Nature Communications (Jan 2024)

ROCK1/2 signaling contributes to corticosteroid-refractory acute graft-versus-host disease

  • Kristina Maas-Bauer,
  • Anna-Verena Stell,
  • Kai-Li Yan,
  • Enrique de Vega,
  • Janaki Manoja Vinnakota,
  • Susanne Unger,
  • Nicolas Núñez,
  • Johana Norona,
  • Nana Talvard-Balland,
  • Stefanie Koßmann,
  • Carsten Schwan,
  • Cornelius Miething,
  • Uta S. Martens,
  • Khalid Shoumariyeh,
  • Rosa P. Nestor,
  • Sandra Duquesne,
  • Kathrin Hanke,
  • Michal Rackiewicz,
  • Zehan Hu,
  • Nadia El Khawanky,
  • Sanaz Taromi,
  • Hana Andrlova,
  • Hemin Faraidun,
  • Stefanie Walter,
  • Dietmar Pfeifer,
  • Marie Follo,
  • Johannes Waldschmidt,
  • Wolfgang Melchinger,
  • Michael Rassner,
  • Claudia Wehr,
  • Annette Schmitt-Graeff,
  • Sebastian Halbach,
  • James Liao,
  • Georg Häcker,
  • Tilman Brummer,
  • Joern Dengjel,
  • Geoffroy Andrieux,
  • Robert Grosse,
  • Sonia Tugues,
  • Bruce R. Blazar,
  • Burkhard Becher,
  • Melanie Boerries,
  • Robert Zeiser

DOI
https://doi.org/10.1038/s41467-024-44703-7
Journal volume & issue
Vol. 15, no. 1
pp. 1 – 18

Abstract

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Abstract Patients with corticosteroid-refractory acute graft-versus-host disease (aGVHD) have a low one-year survival rate. Identification and validation of novel targetable kinases in patients who experience corticosteroid-refractory-aGVHD may help improve outcomes. Kinase-specific proteomics of leukocytes from patients with corticosteroid-refractory-GVHD identified rho kinase type 1 (ROCK1) as the most significantly upregulated kinase. ROCK1/2 inhibition improved survival and histological GVHD severity in mice and was synergistic with JAK1/2 inhibition, without compromising graft-versus-leukemia-effects. ROCK1/2-inhibition in macrophages or dendritic cells prior to transfer reduced GVHD severity. Mechanistically, ROCK1/2 inhibition or ROCK1 knockdown interfered with CD80, CD86, MHC-II expression and IL-6, IL-1β, iNOS and TNF production in myeloid cells. This was accompanied by impaired T cell activation by dendritic cells and inhibition of cytoskeletal rearrangements, thereby reducing macrophage and DC migration. NF-κB signaling was reduced in myeloid cells following ROCK1/2 inhibition. In conclusion, ROCK1/2 inhibition interferes with immune activation at multiple levels and reduces acute GVHD while maintaining GVL-effects, including in corticosteroid-refractory settings.