CD137-selektierte leuk��miereaktive T-Zellen gesunder Spender zur adoptiven Immuntherapie stammzelltransplantierter Leuk��miepatienten = CD137-selected leukaemia-reactive T Cells from healthy donors for adoptive immunotherapy in stem-cell-transplanted leukaemia-patients

Bei stammzelltransplantierten Patienten, die ein Rezidiv ihrer Leuk��mie erleiden, kann eine Donor-Lymphozyten-Infusion (DLI) dauerhafte vollst��ndige Leuk��mieremissionen induzieren. T-Zellen in der DLI vermitteln sowohl den potentiell kurativen Graft-versus-Leukaemia (GVL) Effekt, als auch die potentiell lebensbedrohliche Graft-versus-Host Disease (GVHD). Hingegen k��nnte die Infusion von leuk��miereaktiven T-Zellen einen selektiven GVL Effekt und einen Langzeitschutz vor Rezidiven durch eine spezifisch gegen die Leuk��mie gerichtete Immunantwort und Immunit��t vermitteln. Unsere Arbeitsgruppe hat Protokolle zur in vitro Generierung leuk��miereaktiver T-Zellen entwickelt, die hohe zytotoxische Aktivit��t gegen akute myeloische Leuk��mie-Blasten (AML) bei minimaler Reaktion auf m��gliche GVHD Zielstrukturen zeigen. F��r die klinische Anwendung sind diese Protokolle jedoch zu aufw��ndig, wobei vor allem eine erhebliche Verk��rzung der Kulturzeit auf wenige Wochen erforderlich ist. Diese Verk��rzung der in vitro Kulturzeit k��nnte das Wachstum von T-Zellen vom central memory oder fr��hen effector memory Ph��notyp f��rdern, f��r die eine bessere in vivo Effektorfunktion und l��ngere Persistenz im Rezipienten verglichen mit T-Zellen aus Langzeitkultur gezeigt werden konnte. Der Aktivierungsmarker und Kostimulations-Rezeptor CD137 kann zur Erkennung und Isolation antigenspezifischer T-Zellen genutzt werden, ohne dass daf��r das von den T-Zellen erkannte Peptidepitop bekannt sein muss. Eine CD137-vermittelte Anreicherung mit Hilfe von clinical grade Materialien k��nnte verwendet werden, um DLI-Produkte mit leuk��miespezifischen T-Zellen herzustellen, die sich sowohl durch eine effizientere T-Zell Generierung durch in vitro Selektion und Kostimulation, als auch durch eine verbesserte Spezifit��t des T-Zell-Produkts auszeichnen. Lymphozyten-Leuk��mie Cokulturen (mixed lymphocyte leukaemia cultures) wurden mit CD8 T-Zellen gesunder Spender und HLA-identischen oder einzel-HLA-mismatch AML-Blasten angesetzt und w��chentlich restimuliert. Nach zwei Wochen wurden die T-Zellen 12 Stunden nach Restimulation ��ber den Marker CD137 positiv isoliert und anschlie��end separat weiterkultiviert. Die isolierten Fraktionen und unseparierten Kontrollen wurden im ELISPOT-Assay und im Chrom-Freisetzungstest an Tag 5 nach der Restimulation getestet. Es wurden keine konsistent nachweisbaren Vorteile im Hinblick auf Wachstum und Funktion der isolierten CD137-positiv Fraktion im Vergleich zur unseparierten Kontrolle gefunden. Verschiedene Isolationsmethoden, Patient-Spender-Systeme, Methoden zur Restimulation, Temperaturbedingungen, Zytokinkombinationen und Methoden der Zytokinzugabe sowie zus��tzliche Feeder-Zellen oder AML-Blasten konnten Wachstum, funktionelle Daten und die deutlichen Zellverluste w��hrend der Isolation nicht entscheidend beeinflussen. Vitalf��rbungen zeigten, dass aktivierungsinduzierter Zelltod CD137-positiver Zellen zu diesen Ergebnissen beitragen k��nnte. Im Gegensatz zur Stimulation mit AML-Blasten wurden erfolgreiche CD137-Anreicherungen f��r peptidstimulierte T-Zellen publiziert. Unterschiedliche CD137-Expressionskinetiken, aktivierungsinduzierter Zelltod und regulatorische T-Zellen sind m��gliche Faktoren aufgrund derer die CD137-Anreicherung in diesem spezifischen Kontext ungeeinet sein k��nnte. Der stimulatorische Effekt eines CD137-Signals auf AML-reaktive CD8 T-Zellen wurde mit Hilfe von CD3/CD28 und CD3/CD28/CD137 Antik��rper-beschichteten magnetischen beads untersucht. F��r Nierenzellkarzinom-reaktive T-Zellen war die Stimulation mit CD3/CD28/CD137 beads genauso effektiv wie mit Tumorzellen und effektiver als mit CD3/CD28 beads. Beide Arten von beads waren f��r eine Stimulation w��hrend der ersten Wochen der Zellkultur geeignet, sodass ein zus��tzliches CD137-Signal f��r die l��nger anhaltende Expansion tumorreaktiver T-Zellen zur klinischen Anwendung n��tzlich sein k��nnte. Die bead-Expansion ver��nderte die IFN-Sekretion im ELISPOT nicht, aber verursachte eine m����ige Verschlechterung der Zytotoxizit��t im Chrom-Freisetzungstest. Im Gegensatz dazu zeigten bei AML-reaktiven T-Zellen beide Arten von beads einen nicht apoptosevermittelten, dosisabh��ngigen zellsch��digenden Effekt, der zu einer raschen Abnahme der Zellzahl in Kulturen mit beads f��hrte. Unerw��nschte Effekte auf die T-Zell-Funktionalit��t durch bead-Stimulation sind in der Literatur beschrieben, dennoch gibt es aktuell keine Ver��ffentlichungen, die eine fundierte Erkl��rung f��r den Effekt auf AML-reaktive T-Zellen bieten k��nnten. Abgesehen von Literaturdaten, die darauf hindeuten, dass CD137 ein vielversprechendes Kandidatenmolek��l f��r die Anreicherung und Expansion von AML-reaktiven T-Zellen sein k��nnte, zeigen die eigenen Daten sowohl zur CD137-Isolation als auch zur bead-Stimulation, dass f��r diese spezielle Anwendung CD137 ein ungeeigneter Aktivierungsmarker und Kostimulations-Ligand ist.

Untersuchungen zur Regulation von T-Effektorzellen im peripheren Blut von MS-Patienten und humanisierten M��usen mit einer induzierten autoimmunen Enzephalitis

Die Multiple Sklerose (MS) ist eine Autoimmunkrankheit des zentralen Nervensystems, bei der sich autoreaktive T-Effektorzellen der Kontrolle durch regulatorische T-Zellen (Treg) entziehen. Innerhalb dieser Arbeit wurde gezeigt, dass T-Effektorzellen von MS-Patienten insensitiv gegen��ber der Suppression durch Treg sind. Hervorgerufen wird diese Treg-Resistenz durch Interleukin-6 (IL-6). Die Inhibition des IL-6-Signalweges stellt die Treg-vermittelte Suppression der T-Effektorzellen wieder her. Es zeigte sich, dass die Bildung von IL-6 und die Expression des IL-6-Rezeptors in MS-Patienten in einer positiven R��ckkopplungsschleife von IL-6 selbst induziert werden.rnZur Analyse humaner Immunantworten in vivo und deren Modulation durch humanspezifische Therapeutika wurden humanisierte Mausmodelle etabliert. Der adoptive Transfer humaner Immunzellen in immundefiziente M��use erlaubte die Untersuchung von T-Lymphozyten, die aus dem Blut von MS-Patienten isoliert wurden. Es zeigte sich, dass Treg-resistente T-Effektorzellen aus den MS-Patienten in den Tieren eine letale Graft-versus-Host-Erkrankung ausl��sten, die nicht durch aktivierte Treg therapiert werden konnte. Erst eine Behandlung mit dem humanspezifischen anti-IL-6-Antik��rper Tocilizumab in vivo konnte die Erkrankung der Tiere deutlich abmildern.rnIm zweiten Modell wurden immundefiziente M��use mit humanen CD34+ Blutstammzellen immunologisch rekonstituiert. Diese Tiere entwickelten ein nahezu vollst��ndig humanes Immunsystem. Die Immunisierung mit dem murinen Myelin-Oligodenrozyten-Glykoprotein l��ste in den humanisierten M��usen eine MS-��hnliche Autoimmunit��t aus. Die Neuroinflammation wurde durch humane T- und B-Zellen vermittelt, korrelierte mit erh��hter IL-17-Produktion und f��hrte zu einer IL-6-abh��ngigen Treg-Resistenz der T-Effektorzellen. Somit eignen sich die etablierten Modelle, um zuk��nftig die Wirksamkeit neuer Therapeutika zur Behandlung der MS pr��klinisch zu testen.rn

Regulatory T cell-mediated suppression of Th9 cell development and effector function

T helper (Th) 9 cells are an important subpopulation of the CD4+ T helper cells. Due to their ability to secrete Interleukin-(IL-)9, Th9 cells essentially contribute to the expulsion of parasitic helminths from the intestinal tract but they play also an immunopathological role in the course of asthma. Recently, a beneficial function of Th9 cells in anti-tumor immune responses was published. In a murine melanoma tumor model Th9 cells were shown to enhance the anti-melanoma immune response via the recruitment of CD8+ T cells, dendritic cells and mast cells. In contrast to Th9 effector cells regulatory T cells (Tregs) are able to control an immune response with the aid of different suppressive mechanisms. Based on their ability to suppress an immune response Tregs are believed to be beneficial in asthma by diminishing excessive allergic reactions. However, concerning cancer they can have a detrimental function because Tregs inhibit an effective anti-tumor immune reaction. Thus, the analysis of Th9 suppression by Tregs is of central importance concerning the development of therapeutic strategies for the treatment of cancer and allergic diseases and was therefore the main objective of this PhD thesis.rnIn general it could be demonstrated that the development of Th9 cells can be inhibited by Tregs in vitro. The production of the lineage-specific cytokine IL-9 by developing Th9 cells was completely suppressed at a Treg/Th9 ratio of 1:1 on the transcriptional (qRT-PCR) as well as on the translational level (ELISA). In contrast, the expression of IRF4 that was found to strongly promote Th9 development was not reduced in the presence of Tregs, suggesting that IRF4 requires additional transcription factors to induce the differentiation of Th9 cells. In order to identify such factors, which regulate Th9 development and therefore represent potential targets for Treg-mediated suppressive mechanisms, a transcriptome analysis using ���next-generation sequencing��� was performed. The expression of some genes which were found to be up- or downregulated in Th9 cells in the presence of Tregs was validated with qRT-PCR. Time limitations prevented a detailed functional analysis of these candidate genes. Nevertheless, the analysis of the suppressive mechanisms revealed that Tregs probably suppress Th9 cells via the increase of the intracellular cAMP concentration. In contrast, IL-9 production by differentiated Th9 cells was only marginally affected by Tregs in vitro and in vivo analysis (asthma, melanoma model). Hence, Tregs represent very effective inhibitors of Th9 development whereas they have only a minimal suppressive influence on differentiated Th9 cells.rn

Evaluation zellul��rer Mechanismen der allergen-spezifischen Immuntherapie in einem chronischen Modell der allergischen Atemwegsentz��ndung

Klinische Studien haben gezeigt, dass die allergenspezifische Immuntherapie (SIT) eine effektive Therapieoption f��r allergische Erkrankungen ist. Obwohl dieses Therapieverfahren seit ��ber 100 Jahren existiert, sind die zugrunde liegenden Suppressionsmechanismen jedoch nicht vollst��ndig verstanden. Bisher wird angenommen, dass der Behandlungserfolg der SIT auf einer Blockade durch allergenspezifische Antik��rper, einer Verschiebung des Th1-Th2-Gleichgewichtes und/oder auf einer Suppression durch regulatorische T-Zellen (Tregs) basiert. Um die Effekte der SIT in einer chronischen Erkrankung in vivo untersuchen zu k��nnen, wurde in dieser Doktorarbeit ein Mausmodell f��r chronisches Asthma entwickelt, das die Situation im Menschen nach einer SIT nachahmt. rnDurch eine SIT war es m��glich, allergeninduzierte Asthmasymptome wie Atemwegshyperreagibilit��t (AHR), Eosinophilie in der Lunge, IgE-Produktion und Atemwegsentz��ndung im Modell zu unterdr��cken. Bemerkenswert ist, dass durch OVA-spezifische Immuntherapie (OVA-IT) ebenfalls eine Verringerung der strukturellen Ver��nderungen im Lungengewebe im chronischen Krankheitsverlauf erreicht wurde.rnDes Weiteren wurde in diesem Modell nach den Prozessen gesucht, die f��r die toleranzinduzierende Wirkung der SIT verantwortlich sein k��nnen. Dabei wurde im Vergleich zur Placebo-behandelten Gruppe eine erh��hte Antwort spezifischer IgG1-Antik��rper, eine verst��rkte Th1-Antwort, sowie eine erh��hte Frequenz von FoxP3+ Tregs und von IL-10-produzierenden T-Zellen (Tr1-Zellen) nach OVA-IT festge-stellt. Zur weiteren Untersuchung der von SIT-induzierten T-Zellantworten wurden Mausmodelle des allergischen Asthmas mit einem akuten Verlauf gew��hlt.rnDie Bedeutung der Th1-Zellen f��r die SIT wurde in T-bet-/- M��usen untersucht, welche aufgrund des Fehlens des Transkriptionsfaktors T-bet keine stabile Th1-Antwort induzieren k��nnen. Durch SIT war es m��glich, allergeninduzierte Asthmasymptome wie AHR, eosinophile Granulozyten in der Lunge, IgE-Produktion und Atemwegsentz��ndung in den T-bet-/- Tieren im gleichen Ma��e wie in den Wildtyptieren zu unterdr��cken. Diese Untersuchung zeigte, dass die SIT auch ohne funktionelle Th1-Zellen die allergische Entz��ndung unterdr��cken kann. rnDie Rolle der Tregs f��r die SIT wurde in DO11.10 M��usen und DO11.10 RAG-/- M��usen untersucht. In beiden St��mmen konnte nach SIT eine Induktion OVA-spezifischer Tregs nachgewiesen werden. In DO11.10 RAG-/- M��usen k��nnen durch den Knockout im rag2-Gen keine nat��rlichen, d.h. im Thymus gereiften, Tregs entstehen. Im Blut von DO11.10 RAG-/- M��usen war direkt nach Durchf��hrung der OVA-IT eine FoxP3+ Treg-Population detektierbar. Demnach wird durch die OVA-IT eine de-novo-Induktion von FoxP3+ Tregs in Gang gesetzt. In Abwesenheit der nat��rlichen Tregs zeigte sich weiterhin, dass diese Zellen zur Produktion von IL-10 in T-Zellen und somit zum Erfolg der SIT beitragen.rnDie Rolle der FoxP3+ Tregs bei der SIT wurde in DEREG M��usen untersucht. Eine Depletion der FoxP3+ Tregs in DEREG M��usen w��hrend der Durchf��hrung der OVA-IT hob die protektiven Effekte der Therapie jedoch nur teilweise auf. rnUm die Rolle des regulatorischen Zytokins IL-10 bei der SIT zu untersuchen, wurde ein blockierender Antik��rper gegen den IL-10-Rezeptor (anti-IL-10R) im chronischen Modell des allergischen Asthmas mit SIT angewendet. Anti-IL-10R hob die protektive Wirkung der SIT auf die AHR, die Atemwegsentz��ndung und die strukturellen Ver��nderungen im Lungengewebe auf. Somit ist die protektive Wirkung der SIT abh��ngig vom IL-10-Signalweg.rnZusammenfassend stellt diese Arbeit die Bedeutung der SIT f��r allergische Erkrankungen heraus. SIT kann durch die positive Beeinflussung der allergiebedingten, strukturellen Ver��nderungen in der Lunge auch f��r Asthmapatienten gro��e Vorteile bringen. Die aus Studien bekannten Mechanismen konnten im Modell best��tigt werden und wurden im weiteren Verlauf untersucht. Die Arbeit stellt im Besonderen die Bedeutung der IL-10-produzierenden und FoxP3+ Tregs f��r die Effektivit��t der SIT in den Vordergrund. Zudem ist durch die Etablierung eines neuen Mausmodells der SIT f��r chronisches allergisches Asthma ein Mittel zur weiteren Erforschung der zugrunde liegenden Prozesse dieser erfolgreichen Therapie geschaffen worden. rn

Improving adoptive T cell therapies of cancer by ectopic expression of miR181a to repress inhibitory phosphatases

Adoptive T cell therapy using antigen-specific T lymphocytes is a powerful immunotherapeutic approach against cancer. Nevertheless, many T cells against tumor-antigens exhibit only weak anti-tumoral response. To overcome this barrier it is necessary to improve the potency and anti-tumoral efficacy of these T cells. Activation and activity of T cells are tightly controlled to inhibit unwanted T cell responses and to reduce the risk of autoimmunity. Both are regulated by extrinsic signals and intrinsic mechanisms which suppress T cell activation. The intrinsic mechanisms include the expression of phosphatases that counteract the activation-inducing kinases. Modifying the expression of these phosphatases allows the targeted modulation of T cell reactivity. MicroRNAs (miRNAs) are regulatory small noncoding RNA molecules that control gene expression by targeting messenger RNAs in a sequence specific manner. Gene-specific silencing plays a key role in diverse biological processes, such as development, differentiation, and functionality. miR181a has been shown to be highly expressed in immature T cells that recognize low-affinity antigens.rnThe present study successfully shows that ectopic expression of miR181a is able to enhance the sensitivity of both murine and human T cells. In CD4+ T helper cells as well as in CD8+ cytotoxic T cells the overexpression of miR181a leads to downregulation of multiple phosphatases involved in the T cell receptor signaling pathway. Overexpression of miR181a in human T cells achieves a co-stimulatory independent activation and has an anti-apoptotic effect on CD4+ T helper cells. Additionally, increasing the amount of miR181a enhances the cytolytic activity of murine CD8+ TCRtg T cells in an antigen-specific manner.rnTo test miR181a overexpressing T cells in vivo, a mouse tumor model using a B cell lymphoma cell line (A20-HA) expressing the Influenza hemagglutinin (Infl.-HA) antigen was established. The expression of model antigens in tumor cell lines enables targeted elimination of tumors using TCRtg T cells. The transfer of miR181a overexpressing Infl.-HA TCRtg CD8+ T cells alone has no positive effect neither on tumor control nor on survival of A20-HA tumor-bearing mice. In contrast, the co-transfer of miR181a overexpressing Infl.-HA TCRtg CD8+ and CD4+ T cells leads to improved tumor control and prolongs survival of A20-HA tumor-bearing mice. This effect is characterized by higher amounts of effector T cells and the expansion of Infl.-HA TCRtg CD8+ T cells.rnAll effects were achieved by changes in expression of several genes including molecules involved in T cell differentiation, activation, and regulation, cytotoxic effector molecules, and receptors important for the homing process of T cells in miR181a overexpressing T cells. The present study demonstrates that miR181a is able to enhance the anti-tumoral response of antigen-specific T cells and is a promising candidate for improving adoptive cell therapy.

Expression of human cathepsin L or human cathepsin V in mouse thymus mediates positive selection of T helper cells in cathepsin L knock-out mice

A genetic deficiency of the cysteine protease cathepsin L (Ctsl) in mice results in impaired positive selection of conventional CD4+ T helper cells as a result of an incomplete processing of the MHC class II associated invariant chain or incomplete proteolytic generation of positively selecting peptide ligands. The human genome encodes, in contrast to the mouse genome, for two cathepsin L proteases, namely cathepsin L (CTSL) and cathepsin V (CTSV; alternatively cathepsin L2). In the human thymic cortex, CTSV is the predominately expressed protease as compared to CTSL or other cysteine cathepsins. In order to analyze the functions of CTSL and CTSV in the positive selection of CD4+ T cells we employed Ctsl knock-out mice crossed either with transgenic mice expressing CTSL under the control of its genuine human promoter or with transgenic mice expressing CTSV under the control of the keratin 14 (K14) promoter, which drives expression to the cortical epithelium. Both human proteases are expressed in the thymus of the transgenic mice, and independent expression of both CTSL and CTSV rescues the reduced frequency of CD4+ T cells in Ctsl-deficient mice. Moreover, the expression of the human cathepsins does not change the number of CD4+CD25+Foxp3+ regulatory T cells, but the normalization of the frequency of conventional CD4+ T cell in the transgenic mice results in a rebalancing of conventional T cells and regulatory T cells. We conclude that the functional differences of CTSL and CTSV in vivo are not mainly determined by their inherent biochemical properties, but rather by their tissue specific expression pattern.

T cell-mediated immunoregulation in the gastrointestinal tract

In the intestinal tract, only a single layer of epithelial cells separates innate and adaptive immune effector cells from a vast amount of antigens. Here, the immune system faces a considerable challenge in tolerating commensal flora and dietary antigens while preventing the dissemination of potential pathogens. Failure to tightly control immune reactions may result in detrimental inflammation. In this respect, 'conventional' regulatory CD4(+) T cells, including naturally occurring and adaptive CD4(+) CD25(+) Foxp3(+) T cells, Th3 and Tr1 cells, have recently been the focus of considerable attention. However, regulatory mechanisms in the intestinal mucosa are highly complex, including adaptations of nonhaematopoietic cells and innate immune cells as well as the presence of unconventional T cells with regulatory properties such as resident TCRgammadelta or TCRalphabeta CD8(+) intraepithelial lymphocytes. This review aims to summarize the currently available knowledge on conventional and unconventional regulatory T cell subsets (Tregs), with special emphasis on clinical data and the potential role or malfunctioning of Tregs in four major human gastrointestinal diseases, i.e. inflammatory bowel diseases, coeliac disease, food allergy and colorectal cancer. We conclude that the clinical data confirms some but not all of the findings derived from experimental animal models.

Prednisolone treatment induces tolerogenic dendritic cells and a regulatory milieu in myasthenia gravis patients

FOXP3-expressing naturally occurring CD4(+)CD25(high) T regulatory cells (Treg) are relevant in the control of autoimmunity, and a defect in this cell population has been observed in several human autoimmune diseases. We hypothesized that altered functions of peripheral Treg cells might play a role in the immunopathogenesis of myasthenia gravis, a T cell-dependent autoimmune disease characterized by the presence of pathogenic autoantibodies specific for the nicotinic acetylcholine receptor. We report in this study a significant decrease in the in vitro suppressive function of peripheral Treg cells isolated from myasthenia patients in comparison to those from healthy donors. Interestingly, Treg cells from prednisolone-treated myasthenia gravis patients showed an improved suppressive function compared with untreated patients, suggesting that prednisolone may play a role in the control of the peripheral regulatory network. Indeed, prednisolone treatment prevents LPS-induced maturation of monocyte-derived dendritic cells by hampering the up-regulation of costimulatory molecules and by limiting secretion of IL-12 and IL-23, and enhancing IL-10. In addition, CD4(+) T cells cultured in the presence of such tolerogenic dendritic cells are hyporesponsive and can suppress autologous CD4(+) T cell proliferation. The results shown in this study indicate that prednisolone treatment promotes an environment that favors immune regulation rather than inflammation.

Depletion of regulatory T cells augments a vaccine-induced T effector cell response against the liver-stage of malaria but fails to increase memory

Regulatory T cells (T(reg)) have been shown to restrict vaccine-induced T cell responses in different experimental models. In these studies CD4(+)CD25(+) T(reg) were depleted using monoclonal antibodies against CD25, which might also interfere with CD25 on non-regulatory T cell populations and would have no effect on Foxp3(+)CD25(-) T(reg). To obtain more insights in the specific function of T(reg) during vaccination we used mice that are transgenic for a bacterial artificial chromosome expressing a diphtheria toxin (DT) receptor-eGFP fusion protein under the control of the foxp3 gene locus (depletion of regulatory T cell mice; DEREG). As an experimental vaccine-carrier recombinant Bordetella adenylate cyclase toxoid fused with a MHC-class I-restricted epitope of the circumsporozoite protein (ACT-CSP) of Plasmodium berghei (Pb) was used. ACT-CSP was shown by us previously to introduce the CD8+ epitope of Pb-CSP into the MHC class I presentation pathway of professional antigen-presenting cells (APC). Using this system we demonstrate here that the number of CSP-specific T cells increases when T(reg) are depleted during prime but also during boost immunization. Importantly, despite this increase of T effector cells no difference in the number of antigen-specific memory cells was observed.

Differential influence of maternal and fetal pregnancy factors on the in-vitro induction of human regulatory T cells: a preliminary study.

PROBLEM Given the important role of regulatory T cells (Treg) for successful pregnancy, the ability of soluble maternal and fetal pregnancy factors to induce human Treg was investigated. METHOD OF STUDY Peripheral blood mononuclear cells (PBMCs) or isolated CD4+CD25��� cells were cultured in the presence of pooled second or third trimester pregnancy sera, steroid hormones or supernatants from placental explants, and the numbers and function of induced CD4+CD25+FOXP3+ Treg were analysed. RESULTS Third trimester pregnancy sera and supernatants of early placental explants, but not sex steroid hormones, induced an increase of Tregs from PBMCs. Early placental supernatant containing high levels of tumour necrosis factor-��, interferon-��, interleukins -1, -6 and -17, soluble human leucocyte antigen-G, and transforming growth factor-��1, increased the proportion of Treg most effectively and was able to induce interleukin-10-secreting-Treg from CD4+CD25���cells. CONCLUSIONS Compared with circulating maternal factors, placental- and fetal-derived factors appear to exert a more powerful effect on numerical changes of Treg, thereby supporting fetomaternal tolerance during human pregnancy.

Regulatory T-cells infiltrate periodontal disease tissues

CD4(+) CD25(+) regulatory T ( Tr) cells are critical in regulating the immune response and thereby play an important role in the defense against infection and control of autoimmune diseases. Our previous studies demonstrated the involvement of autoimmune responses in periodontitis. The aim of this study was to identify CD4(+) CD25(+) Tr cells in periodontitis tissues and compare them with those in gingivitis tissues. Immunohistological analysis of CD4, CD25, and CTLA- 4 and the gene expression analysis of FOXP3, TGF- beta 1, and IL-10 on gingival biopsies revealed the presence of CD4(+) CD25(+) Tr cells in all tissues. In periodontitis, the percentage of CD4(+) CD25(+) Tr cells increased with increasing proportions of B-cells relative to T- cells. FOXP3, a characteristic marker for CD4(+) CD25(+) Tr cells, TGF- beta 1 and IL-10 were expressed more highly in periodontitis compared with gingivitis. These findings suggest that CD4(+) CD25(+) Tr cells and possibly other regulatory T- cell populations do exist and may play regulatory roles in periodontal diseases.

Expression of LAG-3 by tumor-infiltrating lymphocytes is coincident with the suppression of latent membrane antigen-specific CD8(+) T-cell function in Hodgkin lymphoma patients

In Hodgkin lymphoma (HL), the malignant Hodgkin Reed-Sternberg (HRS) cells constitute only 0.5% of 10% of the diseased tissue. The surrounding cellular infiltrate is enriched with T cells that are hypothesized to modulate antitumor immunity. We show that a marker of regulatory T cells, LAG-3, is strongly expressed on infiltrating lymphocytes present in proximity to HRS cells. Circulating regulatory T cells (CD4(+) CD25(hi) CD45 ROhi, CD4(+) CTLA4(hi), and CD4(+) LAG-3(hi)) were elevated in HL patients with active disease when compared with remission. Longitudinal profiling of EBV-specific CD8(+) T-cell responses in 94 HL patients revealed a selective loss of interferon-gamma expression by CD8(+) T cells specific for latent membrane proteins 1 and 2 (LMP1/2), irrespective of EBV tissue status. Intratumoral LAG-3 expression was associated with EBV tissue positivity, whereas FOXP3 was linked with neither LAG-3 nor EBV tissue status. The level of LAG-3 and FOXP3 expression on the tumor-infiltrating lymphocytes was coincident with impairment of LMP1/2-specific T-cell function. In vitro pre-exposure of peripheral blood mono-nuclear cells to HRS cell line supernatant significantly increased the expansion of regulatory T cells and suppressed LMP-specific T-cell responses. Deletion of CD4(+) LAG-3(+) T cells enhanced LMP-specific reactivity. These findings indicate a pivotal role for regulatory T cells and LAG-3 in the suppression of EBV-specific cell-mediated immunity in HL.

Traitement de la maladie du greffon contre l���h��te chronique par la photoph��r��se extra corporelle au TH9402 : m ��canisme de r��gulation de la maladie du greffon contre l���h��te chronique par les cellules T r��gulatrices

La maladie du greffon contre l���h��te (GVHD) est la principale cause de mortalit�� et de morbidit�� suite aux greffes de cellules souches h��matopo����tiques. Plusieurs patients demeurent r��fractaires aux traitements actuels ce qui rend n��cessaire le d��veloppement de nouvelles strat��gies afin de combattre cette maladie. Dans l�����tude qui suit, nous avons utilis�� un nouvel agent th��rapeutique, le TH9402, une mol��cule photosensible et d��montr�� qu���elle permet, lorsqu���expos��e �� la lumi��re visible (514 nm), d�����liminer s��lectivement les cellules T activ��es in vivo tout en pr��servant les cellules T au repos et les cellules T r��gulatrices (Tregs). Les Tregs ainsi pr��serv��s peuvent abroger la r��ponse allor��active par la s��cr��tion d���IL-10 ou par contact cellule-cellule via un m��canisme impliquant le CTLA-4. Nous avons d��couvert que la signalisation du CTLA-4 ��tait associ��e �� une hausse de la population Treg in vitro. Cette hausse est due �� la conversion de cellules T CD4+CD25- en Tregs et non �� une prolif��ration s��lective des Tregs. Dans la deuxi��me partie de cette ��tude, nous avons d��montr�� que la signalisation de CTLA-4 ��tait associ��e �� une augmentation de l���expression de la prot��ine Indoleamine 2,3 dioxygenase (IDO). Ces effets n��cessitent la d��pl��tion du tryptophane ainsi que de la prot��ine de phase aigue GCN2. Finalement, nous avons observ�� que l���infusion de cellules trait��es au TH9402 chez des patients souffrant de GVHD chronique est associ��e �� une augmentation de la population Treg chez ces patients sans causer de lymphop��nie ni de diminution de la r��ponse immunitaire dirig��e contre les antig��nes viraux. Ces r��sultats sugg��rent que le traitement au TH9402 pourrait repr��senter une approche particuli��rement int��ressante pour le traitement de la GVHD chronique r��fractaire aux traitements actuels. De plus, l���augmentation de l���expression d���IDO pourrait ��tre utilis��e comme valeur pr��dictive de la r��ponse du patient au traitement. Ceci pourrait permettre d���am��liorer la qualit�� de soins ainsi que de la qualit�� de vie des patients souffrant de GVHD chronique.

Perfil de mem��ria e ativa����o de linf��citos T na leishmaniose visceral

Visceral leishmaniasis (VL) in Brazil is a disease caused by Leishmania infantum chagasi (L.i.chagasi). The clinical evolution post-infection depends on the vertebrate host immune response, which is genetically mediated. This study aimed to evaluate the immune response of individuals living in endemic area for VL in the state of the Rio Grande do Norte, considering individuals with VL under treatment (n = 9), recovered VL <1 year post treatment (n = 10), > 10 years posttreatment (n = 9), uninfected individuals living in endemic areas (n = 7), individuals that lost DTH response (n=6) and asymptomatic individuals for VL (n=9). Peripheral blood cells were evaluated in the presence and absence of soluble Leishmania antigens (SLA) and ex vivo, to determine activation, presence of regulatory cells and memory cells. The Leishmania parasitemia and anti-Leishmania antibodies were determined respectively by qPCR and ELISA. Cells from individuals with VL under treatment showed less cell activation after stimulation with SLA for the markers CD4/CD69, CD8/CD69 and CD8/CD25 compared with VL post treatment treatment (p <0.001). Apparently uninfected individuals have a higher cell activation than symptomatic VL (p <0.001), with the exception of CD8/CD25 marker (p = 0.6662). On the other hand, in the ex-vivo group, significant differences were observed for CD4/CD69, CD8/CD69 and CD8/CD25 between the 4 groups due to increased cell activation present in cells of individuals symptomatic LV (p <0.001). VL cells under treatment, ex vivo, have a lower percentage of memory cells (CD4/CD45RO and CD8/CD45RO) than individuals VL post-treatment or control group (p = <0.01). Likewise, individuals with symptomatic VL have fewer regulatory cells when stimulated by SLA [CD4/CD25 (p = 0.0022) and CD4/FOXP3 (p = 0.0016)] and in the ex-vivo group (p = 0.0017). Finally, DNA isolated from recovered VL contained Leishmania DNA, supporting the hypothesis of non-sterile clinical cure for Leishmania infection. Recovered VL, even 10 years after treatment have high levels of memory cells, which may be due to the presence of stimulation, either by reexposure to Leishmania or non-sterile cure

Estado nutricional e efeito da vitamina A na resposta imune frente �� infec����o por Leishmania Infantum

Nutritional status is an important determinant to the response against Leishmania infection, although few studies have characterized the molecular basis for the association found between malnutrition and the disease. Vitamin A supplementation has long been used in developing countries to prevent mortality by diarrheal and respiratory diseases, but there are no studies on the role of vitamin A in Leishmania infection, although we and others have found vitamin A deficiency in visceral Leishmaniasis (VL). Regulatory T cells are induced in vitro by vitamin A metabolites and are considered important cells implicated T CD4+ cell suppression in human VL. This work aimed to examine the correlation of nutritional status and the effect of vitamin A in the response against Leishmania infantum infection. A total of 179 children were studied: 31 had active VL, 33 VL history, 44 were DTH+ and 71 were DTH- and had negative antibody to Leishmania (DTH-/Ac-). Peripheral blood monuclear cells were isolated in a subgroup of 10 active VL and 16 DTH-/Ac- children and cultivated for 20h under 5 different conditions: 1) Medium, 2) Soluble promastigote L. infantum antigens (SLA), 3) All-trans retinoic acid (ATRA), 4) SLA + ATRA and 5) Concanavalin A. T CD4+CD25highFoxp3+, T CD4+CD25-Foxp3- and CD14+ monocytes were stained and studied by flow cytometry for IL-10, TGF-&#946; and IL-17 production. Nutritional status was compromised in VL children, which presented lower BMI/Age and retinol concentrations when compared to healthy controls. We found a negative correlation between nutritional status (measured by BMI/Age and serum retinol) and anti-Leishmania antibodies and acute phase proteins. There was no correlation between nutritional status and parasite load. ATRA presented a dual effect in Treg cells and monocytes: In healthy children (DTH-/Ac-), it induced a regulatory response, increasing IL-10 and TGF-&#946; production; in VL children it modulated the immune response, preventing increased IL-10 production after SLA stimulation. Furthermore, we found a positive correlation between BMI/Age and IL-17 production and negative correlation between serum retinol and IL-10 and TGF-&#946; production in T CD4+CD25highFoxp3+ cells after SLA stimulus. Our results show a potential dual role of vitamin A in the immune system: improvement of regulatory profile during homeostasis and down modulation of IL-10 in Treg cells and monocytes during symptomatic VL. Therefore, the use of vitamin A concomitant to VL therapy might improve recovery from disease status in Leishmania infantum infection