imatinib treatment of patients with diffuse cutaneous systemic sclerosis modifies gene expression in...

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T.9. Disruption of Dendritic Cell-mediated Vascular Homeostasis May Contribute to UVB-induced Skin Inflammation Anusha Ramanathan 1 , Sha Tian 1 , Te-Chen Jenny Tzeng 2 , Theresa Lu 1 . 1 Hospital for Special Surgery, New York, NY; 2 Weill Cornell Medical College, New York, NY Ultraviolet irradiation is known to exacerbate cutaneous lupus lesions. UV irradiation is also known to cause skin resident dendritic cells to leave their niche and migrate to draining lymph nodes. We hypothesized that dendritic cells mediate vascular homeostasis in skin and that UV irradiation causes skin inflammation in part by disrupting this dendritic cell-mediated vascular homeostasis. First, we asked about the importance of dendritic cells to vascular homeostasis in skin. Depletion of skin CD11c hi cells by injection of diphtheria toxin into CD11c-DTR mice led to upregulation of VCAM-1 on skin endothelial cells, and upregulation of endothelial cell proliferation, suggesting that CD11c hi dendritic cells mediate skin vascular homeostasis. We then asked whether UVB irradiation induced similar findings as in the CD11c hi dendritic cell-depleted mice. Irradiation with UVB light at a single dose of 900 J/m 2 resulted in selective depletion of CD11c hi dendritic cells, as well as vasodilation and upregula- tion of VCAM-1 on skin endothelial cells. Together, our results suggest that CD11c hi dendritic cells regulate vascular quiescence and homeostasis in skin and that UVB irradiation may cause inflammation by inducing these CD11c hi cells to migrate out of skin. Our results have implications for understanding the pathogenesis of lupus skin lesions as well as for identifying targets for novel therapies. doi:10.1016/j.clim.2010.03.124 T.10. Imatinib Treatment of Patients with Diffuse Cutaneous Systemic Sclerosis Modifies Gene Expression in Peripheral Blood Mononuclear Cells of Clinical Responders Jessica Gordon 1 , Robert Spiera 1 , Jamie Mersten 1 , Jacqueline Salit 2 , Neil Hackett 2 , Mary Crow 1 . 1 Hospital for Special Surgery, New York, NY; 2 Weill-Cornell Medical College, New York, NY Systemic sclerosis (SSc) is a multisystem, autoimmune disease in which abnormal signaling through abelson kinase (abl) and the platelet-derived growth factor receptor (PDGFR) contributes to pathologic fibrosis and vasculopathy. Imatinib mesylate (Gleevec), a tyrosine kinase inhibitor, is a therapy of interest because it can block both pathways. We hypothesized that imatinib would modulate gene expression in peripheral blood mononuclear cells (PBMC), and we performed microarray analysis on PBMC RNA from 5 SSc patients before and after 12 months of treatment. All patients are enrolled in an ongoing clinical trial, and those selected had clinically meaningful improvements. Patient characteristics: 80% female; median age: 44 years [2152 years]; median disease duration: 1.6 years [0.38 years]; and median change in Modified Rodnan Skin Score: -9[-5 to -11]. RNA was extracted from PBMC and processed for microarray. A paired t-test was performed using Genespring GX11 and Ingenuity Pathways. Treatment led to differential expression of 168 genes at a P value of 0.01 and a fold-change cutoff of 1.2. Of the genes downregulated were several members of the MAP kinase family. Increased expression of von Hippel Lindau, HIF1α-inhibitor, and ubiquitin-conjugat- ing enzyme E2V1 transcripts were accompanied by down- regulation of MDM2, demonstrating changes in hypoxia pathway signaling. Decreased expression of calmodulin, NFAT5, PIK3CA, and NLRP3 and increased expression of CD40 after treatment may signify changes in immune regulation or signaling. These preliminary data suggest that imatinib therapy results in modulation of gene expression downstream of PDGFR and c-abl as detected in PBMC. Studies with additional paired samples will extend and confirm these findings. doi:10.1016/j.clim.2010.03.125 T.11. SHIP1 Blocks Crohn's-like Intestinal Inflammation in a Murine Model Keith McLarren 1 , Shelley Miller 1 , Nicole Voglmaier 1 , Oana Popescu 2 , Laura Sly 1 . 1 Child and Family Research Institute, Vancouver, BC, Canada; 2 British Columbia Children's Hospital, Vancouver, BC, Canada Crohn's disease is an inflammatory disease of the gastrointestinal tract occurring anywhere between the mouth and the anus. Fibrosis is a serious complication in patients with Crohn's disease which can result in stricture formation often requiring surgery. A large challenge in the study of Crohn's disease is the lack of acceptable animal models. Src homology 2 domain-containing inositol 5- phosphatase (SHIP1) knockout (-/-) mice are a model of profoundly M2 skewed macrophages. We have found that SHIP1-/- mice spontaneously develop intestinal inflamma- tion that is evident as early as 4 weeks of age and that shares features with Crohn's disease. Hematoxylin and eosin staining revealed disease characterized by discontinuous, transmural inflammation, and granuloma in the submucosa and gut-associated lymphoid tissue. In the SHIP1-/- mice, inflammation was restricted to the distal ileum, while colons and ceca appeared normal. Masson's trichrome staining and Sircoll assays for soluble collagen revealed increased collagen deposition in SHIP-/- mice compared to wild-type littermates. Immunohistochemistry for arginase I and Ym1, canonical markers of M2 macrophages, demonstrated ex- pression in cells within the submucosa and lymphoid follicles and in intestinal epithelial cells. Interestingly, the inflam- mation and increased collagen deposition in SHIP-/- mice occurred in the distal ileum, the most common site of surgical resection required due to fibrosis and stricture formation in patients with Crohn's disease. Characterization of this new murine model of intestinal inflammation may provide a valuable new tool for therapeutic intervention in disease. doi:10.1016/j.clim.2010.03.126 S41 Abstracts

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Page 1: Imatinib Treatment of Patients with Diffuse Cutaneous Systemic Sclerosis Modifies Gene Expression in Peripheral Blood Mononuclear Cells of Clinical Responders

S41Abstracts

T.9. Disruption of Dendritic Cell-mediated VascularHomeostasis May Contribute to UVB-induced SkinInflammationAnusha Ramanathan1, Sha Tian1, Te-Chen Jenny Tzeng2,Theresa Lu1. 1Hospital for Special Surgery, New York, NY;2Weill Cornell Medical College, New York, NY

Ultraviolet irradiation is known to exacerbate cutaneouslupus lesions. UV irradiation is also known to cause skinresident dendritic cells to leave their niche and migrate todraining lymph nodes. We hypothesized that dendritic cellsmediate vascular homeostasis in skin and that UV irradiationcauses skin inflammation in part by disrupting this dendriticcell-mediated vascular homeostasis. First, we asked aboutthe importance of dendritic cells to vascular homeostasis inskin. Depletion of skin CD11chi cells by injection of diphtheriatoxin into CD11c-DTR mice led to upregulation of VCAM-1 onskin endothelial cells, and upregulation of endothelial cellproliferation, suggesting that CD11chi dendritic cells mediateskin vascular homeostasis. We then asked whether UVBirradiation induced similar findings as in the CD11chi

dendritic cell-depleted mice. Irradiation with UVB light ata single dose of 900 J/m2 resulted in selective depletion ofCD11chi dendritic cells, as well as vasodilation and upregula-tion of VCAM-1 on skin endothelial cells. Together, ourresults suggest that CD11chi dendritic cells regulate vascularquiescence and homeostasis in skin and that UVB irradiationmay cause inflammation by inducing these CD11chi cells tomigrate out of skin. Our results have implications forunderstanding the pathogenesis of lupus skin lesions as wellas for identifying targets for novel therapies.

doi:10.1016/j.clim.2010.03.124

T.10. Imatinib Treatment of Patients with DiffuseCutaneous Systemic Sclerosis Modifies GeneExpression in Peripheral Blood Mononuclear Cells ofClinical RespondersJessica Gordon1, Robert Spiera1, Jamie Mersten1,Jacqueline Salit2, Neil Hackett2, Mary Crow1. 1Hospital forSpecial Surgery, New York, NY; 2Weill-Cornell MedicalCollege, New York, NY

Systemic sclerosis (SSc) is a multisystem, autoimmunedisease in which abnormal signaling through abelson kinase(abl) and the platelet-derived growth factor receptor(PDGFR) contributes to pathologic fibrosis and vasculopathy.Imatinib mesylate (Gleevec™), a tyrosine kinase inhibitor, isa therapy of interest because it can block both pathways. Wehypothesized that imatinib would modulate gene expressionin peripheral blood mononuclear cells (PBMC), and weperformed microarray analysis on PBMC RNA from 5 SScpatients before and after 12 months of treatment. Allpatients are enrolled in an ongoing clinical trial, and thoseselected had clinically meaningful improvements. Patientcharacteristics: 80% female; median age: 44 years [21–52 years]; median disease duration: 1.6 years [0.3–8 years];and median change in Modified Rodnan Skin Score: −9 [−5 to

−11]. RNA was extracted from PBMC and processed formicroarray. A paired t-test was performed using GenespringGX11 and Ingenuity Pathways. Treatment led to differentialexpression of 168 genes at a P value of 0.01 and a fold-changecutoff of 1.2. Of the genes downregulated were severalmembers of the MAP kinase family. Increased expression ofvon Hippel Lindau, HIF1α-inhibitor, and ubiquitin-conjugat-ing enzyme E2V1 transcripts were accompanied by down-regulation of MDM2, demonstrating changes in hypoxiapathway signaling. Decreased expression of calmodulin,NFAT5, PIK3CA, and NLRP3 and increased expression ofCD40 after treatment may signify changes in immuneregulation or signaling. These preliminary data suggest thatimatinib therapy results in modulation of gene expressiondownstream of PDGFR and c-abl as detected in PBMC. Studieswith additional paired samples will extend and confirm thesefindings.

doi:10.1016/j.clim.2010.03.125

T.11. SHIP1 Blocks Crohn's-like IntestinalInflammation in a Murine ModelKeith McLarren1, Shelley Miller1, Nicole Voglmaier1, OanaPopescu2, Laura Sly1. 1Child and Family Research Institute,Vancouver, BC, Canada; 2British Columbia Children'sHospital, Vancouver, BC, Canada

Crohn's disease is an inflammatory disease of thegastrointestinal tract occurring anywhere between themouth and the anus. Fibrosis is a serious complication inpatients with Crohn's disease which can result in strictureformation often requiring surgery. A large challenge in thestudy of Crohn's disease is the lack of acceptable animalmodels. Src homology 2 domain-containing inositol 5′-phosphatase (SHIP1) knockout (−/−) mice are a model ofprofoundly M2 skewed macrophages. We have found thatSHIP1−/− mice spontaneously develop intestinal inflamma-tion that is evident as early as 4 weeks of age and that sharesfeatures with Crohn's disease. Hematoxylin and eosinstaining revealed disease characterized by discontinuous,transmural inflammation, and granuloma in the submucosaand gut-associated lymphoid tissue. In the SHIP1−/− mice,inflammation was restricted to the distal ileum, while colonsand ceca appeared normal. Masson's trichrome staining andSircoll assays for soluble collagen revealed increasedcollagen deposition in SHIP−/− mice compared to wild-typelittermates. Immunohistochemistry for arginase I and Ym1,canonical markers of M2 macrophages, demonstrated ex-pression in cells within the submucosa and lymphoid folliclesand in intestinal epithelial cells. Interestingly, the inflam-mation and increased collagen deposition in SHIP−/− miceoccurred in the distal ileum, the most common site ofsurgical resection required due to fibrosis and strictureformation in patients with Crohn's disease. Characterizationof this new murine model of intestinal inflammation mayprovide a valuable new tool for therapeutic intervention indisease.

doi:10.1016/j.clim.2010.03.126