HIV-1 tropism and CD4 T lymphocyte recovery in a prospective cohort of patients initiating HAART in Ribeirao Preto, Brazil

While human immunodeficiency virus (HIV)-1 chemokine co-receptors 5 tropism and the GWGR motif in the envelope third variable region (V3 loop) have been associated with a slower disease progression, their influence on antiretroviral response remains unclear. The impact of baseline V3 characteristics on treatment response was evaluated in a randomised, double blind, prospective cohort study with patients initiating highly active antiretroviral therapy with lopinavir or efavirenz plus azithothymidine/3TC (1:1) over 48 weeks. Similar virological and immunological responses were observed for both treatment regimens. The 43 individuals had a mean baseline CD4 T cell count of 119 cells/mm(3) [standard deviation (SD) = 99] and a mean viral load of 5.09 log(10) copies/mL (SD = 0.49). The GWGR motif was not associated with a CD4 T cell response, but predicted R5 tropism by the geno2pheno([clinical20%]) algorithm correlated with higher CD4 T cell levels at all monitoring points (p < 0.05). Moreover, higher false-positive rates (FPR) values from this analysis revealed a strong correlation with CD4 T cell recovery (p < 0.0001). Transmitted drug resistance mutations, documented in 3/41 (7.3%) cases, were unrelated to the assigned antiretroviral regimen and had no impact on patient outcomes. In conclusion, naive HIV-1 R5 infected patients exhibited higher CD4 T cell counts at baseline; this difference was sustained throughout therapy. The geno2pheno[clinical] option FPR positively correlated with CD4 T cell gain and may be useful in predicting CD4 T cell recovery.

Protection conferred by heterologous vaccination against tuberculosis is dependent on the ratio of CD4(+)/CD4(+) Foxp3(+) cells

CD4(+) Foxp3(+) regulatory T cells inhibit the production of interferon-?, which is the major mediator of protection against Mycobacterium tuberculosis infection. In this study, we evaluated whether the protection conferred by three different vaccines against tuberculosis was associated with the number of spleen and lung regulatory T cells. We observed that after homologous immunization with the 65 000 molecular weight heat-shock protein (hsp 65) DNA vaccine, there was a significantly higher number of spleen CD4(+) Foxp3(+) cells compared with non-immunized mice. Heterologous immunization using bacillus Calmette Guerin (BCG) to prime and DNA-hsp 65 to boost (BCG/DNA-hsp 65) or BCG to prime and culture filtrate proteins (CFP)-CpG to boost (BCG/CFP-CpG) induced a significantly higher ratio of spleen CD4(+)/CD4(+) Foxp3(+) cells compared with non-immunized mice. In addition, the protection conferred by either the BCG/DNA-hsp 65 or the BCG/CFP-CpG vaccines was significant compared with the DNA-hsp 65 vaccine. Despite the higher ratio of spleen CD4(+)/CD4(+) Foxp3(+) cells found in BCG/DNA-hsp 65-immunized or BCG/CFP-CpG-immunized mice, the lungs of both groups of mice were better preserved than those of DNA-hsp 65-immunized mice. These results confirm the protective efficacy of BCG/DNA-hsp 65 and BCG/CFP-CpG heterologous prime-boost vaccines and the DNA-hsp 65 homologous vaccine. Additionally, the prime-boost regimens assayed here represent a promising strategy for the development of new vaccines to protect against tuberculosis because they probably induce a proper ratio of CD4(+) and regulatory (CD4(+) Foxp3(+)) cells during the immunization regimen. In this study, this ratio was associated with a reduced number of regulatory cells and no injury to the lungs.

CD4+CD25highFoxp3+Cells Increased in the Peritoneal Fluid of Patients with Endometriosis

Problem To evaluate CD4+CD25highFoxp3+ cells and IL-6, IL-10, IL-17, and TGF-beta in the peritoneal fluid of women with endometriosis. Method of study A total of ninety-eight patients were studied: endometriosis (n = 70) and control (n = 28). First, peritoneal fluid lymphocytes were isolated, and CD4+CD25high cells were identified using flow cytometry. Then, RT-PCR was performed to verify Foxp3 expression in these cells. Also, IL-6, IL-10, IL-17, and TGF-beta concentration was determined. Results Of all the lymphocytes in the peritoneal fluid of women with endometriosis, 36.5% (median) were CD4+CD25high compared to only 1.15% (median) in the control group (P < 0.001). Foxp3 expression was similarly elevated in patients with the disease compared to those without (median, 50 versus 5; P < 0.001). IL-6 and TGF-beta were higher in endometriosis group (IL-6: 327.5 pg/mL versus 195.5 pg/mL; TGF-beta: 340 pg/mL versus 171.5 pg/mL; both P < 0.001). IL-10 and IL-17 showed no significant differences between the two groups. Conclusion The peritoneal fluid of patients with endometriosis had a higher percentage of CD4+CD25highFoxp3+ cells and also higher levels of IL-6 and TGF-beta compared to women without the disease. These findings suggest that CD4+CD25highFoxp3+ cells may play a role in the pathogenesis of endometriosis.

Monocyte-derived dendritic cells from breast cancer patients are biased to induce CD4(+)CD25(+)Foxp3(+) regulatory T cells

DCs orchestrate immune responses contributing to the pattern of response developed. In cancer, DCs may play a dysfunctional role in the induction of CD4(+)CD25(+) Foxp3(+) Tregs, contributing to immune evasion. We show here that Mo-DCs from breast cancer patients show an altered phenotype and induce preferentially Tregs, a phenomenon that occurred regardless of DC maturation stimulus (sCD40L, cytokine cocktail, TNF-alpha, and LPS). The Mo-DCs of patients induced low proliferation of allogeneic CD3(+)CD25(neg)Foxp3(neg) cells, which after becoming CD25(+), suppressed mitogen-stimulated T cells. Contrastingly, Mo-DCs from healthy donors induced a stronger proliferative response, a low frequency of CD4(+)CD25(+)Foxp3(+) with no suppressive activity. Furthermore, healthy Mo-DCs induced higher levels of IFN-gamma, whereas the Mo-DCs of patients induced higher levels of bioactive TGF-beta 1 and IL-10 in cocultures with allogeneic T cells. Interestingly, TGF-beta 1 blocking with mAb in cocultures was not enough to completely revert the Mo-DCs of patients' bias toward Treg induction. Altogether, these findings should be considered in immunotherapeutic approaches for cancer based on Mo-DCs. J. Leukoc. Biol. 92: 673-682; 2012.

miR-15a and 16-1 Are Downregulated in CD4(+) T Cells of Multiple Sclerosis Relapsing Patients

The pathology of relapsing-remitting multiple sclerosis (RR-MS) is largely attributed to activated autoreactive effector T lymphocytes. The influence of microRNAs on the immune response has been shown to occur in different pathways of lymphocyte differentiation and function. Here, the expression of the miRNAs miR-15a/161 in PBMC, CD4(+), and CD8(+) from RR-MS patients has been investigated. BCL2, a known miR-15a/16-1 target, has also been analyzed. The results have shown that miR-15a/16-1 is downregulated in CD4(+) T cells, whereas BCL2 is highly expressed in RR-MS patients only. Our data suggest that miR-15a/16-1 can also modulate the BCL2 gene expression in CD4(+) T cells from RR-MS patients, thereby affecting apoptosis processes.

Relaxation of Adaptive Evolution during the HIV-1 Infection Owing to Reduction of CD4+T Cell Counts

Background: The first stages of HIV-1 infection are essential to establish the diversity of virus population within host. It has been suggested that adaptation to host cells and antibody evasion are the leading forces driving HIV evolution at the initial stages of AIDS infection. In order to gain more insights on adaptive HIV-1 evolution, the genetic diversity was evaluated during the infection time in individuals contaminated by the same viral source in an epidemic cluster. Multiple sequences of V3 loop region of the HIV-1 were serially sampled from four individuals: comprising a single blood donor, two blood recipients, and another sexually infected by one of the blood recipients. The diversity of the viral population within each host was analyzed independently in distinct time points during HIV-1 infection. Results: Phylogenetic analysis identified multiple HIV-1 variants transmitted through blood transfusion but the establishing of new infections was initiated by a limited number of viruses. Positive selection (d(N)/d(S)>1) was detected in the viruses within each host in all time points. In the intra-host viruses of the blood donor and of one blood recipient, X4 variants appeared respectively in 1993 and 1989. In both patients X4 variants never reached high frequencies during infection time. The recipient, who X4 variants appeared, developed AIDS but kept narrow and constant immune response against HIV-1 during the infection time. Conclusion: Slowing rates of adaptive evolution and increasing diversity in HIV-1 are consequences of the CD4+ T cells depletion. The dynamic of R5 to X4 shift is not associated with the initial amplitude of humoral immune response or intensity of positive selection.

HIV-1 tropism and CD4 T lymphocyte recovery in a prospective cohort of patients initiating HAART in Ribeirão Preto, Brazil

While human immunodeficiency virus (HIV)-1 chemokine co-receptors 5 tropism and the GWGR motif in the envelope third variable region (V3 loop) have been associated with a slower disease progression, their influence on antiretroviral response remains unclear. The impact of baseline V3 characteristics on treatment response was evaluated in a randomised, double blind, prospective cohort study with patients initiating highly active antiretroviral therapy with lopinavir or efavirenz plus azithothymidine/3TC (1:1) over 48 weeks. Similar virological and immunological responses were observed for both treatment regimens. The 43 individuals had a mean baseline CD4 T cell count of 119 cells/mm³ [standard deviation (SD) = 99] and a mean viral load of 5.09 log10 copies/mL (SD = 0.49). The GWGR motif was not associated with a CD4 T cell response, but predicted R5 tropism by the geno2pheno[clinical20%] algorithm correlated with higher CD4 T cell levels at all monitoring points (p < 0.05). Moreover, higher false-positive rates (FPR) values from this analysis revealed a strong correlation with CD4 T cell recovery (p < 0.0001). Transmitted drug resistance mutations, documented in 3/41 (7.3%) cases, were unrelated to the assigned antiretroviral regimen and had no impact on patient outcomes. In conclusion, naÏve HIV-1 R5 infected patients exhibited higher CD4 T cell counts at baseline; this difference was sustained throughout therapy. The geno2pheno[clinical] option FPR positively correlated with CD4 T cell gain and may be useful in predicting CD4 T cell recovery.

Ovariectomized OVA-sensitized mice display increased frequency of CD4+Foxp3+ T regulatory cells in the periphery

It is well established that female sex hormones have a pivotal role in inflammation. For instance, our group has previously reported that estradiol has proinflammatory actions during allergic lung response in animal models. Based on these findings, we have decided to further investigate whether T regulatory cells are affected by female sex hormones absence after ovariectomy. We evaluated by flow cytometry the frequencies of CD4+Foxp3+ T regulatory cells (Tregs) in central and peripheral lymphoid organs, such as the thymus, spleen and lymph nodes. Moreover, we have also used the murine model of allergic lung inflammation a to evaluate how female sex hormones would affect the immune response in vivo. To address that, ovariectomized or sham operated female Balb/c mice were sensitized or not with ovalbumin 7 and 14 days later and subsequently challenged twice by aerosolized ovalbumin on day 21. Besides the frequency of CD4+Foxp3+ T regulatory cells, we also measured the cytokines IL-4, IL-5, IL-10, IL-13 and IL-17 in the bronchoalveolar lavage from lungs of ovalbumine challenged groups. Our results demonstrate that the absence of female sex hormones after ovariectomy is able to increase the frequency of Tregs in the periphery. As we did not observe differences in the thymus-derived natural occurring Tregs, our data may indicate expansion or conversion of peripheral adaptive Tregs. In accordance with Treg suppressive activity, ovariectomized and ovalbumine-sensitized and challenged animals had significantly reduced lung inflammation. This was observed after cytokine analysis of lung explants showing significant reduction of pro-inflammatory cytokines, such as IL-4, IL-5, IL-13 and IL-17, associated to increased amount of IL-10. In summary, our data clearly demonstrates that OVA sensitization 7 days after ovariectomy culminates in reduced lung inflammation, which may be directly correlated with the expansion of Tregs in the periphery and further higher IL-10 secretion in the lungs.

Effetto della combinazione di cellule CD4+CD25+, cellule staminali emopoietiche CD34+e ATG nella prevenzione della risposta alloreattiva delle cellule T in vitro ed in vivo

Il trapianto delle cellule staminali emopoietiche umane CD34+ in combinazione con le cellule T regolatorie CD4+/CD25+ FoxP3+ (Tregs) potrebbe prevenire l'alloreattività verso le cellule staminali emopoietiche e ridurre il rischio di rigetto in trapianti allogenici HLA non correlati. Per dimostrare questa ipotesi abbiamo messo in coltura le cellule CD34+ e le cellule CD4+/CD25+ isolate con metodica immunomagnetica (Miltnyi Biotec)da sangue periferico non manipolato,sangue periferico mobilizzato con G-CSF o da Cordone ombelicale. Gli esperimenti svolti in vitro, hanno evidenziato che le cellule Tregs arricchite, ottenute dalla stessa fonte delle cellule CD34+( autologhe), mostravano un effetto inibitorio maggiore sulle celulle T alloreattive, rispetto alle cellule Tregs ottenute da un donatore terzo(allogenico).Inoltre l'attività immunosoppressoria delle Tregs era mantenuta dopo stimolazione con cellule CD34+ allogeniche e i Tregs non modificavano l'attività clonogenica delle cellule staminali CD34+. Avendo ottenuto questi dati in vitro abbiamo trapiantato in topi NOD/SCID le cellule Tregs e le cellule CD34+ in rapporto 1:1 o 1:2 ed è stato osservato un normale attecchimento delle cellule staminali. Incubando queste cellule con dosi fisiologiche di timoglobulina derivata da coniglio (nota molecola immunosopressoria) non veniva modificato il numero dei Tregs dopo 6 giorni di coltura. Dopo l'esposizione alla Timoglobulina, inoltre, i Tregs mantenevano la loro attività soppressoria, aumentava l'espressione del recettore chemochinico CCR7, e venivano rilasciate diverse citochine principalmente l'interleuchina 10(IL-10). Tali dati dimostrano come sia le cellule tregs autologhe che quelle allogeniche potrebbero essere trapiantate insieme alle cellule staminali CD34+ dopo un regime preparatorio di terapia che include la timoglobulina. A tale scopo sono state eseguite selezioni di Tregs da aferesi di donatori sani mobilizzati con G-CSF su scala clinica utilizzando biglie immunomagnetiche Clinical grade (Miltenyi Biotec) e sono state confrontate 2 modalità di selezione con due o tre passaggi con o senza la deplezione dei monociti CD14+.Si è dimostrato così che è possibile selezionare un numero uguale di CD34+ e Tregs ,che con la metodica che prevede la deplezione dei monociti si ottiene una popolazione di cellule Tregs più pura ( > 80%) e infine le applicazioni possibili di questi risultati includo: trapianto di cellule CD34+ del donatore insieme a cellule Tregs in trapianti aploidentici ; infusione of cellule tregs isolate da PBSC mobilizzati con G-nei casi di pazienti con GVHD steroide-resistente; infusione di G-Tregs del donatore nei casi di rigetto di organo trapiantato da of donatore ancora vivente.

Molekulare Mechanismen der Kontrolle von T-Helferzellen durch natürlich vorkommende CD4 +CD25 + regulatorische T-Zellen

CD4+CD25+ regulatorische T-Zellen (CD4+CD25+ Tregs) sind in der Lage die Proliferation und Cytokin-Produktion konventioneller T-Zellen zu supprimieren. Obwohl ein entscheidender Mechanismus dieses Prozesses die Inhibition der Interleukin-2 Produktion ist, sind die beteiligten Moleküle weitestgehend unbekannt. Interessanterweise entwickeln NFATc2-, NFATc3-doppeldefiziente Mäuse (DKO Mäuse) schwerste Autoimmunerkrankungen, so dass im Rahmen dieser Arbeit die Rolle der Transkriptionsfaktoren NFATc2 und NFATc3 bei der Entstehung von CD4+CD25+ Tregs und der CD4+CD25+ Treg-vermittelten Suppression konventioneller T-Zellen untersucht wurde. Es konnte gezeigt werden, dass zwar die Gesamtheit der peripheren CD4+CD25+ T-Zellen keinerlei suppressives Potential besitzt, eine Subpopulation dieser Zellpopulation, die sehr stark CD25 und GITR exprimiert (CD4+CD25++GITR++ T-Zellen), jedoch in der Lage ist kokultivierte konventionelle CD4+ T-Zellen in ihren Effektorfunktionen zu inhibieren. Allerdings ließen sich die konventionellen CD4+ T-Zellen aus DKO Mäusen nicht von CD4+CD25+ Tregs in ihrer Proliferation und Zytokinproduktion inhibieren. Es kann also abschließend gesagt werden, dass das Fehlen der Transkriptionsfaktoren NFATc2 und NFATc3 die Entstehung und Funktion von CD4+CD25+ Tregs nicht beeinflusst, jedoch konventionelle CD4+ T-Zellen resistent gegen eine CD4+CD25+ Treg-vermittelte Suppression werden lässt.

Humane CD4 + CD25 + regulatorische T-Zellen: Charakterisierung von Subpopulationen und Identifizierung eines Markers

CD4+CD25+ regulatorische T-Zellen (CD4+CD25+ Tregs) sind essentiell an der Homöostase des Immunsystems beteiligt, indem sie eine antigenspezifische Toleranzinduktion in der Peripherie vermitteln und vor der Entstehung von Autoimmunerkrankungen schützen. Darüber hinaus sind diese Zellen wesentlich an der Kontrolle von Allergien, Infektionen und Tumoren beteiligt. Innerhalb dieser Arbeit konnten zwei bisher unbekannte Subpopulationen humaner CD4+CD25+ Tregs, isoliert aus dem peripheren Blut des Menschen, nachgewiesen werden. Diese Subpopulationen unterscheiden sich in ihrer Oberflächenexpression und exprimieren die Integrine a4b1 bzw. a4b7. Beide Treg-Subpopulationen supprimieren kokultivierte CD4+ T-Helferzellen Zellkontakt-abhängig und konvertieren gleichzeitig einen Teil dieser Zellen in sekundäre Suppressorzellen (iTregs). a4b1+ Tregs induzieren TGF-β-sezernierende iTregs, a4b7+ Tregs führen zur Bildung von IL-10-produzierenden iTregs. Differentielle Proteomanalysen humaner CD4+CD25+ Tregs, im Vergleich zu CD4+CD25- T-Helferzellen, führten zur Identifizierung von Galectin-10 als Markerprotein, das fast ausschließlich von CD4+CD25+ Tregs und nicht von CD4+ T-Helferzellen exprimiert wird. Galectin-10 ist ein intrazelluläres Protein, das essentiell für die funktionellen Eigenschaften humaner CD4+CD25+ Tregs ist. Die Blockade der Galectin-10-Bildung in den CD4+CD25+ Tregs durch RNA-Interferenz führte zu wesentlichen funktionellen Veränderungen der CD4+CD25+ Tregs. In Abwesenheit von Galectin-10 verlieren humane CD4+CD25+ Tregs ihre suppressiven Eigenschaften und ihren anergischen Phänotyp. Somit konnte mit Galectin-10 erstmals ein spezifischer Marker für humane CD4+CD25+ Tregs identifiziert werden, der wesentlich für den funktionellen Phänotyp dieser Regulatoren peripherer T-Zelltoleranz ist.

Transkriptionelle Kontrolle der Entwicklung und Funktion natürlich vorkommender CD4 + CD25 + regulatorischer T-Zellen

CD4+CD25+ natürlich vorkommende regulatorische T-Zellen (nTregs) repräsentieren in Menschen und Mäusen etwa 5-10% aller peripheren CD4+ T-Zellen und besitzen eine wichtige Aufgabe im Immunsystem. nTregs sind entscheidend an der peripheren Toleranz beteiligt, da sie potenziell autoaggressive T-Zellen in ihrer Cytokinproduktion und Proliferation hemmen. Trotzdem ist der molekulare Mechanismus der nTreg-vermittelten Suppression und der Entwicklung dieser nTregs noch weitestgehend unbekannt. Vor einigen Jahren wurde der Transkriptionsfaktor FoxP3 (Forkhead Box P3) als der „Hauptregulator“ für die Entwicklung und Funktion von nTregs identifiziert. Um die suppressiven Fähigkeiten von nTregs optimal für therapeutische Zwecke einsetzen zu können, ist es daher von großer Notwendigkeit den zugrundeliegenden molekularen Mechanismus zu verstehen und Moleküle zu identifizieren, die an der Regulation des nTreg-spezifischen Faktors FoxP3 beteiligt sind. Ein Teil dieser Arbeit beschäftigt sich mit der microRNA155 (miR155) bei der nTreg-vermittelten Suppression. Es konnte gezeigt werden, dass die ektopische Expression der miR155 in konventionellen CD4+ T-Zellen zu einer Erhöhung der IL-2 Produktion führte, so dass die Zellen resistenter gegenüber der nTreg-vermittelten Suppression wurden. Die transiente Aufhebung der Suppression durch die miR155 bietet somit einen möglichen therapeutischen Einsatz bei der Behandlung von Tumorerkrankungen. Weiterhin konnte in dieser Arbeit demonstriert werden, dass der Transkriptionsfaktor HELIOS, oder vielmehr seine lange Isoform, HELIOS_long, eine entscheidende Rolle bei der Regulation der FoxP3 Expression einnimmt. Im Vergleich zu konventionellen CD4+ T-Zellen exprimieren nTregs hohe Mengen an HELIOS. In in vitro Studien zeigte sich, dass endogenes HELIOS in nTregs an den FoxP3 Promotor binden und diesen aktivieren kann. Die ektopische Expression von HELIOS_long führte in konventionellen CD4+ T-Zellen (HELIOSlowFoxP3-) nur in Gegenwart der Cytokine IL-2 und TGF-β zu einer gesteigerten FoxP3 Promotor Aktivität. Neben der Aktivierung konnte auch eine gesteigerte FoxP3 Protein Expression detektiert werden. Diese in vitro Daten konnten auch in einem in vivo Mausmodell verifiziert werden. Der adoptive Transfer HELIOS_long transfizierter CD4+ T-Zellen (HELIOSlowFoxP3-) in T-Zell-defiziente Mäuse führte zu der Induktion FoxP3+ T-Zellen mit suppressiven Fähigkeiten sowohl ex vivo als auch in vivo. Zusammengefasst zeigte sich, dass der Transkriptionsfaktor HELIOS einen stark fördernden Einfluss auf die Expression von FoxP3 besitzt. Diese Beobachtung bietet eine Möglichkeit für die Induktion stabiler regulatorischer T-Zellen als therapeutischen Einsatz für die Behandlung von Autoimmunerkrankungen.

Die Rolle CD4 + CD25 + regulatorischer T-Zellen in der Niedrigzonentoleranz gegenüber Kontaktallergenen

Die allergische Kontaktdermatitis ist eine der häufigsten Berufserkrankungen, die durch die Exposition mit hohen Mengen eines Kontaktallergens ausgelöst wird. In Mausmodellen sehen wir, dass mittels einer Niedrigzonentoleranz (NZT) die Bildung einer Kontaktsensibilisierung unterdrückt werden kann. Bei der NZT führt die epikutane Applikation von subimmunogenen Dosen zu einer systemischen Toleranzentwicklung, die durch CD8+ Suppressor-T-Zellen Hapten-spezifisch vermittelt wird. Für die Generierung dieser CD8+ Suppressor-T-Zellen sind IL-10-sezernierende CD4+ regulatorischen T-Zellen (Tregs) notwendig. Aufbauend auf diesen Ergebnissen sollte in dieser Arbeit überprüft werden, ob natürlichen Tregs (nTregs) bei der NZT eine Rolle spielen und die Funktion und Aufgaben dieser Zellen während der NZT untersucht werden. rnWir konnten keine erhöhte Anzahl von nTregs während der Niedrigzonentoleranz gegenüber Kontaktallergenen im Vergleich zur CHS charakterisieren. Weiterhin haben wir gezeigt, dass eine Reduktion der nTregs durch Depletion mittels anti-CD25-Anikörper oder durch Cyclophosphamid-Gabe die Entstehung der CD8+ Suppressor-T-Zellen der NZT unterdrückt und damit die Entwicklung der Toleranzreaktion verhindert wird. Ferner wurde beobachtet, dass eine epikutane NZT Hapten-spezifisch durch CD8+ T-Zellen übertragen werden kann, während CD4+CD25+ T-Zellen eine Hapten-unspezifische Wirkung zeigten.rn