The Journal of Immunology, 1999, 163: 3914-3919.
Copyright © 1999 by The American Association of Immunologists
Monocyte-Driven Activation-Induced Apoptotic Cell Death of Human T-Lymphotropic Virus Type I-Infected T Cells1
Shin-ichi Wakamatsu*,
,
Masahiko Makino2,*,
Chuuwa Tei
and
Masanori Baba*
*
Division of Human Retroviruses, Center for Chronic Viral Diseases, and
First Internal Medicine, Faculty of Medicine, Kagoshima University, Kagoshima, Japan
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Abstract
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We attempted apoptotic cell death induction of T cells infected
with human T lymphotropic virus type I (HTLV-I) which induces
HTLV-I-associated myelopathy/tropical spastic paraparesis and adult T
cell leukemia. T cells acutely infected and expressing
HTLV-Igag Ags were killed by cross-linking their TCR
with anti-CD3 mAb. Cells in apoptotic process were found by
staining with annexin V. The apoptosis was not affected by
costimulation through CD28 molecules and was resistant to ligation of
Fas molecules. Whereas the virus-infected T cells expressed higher
levels of HLA-DR, CD25, CD80, and CD86 Ags than apoptosis-resistant
PHA-blasts, the T cell apoptosis was enhanced by addition of exogenous
IL-2. Furthermore, in this apoptosis, monocytes played an important
role because T cells infected in the absence of monocytes were
resistant to the death signals. The apoptosis-sensitive T cells
responded to TCR signaling more strongly by proliferating than those
apoptosis-resistant cells. Monocytes weakly affected the expression
levels of viral Ags on T cells. However, HTLV-I-infected monocytes
primed T cells to die by subsequent TCR signaling. T cells primed with
the monocytes, subsequently infected in the absence of monocytes, were
killed by TCR signaling. These observations suggest that primed and
infected T cells could be killed by activation-induced cell
death.
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Introduction
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Human
T-lymphotropic virus type I
(HTLV-I)3 is the
causative agent of HTLV-I-associated myelopathy/tropical spastic
paraparesis and adult T cell leukemia (ATL) (1, 2). The
former is thought to be an autoimmune disease induced by activated
autoreactive T cells (3), and the latter to be manifested
by the expansion of leukemic T cells which are considered to be
produced from HTLV-I-infected T cells by an unknown mechanism. The
manifestation of these diseases is closely associated with an increase
of virus-infected T cells. These diseases are manifested 4060 years
after infection with HTLV-I in the newborn period (2, 4).
During the asymptomatic state, the number of virus-infected T cells is
well controlled, and expansion of leukemic T cells is not allowed. In
this process, HTLV-I Ag-specific CTL are believed to play a major role
in controlling the expansion of these T cells. In addition to the
cytolysis by CTL, however, induction of apoptosis of HTLV-I-infected T
cells should be a desirable strategy to eliminate virus-infected T
cells and to prevent a life-threatening disease such as ATL, if it
could be induced under physiological conditions. After T cells are
activated by responding to antigenic stimuli, they are generally killed
by apoptotic mechanisms. Among the apoptotic mechanisms,
activation-induced cell death (AICD) play a central role, especially in
killing autoreactive T cells and in preventing hyperimmune responses
(5, 6, 7). It has recently been reported that Jurkat cells
artificially introduced with the HTLV-Itax gene undergo AICD
by signaling through TCR (8).
The direction of the host immune response to exogenous Ags is largely
determined by the quantity of Ags inoculated and the sort of APC that
are enrolled in the immune responses. In the presence of a large amount
of Ags and/or prolonged contact with Ags, T cells usually undergo
anergic processes and enter an anergic or unresponsive state (9, 10). Therefore, the quick elimination of antigenic stimuli at
the initial viral infection stage is extremely important for keeping T
cell function normal. In this respect, the elimination of freshly
HTLV-I-infected CD4+ T cells by an apoptotic cell
death induction should be a reasonable and effective tool for
preventing the manifestation of HTLV-I-induced diseases. However,
although HTLV-I-infected T cells are easily activated
(11), there are very few consistent observations on the
apoptosis of HTLV-I-infected T cells. Therefore, in this study we tried
to induce AICD of acutely infected CD4+ T cells
and found that T cells infected with HTLV-I in the presence of
monocytes for 1 wk could be killed by TCR signaling. In addition to the
TCR signals, HTLV-I-infected monocytes played a major role in priming
uninfected T cells to be feasibly killed by subsequent infection and a
death signal.
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Materials and Methods
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Cell preparation
PBMCs were donated by uninfected healthy donors. The PBMCs were
isolated from heparinized blood by using Ficoll-Paque Plus (Pharmacia,
Uppsala, Sweden) and cryopreserved in liquid nitrogen until used as
described previously (12). Plastic-adherent monocytes were
obtained by culturing PBMCs for 60 min in the culture plate and by
washing out nonadherent cells with prewarmed medium.
Purified T cells were obtained as follows: Fresh or cryopreserved
PBMCs were cultured for 60 min and nonadherent cells were
obtained. They were further depleted of MHC class
II+ cells by using magnetic beads coated with mAb
to MHC class II Ag (Dynabeads 450, Dynal, Oslo, Norway). Contamination
of the purified population by HLA-DR-positive cells was <2%. The
complete elimination of monocytes from the T cell population was
accomplished by further treating the purified population with beads
coated with anti-CD14 mAbs (Dynabeads 450). In this highly purified
population, <0.5% of CD14+ monocytes were
included. Depletion of CD8+ T cells from PBMCs
was conducted by using beads coated with anti-CD8 mAb
(Dynabeads 450).
Infection of T cells with HTLV-I
The HTLV-I-producing cell line MT-2, a generous gift from Dr. I.
Miyoshi, Kochi Medical School, was used as a viral source. T cells
(2.5 x 105/ml) from healthy donors were
cocultured with mitomycin C (200 µg/ml)-treated MT-2 cells (5 x
104/ml) in the presence or absence of uninfected
monocytes. The mitomycin C treatment was done by incubating cells for
30 min at 37°C. Cocultivated T cells were maintained in the presence
of 1 µg/ml PHA-P (Difco, Detroit, MI) for 7 days. At day 7 of
culture, live and activated T cells were obtained by using 30 and 55%
Percoll solutions (Pharmacia, Piscataway, NJ) and were maintained in
the presence of 2 µg/ml PHA-P and 100 U/ml rIL-2 (TGP-3, Takeda
Chemical Industries, Osaka, Japan). Monocytes were infected with HTLV-I
by cocultivating them with mitomycin C-treated MT-2 cells for 5 days in
the presence of 20% FCS. Priming of T cells by HTLV-I-infected
monocytes was conducted by coculturing uninfected and purified T cells
with virus-infected monocytes for 5 days. In some cases, the primed T
cells were infected by using MT-2 after completely eliminating
CD14+ cells from the population. Infection of
monocytes and T cells with HTLV-I was determined by cytometry analysis
(FACScan, Becton Dickinson ImmunoCytometry Systems, San Jose, CA) for
surface expression of HTLV-Igag and HTLV-Ienv
proteins. HTLV-Itax protein was detected by FACScan by
permeabilizing cells with 0.3% saponin solution (Sigma, St.
Louis, MO).
Analysis of cell surface Ag
The expression of cell surface Ags on the T cells was determined
by using FACScan (Becton Dickinson). Live cells (1 x
104) were gated and analyzed. To eliminate dead
cells from analysis, propidium iodide (PI, Sigma) was used. We used
FITC-conjugated mAb against CD25 (2A3), HLA-DR (L243, Becton
Dickinson), and CD80 (BB1, PharMingen, San Diego, CA) and PE-labeled
mAb to CD86 (IT2.2, PharMingen), and purified murine mAb to
HTLV-Igag (GIN14), HTLV-Ienv (F10), and
HTLV-Itax (LT4) (generously given to us by Dr. Y. Tanaka,
Department of Hygiene, Kitazato University, Sagamihara, Japan) which
were followed by FITC-labeled goat F(ab')2
anti-mouse Igs (Tago Immunologicals, Camarillo, CA). The optimal
concentrations of mAbs were determined in advance. T cells in an
apoptotic process were determined by staining them with FITC-conjugated
annexin V (Genzyme, Cambridge, MA) and PI. The T cells were
preincubated for 20 min on ice with 2% BSA solution and were stained
with 0.15 µg/ml annexin V conjugates.
Proliferation assay
T cells infected with HTLV-I in the presence or absence of
monocytes were stimulated with various concentrations of immobilized
CD3 mAb. The infected T cells (2.5 x
104/well) were plated in 96-well round-bottom
tissue culture plates that were precoated with CD3 mAb. The cell
proliferation during the last 16 h of the 48-h culture was
quantified by incubating the cells with 1 µCi/well
[3H]thymidine. The results are expressed as the
mean value in cpm obtained from triplicate cultures.
Apoptotic cell death induction
HTLV-I-infected T cells or PHA-blasts were stimulated with 2
µg/ml CD3 mAb. The CD3 mAb was precoated in 96-well round-bottom
tissue culture plates, and an excess of mAb was washed out with PBS
before use. T cells (2.5 x 104) were plated
and harvested 16 h after stimulation. The apoptosis of T cells was
determined by using FACScan. In some cases, T cells were stimulated
with CD3 mAb in the presence of mAbs antagonistic to Fas (ZB4, Medical
and Biological Lab., Nagoya, Japan) and/or Fas ligand (NOK-2, Sumitomo
Electric, Yokohama, Japan).
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Results
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Apoptotic cell death induction of HTLV-I-infected T cells
CD4+ T cells were obtained from normal
uninfected donors and infected with HTLV-I. One week after infection,
live viral infected T cells were purified and tested for their ability
to undergo AICD after cross-linking with CD3 mAb (Fig. 1
). These restimulated T cells were
positively stained with annexin V (Fig. 1
a). T cells were
infected by using various amounts of MT-2 cells, and they consistently
showed apoptosis (not shown). The apoptosis level decreased in a
time-dependent manner after infection, and the cells maintained for 4
wk showed no apoptosis (Fig. 1
a). Several donors were
examined and most viral infected T cells changed to be resistant to CD3
mAb stimulation 24 wk after infection (not shown). However, massive
apoptotic cell death was not induced in T cells stimulated by PHA and
IL-2 and restimulated by CD3 mAb (Fig. 1
b). No apparent
changes were induced on HTLV-I-infected T cells by CD28 mAb stimulation
(Fig. 1
c). Furthermore, the effect of CD28 mAb costimulation
to CD3 stimulation in the T cell apoptosis was not observed (not
shown). To confirm that the HTLV-I-infected T cells were killed by CD3
mAb stimulation, we conducted double staining analysis by using mAb to
HTLV-Igag Ags and annexin V (Fig. 2
). Although 3.5% of T cells among the
whole population showed apoptosis before restimulation, most of the
apoptotic cells (94.3%) were positively stained with
HTLV-Igag Ags. By restimulation with CD3 mAb, both
HTLV-I-infected cells and apoptotic cells increased, and again, most of
the apoptotic cells (90.5%) expressed HTLV-Igag Ags. In contrast to
HTLV-I-infected T cells, T cells stimulated with heat-inactivated MT-2
cells were minimally stained with HTLV-Igag mAb and showed
no apparent apoptotic cell death. Therefore, HTLV-I-infected T cells
were considered to be killed mainly by CD3 mAb stimulation.

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FIGURE 2. Double staining of T cells with HTLV-Igag mAb and
annexin V. Uninfected T cells were stimulated with MT-2 cells or heat
(56°C, 30 min)-inactivated MT-2 cells in the presence of PHA. One
week after stimulation, live T cells were stained with
HTLV-Igag mAb (GIN-14) and annexin V. The number
represents percent positive cells. A representative of three
independent experiments is shown.
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Contribution of Fas ligand and CD8+ T cells to
apoptosis of HTLV-I-infected T cells
To clarify the roles of Fas and Fas ligand molecules and
CD8+ T cells in the apoptosis, we induced the
virus-infected T cell death in the presence of mAbs antagonistic to
Fas, Fas ligand, and both (Table I
). The
concentrations of the antagonistic mAbs were enough to block apoptotic
death of Jurkat cells induced by mAb agonistic to Fas Ag. However, no
apparent reduction of apoptosis by those mAbs was observed.
Furthermore, T cells infected in the absence of
CD8+ T cells showed a level of apoptosis similar
to those infected in the presence of CD8+ T
cells.
The possibility of activation-induced cell death in HTLV-I-infected
T cells
The minor contribution of Fas and Fas ligand to the apoptosis
prompted us to check the possibility of Fas signaling-independent AICD
of HTLV-I-infected T cells by CD3 mAb stimulation. Therefore, we
compared the expression level of various activation-related molecules.
When we compared the expression of these molecules on virus-infected T
cells with that on uninfected PHA-blasts, the former expressed
significantly higher levels of HLA-DR (126 vs 95 in the mean
fluorescence intensity), CD86 (94 vs 19), and CD25 (192 vs 39) Ags
(Fig. 3
A). Furthermore,
because IL-2 is known to activate T cells, we checked the effect of
exogenous IL-2 on the apoptosis. Addition of exogenous IL-2, especially
at 100 U/ml, significantly enhanced the ability of the virus-infected T
cells to undergo apoptosis to a subsequent cross-linking of the CD3 mAb
(Fig. 3
B).
The role of HTLV-I-infected monocytes in virus-infected T cell
apoptosis
To clarify the role of APCs in the activation of HTLV-I-infected
cells, we removed monocytes from PBMCs, infected them with HTLV-I, and
induced apoptosis (Fig. 4
). As observed
before (Fig. 1
), T cells infected with HTLV-I 1 wk before in the
presence of monocytes were sensitive to the apoptosis signal, whereas
those infected 2 wk before were less sensitive to the signaling.
However, surprisingly, in contrast to these T cells, T cells infected 1
or 2 wk before in the absence of monocytes showed little apoptosis by
CD3 mAb stimulation. This difference might come from a difference in
sensitivity to CD3 mAb stimuli. T cells infected in the presence or
absence of monocytes were stimulated by various concentrations of CD3
mAb (Fig. 5
). The proliferative responses
of T cells infected with HTLV-I in the presence of monocyte to CD3 mAb
stimuli were significantly higher than that of T cells infected in the
absence of monocytes. Therefore, the former viral infected T cells
seemed more sensitive to CD3 mAb stimuli than the latter ones. This
observation might reflect that viral infection level of T cells is
influenced by monocytes. However, there was no apparent correlation
between the number of monocytes and the infection level of T cells
(Fig. 6
). T cells (5 x
105) were infected in the presence of various
numbers (01 x 105) of monocytes. The
expression level of HTLV-Igag Ags on T cells was not
influenced by the presence of monocytes. Then, to clarify the action of
monocytes on T cells, we checked another possibility that
HTLV-I-infected monocytes worked to prime T cells to die by subsequent
viral infection and CD3 mAb stimuli (Fig. 7
). Plastic-adherent monocytes were
infected in vitro and cocultured with highly purified
CD4+ T cells for 7 days. Only T cells primed with
virus-infected monocytes were weakly stained with annexin V after CD3
mAb stimulation. Furthermore, when T cells primed by the infected
monocytes were infected with HTLV-I after complete depletion of
CD14+ monocytes and were restimulated with CD3
mAb, massive apoptosis was induced solely in T cells primed with
virus-infected monocytes. No apparent apoptosis was observed in T cells
primed with uninfected monocytes and infected with HTLV-I.

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FIGURE 5. Proliferative responses of HTLV-I-infected T cells to CD3 mAb stimuli.
T cells were infected with HTLV-I in the presence or absence of
monocytes for 1 wk. T cells (1.25 x 105/ml) were
cultured for 48 h in wells precoated with various concentrations
of CD3 mAb. Assay was done in triplicate and the mean SD is shown. A
representative of three independent experiments is shown.
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Discussion
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In this study, we induced apoptotic cell death of acutely
HTLV-I-infected CD4+ T cells by TCR signaling in
combination with virus-infected monocytes. In general, Fas/Fas ligand
signaling (13, 14), TNF/TNFR binding (15, 16), CTLA-4 cross-linking (17, 18), AICD
(5, 6, 7), and cell lysis by CTL and NK cells are considered
representative mechanisms for apoptotic cell death. Among them,
Fas-independent AICD seemed the most appropriate mechanism for the
apoptosis of HTLV-I-infected cells. The virus-infected T cells were
more strongly activated than PHA-blasts and were more sensitive to CD3
mAb-mediated proliferative stimuli than apoptosis-resistant T cells.
Furthermore, the apoptosis was enhanced by an addition of exogenous
IL-2. IL-2 seems essential for induction of Fas-independent AICD as
well as Fas-dependent AICD (19, 20, 21). The role of IL-2 is
considered to be to enter cells at the S stage of the cell cycle in
which the cells are most sensitive to apoptotic signals
(22). However, the AICD was not induced in cells infected
for more than 4 wk. The exact reason for this resistance is unknown,
but they were least sensitive to CD3 mAb in proliferative responses
(not shown). The reduced sensitivity of chronically infected T cells to
CD3 mAb signaling might be an important mechanism for their
resistance.
The contribution of CD8+ T cells to the
virus-infected T cell lysis seems less likely because cell death was
induced in the absence of CD8+ T cells. However,
we could not rule out the contribution of CD4+
CTL. There are some uninfected CD4+ T cells
remaining in the T cell population. It is reported that
CD4+ CTL kill their target in a TNF-related
apoptosis-inducing ligand (TRAIL)-mediated fashion (23)
and that some CD4+ T cells undergo AICD by
signals through the TRAIL (24). Therefore, we checked the
possibility by using an inhibitory mAb to TRAIL, RIK-2 (25). However,
the AICD of HTLV-I-infected T cells was not suppressed by RIK-2 (not
shown).
Thus far two mechanisms are reported concerning the apoptosis of
HTLV-I-infected T cells. One of them is the cell death by Fas-Fas
ligand signaling. Debatin et al. (26) reported that the
virus-infected T cells were sensitive to Fas signaling. However, in our
study, both acutely and chronically infected T cells were resistant to
a mAb agonistic to Fas in spite of expressing a high level of the Ag
(not shown), and the apoptosis of acutely infected T cells was not
blocked by a mAb antagonistic to Fas ligand (Table I
). These
observations are in line with many other reports in which
HTLV-I-infected T cells are reported to be Fas insensitive for unknown
reasons (27, 28). Quite recently, however, mutation of the
Fas gene was found in HTLV-I-infected ATL cells (29, 30). These observations might be able to explain the resistance
of virus-infected T cells to Fas signal. The second mechanism is
HTLV-Itax-mediated apoptosis. The fibroblasts and
osteoblasts expressing genetically introduced HTLV-Itax
molecules have easily undergone apoptosis (31, 32) and, in
some cases, the Tax-mediated apoptosis was observed in thymocytes
(33). Quite recently, it was reported that Jurkat cells
transfected with HTLV-Itax showed AICD by TCR signaling
(8). However, in our study, there were no marked
differences in the Tax-expressing level between AICD-sensitive and
AICD-resistant virus-infected T cells as determined by FACS (not
shown). Therefore, a contribution of HTLV-Itax to our AICD
seems less likely.
In addition to TCR signaling, HTLV-I-infected monocytes played a major
role in the T cell apoptosis. Our data clearly indicate that, on one
hand, monocyte depletion prevents sensitization of T cells for
subsequent AICD and that, on the other hand, uninfected T cells primed
with virus-infected monocytes showed weak AICD on TCR signaling, and
their apoptosis was clearly enhanced by subsequent HTLV-I infection in
the absence of the monocytes. In the former case, limited cell death
was observed. This might be due to poor viral transmission efficiency
from monocytes to T cells. Depending on the experimental conditions,
monocytes are suggested to transfer virus to T cells (34).
However, in our case, apparent transmission was not observed (not
shown). Monocytes activated by PHA or superantigens induce apoptosis of
target cells by secreting a soluble form of Fas ligand
(35), although in another study soluble Fas ligands made
target cells resistant to apoptosis (36). In addition,
HIV-1-infected monocytes directly killed uninfected
CD4+ T cells by signaling through gp120
(37). In our study, however, the direct killing of
HTLV-I-infected T cells by virus-infected monocytes was not observed
(not shown), and the monocytes primed T cells solely by up-regulating
their sensitivity to apoptosis signals. To our knowledge, this is the
first report indicating that HTLV-I-infected monocytes were able to
prime T cells to be killed by subsequent viral infection.
There are still 20 million people infected with HTLV-I
(38), and they have a possibility of manifesting
HTLV-I-associated myelopathy/tropical spastic paraparesis or ATL.
Elimination of virus-infected T cells is a quite important therapeutic
strategy. In our system, virus-infected monocytes and TCR signaling are
solely required for the T cell killing. Monocytes are sensitive to
HTLV-I-infection both in vitro and in vivo
(39),4
and TCR signaling can be provided by virus-infected dendritic cells
(DCs). DCs are also sensitive to HTLV-I infection (40),
and the infected DCs can strikingly stimulate
CD4+ T cells in a MHC-dependent manner
(40). Therefore, both HTLV-I-infected monocytes and TCR
signaling will be easily prepared in vitro that should be useful for
the development of a new immunological treatment.
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Acknowledgments
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We thank Ms. N. Makino for preparation of the manuscript, Dr.
M. L. Robbins for reviewing the manuscript, and Drs. N.
Kayagaki and H. Yagita (Juntendo University, Tokyo, Japan) for
donating RIK-2.
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Footnotes
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1 This work was supported in part by a Grant-in-Aid for a Second-Term Comprehensive 10-Year Strategy for Cancer Control from the Ministry of Health and Welfare of Japan. 
2 Address correspondence and reprint requests to Dr. Masahiko Makino, Division of Human Retroviruses, Center for Chronic Viral Diseases, Faculty of Medicine, Kagoshima University, 8-35-1 Sakuragaoka, Kagoshima, 890-8520 Japan. E-mail address: 
3 Abbreviations used in this paper: HTLV-I, human T lymphotropic virus type I; ATL, adult T cell leukemia; AICD, activation-induced cell death; PI, propidium iodide; TRAIL, TNF-related apoptosis-inducing ligand; DC, dendritic cell. 
4 M. Makino, S. Wakamatsu, S. Shimokubo, N. Arima, and M. Baba. Production of functionally deficient dendritic cells from HTLV-I-infected monocytes: implication for the dendritic cell defect in adult T cell leukemia. Submitted for publication. 
Received for publication May 27, 1999.
Accepted for publication July 16, 1999.
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