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 SpielmanJan Trka, Shai Izraeli, Simon Yona, Sarah Elitzur*

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review

7 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

Funding

FundersFunder number
Chaim Association
Core Research Facility of Hebrew University
Davidoff Foundation
Israel Childhood Cancer Fund
Israel Science Foundation Israel Precision Medicine
Mantoux Bioinformatics Institute of the Nancy and Stephen Grand Israel National Center for Personalized Medicine, Weizmann Institute of Science
Schneider Children's Medical Center of Israel
Universite de Versailles Saint-Quentin
Samuel Waxman Cancer Research Foundation
National Cancer Research InstituteLX22NPO5102
Noaber Foundation
Department of Systems Biology, Harvard Medical School
European Commission
Israel Cancer Association
Israel Science Foundation
Ministry of Health, State of Israel

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