Immunomodulatory agents lenalidomide and pomalidomide co‐stimulate T cells by inducing degradation of T cell repressors I karos and A iolos via modulation of the …

AK Gandhi, J Kang, CG Havens… - British journal of …, 2014 - Wiley Online Library
AK Gandhi, J Kang, CG Havens, T Conklin, Y Ning, L Wu, T Ito, H Ando, MF Waldman…
British journal of haematology, 2014Wiley Online Library
Cereblon (CRBN), the molecular target of lenalidomide and pomalidomide, is a substrate
receptor of the cullin ring E 3 ubiquitin ligase complex, CRL 4 CRBN. T cell co‐stimulation
by lenalidomide or pomalidomide is cereblon dependent: however, the CRL 4 CRBN
substrates responsible for T cell co‐stimulation have yet to be identified. Here we
demonstrate that interaction of the transcription factors Ikaros (IKZF 1, encoded by the IKZF 1
gene) and A iolos (IKZF 3, encoded by the IKZF 3 gene) with CRL 4 CRBN is induced by …
Summary
Cereblon (CRBN), the molecular target of lenalidomide and pomalidomide, is a substrate receptor of the cullin ring E3 ubiquitin ligase complex, CRL4CRBN. T cell co‐stimulation by lenalidomide or pomalidomide is cereblon dependent: however, the CRL4CRBN substrates responsible for T cell co‐stimulation have yet to be identified. Here we demonstrate that interaction of the transcription factors Ikaros (IKZF1, encoded by the IKZF1 gene) and Aiolos (IKZF3, encoded by the IKZF3 gene) with CRL4CRBN is induced by lenalidomide or pomalidomide. Each agent promotes Aiolos and Ikaros binding to CRL4CRBN with enhanced ubiquitination leading to cereblon‐dependent proteosomal degradation in T lymphocytes. We confirm that Aiolos and Ikaros are transcriptional repressors of interleukin‐2 expression. The findings link lenalidomide‐ or pomalidomide‐induced degradation of these transcriptional suppressors to well documented T cell activation. Importantly, Aiolos could serve as a proximal pharmacodynamic marker for lenalidomide and pomalidomide, as healthy human subjects administered lenalidomide demonstrated Aiolos degradation in their peripheral T cells. In conclusion, we present a molecular model in which drug binding to cereblon results in the interaction of Ikaros and Aiolos to CRL4CRBN, leading to their ubiquitination, subsequent proteasomal degradation and T cell activation.
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