of 3-indoxyl-sulphate as an indirect marker of reduced microbial diversity. In conclusion acute GvHD correlates with intestinal expression of Paneth cell defensins as well as Reg3α serum levels, both associated with intestinal dysbiosis.

Projektbezogene Publikationen (Auswahl)

 
 

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