Exploiting Bioenergetic Differences to Stop GVHD



Image: Flickr - Junichiro Aoyama

Bz-423, a mitochondrial F1F0-ATP synthase inhibitor, that has previously shown promise for the treatment of autoimmune disorders such as lupus, arthritis and psoriasis has now been shown to halt the progression of established graft-versus-host disease (GVHD) in mouse models of allogeneic bone marrow transplantation. GVHD, in which functional immune cells in the transplanted marrow mount an immunological attack on the recipient, is a common complication of allogeneic bone marrow transplantation that can cause severe organ damage and even be life-threatening. As well as demonstrating that Bz-423 can reduce GVHD clinical scores and improve survival in mice, researchers at the University of Michigan and the University of Florida have shed new light on the metabolism of alloreactive T cells.

Bz-423 structure


Resting lymphocytes meet their minimal demand for ATP using low rates of oxidative phosphorylation. Upon activation, normal lymphocytes meet the increased demand for ATP by dramatically increasing their rate of aerobic glycolysis which also helps to maintain high levels of antioxidants in activated cells. Data from the present study suggest that alloreactive T cells, on the other hand, rely heavily on increased oxidative phosphorylation to generate more ATP. This difference in energy generation is also seen in pathogenic T cells involved in autoimmune diseases and provides a mechanistic basis for the specific elimination of pathogenic cells by Bz-423, whilst preserving normal immune function.

The study is published in Science Translational Medicine.

Lycera Corporation has a program to develop orally bioavailable F1F0-ATP synthase inhibitors that exploit bioenergetic abnormalities in pathologically activated lymphocytes and result in the selective silencing of these cells.

4 comments on “Exploiting Bioenergetic Differences to Stop GVHD
  1. GVHD happens in 30% – 70% of patients who undergo allogeneic hematopoietic stem cell relocation, usually as a treatment for leukemia or other blood cancers, and is a major reason of injury and mortality in these patients.

  2. shumz says:

    very informative and good articles

  3. Barry Bunin says:

    This was the benzodiazepine that I (Barry Bunin) synthesized first at UC Berkeley in the Ellman Group using solid phase synthesis. I still remember first scaling it up:


    Glad to see it getting some news.

    • According to a new research, various means are used to prevent acute GVHD. These typically include an immunosuppressive regimen of one or more drugs such as tacrolimus, cyclosporine, methotrexate, and mycophenolate that begins at the time of the transplant.

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