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A STAT3 inhibitor ameliorates CNS autoimmunity by restoring Teff:Treg balance
Saba I. Aqel, Xiaozhi Yang, Emma E. Kraus, Jinhua Song, Marissa F. Farinas, Erin Y. Zhao, Wei Pei, Amy E. Lovett-Racke, Michael K. Racke, Chenglong Li, Yuhong Yang
Saba I. Aqel, Xiaozhi Yang, Emma E. Kraus, Jinhua Song, Marissa F. Farinas, Erin Y. Zhao, Wei Pei, Amy E. Lovett-Racke, Michael K. Racke, Chenglong Li, Yuhong Yang
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Research Article Therapeutics

A STAT3 inhibitor ameliorates CNS autoimmunity by restoring Teff:Treg balance

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Abstract

Reestablishing an appropriate balance between T effector cells (Teff) and Tregs is essential for correcting autoimmunity. Multiple sclerosis (MS) is an immune-mediated chronic CNS disease characterized by neuroinflammation, demyelination, and neuronal degeneration, in which the Teff:Treg balance is skewed toward pathogenic Teffs Th1 and Th17 cells. STAT3 is a key regulator of Teff:Treg balance. Using the structure-based design, we have developed a potentially novel small-molecule prodrug LLL12b that specifically inhibits STAT3 and suppresses Th17 differentiation and expansion. Moreover, LLL12b regulates the fate decision between Th17 and Tregs in an inflammatory environment, shifting Th17:Treg balance toward Tregs and favoring the resolution of inflammation. Therapeutic administration of LLL12b after disease onset significantly suppresses disease progression in adoptively transferred, chronic, and relapsing-remitting experimental autoimmune encephalomyelitis. Disease relapses were also significantly suppressed by LLL12b given during the remission phase. Additionally, LLL12b shifts Th17:Treg balance of CD4+ T cells from MS patients toward Tregs and increases Teff sensitivity to Treg-mediated suppression. These data suggest that selective inhibition of STAT3 by the small molecule LLL12b recalibrates the effector and regulatory arms of CD4+ T responses, representing a potentially clinically translatable therapeutic strategy for MS.

Authors

Saba I. Aqel, Xiaozhi Yang, Emma E. Kraus, Jinhua Song, Marissa F. Farinas, Erin Y. Zhao, Wei Pei, Amy E. Lovett-Racke, Michael K. Racke, Chenglong Li, Yuhong Yang

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Figure 5

LLL12b restores Th17.

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LLL12b restores Th17.
Treg balance of CD4+ T cells from MS patients. (A–...
Treg balance of CD4+ T cells from MS patients. (A–L) PBMCs from treatment-naive MS patients (n = 22) were activated with αCD3/CD28 plus TGF-β/IL-6 for 3 days with LLL12b. DMSO was used as vehicle control. (A–D) IL-17 in supernatant of 1 patient sample was determined by ELISA and compared with 1-way ANOVA (A). IL-17 in LLL12b (0.125 μM) group was compared with control group of the same patient using Wilcoxon matched-pairs signed rank test (B). The percentage of decrease of IL-17 was calculated (C), and the patients in different ranges were shown in a pie chart (D). (E–H) Tregs (FoxP3+CD25+) were determined by intracellular staining, gating on CD45RA+CD4+ cells (E), and compared between LLL12b- (0.125 μM) and control-treated groups of the same patient using Wilcoxon matched-pairs signed rank test (F). The percentage of increase of Tregs was calculated (G), and the patients in different ranges were shown in a pie chart (H). (I–K) IL-17/Treg ratio of each patient was calculated and compared between LLL12b and control groups with Wilcoxon matched-pairs signed rank test (I). The percentage of decrease of IL-17/Treg ratio was calculated (J) and shown in a pie chart (K). (L) A nonparametric Pearson correlation test was used to analyze the degree of relatedness between percent increase of Treg and percent decrease of IL-17. (M) PBMCs from MS patients (n = 3) were activated with αCD3/CD28 under iTreg differentiation condition for 3 days. CFSE-labeled PBMCs from the same 3 patients were cultured with LLL12b (0.25 μM) or vehicle control DMSO for 2 hours, washed and mixed with iTregs cultured cells (Teff:Treg = 16:1), followed by activation with αCD3/CD28 for 5 days. CFSE in CD4+ T cells was determined by flow cytometry. The percentage of suppression was calculated and compared with a paired Student’s t test. **P < 0.01; ****P < 0.0001.

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