Phosphatidylinositol 3-kinase delta pathway: a novel therapeutic target for Sjögren's syndrome

磷脂酰肌醇 3-激酶 delta 通路:干燥综合征的新型治疗靶点

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作者:Saba Nayar, Joana Campos, Charlotte G Smith, Valentina Iannizzotto, David H Gardner, Serena Colafrancesco, Elena Pipi, Florian Kollert, Kelly J Hunter, Charlotte Brewer, Christopher Dominic Buckley, Simon J Bowman, Roberta Priori, Guido Valesini, Maria Juarez, William A Fahy, Benjamin A Fisher, Andr

Background

The phosphatidylinositol 3-kinase delta isoform (PI3Kδ) belongs to an intracellular lipid kinase family that regulate lymphocyte metabolism, survival, proliferation, apoptosis and migration and has been successfully targeted in B-cell malignancies. Primary Sjögren's syndrome (pSS) is a chronic immune-mediated inflammatory disease characterised by exocrine gland lymphocytic infiltration and B-cell hyperactivation which

Conclusion

These data demonstrate activation of PI3Kδ pathway within the glands of patients with pSS and its contribution to disease pathogenesis in a model of disease, supporting the exploration of the therapeutic potential of PI3Kδ pathway inhibition in this condition.

Results

Target validation assays showed significant expression of phosphorylated ribosomal protein S6 (pS6), a downstream mediator of the phosphatidylinositol 3-kinase delta (PI3Kδ) pathway, within pSS salivary glands. pS6 distribution was found to co-localise with T/B cell markers within pSS aggregates and the CD138+ plasma cells infiltrating the glands. In vivo blockade of PI3Kδ activity with seletalisib, a PI3Kδ-selective inhibitor, in a murine model of focal sialoadenitis decreased accumulation of lymphocytes and plasma cells within the glands of treated mice in the prophylactic and therapeutic regimes. Additionally, production of lymphoid chemokines and cytokines associated with ectopic lymphoneogenesis and, remarkably, saliva flow and autoantibody production, were significantly affected by treatment with seletalisib.

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