Andras Perl, United States of America

SUNY Medicine
Andras Perl received his MD and PhD from Semmelweis University in Budapest, Hungary. He held faculty positions at Semmelweis, the University of Rochester, and the State University of New York (SUNY) in Buffalo and Syracuse. He has been Professor of Medicine, Microbiology and Immunology, and Biochemistry and Molecular Biology since 1997, Chief of Rheumatology since 2001, and SUNY Distinguished Professor since 2017. His laboratory discovered mitochondrial hyperpolarization (MHP). MHP is a source of mitochondrial oxidative stress and a checkpoint of T-cell activation and death signal processing. His team has identified disease susceptibility genes that regulate mitochondrial homeostasis, autophagy, activation of the mechanistic target of rapamycin (mTOR) pathway, and cell death signal processing in mouse models and patients with autoimmunity, cancer, metabolic diseases. He has initiated successful clinical trials in patients with systemic lupus erythematosus (SLE) blocking mTOR with N-acetylcysteine or sirolimus. He has published over 190 original peer-reviewed papers in leading medical and scientific journals, authored chapters in rheumatology and immunology textbooks, trained over 60 MD/PhD and PhD students and postdoctoral and rheumatology fellows. His laboratory has been continuously funded by the National Institutes of Health since 1996. He has been listed among the Best Doctors in America since 2007.

Presenter of 2 Presentations

METABOLIC CONTROL AND THERAPEUTIC TARGETING OF MTOR-DEPENDENT T-CELL LINEAGE SPECIFICATION IN AUTOIMMUNITY"

Session Type
PARALLEL SESSIONS
Date
30.05.2021, Sunday
Session Time
13:30 - 15:30
Room
HALL C
Lecture Time
14:30 - 14:45
Session Icon
Pre Recorded

RAB4A-DEPENDENT MECHANISTIC TARGET OF RAPAMYCIN ACTIVATION CONTROLS ORGAN-SPECIFIC DISEASE PATHOGENESIS IN SYSTEMIC LUPUS ERYTHEMATOSUS

Session Type
PARALLEL SESSIONS
Date
30.05.2021, Sunday
Session Time
13:30 - 15:30
Room
HALL G
Lecture Time
13:50 - 14:10
Session Icon
Pre Recorded

Abstract

Background and Aims

Genetic polymorphism and methylation-dependent overexpression of Rab4A influences mechanistic target of rapamycin (mTOR) activation that in turn controls immune cell lineage specification and constitutes an effective treatment target for autoimmunity in systemic lupus erythematosus (SLE).

Methods

To determine the impact of Rab4A during lupus pathogenesis, we generated mice with constitutively active Rab4AQ72Lalleles or lacking expression of Rab4A in T cells (Rab4A-KOCD4Cre) on the C57Bl/6 background and further backcrossed them onto the lupus-prone SLE1.2.3 triple-congenic (B6.TC) line.

Results

Activation of Rab4A accelerated the production of antinuclear antibodies (ANA) and antiphospholipid antibodies (aPL), anti-cardiolipin (ACLA) and anti-β2 glycoprotein I autoantibodies (anti-β2GPI), proteinuria, glomerulonephritis, and neurobehavioral dysfunction, while deletion of Rab4A in T cells abrogated pathogenesis. Dual mTORC1/mTORC2 activation was restrained in CD4 T cells, while mTORC2 was selectively blocked in CD8 T cells of B6.TC/Rab4A-KOCD4Cre mice. By contrast, pristane-inducible ANA, ACLA and anti-β2GPI production and pulmonary vasculitis (PV) were increased in Rab4A-KOCD4Cre mice but blocked in Rab4AQ72L mice relative to age-matched wildtype (WT) controls. However, intrahepatic lymphocytic infiltration and vasculitis were enhanced in Rab4AQ72L but diminished in Rab4A-KOCD4Cre mice. Thymus-derived FoxP3+Helios+ Tregs and mTORC1+/mTORC2+ CD4+CD25+ Tregs were expanded in Rab4AQ72L mice but depleted in Rab4A-KOCD4Cre mice. IL-17-producing CD11b+ pro-inflammatory macrophages were accumulated in the spleen and Gr1+ neutrophils were expanded in the lung of Rab4A-KOCD4Cre mice. Rapamycin completely abrogated nephritis and improved neurobehavioral dysfunction in B6.TC/Rab4AQ72L mice but failed to block PV in WT or Rab4A-KOCD4Cre mice.

Conclusions

The findings suggest that Rab4A impacts organ-specific lupus pathogenesis through modulating mTOR-dependent pro-inflammatory T-cell development and trafficking.

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