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The Journal of Immunology, 1999, 163: 5770-5780.
Copyright © 1999 by The American Association of Immunologists

Role of Inflammatory Infiltrate in Activation and Effector Function of Cloned Islet Reactive Nonobese Diabetic CD8+ T Cells: Involvement of a Nitric Oxide-Dependent Pathway1

Tatyana Gurlo, Kenneth Kawamura and Hermann von Grafenstein2

School of Pharmacy, University of Southern California, Los Angeles, CA 90033


    Abstract
 Top
 Abstract
 Introduction
 Materials and Methods
 Results
 Discussion
 References
 
To investigate how CD8+ T cells interact with ß cells and local inflammatory cells in islets, we have isolated CD8+ T cell clones from nonobese diabetic (NOD) spleen that recognize and destroy both islets and the NOD insulinoma cell line NIT-1. The clones destroyed NOD islets with pre-existing inflammation better than islets without signs of inflammation. Islets from NOD-scid mice were destroyed only poorly, but that could be improved by adding IL-7 to the assay. Anti-IFN-{gamma} Abs inhibited destruction of infiltrated islets. Single islets were effective stimulators of IFN-{gamma} production by cloned CD8+ T cells, which varied >50-fold depending on the degree of islet infiltration. This effect of the islet mononuclear infiltrate could be mimicked by adding spleen cells to NIT-1 cells, which augmented IFN-{gamma} production above the level stimulated by NIT-1 cells alone. The enhancing effect of spleen cells could be attributed to their macrophage subpopulation and was not MHC restricted, although recognition of islet Ag by cloned CD8+ T cells and subsequent islet destruction was restricted to islets expressing H-2Db molecules. An inhibitor of inducible NO synthase inhibited destruction of inflamed islets by cloned CD8+ T cells. We propose that macrophages in inflamed islets provide a form of bystander costimulation of ß cell-specific CD8+ T cells. CD8+ T cells respond to Ag and costimulation by producing IFN-{gamma} that activates macrophages. Activated macrophages facilitate islet destruction by CD8+ T cells through a NO synthesis-dependent pathway.


    Introduction
 Top
 Abstract
 Introduction
 Materials and Methods
 Results
 Discussion
 References
 
The pathogenesis of insulin-dependent diabetes mellitus (IDDM)3 is a multistep process that requires the coordinated interaction of a multitude of cells ultimately leading to the destruction of insulin-producing ß cells in the islets of Langerhans (1, 2). The nonobese diabetic (NOD) mouse, an animal model of IDDM (3), is widely used for investigations of the events that lead to ß cell destruction. Most of the cells that contribute to adaptive immune responses have also been recognized to be essential for disease development in NOD mice including macrophages (4, 5), the CD4+ and CD8+ subsets of T cells (6, 7), and B cells (8, 9, 10).

Although in special experimental systems individual cell types appear to be sufficient for disease induction, most studies have shown that the interaction of several cell types is essential for natural, spontaneous disease development. Thus, while at later stages of disease development CD4+ T cells appear to be sufficient for disease transfer in NOD mice, blocking CD8+ T cell function with anti-CD8 Abs at an early stage prevented spontaneous disease development, and T cells from prediabetic mice no longer transferred disease when depletion of CD8+ T cells was combined with anti-CD8 Ab treatment (11). Likewise, monoclonal CD8+ T cells grown on islets that express a B7 transgene could transfer disease on their own (12), but disease transfer by naturally developing polyclonal T cells requires both the CD4+ and CD8+ subsets (6). In addition to T cells, macrophages have been found to be essential for both the development and the effector phases of anti-islet immunity. Depletion of resident macrophages prevented disease development, and inhibiting the entry of host macrophages into the islet environment prevented transfer of disease by donor T cells (5). Recruitment of macrophages into the islet environment by islet-specific expression of a TNF-{alpha} transgene accelerated disease development in neonatal mice (13). These studies suggest that all of these cell types are essential for natural disease development and appear to cooperate at various stages during disease development.

CD8+ T cells can, at least in principle, recognize and destroy ß cells directly, and primed CD8+ T cells would be expected to be independent from APCs in the local environment of islets. However, without costimulatory signals derived from APCs, the effect of CD8+ T cells is short lived, and APCs are thought to be essential not only for priming of naive CD8+ T cells but also for the maintenance of CD8+ T cell memory and CTL effector function in response to exogenous Ags (14, 15, 16, 17). Priming as well as maintenance stimulation are thought to occur in lymphoid organs such as lymph nodes or spleen. How CD8+ T cells become and remain activated during the development of autoimmune diabetes is still unresolved.

Ag presentation is the best known but probably not the only mechanism by which professional APCs may contribute to priming of T cells and maintenance of their activated state. Zinkernagel et al. have shown that fibroblasts can prime and activate CD8+ T cells provided that the fibroblasts are localized in lymphoid tissue but not outside it (18). In that study, the Ag was clearly presented by fibroblast MHC class I molecules, not by local professional APCs. The authors concluded that localization in lymphoid tissue is the key determinant of immunogenicity, not Ag presentation in the context of costimulatory activity by the presenting cell (19). Presumably some form of bystander costimulation by cells in close proximity or the cytokine milieu constitutes this environment. It is not clear whether cells in an inflammatory infiltrate cooperate in similar ways.

During the development of some organ-specific autoimmune diseases, the chronic inflammatory infiltrate begins to resemble organized lymphoid tissue. Locally assembled organized lymphoid tissue may obviate the need to transport autoantigen to distant lymphoid organs. In infiltrated islets, the lymphoid tissue would be located close to ß cells rather than ß cells or Ags released by them being transported to lymphoid tissue. Analogous to fibroblasts in lymphoid tissue, ß cells in the vicinity of the locally assembled infiltrate may activate CD8+ T cells without a requirement to shed Ag for presentation by phagocytic APCs. However, no direct evidence is available for a role of local islet-infiltrating accessory cells in the activation of CD8+ T cells.

Cells of the monocyte-macrophage-dendritic cell lineage not only generate signals that control the function of T cells, but also respond to T cell-derived signals. For example, T cell-derived IFN-{gamma} may activate local macrophages and up-regulate expression of costimulatory activity and contribute to a local environment in which priming of T cells can occur and an autoimmune response can be initiated and maintained (20, 21). This mutual exchange of signals may lead to a process of self-enhancing activation and tissue organization. After an initial trigger, disease progression may be the result of an ongoing process of self-organization of the lymphocytic infiltrate, which would be determined by local as well as systemic factors. During the destructive phase of insulitis, activated macrophages can produce amounts of NO and other products that are toxic to ß cells (22) or up-regulate expression of Fas and increase the sensitivity of ß cells to killing by T cells (23). However, it is not clear how the release of these macrophage products is linked to the specific recognition of islet Ags by T cells.

In this work, we have investigated the role of islet-infiltrating mononuclear cells in the activation and effector function of CD8+ T cells. The inflammatory infiltrate greatly enhanced both islet destruction and IFN-{gamma} production by cloned CD8+ T cells. In vitro reconstitution experiments, in which spleen cells were added to NIT-1 cells, showed that at least some of the enhancing effect of non-ß cells could be attributed to bystander costimulation by macrophages. Macrophages were also implicated in enhancing islet destruction by cloned CD8+ T cells because inhibitors of the inducible form of NO synthase protected inflamed islets from destruction by the CD8+ T cell clones. We propose a novel two-way signal exchange between macrophages and CD8+ T cells that enhances and complements Ag-specific interaction of ß cells and CD8+ T cells.


    Materials and Methods
 Top
 Abstract
 Introduction
 Materials and Methods
 Results
 Discussion
 References
 
Mice

NOD, NOD/Lt-scid/scid (NOD-scid), BALB.B, BALB/c, B10.BR, and C57BL/6 mice were obtained from The Jackson Laboratory (Bar Harbor, ME) and were bred and maintained in the University of Southern California Animal Facility under pathogen-free conditions. The spontaneous incidence of diabetes in our colony reaches 65–70% in female NOD mice by 20 wk of age, and diabetes usually commences by 13 wk of age. For experiments, 8- to 12-wk-old mice were used.

Reagents, Abs, and cell culture

Murine rIL-2 and rIFN-{gamma}, Con A, and bacterial LPS were obtained from Sigma (St. Louis, MO). Ionomycin, PMA, and L-N6-(1-iminoethyl)lysine · HCl (L-NIL) were purchased from Calbiochem (La Jolla, CA). Anti-mouse IFN-{gamma} mAb (XMG1.2, rat IgG1), and murine rTNF-{alpha} were obtained from PharMingen (San Diego, CA). Murine rIL-7 was obtained from Life Technologies (Gaithersburg, MD), and collagenase P was obtained from Boehringer Mannheim (Indianapolis, IN). Hybridoma YCD3–1 (anti-CD3{epsilon}), A20 lymphoma cells, NXA cells, and CTLL-2 cells were kind gifts from Dr. C. A. Janeway, Jr. (Yale University, New Haven, CT). J774A.1 cells (H-2d), hybridomas 10-2.16 (anti-I-Ak), 30-H12 (anti-Thy1.2), H57-597 (anti-{alpha}ßTCR), 3.155 (anti-CD8), GK1.5 (anti-CD4), M1/70.15.11.5.HL (anti-Mac-1), N418 (anti-CD11c), and RA3-3A1/6.1 (anti-B220) were obtained from American Type Culture Collection (Manassas, VA). Anti-CD28 mAb HM3500 and FITC-goat F(ab')2 anti-hamster IgG were purchased from Caltag Laboratories (South San Francisco, CA), and goat F(ab')2 anti-rat IgMµ and goat F(ab')2 anti-rat IgGFc were obtained from Accurate Chemicals (Westbury, NY). Pooled rabbit complement was obtained from ICN Pharmaceuticals (Aurora, OH). RMA (H-2d) cells were kindly provided by Dr. M. McMillan (University of Southern California, Los Angeles, CA), and EL-4 (H-2b), P815 (H-2d), and YAC-1 cells were kindly provided by Dr. G. Dennert (University of Southern California). The ß cell line NIT-1 (I-Ag7; Kd, Db) was kindly provided by Dr. E. H. Leiter (The Jackson Laboratory), and TCX6310 cells were kindly provided by Dr. F. Melchers (Basel Institute for Immunology, Basel, Switzerland).

Abs were used in the form of diluted cell culture supernatant or were purified from culture supernatant using GammaBind Plus Sepharose (Pharmacia Biotech, Piscataway, NJ) columns. The tissue culture medium (TCM) used for cell culture and all experiments was based on Click’s medium (Irvine Scientific, Santa Ana, CA), which was supplemented with 4 mM L-glutamine, 100 U/ml penicillin, 100 µg/ml streptomycin (Life Technologies), 40 µM 2-ME, and 10% FBS (BioWhittaker, Walkersville, MD). For routine T cell culture, we used supernatant of TCX6310 cells (24) as a source of IL-2.

Islet isolation

Islets were prepared by collagenase digestion as described previously (25) with minor modifications. Islets were manually picked using a dissection microscope and cultured for 1–2 days in TCM. Unless indicated otherwise, only islets that had intact borders after this culture period were used in experiments. For some experiments, islets were treated with IFN-{gamma} for 72 h.

Generation of an islet-specific CTL line

To obtain islet-destructive CTLs, spleen cells (5 x 105) from newly diabetic female NOD mice were cultured with five islets in the presence of IFN-{gamma} (10 U/ml), IL-2 (10 U/ml), and IL-7 (10 ng/ml) in 24-well plates. After 5 days, T cell blasts surrounding disintegrating islets were picked up using a pipette, pooled, and restimulated with islets 1 wk later. Four days after restimulation, T cells were placed in cultures of adherent NIT-1 cells in the presence of cytokines as above. Cultures were checked daily for NIT-1 cell destruction. Cells from positive wells were pooled and stimulated again with islets and NIT-1 cells. We applied two cycles of expansion alternating between islets and NIT-1 cells. Restimulated cells, referred to as "polyclonal cytotoxic T cells (polyclonal CTLs)," were used for cloning.

T cell cloning and maintenance of clones

For cloning and expansion, we stimulated T cells with anti-CD3 mAb. Polyclonal cytotoxic T cells were seeded at a density of 0.3–1 cells/well into 96-well round-bottom plates in TCM containing anti-CD3{epsilon} mAb (culture supernatant of hybridoma YCD3–1 diluted 1:20) and mitomycin C-treated NOD spleen cells (3 x 104 per well). The anti-CD3 mAb was removed after 48 h by washing cells two to three times, and cell proliferation was stimulated by resuspending cells in TCM supplemented with IL-2 (40 U/ml) and IL-7 (10 ng/ml). After 48 h, cells were fed once more with the same medium, and after that every 3 to 4 days with TCM alone or, during every other feeding cycle, with TCM supplemented with IL-2 and IL-7 (10 U/ml and 10 ng/ml, respectively). T cells were stimulated in this way every 10–14 days. After the second and the third stimulation, plates were checked for apparent growth of T cells, and cells from positive wells were expanded further.

For routine maintenance, clones were restimulated with anti-CD3 mAb every 2–3 wk. T cells (1–5 x 105) were cultured with mitomycin C-treated spleen cells (5 x 106) in 5 ml of TCM in the presence of YCD3–1 cell culture supernatant diluted 1:20. After 48 h, cells were washed and treated with cytokines as described above. In all experiments T cell clones were used after removal of dead cells using lymphocyte separation medium (Organon Teknika, Durham, NC).

Disease transfer experiments

Newly diabetic 12- to 20-wk-old female NOD mice were used as donors of diabetogenic spleen cells, and 8-wk-old female NOD-scid mice were used as recipients. T cell clones (107), spleen cells (107), or T cell clones (107) mixed with spleen cells from diabetic mice (107) were suspended in 200 µl of HBSS and injected into the tail vein of recipients. Onset of disease was monitored by testing the urinary glucose level three times a week with Chemstrip uG (Boehringer Mannheim). Mice were considered diabetic from the first day of twice consecutive detection of glucosurea (100 mg/dL or higher).

Morphological detection of islet destruction

Islets were placed in 96-well flat-bottom assay plates together with 1 x 105 clonal T cells. Anti-IFN-{gamma} mAb XMG1.2, the NO synthase inhibitor L-NIL, and the cytokines IL-2, IFN-{gamma}, and IL-7 were added as indicated. T cells were used 5–6 d after stimulation. Islet morphology was assessed at regular time intervals by phase contrast microscopy. Residual islet mass at intermediary stages before complete destruction could be assessed after removing the large cluster of T cells around them. To achieve this, the T cells surrounding the islet were dispersed by pipetting the islet T cell cluster up and down several times through a 100-µl pipette tip. This had no effect on islet integrity in the absence of T cells. In this assay, ~8 ± 3% (average ± SEM, n = 84) of untreated islets disintegrated spontaneously. In the presence of IL-7 (10 ng/ml) and IL-2 (10 U/ml), islet-specific clones increased the rate of disintegration to 88 ± 3% (n = 192), whereas in the presence of irrelevant clones 5 ± 2% (n = 35) of the islets disintegrated.

Stimulation of cytokine release from T cells

To determine their cytokine release profile, T cell clones were stimulated simultaneously with anti-CD3 and anti-CD28 mAbs immobilized in tissue culture plates (96-well flat-bottom plates (Falcon, Becton Dickinson, San Diego, CA) coated with 10 µg/ml of each Ab in PBS at 4°C overnight). Cloned T cells (5 x 104 in 100 µl TCM) were added to Ab-coated plates, and, 24–48 h later, cell culture supernatant was collected for assay of cytokines. In experiments where islets or cell lines were used to stimulate IFN-{gamma} release, clones were used 7–8 days after stimulation. Cloned T cells (5 x 104) were cultured with a single islet in 96-well round-bottom plates in the presence of 10 U/ml IL-2. After 24–48 h, supernatant was collected for assay of IFN-{gamma}. In controls, only islets or only T cells were added to wells. In experiments where cell lines or spleen cells were used as stimulators, T cells (5 x 104) were added to either 1 x 105 spleen cells or to 5 x 104 RMA, J774A.1, YAC-1, P815, or EL-4 cells alone or in combination with 1 x 105 adherent NIT-1 cells. IL-2 was added at 10 U/ml as indicated in the figure legends. The incubation time was 24–48 h. For maximal stimulation of IFN-{gamma} release from islet-infiltrating or cloned T cells, single islets or cloned T cells (105/well) were treated with Con A (4 µg/ml) or a combination of PMA (10 ng/ml) and ionomycin (0.5 µM).

Cytokine assays

IL-2 activity in cell culture supernatant was measured using the IL-2-dependent cell line CTLL-2. The assay was calibrated using rIL-2. The sensitivity of the assay was 0.1 U/ml (0.02 ng/ml). The concentrations of IFN-{gamma} and TNF-{alpha} in culture supernatants were measured by sandwich ELISA, using paired anti-cytokine Abs (PharMingen), following protocols recommended by the manufacturer. The sensitivities of the assays were 1 U/ml (67 pg/ml) for IFN-{gamma} and 0.4 U/ml (40 pg/ml) for TNF-{alpha}.

Depletion of splenocyte subpopulations

Spleen cells were incubated with anti-MHC class II Ab or anti-Thy-1.2 Ab (supernatant from hybridomas 10-2.16 or 30-H12, respectively, diluted 1:2) for 30 min on ice, washed, and treated with diluted (1:10) pooled rabbit complement for 45 min at 37°C. To deplete adherent cells (macrophages and dendritic cells), 15 x 106 spleen cells were cultured in 60 x 15 mm tissue culture dishes in TCM for 2 h at 37°C. Nonadherent cells were collected after gentle pipetting.

Preparation of macrophages and B cell blasts

For preparation of macrophages, NOD or BALB/c mice were injected with 1.5 ml 3% thioglycollate, and, 4 days later, peritoneal exudate cells (PEC) were obtained by peritoneal lavage with PBS supplemented with 20 U/ml heparin. PEC were cultured in TCM for 2 h at 37°C to allow macrophages to adhere to the tissue culture plastic. Nonadherent cells were removed by washing with culture medium. Adherent cells contained >=90% of Mac-1+ cells as determined by FACS analysis. B cell blasts were prepared by incubating spleen cells with 10 µg/ml LPS for 48 h. After stimulation with LPS, dead cells were removed by centrifugation through lymphocyte separation medium. This preparation of B cell blasts contained ~87% B220+ cells, 9% Thy1.2+ cells, <1% Mac-1+, and <1% CD11c+ cells.


    Results
 Top
 Abstract
 Introduction
 Materials and Methods
 Results
 Discussion
 References
 
Islets and NIT-1 cells drive expansion of CD8+ T cells

To investigate how islet-reactive CD8+ T cells interact with both ß cells and accessory cells that infiltrate the islets of Langerhans during the development of IDDM, we isolated CD8+ T cell clones that recognize and destroy islets and an insulinoma cell line in vitro and contribute to disease development in vivo. The insulinoma cell line NIT-1 (26) was to be used for in vitro reconstitution experiments instead of islets because it would provide a homogeneous and readily available model for ß cells devoid of APCs. To first select islet-specific T cells and then a subset of those T cells that also recognize NIT-1 cells, we expanded CD8+ T cells using an islet preparation as antigenic stimulus, followed by expansion using the NOD syngeneic insulinoma cell line NIT-1 as a source of Ag. Because we had found that a combination of IL-2, IFN-{gamma}, and IL-7 was optimal in promoting islet destruction (data not shown), we used this combination of cytokines to expand a polyclonal population of T cells. Using spleen cells from a 12-wk-old newly diabetic NOD female mouse, we obtained a polyclonal population of T cells, termed polyclonal CTLs, that potently destroyed both islets and NIT-1 cells. Because islets and NIT-1 cells did not support the growth of highly diluted T cells, we used an anti-CD3 Ab together with splenocytes and IL-2 for cloning by limiting dilution. The cloning efficiency of this protocol was as high as ~50%. We also used anti-CD3 mAb stimulation followed by cytokine treatment to clone directly from islet infiltrate without prior expansion on islets and NIT-1 cells.

To characterize the clones, we determined their expression of surface markers, stimulation-induced cytokine release profile, cytotoxic activity toward islets and NIT-1 cells, and ability to contribute to disease development in vivo. We also investigated whether they specifically recognized islet Ags in an MHC-restricted manner.

All clones expressed TCR and were single positive for either CD8 or CD4 (Table IGo). The panel of clones that was obtained after the expansion step on NIT-1 cells contained only CD8+ T cells, whereas cloning without such prior expansion yielded both CD4+ and CD8+ T cells. Because NIT-1 cells express MHC class I but not MHC class II molecules, this suggests that the expansion step before cloning was driven by Ags presented by MHC class I molecules.


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Table I. NIT-1 cells select CD8+ T cells

 
All of the six clones examined produced IFN-{gamma}, only two produced IL-2, and none of them produced significant levels of TNF-{alpha} when stimulated with immobilized anti-{alpha}ßTCR Ab or a combination of anti-CD3 and anti-CD28 mAbs.

In vitro destruction of islets and NIT-1 cells was monitored using a morphological assay (Fig. 1GoA). T cells first accumulated around islets and enlarged while the border of the islets remained intact. After an initial attack at the islet perimeter, the islet was destroyed rapidly. Different islets in the same well had different lag times for destruction. In most cases, islets were destroyed over a time period of 48–72 h. A similarly slow process of destruction was observed for NIT-1 cells.



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FIGURE 1. A, Kinetics of islet and NIT-1 cell destruction by clone 9B7. T cells were cultured with islets (b–e) or adherent NIT-1 cells (h and i) for the indicated periods of time in the presence of 10 U/ml IL-2, 10 ng/ml IL-7, and 10 U/ml IFN-{gamma}. As controls, islets (a and f) and NIT-1 cells (g) were cultured alone in the same medium. B, Clone 9B7 accelerates diabetes transfer by diabetic spleen cells. Diabetic spleen cells alone or mixed with cloned CD8+ T cells were injected into the tail vein of 8-wk-old female NOD-scid recipients. Results of one representative experiment. C and D, Islet destruction by clones 9B7 and 8F7 is MHC class I restricted. Islets were prepared from B10.BR (H-2k), NOD (Db, Kd), C57BL/6 (H-2b), BALB/c (H-2d), and BALB.B (H-2b) mice. C, T cells were cultured with islets in the presence of 10 U/ml IL-2, 10 ng/ml IL-7, and 10 U/ml IFN-{gamma}. Islet destruction was assessed morphologically at the indicated time intervals after adding T cells. Data are from one representative experiment for each clone. D, Islet destruction by clones 9B7 and 8F7 at 48 h. T cells were added to islets as described above. Shown are summary data from five experiments. Error bars represent SEM.

 
A summary of the results with many more clones is included in Table IGo. The results show that clones can be classified into four groups, those that destroyed 1) islets only, 2) NIT-1 cells only, 3) both, or 4) neither. The third group was by far the largest, suggesting that NIT-1 cells present at least some Ags in common with islets. Interestingly, 14 of 18 clones that were obtained after expansion on both islets and NIT-1 cells were cytotoxic to both, whereas this was true for only 1 of 11 clones that were derived from the islet lymphocytic infiltrate without the prior expansion step. This striking difference together with the shift toward CD8-positive T cells suggests again that expansion on islets and NIT-1 cells is driven by Ag presented by MHC class I molecules.

We next tested some of the clones from group 3, which are islet and NIT-1 cell destructive, for the ability to influence disease development in vivo. Clone 9B7 accelerated disease (Fig. 1GoB), as did clone 8F7 (not shown). Four other clones tested had no effect on disease development.

NOD mice express the MHC class I molecules H-2Kd and H-2Db. To determine the MHC restriction of the clones, we used islets from different strains of mice sharing with NOD mice either Kd, Db, or neither of the two as targets. As shown in Fig. 1GoC, islets from C57BL/6 mice (H-2b) were destroyed, whereas islets from BALB/c mice (H-2d) were not, indicating that the clones examined here were Db restricted. Surprisingly, all of the other five clones examined showed the same MHC restriction. To confirm that it is indeed the MHC locus rather than some other polymorphism that distinguishes NOD and C57BL/6 mice on the one hand and BALB/c mice on the other, we also tested islets prepared from the BALB/c congenic strain BALB.B. In contrast to BALB/c islets, BALB.B islets were susceptible to killing by clones 9B7 and 8F7. A summary of the results of many more experiments is shown in Fig. 1GoD. Although these data clearly confirm that islet destruction is Db restricted, our data also show that, on average, NOD islets are destroyed more effectively than islets from other strains that express Db, a finding that cannot be explained solely by allelic differences in the MHC locus.

In separate experiments, we confirmed that activation of killing activity by clone 8F7 is not only MHC restricted but also islet specific. Thus, neither NOD fibroblasts nor NOD Con A blasts were destroyed. Furthermore, several non-ß cell lines expressing H-2Db, such as A20 cells fused with NOD splenocytes (NXA cells) and EL-4 cells, were not destroyed (data not shown). Islet destruction was contact dependent, as supernatant from cloned CD8+ T cells taken during an islet destruction assay or collected from cells activated by anti-TCR Abs had no destructive effect (not shown).

We selected clones 9B7 and 8F7 for experiments designed to investigate the role of both ß cells and accessory cells within the islet inflammatory infiltrate in the activation and islet-destructive function of CD8+ T cells.

The activation and islet-destructive function of cloned CD8+ T cells are influenced by the degree of mononuclear cell infiltration in islets

Does the mononuclear cell infiltrate influence the islet-destructive function of CD8+ T cells? The large variation of the severity of lymphocytic infiltration, observed between islets even within a single animal before the onset of disease, can be exploited to address this. To asses the severity of inflammation, we placed islets at low density into tissue culture dishes, cultured them for 16 h, and monitored the number of mononuclear cells emanating from them. We separated the islets into three groups: those that did not show any sign of infiltration, those that showed an intermediate degree of infiltration, and those that were severely infiltrated as indicated by having none, between 1 and 10, or >10 cells around them, respectively. We also used islets from NOD-scid mice as these should be free from any inflammatory infiltrate. Cloned T cells were added to islets from different groups, and, after a further culture period, islet destruction was assayed. As shown in Fig. 2GoA, infiltrated islets were destroyed faster than islets that did not show signs of infiltration. The latter group may still contain some level of infiltration that is not detected by our scoring method. Indeed, destruction of islets prepared from NOD-scid mice required an even longer time. In all cases, destruction was clearly an effect of the added clones, because even heavily infiltrated islets only rarely underwent spontaneous destruction. Without added clones, infiltrated islets lost infiltrating cells over time and damaged islets recovered in culture.



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FIGURE 2. Influence of lymphocytic infiltrate on islet destruction by clone 8F7. T cells were cultured with NOD-scid islets, NOD-scid islets pretreated with 20 U/ml IFN-{gamma} (NOD-scid(IFN-{gamma})), NOD islets without signs of infiltration (NOD), or severely infiltrated NOD islets (NODinf) as indicated by the number of mononuclear cells that had emanated from islets during overnight culture (details described in Results). A, IL-2 and IL-7 were added to cultures at 10 U/ml and 10 ng/ml, respectively; B, only IL-2 was added at 2.5 U/ml. Anti-IFN-{gamma} Ab and control anti-kinesin Ab were added to the culture at 200 µg/ml as indicated. Islet destruction was assessed morphologically at the indicated time intervals after adding T cells. Data are the mean ± SEM of three experiments.

 
To investigate whether up-regulation of MHC class I molecules, which is thought to be a consequence of lymphocytic infiltration, could account for the difference in killing between infiltrated and noninfiltrated islets, we pretreated NOD-scid islets with a dose of IFN-{gamma} that fully up-regulated MHC class I expression and compared the speed of islet destruction with that of untreated NOD-scid and that of NOD islets with or without signs of infiltration. The results (Fig. 2GoA) show that pretreatment with IFN-{gamma} increased the speed of islet destruction to that of noninfiltrated NOD islets, but not to that of infiltrated islets. These results suggested that an increase of Ag presentation by ß cells is not likely be the only effect of the infiltrate.

For the experiments shown in Fig. 2GoA, both IL-2 (10 U/ml) and IL-7 (10 ng/ml) were included in the islet-destruction assay because they had been found to optimize killing during cloning. Without exogenously added IL-7 and at a reduced level of IL-2 (2.5 U/ml), the effect of the infiltrate was essential, not just accelerating (Fig. 2GoB). NOD-scid islets were no longer destroyed, whereas the majority of heavily infiltrated islets were. As in Fig. 2GoA, NOD islets that did not show obvious signs of infiltration were destroyed to a lesser degree than heavily infiltrated islets.

Islet destruction is a complex consequence of T cell activation. Although clearly an effect of cloned CD8+ T cells, islet destruction could also involve accessory cells in the islet infiltrate. To have a second and more direct assay for activation of CD8+ T cells, we used IFN-{gamma} release as a marker. Fig. 3Go shows that it is possible to measure IFN-{gamma} release from cloned CD8+ T cells triggered by single islets, an observation that facilitated the use of the large heterogeneity of the magnitude of the mononuclear infiltrate for studies of its influence on IFN-{gamma} release from CD8+ T cells. The signal-to-background ratio of IFN-{gamma} release varied from 1:1 to close to 50:1 relative to controls containing T cells but no islets. The IFN-{gamma} release data confirmed that the infiltrate plays an important role in the activation of T cell clones. Thus, the most severely infiltrated islets stimulated more IFN-{gamma} release from clone 8F7 than moderately infiltrated islets (p < 0.02), which in turn were more effective than NOD islets without signs of infiltration (p < 10-5). In accord with the islet-destruction experiments, NOD islets with no signs of infiltration still stimulated significantly more IFN-{gamma} release than NOD-scid islets (p < 10-6). NOD-scid islets stimulated very little IFN-{gamma} release from cloned CD8+ T cells, suggesting that ß cells alone may not be sufficient to stimulate high levels of IFN-{gamma} release.



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FIGURE 3. IFN-{gamma} release by clone 8F7 in response to single islets. NOD islets were separated into three groups according to the level of infiltration as indicated by the number of mononuclear cells that had emanated from islets during overnight culture (see Results for details). BALB/c and NOD-scid islets were pretreated with IFN-{gamma} as indicated. T cells were cultured with islets in the presence of 10 U/ml IL-2 (•). As controls T cells alone (x) and islets alone ({circ}) were cultured in the same medium. Data are pooled from five experiments. {diamond}, The mean of IFN-{gamma} release in samples containing T cells (n = number of samples). *, p < 0.001 vs T cell response to NOD-scid islets. For further statistical analysis, see Results.

 
The IFN-{gamma} release during coculture of infiltrated islets with cloned CD8+ T cells came from the clones and not from cells in the islet infiltrate because even heavily infiltrated islets released only low levels of IFN-{gamma} on their own (Fig. 3Go, {circ}), and infiltrated islets did not have the capacity to produce sufficient amounts of IFN-{gamma}, even when stimulated with potent T cell activators (10 ng/ml PMA + 0.5 µM ionomycin, 10 ± 2 U/ml; 4 µg/ml Con A, 2 ± 1 U/ml). In contrast, in the same experiment, these agonists potently triggered IFN-{gamma} release from cloned CD8+ T cells (PMA + ionomycin, 24,081 ± 2,825 U/ml; Con A, 2,143 ± 551 U/ml; anti-TCR mAb, 13,075 ± 684 U/ml), and, during a coculture of clones with islets, run in parallel, 194 ± 20 U/ml were released.

The enhancing effect of the islet infiltrate was a general property of islet-reactive CTLs, not just a characteristic of the clones studied here, because it could be reproduced with the polyclonal islet-reactive CD8+ T cells (data not shown).

Although the severity of mononuclear infiltration was a highly significant determinant of an islet’s ability to stimulate IFN-{gamma} release from exogenously added cloned T cells, it was not the only factor. Even within one group, the magnitude of IFN-{gamma} release varied greatly between individual islets, suggesting that not only the number of infiltrating cells but also their composition and/or organization may be important.

As above for islet destruction, we tested whether the effect of the islet infiltrate on IFN-{gamma} release from cloned CD8+ T cells was due to up-regulation of MHC class I molecules on ß cells. We pretreated NOD-scid islets and MHC-mismatched BALB/c islets with IFN-{gamma} and used both for stimulation of cloned CD8+ T cells. IFN-{gamma} pretreatment of NOD-scid islets clearly increased their effectiveness (p < 10-9) to stimulate IFN-{gamma} release from cloned CD8+ T cells (Fig. 3Go). This increase was not observed with MHC-mismatched BALB/c islets, suggesting that it is indeed mediated by NOD MHC molecules and not due to some other, nonspecific effect of IFN-{gamma}. Although clearly detectable, the effect of IFN-{gamma} on NOD-scid islets does not fully account for the much stronger effect of the islet infiltrate. Some or all of the cells that constitute the mononuclear islet infiltrate appear to play an important role other than merely up-regulating of MHC class I molecules on ß cells.

The effect of the mononuclear infiltrate was not due to some soluble factor acting on cloned T cells because supernatant collected from inflamed islets had no effect (data not shown).

We asked whether the ability of CD8+ T cell clones to destroy islets and to produce IFN-{gamma} are linked. Fig. 2GoB shows that an anti-IFN-{gamma} Ab reduced the ability of cloned CD8+ T cells to destroy islets in vitro. An isotype-matched control Ab had no effect. This result indicates that IFN-{gamma} plays an important role in islet destruction in our system.

Accessory cells from the islet infiltrate stimulate cloned CD8+ T cells directly

The results described above suggest that accessory cells in the islet infiltrate play a role in enhancing the activation of cloned CD8+ T cells added to islets. To demonstrate a direct effect of accessory cells, we collected cells that had emanated from infiltrated islets during overnight culture and assayed their ability to stimulate cloned CD8+ T cells. The data in Fig. 4Go demonstrate the efficacy of infiltrate cells. However, the data also show that infiltrate cells alone are not as potent as infiltrated islets. As many as 25,000 cells collected from ~10 infiltrated islets stimulated only ~30 U/ml, whereas many of the single islets with infiltrate stimulated between 100–200 U/ml. This observation suggests that accessory cells within the infiltrate are either more numerous or more effective activators of cloned CD8+ T cells, or that infiltrating cell in combination with ß cells are more effective than ß cells alone or infiltrating cells alone.



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FIGURE 4. IFN-{gamma} release from clone 8F7 in response to cells that had emanated from infiltrated islets. Cloned T cells were cultured with different numbers of infiltrate cells in the presence of 10 U/ml IL-2. Data are the mean ± SEM of two experiments.

 
Spleen cells and NIT-1 cells cooperate in stimulating IFN-{gamma} release from CD8+ T cell clones

We have demonstrated that the severity of lymphocytic infiltration in islets correlates with their ability to stimulate IFN-{gamma} release from cloned CD8+ T cells. In the following experiments, we attempted to simulate the effect of accessory cells in the islet infiltrate by adding mononuclear cells to a ß cell model in vitro. Although NOD-scid islets should be completely free from a lymphocytic infiltrate, they may still contain nonlymphoid accessory cells such as dendritic cells and macrophages, whereas NIT-1 cells are a homogeneous ß cell preparation devoid of any APCs. We used spleen cells as a model for mononuclear cells. To test a cooperative effect of NIT-1 cells and mononuclear cells, clones 9B7 and 8F7 were stimulated with NIT-1 cells in the presence or absence of splenocytes. The effect of splenocytes in combination with NIT-1 cells was not only more than that of NIT-1 cells or splenocytes alone, but also more than the sum of both (Fig. 5Go). Although both clones showed similar qualitative responses to the combination of NIT-1 cells and splenocytes, 9B7 cells responded better to splenocytes alone than to NIT-1 cells alone and the reverse was true for 8F7 cells. Despite these quantitative differences, there was clear cooperative effect between NIT-1 cells and splenocytes for both clones.



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FIGURE 5. Cooperativity of NIT-1 and spleen cells in stimulating IFN-{gamma} release. Cloned CD8+ T cells, spleen cells, or a mixture of both were cultured with NIT-1 cells (controls: no NIT-1, no spleen cells). In each pair of bars, the upper, filled bar represents samples with, and the lower, open bar represents samples without cloned T cells. Data are the mean ± SEM of four experiments for clone 9B7 and two experiments for clone 8F7.

 
Although the independent stimulatory effect of splenocytes mimics the independent stimulatory effect of cells emanating from infiltrated islets, it was still unexpected and we decided to investigate it further. While infiltrating accessory cells may have acquired islet Ag in the islet environment, it is less clear how the large number of cells in the spleen could take up and present sufficient islet Ag to stimulate cloned CD8+ T cells in the absence of ß cells. Indeed, others have found that spleen cells do not carry islet Ags (13).

The following experiments were conducted to investigate the mechanism by which splenocytes cooperated with NIT-1 cells to stimulate IFN-{gamma} release from cloned CD8+ T cells and how splenocytes may stimulate CD8+ T cells on their own. For both situations, we considered Ag presentation, costimulation, and a contribution of splenic T cells.

The effect of spleen cells on IFN-{gamma} release is not MHC restricted

Could the cooperative effect between NIT-1 and spleen cells be due to presentation of NIT-1 cell Ags by spleen cells? There is precedence that phagocytic cells such as macrophages and dendritic cells, both of which are constituents of splenocytes, can present exogenous cell-bound Ags to CD8+ T cells (15). Even stimulation of IFN-{gamma} release by NOD spleen cells alone is, at least in principle, compatible with this notion as it may reflect uptake and presentation of ß cell Ag in vivo before the experiment and retention of specific peptide-MHC complexes for the duration of the experiment. If Ag presentation is the mechanism of enhancement, it should be MHC restricted. To test this, we assayed the ability of splenocytes from various strains of mice to enhance NIT-1 cell-triggered IFN-{gamma} release from clones 9B7 and 8F7. Surprisingly, splenocytes from strains NOD (H-2g7), BALB/c (H-2d), B10.BR (H-2k), and BALB.B (H-2b) all had an enhancing effect (Fig. 6GoA), arguing against Ag presentation as the sole mechanism for the enhancing effect of splenocytes.



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FIGURE 6. The effect of spleen cells on IFN-{gamma} release from cloned CD8+ T cells is not MHC restricted. A, Cloned T cells were cultured with spleen cells, NIT-1 cells, or a mixture of both. B, Cloned T cells were cultured with spleen cells in the presence of 10 U/ml IL-2. A and B, In controls, spleen cells were omitted. Data are the mean ± SEM of triplicate wells of one representative experiment.

 
Similarly, the ability of splenocytes to stimulate IFN-{gamma} release on their own did not require expression of NOD-specific MHC alleles (Fig. 6GoB). For all strains of mice used, the NIT-1 cell-independent stimulatory effect of spleen cells was greatly enhanced by exogenous IL-2 and to a large extent depended on it.

Taken together, Ag presentation can be ruled out as the sole or even major mechanism for the in vitro ability of spleen cells to enhance IFN-{gamma} release from CD8+ T cell clones. It appears that spleen cells provide a stimulatory signal other than Ag that can trigger IFN-{gamma} release on its own but at the same time cooperates with, and enhances, Ag-specific stimulation of cloned CD8+ T cells by NIT-1 cells. In the absence of Ag, prior activation or IL-2 appear to be required in lieu of simultaneous stimulation through the TCR.

Depletion of MHC class II-expressing and adherent cells from spleen cells reduces their effectiveness to enhance and stimulate IFN-{gamma} release from CD8+ T cell clones

We next asked which subpopulation within spleen cells might contribute to their cooperative effect with NIT-1 cells or their independent stimulatory effect. As shown in Fig. 7GoA, removing T cells from splenocytes, before adding them to cloned T cells together with NIT-1 cells, reduced the cooperative effect, but did not eliminate it. This reduction is probably due to some T cell-derived cytokine, such as IL-2, that enhances IFN-{gamma} production. In contrast, removing adherent cells abolished the enhancing effect. This result suggests that either macrophages and/or dendritic cells account for the stimulatory effect of spleen cells because removal of adherent cells led to a drastic decrease, as determined by flow cytometry, of the number of dendritic cells and macrophages (CD11c+ from 4.0 ± 0.2% to 1 ± 0.4%, Mac-1+ from 4.1 ± 0.6% to 1 ± 0.4%, respectively), but did not change the number of B cells (B220+ from 33 ± 5% to 31 ± 2%) or T cells (Thy-1.2+ from 50 ± 3% to 51 ± 3%).



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FIGURE 7. Depletion of macrophages (M{Phi}) and dendritic cells (DC) abolishes the cooperative effect of spleen cells and NIT-1 cells (A) as well as the IL-2-dependent stimulatory effect of spleen cells (B) on IFN-{gamma} release from cloned CD8+ T cells. C, Depletion of APCs from spleen cells reduces stimulation of IFN-{gamma} release from cloned CD8+ T cells. D, B cell blasts do not induce IFN-{gamma} release from cloned CD8+ T cells. A and C, T cells (5 x 104) were cultured with 1 x 105 spleen cells or depleted spleen cells. B and D, T cells (5 x 104) were cultured with the indicated number of spleen cells ({circ} •), T cell-depleted spleen cells ({diamondsuit}), M{Phi}- and DC-depleted spleen cells ({blacksquare}) or B cell blasts ({blacktriangleup}). IL-2 was added to the culture at 10 U/ml (B and D, closed symbols; C, as indicated). All experiments were done using clone 8F7.

 
Removing adherent cells from splenocytes drastically reduced not only their enhancing but also their independent stimulatory effect (Fig. 7GoB). As an alternative approach to depletion by adherence, we removed APCs, as defined by their expression of MHC class II molecules, from spleen cells before adding them to cloned CD8+ T cells. In controls, we removed T cells instead of APCs. The data (Fig. 7GoC) show that MHC class II-expressing cells but not T cells account for a large part of the enhancing effect of the total spleen cell population. Conversely, B cell blasts had no effect (Fig. 7GoD), not only confirming the specificity of the clones but again suggesting that MHC class II-expressing cells remaining after excluding B cells, i.e., macrophages and/or dendritic cells, account for the independent stimulatory effect of splenocytes.

The experiments demonstrating that the effect of spleen cells on IFN-{gamma} release from CD8+ T cells is not MHC restricted have ruled out Ag presentation but not alloreactivity as the underlying mechanism. However, in contrast to B10.BR spleen cells, B10.BR B cell blasts had no effect (not shown). We also compared the effect of the macrophage cell line J774A.1 and T cell line RMA. Although J774A.1 and RMA cells express the same MHC haplotype (H-2d) as BALB/c spleen cells, RMA cells were ineffective (Fig. 8GoA). Therefore, alloreactivity is unlikely to account for the effect of H-2k- or H-2d-expressing spleen cells, or of J774A.1 cells. Several other nonmacrophage cell lines were equally ineffective, such as the T cell lines EL-4 (H-2b) and YAC-1, as well as the mastocytoma line P815 (H-2d) (not shown).



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FIGURE 8. A, Stimulation of IFN-{gamma} release from cloned CD8+ T cells depends on the macrophage nature of stimulator cells and is not due to alloreactivity. Cloned CD8+ T cells (5 x 104) were cultured with an equal number of cells of the macrophage cell line J774A.1 (H-2d) or the T cell line RMA (H-2d). B, IFN-{gamma} release from CD8+ T cells in response to peritoneal exudate macrophages. T cells (5 x 104) were cultured with indicated numbers of peritoneal exudate macrophages obtained from NOD (Db, Kd) or BALB/c (H-2d) mice. IL-2 was added to the culture at 10 U/ml (A, as indicated; B, closed symbols). Shown are the mean ± SEM of triplicate wells of one representative experiment of two.

 
Taken together, we conclude that the expression of non-NOD MHC molecules alone is not sufficient for the enhancing effect on IFN-{gamma} release. This rules out alloreactivity to non-NOD MHC molecules expressed by J774A.1 cells as the mechanism of stimulation.

Because J774A.1 is a clonal cell line of macrophage origin, these experiments also suggest again that macrophages may contribute to the stimulation of IFN-{gamma} release from cloned CD8+ T cells. To test this more directly, we confirmed these results with a bona fide macrophage preparation, adherent PEC. PEC macrophages were effective stimulators of IFN-{gamma} release from both clone 8F7 and 9B7 (Fig. 8GoB). Interestingly, this was also true for BALB/c macrophages, confirming that this effect is not MHC restricted. Analogous to the enhancing and the independent stimulatory effects of spleen cells, clone 9B7 responded better to these macrophages than clone 8F7. To ensure that the response to macrophages was representative of NOD CD8+ T cells and not restricted to the clones used in this study, we repeated the experiments with polyclonal islet-reactive CTLs. Again NOD macrophages as well as BALB/c macrophages effectively stimulated IFN-{gamma} release from polyclonal CD8+ T cells (Fig. 8GoB).

CD8+ T cells recruit an inducible NO synthase-dependent pathway in islet destruction

The in vitro reconstitution experiments above have identified macrophages to be important contributors to the activation of IFN-{gamma} release from cloned CD8+ T cells. Islet destruction by CD8+ T cells was blocked by an Ab to IFN-{gamma} and was dependent on a pre-existing inflammatory infiltrate. Because IFN-{gamma} is a potent activator of macrophages, a component in the inflammatory infiltrate, it is possible that macrophages play a role not only in costimulating CD8+ T cells but may also cooperate with CD8+ T cells in islet destruction. Indeed, if macrophages costimulate IFN-{gamma} production by CD8+ T cells in situ, they would be in close proximity of IFN-{gamma}-producing CD8+ T cells. Activated macrophages produce several factors that may contribute to ß cell destruction. These include NO, IL-1, and TNF-{alpha} (22). In rodents, IL-1 alone (27) or in combination with IFN-{gamma} or TNF-{alpha} (22, 27), stimulates ß cells to synthesize NO. Because macrophages are the only source of IL-1 in islets (22, 28, 29), both NO synthesis by macrophages or by ß cells is indicative of macrophage activation. To implicate macrophages as partners in islet destruction by cloned CD8+ T cells, we returned to the islet destruction assays and used an inhibitor of the inducible form of NO synthase, L-NIL (30). Fig. 9GoA shows that this inhibitor protected inflamed islets from being destroyed by CD8+ T cells. This inhibition was observed at a dose range where selective inhibition of the inducible form of NO synthase occurs. The same observations were made using polyclonal CTLs, indicating that the participation of a NO synthesis in islet destruction is not restricted to the clones. In the presence of IL-7, the clones destroyed islets without inflammation also, such as NOD-scid islets (Fig. 9GoB). This type of killing was much less sensitive to inhibition by the NO synthesis inhibitor, suggesting that there are two pathways of islet destruction by cloned CD8+ T cells. In the presence of IL-7, the clones can kill directly, without the participation of macrophages. Without IL-7, the clones recruit a NO-dependent pathway. Most likely, IFN-{gamma} released from activated clones activates local macrophages, which contribute to islet destruction either by producing NO themselves or by releasing IL-1, which up-regulates the inducible form of NO synthase in ß cells.



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FIGURE 9. A, L-NIL, an inhibitor of the inducible form of NO synthase inhibits destruction of infiltrated islets by cloned CD8+ T cells. Infiltrated NOD islets (see Fig. 1Go and Results for details) were cultured with 8F7 T cells in the presence of indicated concentrations of L-NIL (µM). IL-2 was added to the culture at 10 U/ml. B, L-NIL is much less effective in protecting NOD-scid islets from destruction by cloned CD8+ T cells in the presence of IL-7. NOD-scid islets were cultured with 8F7 T cells as described above. IL-2 and IL-7 were added to the culture at 10 U/ml and 10 ng/ml, respectively. Islet destruction was assessed morphologically at the indicated time intervals after adding T cells. Data are the mean ± SEM of three experiments.

 

    Discussion
 Top
 Abstract
 Introduction
 Materials and Methods
 Results
 Discussion
 References
 
The first major novel finding in this paper is that CD8+ T cells interact not only with ß cells, but also with inflammatory cells in islets. This interaction enhances the activation of CD8+ T cells as reflected in two important functions of CD8+ T cells, islet destruction and IFN-{gamma} release. A second major finding is that accessory cells costimulate CD8+ T cells, and we have identified macrophages to account for this effect. A third finding is that CD8+ T cells, when destroying inflamed islets, are able to recruit a NO synthesis-dependent pathway.

The enhancement of islet destruction by the islet inflammatory infiltrate may in part be due to an increase in activation of cloned CD8+ T cells. The increase of IFN-{gamma} production in response to infiltrated islets is clearly an indicator of such increased activation. While information about the role of islet-infiltrating accessory cells in the activation of CD4+ T cells is accumulating (13, 31), evidence for a role of local accessory cells in inflamed islets in the activation of CD8+ T cells has not been reported before.

What could be the mechanism for the influence of inflammatory cells on activation of CD8+ T cells? Such mechanisms could be classified as direct or indirect, depending on whether infiltrating cells interact directly with cloned T cells or modify the interaction of ß cells with cloned T cells. A third possibility is that IFN-{gamma} release from cloned T cells is maximal only in case of a tripartite interaction where CD8+ T cells interact with both ß cells and infiltrating cells either simultaneously or consecutively.

Several of the possible indirect effects, such as up-regulation of MHC class I molecules or adhesion molecules on ß cells would be mediated by IFN-{gamma} released from infiltrating mononuclear cells. However, pretreatment of islets with IFN-{gamma} did not reproduce the effect of the inflammatory infiltrate. Induction of the release of soluble factors from ß cells, another potential indirect effect, is equally unlikely to be the key mechanism of the infiltrate because supernatant from inflamed islets had no effect on cloned CD8+ T cells. Other indirect effects relating to islet tissue integrity are also possible. For example, ß cell death may create gaps in the islet tissue that facilitate access of cloned T cells to ß cells. However, dissociated ß cells (data not shown) and NIT-1 were very ineffective stimulators of CD8+ T cells, suggesting that access to ß cells was not a severe limitation in the activation of cloned CD8+ T cells.

A contribution of direct effects, in which the infiltrating mononuclear cells themselves contribute to activation of CD8+ T cell clones, was suggested by our experiments with spleen cells and cells collected from the infiltrate. Cells of the monocyte-macrophage-dendritic cell lineage are most likely to account for these effects because acute depletion of MHC class II-expressing cells and strongly adherent cells from splenocytes drastically reduced stimulation of IFN-{gamma} production by cloned T cells. Based on these data we cannot differentiate between macrophages and dendritic cells. In this regard, it is noteworthy that macrophages and dendritic cells have recently been shown to belong to a common lineage of phagocytic cells that originates from circulating monocytes and branches upon tissue entry and contact with Ag (32). In principle, these cells could present islet Ag locally. Regardless of the contributing mechanisms, inflamed single islets were far more effective stimulators of IFN-{gamma} release than mononuclear cells collected from the infiltrate of many islets, suggesting that Ag presentation or other direct effects do not fully account for the enhancing effect of the infiltrate.

Taken together, neither indirect nor direct effects alone fully account for the enhancing effect of the infiltrate to activate cloned CD8+ T cells. In quantitative terms, even the sum of the effect of ß cells (or NIT-1 cells) alone and that of infiltrating mononuclear cells alone did not account for the ability of inflamed islets to stimulate IFN-{gamma} release from cloned CD8+ T cells. The data strongly suggest that ß cells and accessory cells in the infiltrate cooperate in a more than additive way in stimulating CD8+ T cells.

The in vitro reconstitution experiments with spleen cells, PEC, and a macrophage cell line were designed to identify candidate mechanisms that may underlie the cooperative effect of ß cells and infiltrating cells. These experiments have revealed an unexpected function of accessory cells that is, at least in part, most likely due to some form of bystander costimulation by macrophages. Spleen cells, when added to NIT-1 cells, appear to costimulate IFN-{gamma} production by cloned CD8+ T cells. This effect did not depend on expression of NOD MHC class I molecules although the CD8+ T cell clones could recognize ß cell Ag in an MHC-restricted way nor was it due to alloreactivity of MHC-mismatched spleen cells. These findings suggests that mechanisms other than Ag presentation may underlie the enhancing effect of spleen cells. Bystander costimulation is a remaining possibility. A similar conclusion was reached by Shimizu et al. (33) based on the fact that spleen cells expressing mismatched MHC alleles enhanced proliferation of NIT-1 cell-specific CD8+ T cells as well as NOD spleen cells did. The cell type and the nature of the costimulatory factor was not resolved in the work by Shimizu et al. (33). In this paper, we have provided evidence that macrophages can provide bystander costimulation. Among the known costimulators, B7-2 is unlikely to be a candidate molecule mediating this effect because B cell blasts expressed B7-2 but had no effect. Similar statements cannot be made for B7-1 because the expression levels were too low.

Spleen cells and PEC can, at least in the presence of IL-2, stimulate cloned CD8+ T cells without a source of ß cell Ags. However, this effect required prior activation of CD8+ T cells through their TCR, suggesting that accessory cells provide costimulatory signals but these do not need to be delivered simultaneously with signal one.

In this study, we have used IFN-{gamma} as a marker of CD8+ T cell activation. Our observation that anti-IFN-{gamma} Abs inhibited islet destruction suggests that IFN-{gamma} may play a role also in their islet-destructive effector function. Although IFN-{gamma} is necessary for islet destruction in our system, it is not sufficient because recombinant IFN-{gamma} did not destroy cultured islets without cloned CD8+ T cells during the time scale of our experiments (<72 h, data not shown). This was true even if the islets were heavily infiltrated. Others have found that IFN-{gamma} is toxic to ß cells, but only in combination with other cytokines or at very high concentrations (34). Those and our present data suggest that ß cells are not likely to be the only target of IFN-{gamma} action.

IFN-{gamma} is a potent coactivator of macrophages. Activation of macrophages is thought to be a major mechanism by which IFN-{gamma}-producing CD4+ T cells contribute to ß cell damage during the development of diabetes. By releasing IFN-{gamma}, Th1 cells are thought to activate macrophages to produce NO and other oxidants that are toxic to ß cells. Our results suggest that a similar interaction may occur between macrophages and CD8+ T cells, because a blocker of inducible NO synthase inhibited destruction of inflamed islets by CD8+ T cells. Although ß cells can also express the inducible form of NO synthase, this again requires products of activated macrophages, such as IL-1. Therefore, our data suggest a second pathway of signal exchange between CD8+ T cells and macrophages. Thus, macrophages may receive signals from CD8+ T cells and participate in their islet destructive function. The model of a tripartite interaction between ß cells, CD8+ T cells, and macrophages described above can account not only for costimulation of IFN-{gamma} release from CD8+ T cells, but also in their islet-destructive function. NO, produced either by activated macrophages themselves or by ß cells in response to macrophage products, may increase the sensitivity of ß cells to killing by CD8+ T cell, for example by up-regulating Fas on ß cells (23). In this model, CD8+ T cells still need to recognize Ag presented by ß cells, but are fully effective only if they are also exchanging signals with macrophages. Our CD8+ T cell clones can clearly recognize and kill ß cells directly as indicated by their ability to destroy NOD-scid islets in the presence of IL-7. IL-7 appears to have an enhancing effect that can substitute the enhancing effect of the infiltrate.

Our data on the role of IFN-{gamma} in islet destruction and IFN-{gamma}-mediated signal exchange between CD8+ T cells and macrophages agree well with studies by others who found that IFN-{gamma} is an important cytokine in the development of type I diabetes. Although earlier studies had suggested that knockout of the IFN-{gamma} gene does not protect against disease (35), recent evidence from IFN-{gamma} receptor knockout mice strongly suggests that IFN-{gamma} receptor signaling is essential for disease development and impacts at several stages of disease development (36). Expression of receptors for IFN-{gamma} on ß cells may not be required (37), but these receptors are essential on non-ß cells for disease development (36). Several studies have shown that blocking IFN-{gamma}, either by using anti-IFN-{gamma} Abs or soluble IFN-{gamma} receptor postnatally, prevented natural disease development and adoptive transfer of disease in NOD mice (38, 39), and regulation of IFN-{gamma} synthesis by IL-18 was found to be abnormal in NOD mice (40). By activating local macrophages, IFN-{gamma} may not only recruit their destructive potential, but also up-regulate their expression of costimulatory activity and contribute to a local environment in which activation of T cells can occur and an autoimmune response can be maintained (20, 21).

While it is well established that IFN-{gamma} plays an important role in disease development, it is not clear which cells produce IFN-{gamma} in the local environment of islets. The data in this paper strongly suggest that CD8+ T cells are, alongside Th1 cells, candidates for IFN-{gamma} production. A similar suggestion as to the role of CD8+ cells as local producers of IFN-{gamma} has been made by Rabinovitch et al. (41). In biobreeding rats, depletion of CD8+ T cells prevented up-regulation of IFN-{gamma} during disease development, and disease incidence was reduced and its onset was delayed (42).

Although our data showing that infiltrated islets from NOD mice are much better stimulators of CD8+ T cells than those that do not contain an infiltrate may in part be explained by the increase in the number of APCs, it is possible that the mere presence of different types of APCs found in islets is not sufficient. Indeed, even heavily infiltrated islets still showed a large variation of stimulatory capacity. We propose that the exact composition or the organization of the infiltrate may also be important. The architecture of the mononuclear infiltrate may bring macrophages in close proximity to ß cells, which may allow macrophages to provide costimulatory signals to CD8+ cells within the islet environment and receive activating signals from them and contribute to ß cell destruction.

The ability to measure the efficacy of single islets to stimulate IFN-{gamma} release from cloned T cells will facilitate the identification of tissue architectural elements that determine functional immunogenicity of the islet environment. In future experiments, cloned CD8+ T cells will serve as probes for the detection of changes in the islet environment that precede the development of destructive insulitis.


    Acknowledgments
 
We thank Dr. Minnie McMillan for numerous helpful discussions during the course of this work and Dr. Gunther Dennert for critically reading this manuscript.


    Footnotes
 
1 This work was supported by National Institutes of Health Grant DK49717. Back

2 Address correspondence and reprint requests to Dr. Hermann von Grafenstein, School of Pharmacy, University of Southern California, 1985 Zonal Avenue, Los Angeles, CA 90033. E-mail address: Back

3 Abbreviations used in this paper: IDDM, insulin-dependent diabetes mellitus; NOD, nonobese diabetic; NOD-scid, NOD/Lt-scid/scid; TCM, tissue culture medium; L-NIL, L-N6-(1-iminoethyl)lysine · HCl; PEC, peritoneal exudate cells. Back

Received for publication May 20, 1998. Accepted for publication September 9, 1999.


    References
 Top
 Abstract
 Introduction
 Materials and Methods
 Results
 Discussion
 References
 

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