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Abacavir stimulates Hsp70 redistribution in Antigen-presenting cells of patients with hypersensitivity: Association with Type-I alcohol dehydrogenase activity
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Abacavir stimulates Hsp70 redistribution in Antigen-presenting cells of patients with hypersensitivity: Association with Type-I alcohol dehydrogenase activity

A. Martin, C. Almeida, D. Nolan, P. Cameron, I. James, T. Purcell, J. McCluskey, E. Phillips and S. Mallal
12th Conference on Retroviruses and Opportunistic Infections (Hynes Convention Center, Boston, MA, 22/02/2005–25/02/2005)
2005
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Abstract

Background: MHC alleles carried on the 57.1 ancestral haplotype (AH), including HLA-B*5701 and heat shock protein (Hsp70) genes, have been shown to be highly predictive of abacavir (ABC) hypersensitivity suggesting a strong immunogenetic basis for this syndrome. We wanted to characterize the specific antigen processing pathways involved in eliciting ABC-specific immune responses. Methods: The effect of ABC on intracellular localisation of HLA-B57, Hsp70 in peripheral blood mononuclear cells (PBMC), monocyte-derived dendritic cells (MDDC) was examined by immunofluorescence confocal microscopy from ABC hypersensitivity (n = 9), ABC-tolerant controls (n = 6), 57.1 AH-positive ABC-naïve individuals (n = 8), and B-cell lines homozygous for MHC haplotypes (n = 13). Hsp70 redistribution was quantified using Image J. The influence of 4-MP-mediated inhibition of abacavir pro-drug metabolising enzyme, type I alcohol dehydrogenase levels on Hsp70 redistribution and interferon-γ (IFN-γ) was also studied. Results: Co-localized distribution of Hsp70 and HLA-B57 was observed in CD14+ and CD56+ cells and was located within peripheral vesicles staining positively for early, late endosomal, or phagosomal markers. Increase in intracellular Hsp70 redistribution occurred after 3-hour ABC stimulation in PBMC of ABC-hypersensitive (n = 8) and ABC-naïve (n = 3) compared with controls (n = 5) with 21.19, 47.0 vs 1.50 average arbitrary units (p = 0.023). Following a 40-hour 4-MP exposure in PBMC of ABC-hypersensitive patients (n = 6), ABC-specific Hsp70 redistribution decreased from 11.2 to 2.9 mean arbitrary units (p = 0.024). Hsp70 redistribution levels correlated with extracellular IFN-γ (r = 0.64, p = 0.0335). In B-cell lines, tumor necrosis factor (TNF)–238A allele was associated with increased Hsp70 redistribution after ABC exposure. Biotinylated ABC retained immunogenicity compared with unlabelled ABC, co-localizing with Hsp70 and HLA-B57 within similar compartments and stimulating similar levels of IFN-γ in PBMC cultures. Conclusions: These data suggest that Hsp70 redistribution represents an early component of the ABC-specific immune response which is sensitive to inhibition of type I alcohol dehydrogenase, and which influences IFN-γ expression. Regulation of Hsp70 redistribution may also be associated or linked with TNF-238A allele. The development of HSR thus represents a multi-step process likely to involve the generation of an aldehyde metabolite by alcohol dehydrogenase followed by intracellular Hsp70 redistribution and finally development of an HLA-B*5701-restricted immune response mediated by inflammatory cytokines.

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