Mycophenolic acid suppresses granulopoiesis by inhibition of interleukin-17 production

Kidney Int. 2010 Jul;78(1):79-88. doi: 10.1038/ki.2010.84. Epub 2010 Apr 7.

Abstract

Mycophenolic acid is a commonly used immunosuppressant after organ transplantation and in autoimmune diseases; however, myelosuppression is a major complication despite its largely favorable side-effect profile. Mycophenolic acid targets inosine monophosphate dehydrogenase, which is essential for T-cell proliferation. The T-cell cytokine interleukin-17 (IL-17 or IL-17A) and its receptor maintain normal neutrophilic granulocyte numbers in mice by induction of granulocyte-colony-stimulating factor. To test whether mycophenolic acid induces neutropenia by inhibiting IL-17-producing T cells, we treated C57Bl/6 mice with mycophenolate-mofetil (the orally available pro-drug) and found a dose-dependent decrease in blood neutrophils. This myelosuppressive effect was completely abolished in mice that lack the IL-17 receptor. Mycophenolic acid delayed myeloid recovery after bone marrow transplantation and decreased the percentage of IL-17-producing T cells in the spleen and thymus, and inhibited IL-17 production in human and mouse T cells in vitro. Injection of IL-17 during mycophenolic acid treatment overcame the suppression of the circulating neutrophil levels. Our study shows that mycophenolic acid suppresses neutrophil production by inhibiting IL-17 expression, suggesting that measurement of this interleukin might be useful in estimating the risk of neutropenia in clinical settings.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Animals
  • Cell Differentiation / drug effects
  • Cell Differentiation / immunology
  • Colony-Stimulating Factors / immunology
  • Colony-Stimulating Factors / pharmacology
  • Cytokines / immunology
  • Cytokines / pharmacology
  • Female
  • Granulocyte Colony-Stimulating Factor / immunology
  • Granulocyte Colony-Stimulating Factor / metabolism
  • Granulocyte Colony-Stimulating Factor / pharmacology
  • Humans
  • Immunosuppressive Agents / immunology
  • Immunosuppressive Agents / pharmacology
  • Interleukin-17 / immunology
  • Interleukin-17 / metabolism*
  • Interleukin-17 / pharmacology
  • Leukopoiesis / drug effects
  • Leukopoiesis / immunology
  • Male
  • Mice
  • Mice, Inbred C57BL
  • Mice, Knockout
  • Mycophenolic Acid / analogs & derivatives
  • Mycophenolic Acid / immunology
  • Mycophenolic Acid / pharmacology*
  • Neutropenia / immunology
  • Neutrophils / drug effects
  • Neutrophils / immunology
  • Neutrophils / metabolism
  • Receptors, Interleukin-17 / immunology
  • T-Lymphocytes / immunology
  • T-Lymphocytes / metabolism

Substances

  • Colony-Stimulating Factors
  • Cytokines
  • Immunosuppressive Agents
  • Interleukin-17
  • Receptors, Interleukin-17
  • Granulocyte Colony-Stimulating Factor
  • Mycophenolic Acid