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Blood, Vol. 95 No. 11 (June 1), 2000: pp. 3460-3466

Hydroxychloroquine inhibits calcium signals in T cells: a new mechanism to explain its immunomodulatory properties

Frederick D. Goldman, Andrew L. Gilman, Clay Hollenback, Roberta M. Kato, Brett A. Premack, and David J. Rawlings

Department of Pediatrics, University of Iowa, Iowa City; Department of Pediatrics, Children's Mercy Hospital, University of Missouri-KC, School of Medicine, Kansas City; Department of Pediatrics, the Jonsson Comprehensive Cancer Center, and the Molecular Biology Institute and Department of Physiology, University of California, Los Angeles.

Hydroxychloroquine (HCQ), a lysosomotropic amine, is an immunosuppressive agent presently being evaluated in bone marrow transplant patients to treat graft-versus-host disease. While its immunosuppressive properties have been attributed primarily to its ability to interfere with antigen processing, recent reports demonstrate HCQ also blocks T-cell activation in vitro. To more precisely define the T-cell inhibitory effects of HCQ, the authors evaluated T-cell antigen receptor (TCR) signaling events in a T-cell line pretreated with HCQ. In a concentration-dependent manner, HCQ inhibited anti-TCR-induced up-regulation of CD69 expression, a distal TCR signaling event. Proximal TCR signals, including inductive protein tyrosine phosphorylation, tyrosine phosphorylation of phospholipase C gamma 1, and total inositol phosphate production, were unaffected by HCQ. Strikingly, anti-TCR-crosslinking-induced calcium mobilization was significantly inhibited by HCQ, particularly at the highest concentrations tested (100 µmol/L) in both T-cell lines and primary T cells. HCQ, in a dose-dependent fashion, also reduced a B-cell antigen receptor calcium signal, indicating this effect may be a general property of HCQ. Inhibition of the calcium signal correlated directly with a reduction in the size of thapsigargin-sensitive intracellular calcium stores in HCQ-treated cells. Together, these findings suggest that disruption of TCR-crosslinking-dependent calcium signaling provides an additional mechanism to explain the immunomodulatory properties of HCQ.


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