Chlorpromazine-induced lupus with circulating anticoagulant. A case report

Abbes, W.; Baâti, I.; Hanene, A.; Snoussi, M.; Kamilia, K.; Zouheir, B.; Masmoudi, J.

doi:10.1016/j.eurpsy.2017.01.1389

Cited by 2 publications

(1 citation statement)

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“…Firstly, extended treatment of mice with the MALT1 protease inhibitor mepazine did not reduce Treg numbers (40). As a counterexample, long-term treatment of psychiatric patients with chlorpromazine, another MALT1 inhibitor, is associated with the induction of autoimmunity markers and occasionally results in a lupus-like disease (80, 81). It is however important to stress that both these phenothiazine compounds also have other MALT1-independent activities that can be responsible for the observed effects (82).…”

Section: Discussionmentioning

confidence: 99%

MALT1 Proteolytic Activity Suppresses Autoimmunity in a T Cell Intrinsic Manner

et al. 2019

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MALT1 is a central signaling component in innate and adaptive immunity by regulating NF-κB and other key signaling pathways in different cell types. Activities of MALT1 are mediated by its scaffold and protease functions. Because of its role in lymphocyte activation and proliferation, inhibition of MALT1 proteolytic activity is of high interest for therapeutic targeting in autoimmunity and certain lymphomas. However, recent studies showing that Malt1 protease-dead knock-in ( Malt1 -PD) mice suffer from autoimmune disease have somewhat tempered the initial enthusiasm. Although it has been proposed that an imbalance between immune suppressive regulatory T cells (Tregs) and activated effector CD4 + T cells plays a key role in the autoimmune phenotype of Malt1 -PD mice, the specific contribution of MALT1 proteolytic activity in T cells remains unclear. Using T cell-conditional Malt1 protease-dead knock-in ( Malt1 -PDT) mice, we here demonstrate that MALT1 has a T cell-intrinsic role in regulating the homeostasis and function of thymic and peripheral T cells. T cell-specific ablation of MALT1 proteolytic activity phenocopies mice in which MALT1 proteolytic activity has been genetically inactivated in all cell types. The Malt1 -PDT mice have a reduced number of Tregs in the thymus and periphery, although the effect in the periphery is less pronounced compared to full-body Malt1 -PD mice, indicating that also other cell types may promote Treg induction in a MALT1 protease-dependent manner. Despite the difference in peripheral Treg number, both T cell-specific and full-body Malt1 -PD mice develop ataxia and multi-organ inflammation to a similar extent. Furthermore, reconstitution of the full-body Malt1 -PD mice with T cell-specific expression of wild-type human MALT1 eliminated all signs of autoimmunity. Together, these findings establish an important T cell-intrinsic role of MALT1 proteolytic activity in the suppression of autoimmune responses.

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