973 resultados para CD4 T-lymphocytes
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Adherence to Highly Active Antiretroviral Therapy (HAART) is the main prognostic factor associated with HIV disease progression and death. The aim was to evaluate the effectiveness of a psycho-educational program to promote adherence to HAART in HIV patients. A longitudinal study (n=102) over 9months in an Infectious Diseases Hospital was carried out. Adherence to HAART was measured with standardized scales and values of viral load. Two groups were defined: adherents and non-adherents. In the latter, a psycho-educational program was implemented and 6months later measured adherence to HAART. Knowledge about the infection, CD4 T lymphocytes and HIV-ribonucleic acid values were measured before and after this program. The sample was predominantly male (70%), heterosexual (78%), with a mean age of 49 (SD=12.7) years, and 48% of participants were not adhering to HAART. After the program, non-adherence decreased to 21.6%. Knowledge about the infection increased from 79 to 97%. A significant increase in CD4 T lymphocytes (mean 540-580) and a decrease in viral load (mean 5411-3052) were observed, the latter of statistical significance. This program seems to be feasible and efficient, improving adherence to HAART.
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The role of T lymphocytes in host responses to sublethal systemic infection with Candida albicans was evaluated by mAb depletion of CD4(+) and CD8(+) cells from BALB/c and CBA/CaH mice, which develop mild and severe tissue damage, respectively. Depletion of CD4(+) lymphocytes from BALB/c mice markedly increased tissue damage, but did not alter the course of infection. In CBA/CaH mice, depletion of CD4+ cells abrogated tissue destruction in both brain and kidney at day 4 after infection, and significantly decreased fungal colonization in the brain. However, the severity of tissue lesions increased relative to controls from day 8 onwards. A small increase in tissue damage was evident in both mouse strains after depletion of CD8(+) cells. There were no major differences between days 4 end 8 after infection in cDNA cytokine profiles of CD4(+) lymphocytes from either BALB/c or CBA/CaH mice. After passive transfer into infected syngeneic recipients, spleen cells from infected CBA/CaH mice markedly increased tissue damage when compared to controls, and also caused a significant increase in fungal colonization in the brain. A similar transfer in BALB/c mice increased the number of inflammatory cells in and around the lesions, but had no effect on the fungal burden in brain and kidney. The data demonstrate that both CD4(+) and CD8(+) lymphocytes contribute to the reduction of tissue damage after systemic infection with C. albicans, and that the development and expression of CD4(+) lymphocyte effector function is influenced by the genetic background of the mouse.
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Patients with AIDS are particularly susceptible to infection with intestinal coccidia. In this study the prevalence of infections with Cryptosporidium sp and Cystoisospora belli were evaluated among HIV/AIDS patients in the Tringulo Mineiro region, Brazil. Between July 1993 and June 2003 faecal samples from 359 patients were collected and stained by a modified Ziehl-Neelsen method, resulting in 19.7% of positivity for coccidian (8.6% with Cryptosporidium sp, 10.3% with Cystoisospora belli and 0.8% with both coccidian). Patients with diarrhoea and T CD4+ lymphocyte levels < 200 cells/mm3 presented higher frequency of these protozoans, demonstrating the opportunistic profile of these infections and its relationship with the immunological status of the individual. It was not possible to determine the influence of HAART, since only 8.5% of the patients positive for coccidian received this therapy regularly. Parasitism by Cryptosporidium sp was more frequent between December and February and thus was characterised by a seasonal pattern of infection, which was not observed with Cystoisospora belli.
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RESUME Dans le cadre de l'infection VIH-1, deux mcanismes gnraux, a) une destruction priphrique massive ou b) un dfaut dans la production priphrique ou centrale de nouvelles cellules, pourraient tre l'origine de l'puisement des lymphocytes T CD4. La question soulve une importante controverse. Dans cette tude, la production thymique et la capacit de prolifration de lymphocytes T ont t tudies conjointement. La production thymique a t value par l'analyse du contenu en cercles d'excision gnrs lors du rarrangement du rcepteur aux cellules T (ou TRECs) des cellules T CD4 et CD8 priphriques, provenant de sujets sains VIH-1 ngatifs (n=120) ou infects par le VIH-1 (n=297), au stade prcoce, intermdiaire et tardif de la phase chronique de la maladie. Au stade prcoce, nous observons que le contenu en TRECs de la population CD4 est suprieur celui de la population contrle. Aucune diffrence n'est observe lors de la phase intermdiaire, alors que le contenu en TRECs est infrieur lors de la phase tardive, en comparaison avec le groupe contrle. Pour les lymphocytes T CD8, le contenu en TRECs reste infrieur au groupe contrle, tous les stades de la maladie. Ainsi, au stade prcoce, la production thymique chercherait compenser la perte de lymphocytes T CD4 puis, avec l'volution de la maladie, cette possibilit s'puiserait. Les profils d'expression des gnes rgulateurs du cycle cellulaire pour les cellules T CD4 et CD8 priphriques, obtenus par la mthode des biopuces d'ADNc (microarray), ont permis l'analyse de la capacit de prolifration priphrique des lymphocytes T. Trois populations cellulaires ont t compares entre elles : lymphocytes provenant de sujets infects par le VIH-1, lymphocytes provenant de sujets VIH-1-ngatifs et lymphocytes activs in vitro provenant de sujets VIH-1-ngatifs. Les rsultats montrent, pour les cellules T CD8, un tat d'activation et un profil d'expression des gnes rgulateurs du cycle cellulaire comparables ceux des cellules actives in vitro. Le profil d'expression gntique des cellules T CD4, par contre, montre une activation sub-optimale, conjointement une forte expression de p53, ce qui pourrait amener un bloc en phase G1 du cycle cellulaire ainsi qu' une forte apoptose. En conclusion, cette perturbation de la progression du cycle cellulaire des lymphocytes T CD4 priphriques pourrait contribuer l'chec de la restauration du nombre de lymphocytes T CD4 et ceci, malgr une production thymique conserve dans les stades prcoces de la maladie, comme dmontr par l'analyse du contenu en TRECs.
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Chez les patients cancreux, les cellules malignes sont souvent reconnues et dtruites par les cellules T cytotoxiques du patient. C'est pourquoi, depuis plusieurs annes, des recherches visent produire des vaccins sensibilisant les cellules de l'immunit adaptative, afin de prvenir certains cancers. Bien que les vaccins ciblant les cellules T CD8+ (cytotoxiques) ont une efficacit in-vitro leve, un vaccin pouvant cibler les cellules T CD8+ et CD4+ aurait une plus grande efficacit (1-3). En effet, les cellules T helper (CD4+) favorisent la production et la maintenance des cellules T CD8+ mmoires longue dure de vie. Il existe un grand nombre de sous-types de cellules T CD4+ et leur action envers les cellules cancreuses est diffrente. Par exemple, les lymphocytes Treg ont une activit pro-tumorale importante (4) et les lymphocytes Th1 ont une activit anti-tumorale (5). Cependant, le taux naturel des diffrents sous-types de cellules T CD4+ spcifiques aux antignes tumoraux est variable. De plus, une certaine flexibilit des diffrents sous-types de cellules T CD4+ a t rcemment dmontre (6). Celle-ci pourrait tre cible par des protocoles de vaccination avec des antignes tumoraux administrs conjointement des adjuvants dfinis. Pour cela, il faut approfondir les connaissances sur le rle des cellules T CD4+ spcifiques aux antignes dans l'immunit anti-tumorale et connatre prcisment la proportion des sous-types de cellules T CD4+ actives avant et aprs la vaccination. L'analyse des cellules T, par la cytomtrie de flux, est trs souvent limit par le besoin d'un nombre trs lev de cellules pour l'analyse de l'expression protique. Or dans l'analyse des cellules T CD4+ spcifiques aux antignes tumoraux cette technique n'est souvent pas applicable, car ces cellules sont prsentes en trs faible quantit dans le sang et dans les tissus tumoraux. C'est pourquoi, une approche base sur l'analyse de la cellule T individuelle a t mise en place afin d'tudier l'expression du profil gntique des cellules T CD8+ et CD4+. (7,8) Mthode : Ce nouveau protocole ( single cell ) a t labor partir d'une modification du protocole PCR-RT, qui permet la dtection spcifique de l'ADN complmentaire (ADNc) aprs la transcription globale de l'ARN messager (ARNm) exprim par une cellule T individuelle. Dans ce travail, nous optimisons cette nouvelle technique d'analyse pour les cellules T CD4+, en slectionnant les meilleures amorces. Tout d'abord, des clones profils fonctionnels connus sont gnrs par cytomtrie de flux partir de cellules T CD4+ d'un donneur sain. Pour cette tape d'optimisation des amorces, la spcificit des cellules T CD4+ n'est pas prise en considration. Il est, donc, possible d'tudier et de trier ces clones par cytomtrie de flux. Ensuite, grce au protocole single cell , nous testons par PCR les amorces des diffrents facteurs spcifiques de chaque sous-type des T CD4+ sur des aliquotes issus d'une cellule provenant des clones gnrs. Nous slectionnons les amorces dont la sensibilit, la spcificit ainsi que les valeurs prdictives positives et ngatives des tests sont les meilleures. (9) Conclusion : Durant ce travail nous avons gnr de l'ADNc de cellules T individuelles et slectionn douze paires d'amorces pour l'identification des sous-types de cellules T CD4+ par la technique d'analyse PCR single cell . Les facteurs spcifiques aux cellules Th2 : IL-4, IL-5, IL-13, CRTh2, GATA3 ; les facteurs spcifiques aux cellules Th1 : TNFα, IL-2 ; les facteurs spcifiques aux cellules Treg : FOXP3, IL-2RA ; les facteurs spcifiques aux cellules Th17 : RORC, CCR6 et un facteur spcifique aux cellules naves : CCR7. Ces amorces peuvent tre utilises dans le futur en combinaison avec des cellules antignes-spcifiques tries par marquage des multimres pMHCII. Cette mthode permettra de comprendre le rle ainsi que l'amplitude et la diversit fonctionnelle de la rponse de la cellule T CD4+ antigne-spcifique dans les cancers et dans d'autres maladies. Cela afin d'affiner les recherches en immunothrapie oncologique. (8)
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Le diabte auto-immun rsulte de la destruction des cellules bta pancratiques scrtrices dinsuline par les lymphocytes T du systme immunitaire. Il sensuit une dficience hormonale qui peut tre comble par des injections quotidiennes dinsuline dorigine exogne, toutefois il demeure ce jour impossible de gurir les patients atteints de la maladie. De faon gnrale, un systme immunitaire sain reconnat une multitude dantignes diffrents et assure ainsi notre dfense lgard de diffrents pathognes ou encore de cellules tumorales. Il arrive cependant que, pour des raisons gntiques et/ou environnementales, les lymphocytes T puissent sactiver de faon aberrante suite la reconnaissance dantignes provenant du soi. Cest ce bris de tolrance qui mne au dveloppement de pathologies auto-immunes telles que le diabte auto-immun. Afin de limiter lauto-immunit, des mcanismes de slection stricts permettent dliminer la majorit des lymphocytes T prsentant une forte affinit envers des antignes du soi lors de leur dveloppement dans le thymus. Certains de ces lymphocytes russissent toutefois chapper lapoptose et migrent en priphrie afin dy circuler en qute dun antigne spcifiquement reconnu. Il est alors primordial que des mcanismes priphriques assurent le maintien de la tolrance immunitaire en faisant obstacle lactivation et la prolifration des lymphocytes T auto-ractifs. Lune des avenues afin dinhiber le dveloppement de rponses immunitaires aberrantes est la gnration de lymphocytes T rgulateurs. Ces cellules, dorigine thymique ou priphrique, peuvent arborer diffrents phnotypes et agissent via de multiples mcanismes afin dinactiver et/ou liminer les cellules impliques dans lapparition de pathologies auto-immunes. Lutilisation de modles murins transgniques a permis la mise en vidence dune population peu caractrise de lymphocytes T au potentiel rgulateur. En effet, la proportion de ces cellules T nexprimant pas les corcepteurs CD4 et CD8 (double ngatives, DN) a t inversement corrle la prdisposition lauto-immunit chez ces ii souris. Lobjectif principal de cette thse est de dmontrer la fonction immuno-rgulatrice des lymphocytes T DN, tout en investiguant les facteurs gntiques responsables du maintien de cette population cellulaire. Nous avons observ que les lymphocytes T DN exercent une activit cytotoxique lgard des lymphocytes B de faon spcifique lantigne, via la libration de granules cytolytiques contenant du granzyme B et de la perforine. Par ailleurs, nous avons tabli quun unique transfert adoptif de ces cellules est suffisant afin dinhiber le dveloppement du diabte auto-immun chez des htes transgniques prdisposs la maladie. Le recours des souris dficientes pour lexpression du gne CD47 a permis de constater que la voie de signalisation CD47-Sirp est essentielle dans le maintien de la proportion des lymphocytes T DN. De plus, le locus murin de prdisposition au diabte auto-immun Idd13, qui contient le gne Sirp, a t identifi pour son rle dans la rgulation de la proportion de ces cellules. Finalement, une analyse gntique a rvl que dautres intervalles gntiques sont impliqus dans le contrle de la population des lymphocytes T DN. Parmi ceux-ci, un locus situ en rgion proximale du chromosome 12 a t valid grce la cration de souris congniques. Grce aux rsultats prsents dans cette thse, notre comprhension de la biologie ainsi que de la rgulation des lymphocytes T DN est approfondie. Ces connaissances constituent un pas important vers la cration de thrapies cellulaires novatrices permettant de prvenir et de gurir diverses pathologies auto-immunes.
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Dans les cas de lymphopnie, les lymphocytes T rsiduels prolifrent exagrment dans un phnomne appel expansion homostatique priphrique (HPE), qui est efficace pour la rgnration des T CD8+, mais inefficace pour les T CD4+. Linterleukine-7 (IL7) est une cytokine homostatique utilise afin daugmenter les comptes lymphocytaires T des patients lymphopniques. Toutefois, la raison de lexpansion prfrentielle des lymphocytes T CD8+ par lIL7 demeure toujours inconnue. Nous montrons que cette expansion est due au fait que lIL7 induit une prolifration efficace des T CD8+ priphriques (CD8+PERI) ainsi que des migrants thymiques CD8+ (CD8+RTEs). Par contre, leffet prolifratif de lIL7 est restreint presquuniquement aux CD4+RTEs mme si les CD4+PERI survivent mieux que les CD4+RTEs. De plus faibles doses dIL7 sont ncessaires aux CD4+RTEs afin de phosphoryler STAT5 ou de prolifrer comparativement aux CD4+PERI et nous dmontrons que les contacts TCR/CMHII sont ncessaires la prolifration induite par lIL7 des CD4+RTEs en priphrie. De fait, augmenter au Flt3 ligand le nombre de cellules dendritiques priphriques dune souris donneuse, avant de transfrer ses TPERI dans des souris receveuses traites lIL7 induit une prolifration significative des CD4+PERI. Nos rsultats indiquent donc que labondance des contacts TCR/CMHII reus dans le thymus semble contrler la sensibilit lIL7 des CD4+RTEs. Finalement, lobservation que les CD8+PERI et CD8+RTEs prolifrent pareillement pendant la thrapie lIL7, alors que la prolifration des T CD4+ est largement restreinte aux RTEs expliquerait pourquoi, dans les cas de lymphopnie, la rgnration des T CD4+ est aussi dpendante de la thymopose.
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Une petite population de lymphocytes T exprimant les deux corcepteurs CD4 et CD8 et appele double positive (DP), a t dtecte dans le sang priphrique de donneurs sains et de patients atteints de diverses pathologies dont la sclrose en plaques (SEP). Nous avons mis lhypothse quil sagissait de lymphocytes T hautement activs pouvant contribuer linflammation chronique prsente dans la SEP. Nous avons compar les cellules T DP obtenues du sang de donneurs sains et de patients atteints de la SEP et non traits. La frquence des cellules DP tait similaire chez les patients et les donneurs sains. La proportion de lymphocytes T DP qui exprimaient les chaines du rcepteur de linterleukine-15 (IL-15) tait plus leve que pour les autres populations lymphocytaires. Des mesures dinduction de la phosphorylation du STAT5 (signal transducer and activator of transcription) ont dmontr que les cellules DP ont rpondu des doses plus faibles et pour de plus longues priodes lIL-15 comparativement aux autres lymphocytes T. Le pourcentage de lymphocytes T DP ayant la capacit de produire linterfron-gamma et des enzymes lytiques tait lev chez les tmoins sains mais ces niveaux taient significativement rduits chez les patients atteints de la SEP. La caractrisation phnotypique de cellules DP a suggr que ces cellules ont des proprits similaires aux lymphocytes T activs. Bien quil ne sagisse que dune caractrisation partielle, il semble que les lymphocytes T DP perdent une partie de leurs proprits chez les patients atteints de la SEP.
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The expression of immune response as a leukocytic infiltrate by CD4+ and CD8+ cells in the epithelium and in the intestinal lamina propria of chicks fed Lactobacillus spp or cecal microflora (CM) and experimentally challenged or not with Salmonella enterica serovar Enteritidis (SE) was studied using immunohistochemistry. Three hundred and twenty day-of-hatch broiler chicks were divided into four groups of 80 birds each and orally received L. reuteri, L. salivarius, L. acidophilus, or CM. Each group was subdivided into four subgroups of 20 birds each, classified as follows: a subgroup did not receive any oral treatment (negative control), subgroup treated with L. spp or CM, subgroup treated with L. spp or CM and challenged with SE, and subgroup only challenged with SE (positive control). The results show that the oral treatment with L. reuteri, L. salivarius, L. acidophilus, or CM and challenge or not with SE stimulated bird immune response as determined by the leukocytic infiltrate by CD8+ lymphocytes followed by CD4+ in the epithelium and in the lamina propria of the duodenum, jejunum, and cecum of chicks up to 12 days of age. CD8+ lymphocyte number was significantly higher in the intestine of chicks receiving CM and challenged with SE. The duodenum, followed by the jejunum, were the segments in which the immune response, as shown by T, CD4+ and CD8+ cells, was stimulated with the greatest intensity.
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The risk of Hodgkin lymphoma (HL) is increased in patients infected with HIV-1. We studied the incidence and outcomes of HL, and compared CD4 T-cell trajectories in HL patients and controls matched for duration of combination antiretroviral therapy (cART). A total of 40 168 adult HIV-1-infected patients (median age, 36 years; 70% male; median CD4 cell count, 234 cells/L) from 16 European cohorts were observed during 159 133 person-years; 78 patients developed HL. The incidence was 49.0 (95% confidence interval [CI], 39.3-61.2) per 100,000 person-years, and similar on cART and not on cART (P = .96). The risk of HL declined as the most recent (time-updated) CD4 count increased: the adjusted hazard ratio comparing more than 350 with less than 50 cells/L was 0.27 (95% CI, 0.08-0.86). Sixty-one HL cases diagnosed on cART were matched to 1652 controls: during the year before diagnosis, cases lost 98 CD4 cells (95% CI, -159 to -36 cells), whereas controls gained 35 cells (95% CI, 24-46 cells; P < .0001). The incidence of HL is not reduced by cART, and patients whose CD4 cell counts decline despite suppression of HIV-1 replication on cART may harbor HL.
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Background Clinical relevance of tumor infiltrating lymphocytes (TILs) in breast cancer is controversial. Here, we used a tumor microarray including a large series of ductal and lobular breast cancers with long term follow up data, to analyze clinical impact of TIL expressing specific phenotypes and distribution of TILs within different tumor compartments and in different histological subtypes. Methods A tissue microarray (TMA) including 894 ductal and 164 lobular breast cancers was stained with antibodies recognizing CD4, FOXP3, and IL-17 by standard immunohistochemical techniques. Lymphocyte counts were correlated with clinico-pathological parameters and survival. Results CD4+ lymphocytes were more prevalent than FOXP3+ TILs whereas IL-17+ TILs were rare. Increased numbers of total CD4+ and FOXP3+ TIL were observed in ductal, as compared with lobular carcinomas. High grade (G3) and estrogen receptor (ER) negative ductal carcinomas displayed significantly (p < 0.001) higher CD4+ and FOXP3+ lymphocyte infiltration while her2/neu over-expression in ductal carcinomas was significantly (p < 0.001) associated with higher FOXP3+ TIL counts. In contrast, lymphocyte infiltration was not linked to any clinico-pathological parameters in lobular cancers. In univariate but not in multivariate analysis CD4+ infiltration was associated with significantly shorter survival in patients bearing ductal, but not lobular cancers. However, a FOXP3+/CD4+ ratio > 1 was associated with improved overall survival even in multivariate analysis (p = 0.033). Conclusions Ductal and lobular breast cancers appear to be infiltrated by different lymphocyte subpopulations. In ductal cancers increased CD4+ and FOXP3+ TIL numbers are associated with more aggressive tumor features. In survival analysis, absolute numbers of TILs do not represent major prognostic indicators in ductal and lobular breast cancer. Remarkably however, a ratio > 1 of total FOXP3+/CD4+ TILs in ductal carcinoma appears to represent an independent favorable prognostic factor.
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Patients with skin nodules characterized by the infiltrate of pleomorphic small/medium T lymphocytes are currently classified as "primary cutaneous CD4+ small-/medium-sized pleomorphic T-cell lymphoma" (SMPTCL) or as T-cell pseudolymphoma. The distinction is often arbitrary, and patients with similar clinicopathologic features have been included in both groups. We studied 136 patients (male:female = 1:1; median age: 53 years, age range: 3-90 years) with cutaneous lesions that could be classified as small-/medium-sized pleomorphic T-cell lymphoma according to current diagnostic criteria. All but 3 patients presented with solitary nodules located mostly on the head and neck area (75%). Histopathologic features were characterized by nonepidermotropic, nodular, or diffuse infiltrates of small- to medium-sized pleomorphic T lymphocytes. A monoclonal rearrangement of the T-cell receptor-gamma gene was found in 60% of tested cases. Follow-up data available for 45 patients revealed that 41 of them were alive without lymphoma after a median time of 63 months (range: 1-357 months), whereas 4 were alive with cutaneous disease (range: 2-16 months). The incongruity between the indolent clinical course and the worrying histopathologic and molecular features poses difficulties in classifying these cases unambiguously as benign or malignant, and it may be better to refer to them with a descriptive term such as "cutaneous nodular proliferation of pleomorphic T lymphocytes of undetermined significance," rather than forcing them into one or the other category. On the other hand, irrespective of the name given to these equivocal cutaneous lymphoid proliferations, published data support a nonaggressive therapeutic strategy, particularly for patients presenting with solitary lesions.
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The tissue distribution of CD4 lymphocytes in normal C57/BL mice and CD4 knockout mice was determined by biodistribution measurements and gamma camera imaging with an 111In-labeled rat IgG2b monoclonal antibody directed against the murine CD-4 antigen. In normal mice high concentrations of antibody accumulated in the spleen and lymph nodes. At 45 hr after injection, the concentration of radiolabel in the spleen and lymph nodes of normal mice were 10- to 20-fold greater than in the corresponding tissue of the CD4 knockout mice and nonlymphoid tissues of both types of mice. At 24 and 45 hr, gamma camera images showed high concentrations of radiolabeled antibody in lymph node and spleen of normal but not knockout mice. These results indicate that radioimmunoscintigraphy with 111In-anti-CD4 is an excellent method for studying tissue distribution of CD lymphocytes in mice. Using an equivalent anti-human CD antibody, this method might be useful for studying the pathophysiology of conditions in which these cells play a critical role and for monitoring therapies for these disorders.
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The Fas/APO-1 cytotoxic pathway plays an important role in the regulation of peripheral immunity. Recent evidence indicates that this regulatory function operates through deletion of activated T and B lymphocytes by CD4+ T cells expressing the Fas ligand. Because macrophages play a key role in peripheral immunity, we asked whether Fas was involved in T-cell-macrophage interactions. Two-color flow cytometry revealed that Fas receptor (FasR) was expressed on resting murine peritoneal macrophages. FasR expression was upregulated after activation of macrophages with cytokines or lipopolysaccharide, although only tumor necrosis factor-alpha rendered macrophages sensitive to anti-FasR antibody-mediated death. To determine the consequence of antigen presentation by macrophages to CD4+ T cells, macrophages were pulsed with antigen and then incubated with either Th1 or Th2 cell lines or clones. Th1, but not Th2, T cells induced lysis of 60-80% of normal macrophages, whereas macrophages obtained from mice with mutations in the FasR were totally resistant to Th1-mediated cytotoxicity. Macrophage cytotoxicity depended upon specific antigen recognition by T cells and was major histocompatibility complex restricted. These findings indicate that, in addition to deletion of activated lymphocytes, Fas plays an important role in deletion of activated macrophages after antigen presentation to Th1 CD4+ T cells. Failure to delete macrophages that constitutively present self-antigens may contribute to the expression of autoimmunity in mice deficient in FasR (lpr) or Fas ligand (gld).
