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Effect of combined cytostatic cyclosporin A and cytolytic suicide gene therapy on the prevention of experimental graft-versus-host disease

Gene Therapy volume 9, pages 201–207 (2002)Cite this article

Abstract

The immunosuppressive drug cyclosporin A (CsA) represents the standard preventive treatment of graft-versus-host disease (GVHD), the main complication of allogeneic hematopoietic stem cell transplantation (HSCT). However, its efficacy is only partial and many patients develop lethal GVHD despite CsA. A strategy of genetic immunosuppression based on conditional elimination of donor T cells expressing the Herpes simplex type 1 thymidine kinase (TK) suicide gene was recently developed. In this system, ganciclovir (GCV) selectively kills dividing but not quiescent TK T cells. Since CsA is known to have a cytostatic effect on T cells, it could negatively interfere with the division-dependent TK gene therapy. We thus tested whether administration of CsA would antagonize elimination of alloreactive donor TK T cells mediated by GCV in a murine model of GVHD. In vivo experiments revealed that, contrary to GCV, CsA only transiently controlled alloactivation-induced T cell proliferation, and likewise could not prevent lethal GVHD. When T cells resumed proliferation under CsA, they were however still sensitive to GCV. Survival, as well as immune reconstitution, was excellent in mice treated with GCV alone or in combination with CsA. These observations should help to design improved suicide gene therapy trials in the field of allogeneic HSCT.

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Acknowledgements

We thank G Gavory for excellent animal care, G Boisserie and F Baillet for the irradiation of mice, JJ Benoliel for CsA dosage, and B Salomon and C Frisen for critical reading of the manuscript. JLC is supported by the Fondation pour la Recherche Médicale, EL is supported by the Ligue Nationale contre le Cancer. This work was supported by the University Pierre et Marie Curie, the Centre National de la Recherche scientifique and Génopoiétic.

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  1. Biologie et Thérapeutique des Pathologies Immunitaires CNRS/UPMC ESA 7087, Hôpital Pitié-Salpêtrière, Paris, France

    S Maury, E Litvinova, O Boyer, S Bruel, D Klatzmann & JL Cohen

  2. Service d'Anatomie Pathologique, Hôpital Pitié-Salpêtrière, Paris, France

    L Benard

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  1. S Maury
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Maury, S., Litvinova, E., Boyer, O. et al. Effect of combined cytostatic cyclosporin A and cytolytic suicide gene therapy on the prevention of experimental graft-versus-host disease. Gene Ther 9, 201–207 (2002). https://doi.org/10.1038/sj.gt.3301637

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