Loss of function of ENT3 drives histiocytosis and inflammation through TLR-MAPK signaling

  • Ruth Shiloh*
  • , Ruth Lubin
  • , Odeya David
  • , Ifat Geron
  • , Elimelech Okon
  • , Idit Hazan
  • , Marketa Zaliova
  • , Gil Amarilyo
  • , Yehudit Birger
  • , Yael Borovitz
  • , Dafna Brik
  • , Arnon Broides
  • , Sarit Cohen-Kedar
  • , Liora Harel
  • , Eyal Kristal
  • , Daria Kozlova
  • , Galina Ling
  • , Mika Shapira Rootman
  • , Noa Shefer Averbuch
  • , Shiri Spielman
  • Jan Trka, Shai Izraeli, Simon Yona, Sarah Elitzur*
*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review

16 Scopus citations

Abstract

Histiocytoses are inflammatory myeloid neoplasms often driven by somatic activating mutations in mitogen-activated protein kinase (MAPK) cascade genes. H syndrome is an inflammatory genetic disorder caused by germ line loss-of-function mutations in SLC29A3, encoding the lysosomal equilibrative nucleoside transporter 3 (ENT3). Patients with H syndrome are predisposed to develop histiocytosis, yet the mechanism is unclear. Here, through phenotypic, molecular, and functional analysis of primary cells from a cohort of patients with H syndrome, we reveal the molecular pathway leading to histiocytosis and inflammation in this genetic disorder. We show that loss of function of ENT3 activates nucleoside-sensing toll-like receptors (TLR) and downstream MAPK signaling, inducing cytokine secretion and inflammation. Importantly, MEK inhibitor therapy led to resolution of histiocytosis and inflammation in a patient with H syndrome. These results demonstrate a yet-unrecognized link between a defect in a lysosomal transporter and pathological activation of MAPK signaling, establishing a novel pathway leading to histiocytosis and inflammation.

Original languageEnglish
Pages (from-to)1740-1751
Number of pages12
JournalBlood
Volume142
Issue number20
DOIs
StatePublished - 16 Nov 2023

Bibliographical note

Publisher Copyright:
© 2023 The American Society of Hematology

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