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The Journal of Immunology, 1999, 163: 4277-4283.
Copyright © 1999 by The American Association of Immunologists

A Soluble Factor Produced by Lamina Propria Mononuclear Cells Is Required for TNF-{alpha} Enhancement of IFN-{gamma} Production by T Cells1

John L. Prehn, Carol J. Landers and Stephan R. Targan2

Cedars-Sinai Inflammatory Bowel Disease Center, Los Angeles, CA 90048


    Abstract
 Top
 Abstract
 Introduction
 Materials and Methods
 Results
 Discussion
 References
 
The role of TNF-{alpha} in the mucosal inflammation of Crohn’s disease has been demonstrated by the prolonged clinical responses and/or remissions among patients receiving i.v. infusion of anti-TNF-{alpha}. A correlation between TNF-{alpha} and elevated IFN-{gamma} production is suggested by the reduction in the number of IFN-{gamma} producing lamina propria mononuclear cells (LPMC) found in colonic biopsies from anti-TNF-{alpha}-treated patients. The aim of this study was to define the mechanism of TNF-{alpha}-augmented mucosal T cell IFN-{gamma} production. In this paper we present evidence that cultured LPMC secrete a factor which acts on preactivated T cells in concert with TNF-{alpha} to augment IFN-{gamma} production. This activity is independent of IL-12 and IL-18, the well-documented potentiators of IFN-{gamma} expression, and is not produced by PBMC. Peripheral blood PHA-activated T cells incubated in supernatants from LPMC became responsive to TNF-{alpha} by increasing IFN-{gamma} output upon stimulation. These results are consistent with a model in which LPMC, but not PBMC, release an unidentified substance when cultured in vitro with low dose IL-2. This substance can act on preactivated peripheral T cells, as well as on lamina propria T cells, conditioning them to respond to TNF-{alpha} by increased IFN-{gamma} secretion upon stimulation. Expression of this factor in the gut mucosa could contribute to up-regulation of the Th1 response in the presence of TNF-{alpha}, and could be important for mucosal immunoregulation.


    Introduction
 Top
 Abstract
 Introduction
 Materials and Methods
 Results
 Discussion
 References
 
The key role of TNF-{alpha} in the mucosal inflammation of Crohn’s disease has been demonstrated by prolonged clinical responses and/or remissions among patients treated with an i.v. infusion of a mAb to TNF-{alpha} (1). Several studies using mouse models of colitis have also indicated a central pathogenic role for TNF-{alpha} (2). Especially cogent are those studies showing abrogation of colitis induction in a mouse TNF-{alpha} knockout model (3) and the lethal exacerbation of colitis in mouse models harboring a TNF-{alpha} transgene (4). A correlation between TNF-{alpha} and elevated IFN-{gamma} production is suggested by the sharp reduction in the number of IFN-{gamma} producing lamina propria (LP)3 mononuclear cells (LPMC) found in colonic biopsies from anti-TNF-{alpha} treated patients (5). Similar evidence of the correlation between TNF-{alpha} and IFN-{gamma} has been obtained from rodent models of colitis in which anti-TNF-{alpha} treatment resulted in decreased production of IFN-{gamma} by LPMC (4). Recently, we established that in vitro culture of LPMC with TNF-{alpha} for 2 days before stimulation increases the amount of IFN-{gamma} produced. In this system, IFN-{gamma} production was usually strongly up-regulated in the presence of nonlymphocyte LPMC, implying that TNF-{alpha} acts on IFN-{gamma}-producing cells in synergy with soluble factor(s) from nonlymphocyte LPMC (5).

Although little is known about TNF-{alpha} potentiation of IFN-{gamma} production, there is evidence that TNF-{alpha} can act on T cells both directly and indirectly, via induction of other factors, to augment IFN-{gamma} production. In mouse T cells, TNF-{alpha} can activate the p38 mitogen-activated protein kinase pathway, which mediates IFN-{gamma} production (6). TNF-{alpha} has been reported to stimulate peripheral blood (PB) mononuclear cells to produce the chemokine IP-10, and recombinant human IP-10 has been shown to increase IFN-{gamma} production by human PB T cells following stimulation by several agents (7). TNF-{alpha} can act on human dendritic cells in synergy with PGE2 to stimulate production of IL-12, which strongly potentiates IFN-{gamma} production by T cells (8). In fact, the cytokines IL-1ß, IL-12 and IL-18 are secreted from nonlymphocytes and act on T cells, singly and in synergy, to potentiate IFN-{gamma} production (9, 10, 11, 12); IL-1ß can be induced by TNF-{alpha}, but whether expression of IL-12 or IL-18 is stimulated by TNF-{alpha} is not known.

Because some cytokines suppress IFN-{gamma} production, TNF-{alpha} might act to increase IFN-{gamma} production by suppressing the production of such inhibitors. Thus, IL-4 suppresses polarization of T cells toward the Th1, IFN-{gamma}-secreting phenotype, and IL-10 inhibits IFN-{gamma} expression by activated T cells (13). In the case of IL-10, however, TNF-{alpha} is known to induce, not suppress, production (14, 15).

The mucosal immune system has several characteristic features that sharply differentiate it from the systemic immune compartment (16). Most mucosal T cells possess surface markers associated with prior activation (17), yet they are relatively unresponsive to stimulation in vitro via the TCR/CD3 complex. However, intestinal mucosal T cells can be strongly activated via the CD2 pathway, especially with CD28 costimulation (18). Mice with functional inactivation of diverse genes (IL-2, IL-10, TCR, G-protein {alpha}i2) show severe chronic intestinal inflammation, often the predominant phenotypic result of the knockout (19). In fact, animal models of intestinal inflammation are almost completely dependent on the presence of T cells (19, 20). Such findings, among others, suggest that T cells within the intestinal mucosa may be poised to produce a strong inflammatory response. Our previous study documented substantial augmentation of IFN-{gamma} production by TNF-{alpha} in LPMC (5). The purpose of this study was to define the mechanism by which TNF-{alpha} augments mucosal T cell IFN-{gamma} production. We have found that LPMC cultured in vitro secrete a factor other than IL-12 or IL-18, which acts on preactivated T cells to augment IFN-{gamma} production in the presence of TNF-{alpha}. Production of this factor appears to be restricted to the gut mucosa, and, once identified, its neutralization could be a useful part of an anti-inflammatory strategy to treat inflammatory bowel disease (IBD).


    Materials and Methods
 Top
 Abstract
 Introduction
 Materials and Methods
 Results
 Discussion
 References
 
Purification of LPMC and PBMC

Intestinal specimens were obtained from patients undergoing surgical resection of the colon (with colon carcinoma or treatment-resistant Crohn’s disease or ulcerative colitis) at Cedars-Sinai Medical Center (Los Angeles). Approval for the use of human subjects was obtained from the Institutional Review Board at Cedars-Sinai Medical Center. In this study, all tissue specimens were taken from an uninvolved area of resected colon from patients with colonic carcinoma (normal), involved areas of patients with ulcerative colitis, as well as from uninvolved and involved areas of patients with Crohn’s disease. LPMC were isolated using a technique modified from that described previously (18). Briefly, the intestinal specimen was washed with HBSS, and the mucosa was dissected away from the underlying layers. The mucosal layer was incubated, in a shaking water bath (37°C, 100 rpm), in calcium- and magnesium-deficient HBSS containing 1 mM EDTA, 50 µg/ml gentamicin, 100 U/ml penicillin, 100 µg/ml streptomycin, and 50 µg/ml Fungizone, with the solution changed every 30 min until the supernatant was free of epithelial cells. The remaining LP was minced into 1- to 2-mm pieces and digested for 10 min in RPMI 1640 containing 10% FCS, 0.5 mg/ml collagenase B (Boehringer Mannheim, Indianapolis, IN), 1 mg/ml hyaluronidase (Sigma, St. Louis, MO), 0.1 mg/ml DNase I (Sigma), 50 µg/ml gentamicin, 100 U/ml penicillin, 100 µg/ml streptomycin, and 50 µg/ml Fungizone in the water bath (100 rpm). The supernatant was collected, filtered through 110-µm nylon mesh (Spectrum Laboratory Products, Houston, TX), and centrifuged at 500 x g for 5 min. The cell pellet was resuspended in 15 ml and centrifuged at 30 x g for 5 min to remove epithelial and other large cells. The supernatant was removed and lymphocytes were isolated by separation on Ficoll-Hypaque gradients. The cells were then washed three times with HBSS and resuspended in RPMI 1640 containing 10% FCS. PBMC were isolated from normal healthy volunteers by separation on Ficoll-Hypaque gradients. Resting T cells were enriched using immunomagnetic beads (Miltenyi Biotech, Auburn, CA) and anti-CD2 Ab (T11, Coulter Immunology, Hialeah, FL).

Induction of LP-like T cells

Mononuclear cells from Ficoll-Hypaque gradients were incubated in medium on nylon wool at 37°C for 2 h to enrich for T cells, then were cultured in RPMI 1640 with 10% FCS with a 1:5 ratio Daudi:lymphocytes plus 10 U/ml rIL-2 for 5 days (18). Daudi were irradiated with 3000 rad and washed three times in HBSS before addition to cultures. Following a 5-day culture, LP-like cells were washed with HBSS to remove dead Daudi cells (at this point, there were virtually no live Daudi cells in the culture as determined by flow cytometry).

Cell culture conditions

LPMC and PBMC were cultured (1 x 106/ml) for 2 days in RPMI 1640 with 10% heat-inactivated FBS, 25 mM HEPES, 2 mM L-glutamine and 50 µg/ml gentamicin. A total of 10 U/ml rIL-2 (R&D Systems, Minneapolis, MN) was added to LPMC and PBT/Daudi cultures to maintain viability (18), and 1 µg/ml PHA (Sigma, St. Louis, MO) was added to PBMC for experiments using PHA-activated PB T cells. Most experiments followed a standard protocol: cells were incubated in cell culture plates for 2 days, with and without TNF-{alpha}, both conditions including any blocking or control Abs or added cytokines. In indicated experiments, adherent PBMC were prestimulated with PMA (10 ng/ml) plus ionomycin (1 µg/ml), or with LPS (2 µg/ml, all from Sigma), or with 1,25-dihydroxyvitamin D3 (10 nM, Biomol, Plymouth Meeting, PA) for 2–20 h before washing and addition of T cells for the 2-day incubation. After incubation, cells were collected, washed with medium, and resuspended in medium containing the stimulatory monoclonal anti-CD2 pair (GD10 and CB6, gift of Dr. C. D. Benjamin, Biogen, Cambridge, MA; 0.2 µg/ml each). Anti-CD3 cross-linking was delivered by OKT3 mAb incubation in a culture well coated with goat anti-mouse IgG (Jackson ImmunoResearch, West Grove, PA). After 18 h, supernatants were frozen for later analysis by ELISA.

Neutralizing Abs

Except for anti-TNF-{alpha}, Abs were added to both control and TNF-{alpha} incubation conditions at 2–10 µg/ml as stated in figure legends. Appropriate species IgG (mouse and goat, Jackson ImmunoResearch; rabbit, Peprotech, Rocky Hill, NJ) at the same concentrations were used for controls. Goat anti-IL-12 IgG was the gift of Dr. M. Gately (Hoffmann-LaRoche, Nutley, NJ), who demonstrated that at 0.5 µg/ml it neutralized the bioactivity of IL-12 at 200 pg/ml (21). Commercial Ab were as follows: anti-IL-18 mAb (MAB318, R&D Systems). The data sheet provided shows a neutralization curve in which 50% of the bioactivity of recombinant human IL-18 at 50 ng/ml or 2.7 nM was neutralized by the monoclonal at 0.4–0.8 µg/ml. (We used the Ab at 10 µg/ml), anti-IL-4 IgG (Peprotech), anti-IL-10 IgG (mAb JES3-9D7, Biosource International, Camarillo, CA), anti-TNF-{alpha} IgG (Genzyme, Cambridge, MA; and R&D Systems), all of which have been shown to be neutralizing by the vendors.

Cytokines

Recombinant cytokines were used at the following final concentrations: 10 U/ml IL-2, 20–100 pM IL-12, 200 U/ml IFN-{gamma}, and 20 ng/ml TNF-{alpha} (all from R&D Systems) and 5 nM IL-18 (Peprotech).

IFN-{gamma} ELISA

IFN-{gamma} was measured by an amplified ELISA assay (18). Dynatech (Chantilly, VA) Immulon 3 microtiter plates were coated overnight with 100 µl of 2.5 µg/ml monoclonal anti-IFN-{gamma} (PharMingen, San Diego, CA). Samples and standards were added for 24 h, followed by washing and addition of 100 µl of 2.5 µg/ml polyclonal rabbit anti-IFN-{gamma} (Endogen, Woburn, MA) for 2 h. This was followed after washing by addition of 100 µl of 1:1000 diluted mouse anti-rabbit alkaline phosphatase-conjugated Ab (Jackson ImmunoResearch) for 2 h. Substrate, 0.2 mM NADP (Sigma), was added for 30 min followed by addition of amplifier (3% 2-propanol, 1 mM iodonitrotetrazolium violet, 75 µg/ml alcohol dehydrogenase, and 50 µg/ml diaphorase; Sigma) for 30 min. Plates were read at 490 nm using an Emax plate reader (Molecular Devices, Menlo Park, CA).

The TNF-{alpha} ELISA used capture and detection Abs from R&D Systems and enhanced development as for IFN-{gamma}. For the IL-12 ELISA, we used the Quantikine kit from R&D Systems which can detect less than 0.5 pg/ml of hIL-12.

Data analysis

Data acquisition and reduction were performed using the ELISA Master program for Macintosh computers, developed by R. L. Deem. Statistical analysis was done by Statview using the paired t test or the nonparametric Wilcoxon signed rank test in cases where individual experiments had very large differences in measured values.


    Results
 Top
 Abstract
 Introduction
 Materials and Methods
 Results
 Discussion
 References
 
Exogenous and endogenous TNF-{alpha} potentiates IFN-{gamma} production by LPMC

We have previously reported that LPMC from normal colon incubated with TNF-{alpha} in vitro for 2 or more days secrete higher levels of IFN-{gamma} upon stimulation with anti-CD2 Abs compared with controls incubated without added TNF-{alpha} (5). In the present study, we have confirmed and extended this finding. Incubation of LPMC from inflamed as well as from normal colon with TNF-{alpha} increases subsequent IFN-{gamma} production upon stimulation with anti-CD2 (see Figs. 1–4GoGoGoGo), but we have seen no consistent difference in augmentation of IFN-{gamma} secretion when comparing LPMC from inflamed and normal tissue (data not shown). We have found that TNF-{alpha} is spontaneously generated in control cultures during incubation (8/15 incubation supernatants had 90–1620 pg/ml TNF-{alpha}, where 90 pg was the lower limit of detection). Thus, we might have underestimated the role that TNF-{alpha} plays in LPMC IFN-{gamma} production, because spontaneous release of TNF-{alpha} during in vitro culture of LPMC might increase the "control" level of IFN-{gamma} production. To test this possibility, LPMC were incubated with neutralizing anti-TNF-{alpha} during the 2 days of culture before stimulating with Abs to CD2. Results in Fig. 1Go show that incubation of LPMC cultures with anti-TNF-{alpha} Ab decreased the secretion of IFN-{gamma} upon stimulation. Thus, if endogenously produced as well as added TNF-{alpha} were taken into account, the magnitude of the effect of TNF-{alpha} on IFN-{gamma} secretion was considerably greater than we had previously found. This anti-TNF-{alpha} Ab did not induce apoptosis of T cells, as determined by Annexin V staining and flow cytometry (data not shown). Therefore, the decrease in IFN-{gamma} production was due to the neutralization of TNF-{alpha}.



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FIGURE 1. Blockade of spontaneous TNF-{alpha} (5 µg/ml anti-TNF-{alpha} and control Ab) during incubation reveals the full magnitude of IFN-{gamma} (ng/ml) potentiation attributable to TNF-{alpha}. Bar graph is experiment 7. TNF-{alpha} (20 ng/ml) condition is significantly different from both control and anti-TNF-{alpha} by Wilcoxon signed rank test (p < 0.018).

 


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FIGURE 2. IL-12 and IL-18 do not participate in TNF-{alpha}-induced augmentation of IFN-{gamma} production in LPMC stimulated with anti-CD2. LPMC were cultured for 2 days with blocking Abs to cytokines (2 µg/ml anti-IL-12 or goat IgG control or 10 µg/ml anti-IL-18 or mouse IgG control) added to both control and TNF-{alpha} (20 ng/ml) conditions, then washed and stimulated in fresh medium using anti-CD2 Abs for 18 h. IFN-{gamma} in supernatants was measured by ELISA. One of seven experiments using anti-IL-12 and one of three using anti-IL-18 are illustrated as bar graphs. There was no significant difference in the relative augmentation of IFN-{gamma} production in the presence of either blocking Ab when all experiments were analyzed by paired t test.

 


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FIGURE 3. LPMC with and without TNF-{alpha} (20 ng/ml) were cultured for 2 days in the presence of high concentrations of recombinant IL-12 (20–100 pM) or IL-18 (5 nM), followed by treatment as in Fig. 2Go. One of four experiments is graphed. There was no significant difference in the relative augmentation of IFN-{gamma} production in the presence of either cytokine by paired t test.

 


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FIGURE 4. IL-4 and IL-10 are not involved in TNF-{alpha}-induced augmentation of IFN-{gamma} production in LPMC. Blocking Abs to cytokines (10 µg/ml anti-IL-4 and anti-IL-10 or control IgG, 10 µg/ml) were added to both control and TNF-{alpha} conditions during the 2-day culture, which was followed by treatment as in Fig. 2Go. One of three experiments with anti-IL-4 and one of four with anti-IL-10 are represented as bar graphs. No significant difference in relative augmentation of IFN-{gamma} by TNF-{alpha} was found by paired t test.

 
TNF-{alpha} potentiation of LPMC IFN-{gamma} production is independent of cytokines known to modulate IFN-{gamma} secretion

Because TNF-{alpha} is spontaneously produced in LPMC cultures, it is possible that other cytokines that can increase IFN-{gamma} production are secreted during the 2-day incubation as well. Further, because the augmentation of IFN-{gamma} requires prolonged incubation with TNF-{alpha}, changes in cytokine levels in the cultures during incubation may underlie the effect of TNF-{alpha}. Therefore, we sought to determine whether IFN-{gamma} potentiation by TNF-{alpha} is mediated via other cytokines known to affect IFN-{gamma} expression.

The TNF-{alpha} effect is independent of IL-12 and IL-18. Augmentation of mucosal Th1 cytokine production appears to require the presence of non-T, non-B cells (mostly macrophages) and at least 2 days of culture in the presence of TNF-{alpha}, suggesting that a soluble factor from nonlymphocytes is generated over this 2-day period. To begin to identify such a soluble factor, we performed experiments to determine whether cytokines known to regulate generation or function of IFN-{gamma}-producing Th1 cells were responsible for the TNF-{alpha} effect. IL-12 is a macrophage-derived cytokine that is known to be required for generation of Th1 responses (10). IL-18 is a recently discovered and cloned cytokine also derived from macrophages that alone, but especially in conjunction with IL-12 augments Th1 function and IFN-{gamma} production (11, 12). IL-12 and TNF-{alpha} synergize to induce IFN-{gamma} production from splenocytes (13). Therefore, to determine whether the augmentation of IFN-{gamma} production by TNF-{alpha} is dependent upon enhancement of IL-12 or IL-18 production and/or interactions with IL-12 present in the in vitro LPMC culture, we added blocking Abs to both control and TNF-{alpha} conditions for the two day cultures. Fig. 2Go demonstrates that addition of anti-IL-12 or anti-IL-18 blocking Abs had no effect on the TNF-{alpha} mediated augmentation of IFN-{gamma} production. Furthermore, if TNF-{alpha} acted by inducing IL-12 or IL-18, addition of high levels of IL-12 and/or IL-18 should eliminate the TNF-{alpha} effect. When high levels of recombinant IL-12 or IL-18 were added to the incubations, as expected, IFN-{gamma} production was elevated by the added cytokines in both control and TNF-{alpha} conditions, but IFN-{gamma} production was consistently greater than control in the TNF-{alpha} condition (Fig. 3Go). Thus, the addition of either IL-12 or IL-18 did not abrogate the enhancing effect of TNF-{alpha}. We measured IL-12 in LPMC supernatants from six surgical resection samples incubated with or without TNF-{alpha}. Values ranged from 0 to 3.5 pg/ml with most below 0.6 pg/ml, near the detection limit, and did not correlate with the addition of TNF-{alpha}. Therefore, taking into account the results from neutralizing Ab and cytokine addition experiments, together with results of ELISA, TNF-{alpha} enhances IFN-{gamma} production independently of any effect on IL-12 or IL-18.

TNF-{alpha} does not act by influencing IL-4 or IL-10 production. IL-4 and IL-10 are readily produced by LPMC and are prominent inhibitors of Th1-type cytokines, particularly production of IFN-{gamma} (22). These cytokines, however, have been reported to potentiate IFN-{gamma} production, as well, in established Th1 cells (15). The effect of TNF-{alpha} on IFN-{gamma} production might be due to an effect of TNF-{alpha} on either IL-4 or IL-10. We have shown previously (5) that no IL-4 or IL-10 is detectable in incubation supernatants when tested by ELISA. However, to determine whether either factor could play a role at very low levels, neutralizing Ab was added to both control and TNF-{alpha} incubations. The presence of neutralizing Ab, while having a small suppression in the case of IL-10, did not block the potentiation of IFN-{gamma} production by TNF-{alpha} (Fig. 4Go).

Potentiation of IFN-{gamma} by TNF-{alpha} does not occur in PBMC

We have demonstrated that incubation of freshly isolated PBMC with TNF-{alpha} for 2–5 days did not result in increased IFN-{gamma} production, in contrast to the case of LPMC (5). This difference could relate to the fact that LPMC are a population of highly activated cells, T and non-T, as compared with the relatively resting state of PBMC. Thus, to determine whether the effects of TNF-{alpha} were unique to the mucosal compartment, PBMC were cultured for 2 days with low-dose PHA, with or without TNF-{alpha}, then activated with anti-CD2 Abs; although high levels of IFN-{gamma} were produced, no potentiation of IFN-{gamma} by TNF-{alpha} occurred (Fig. 5GoA). However, the effect could depend on the activation state of either the T cells or the cells adherent to plastic. Incubations were performed using preactivated T cells, with or without adherent cells, which were themselves untreated or pre-activated. T cells preactivated by coculture with Daudi ("LP-like" T cells; Ref. 18) were cultured with or without TNF-{alpha} by themselves or after remixing with plastic adherent cells preactivated by exposure to IFN-{gamma}, LPS, or 1,25-dihydroxy vitamin D3. Cells were incubated for 2 days, washed, and stimulated via CD2, the same stimulus used for LP-derived T cells. Although cells cocultured with adherent cells could produce large amounts of IFN-{gamma}, no consistent potentiation of IFN-{gamma} by TNF-{alpha} was observed (Fig. 5Go, B--E). Thus, the TNF-{alpha} potentiation of IFN-{gamma} production, which is so prominent in LPMC from the intestinal mucosa, is not shared by PBMC, either resting or preactivated by several modalities commonly used in in vitro studies.



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FIGURE 5. TNF-{alpha} does not augment IFN-{gamma} production in PBMC. PBMC from normal donors were cultured with low dose PHA (A), or enriched for T cells on nylon wool and cocultured with Daudi for 4 days (B–D), then incubated with and without TNF-{alpha} (20 ng/ml) for 2 days, alone or with autologous adherent cells, preactivated overnight as indicated, followed by treatment as in Fig. 2Go (but substituting anti-CD3 for anti-CD2 stimulation in E). No significant differences between control and TNF-{alpha} were found (all p > 0.05)

 
PHA-activated PB T cells conditioned in 2-day supernatants from LPMC respond to TNF-{alpha} with increased IFN-{gamma} production

The fact that TNF-{alpha} does not augment IFN-{gamma} production in PBMC suggests that the potentiation in LPMC may be due either to the unique activation state of LP T cells or to production of a cofactor generated only in LPMC cultures. To test whether PHA-activated PB T cells could respond to a LPMC-generated cofactor, PHA-activated PB T cells were incubated with supernatants from LPMC that had shown a substantial increase in IFN-{gamma} production when incubated with TNF-{alpha}. PHA-activated PB T cells incubated with supernatants from LPMC cultured with TNF-{alpha} did produce more IFN-{gamma} than those incubated with the supernatants cultured without TNF-{alpha} (Fig. 6Go). Possible explanations for this result include: 1) TNF-{alpha} could be necessary to induce LPMC to secrete a factor into the TNF-{alpha} supernatants which then acts alone, or in concert with TNF-{alpha}, on the PHA-activated PB T cells; or 2) LPMC may spontaneously elaborate a factor necessary to sensitize PHA-activated PB T cells to TNF-{alpha}. TNF-{alpha} incubated supernatants doubtless contained residual exogenously added TNF-{alpha}, but control supernatants contained only the (presumably) much lower level of endogenous TNF-{alpha} produced during incubation (Fig. 1Go). To test whether a cofactor was spontaneously produced by LPMC, a high level of TNF-{alpha} was added to control supernatants in which PHA-activated PB T cells were incubated. A lack of effect of addition of TNF-{alpha} would support the first hypothesis above, whereas potentiation of IFN-{gamma} production would support the second. To further support the second hypothesis, when TNF-{alpha} was added to cells incubated in the control supernatants, their IFN-{gamma} production was potentiated (Fig. 7Go, unheated supernatants) and was equivalent to that of cells cultured with the TNF-{alpha} supernatant (data not shown). Thus, while TNF-{alpha} alone did not influence IFN-{gamma} production by PB-PHA cells, TNF-{alpha} in the presence of supernatant from LPMC did. To begin to define the subpopulations that produce this factor, LPMC were depleted of T cells (>94% T cells removed) before incubating LPMC for 2 days. In seven experiments, supernatants from four non-T LPMC incubations were tested on PB-PHA. TNF-{alpha} added to these supernatants increased IFN-{gamma} produced in five experiments (from 15 to 125%), with three of the four supernatants. We conclude that PB-PHA cells, exposed to a factor released by cultured non-T LPMC, are then able, like LP T cells, to respond to prolonged exposure to TNF-{alpha} by expressing more IFN-{gamma} upon subsequent stimulation by Abs to CD2. Because we measured low levels of TNF-{alpha} in most LPMC cultures, the question of whether or not generation of the factor depends on TNF-{alpha} is still open.



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FIGURE 6. Supernatants from LPMC cultured with TNF-{alpha} stimulate IFN-{gamma} production by PBMC (activated by low-dose PHA) relative to the same supernatants without TNF-{alpha}. LPMC from IBD patients with inflamed colons were cultured with (TNF-LPMC) or without (control) TNF-{alpha} (20 ng/ml) for 2 days. Supernatants (90% supernatant:10% new media) from these cultured cells ("LPMC 1 and 2") or medium with and without TNF-{alpha} (20 ng/ml) ("None") were added to normal PBMC along with 1 µg/ml PHA (which induces responsiveness to anti-CD2 stimulation) and cultured for 2 days and treated as in Fig. 2Go.

 


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FIGURE 7. Stringent heating impairs, but does not abolish, the ability of supernatants from LPMC to augment IFN-{gamma} production from PBMC (suboptimally activated with PHA) when incubated with TNF-{alpha}. LPMC supernatants previously heated to 75°C for 40 min derived from four colon specimens were incubated with PBMC in medium with 1 µg/ml PHA with and without TNF-{alpha} (20 ng/ml) for 2 days, and then treated as in Fig. 2Go. The TNF-{alpha} (20 ng/ml) condition is significantly different from control (p = 0.008) for the unheated supernatant. For the heated supernatants, incubation with TNF-{alpha} always increased IFN-{gamma} production, but the p value was reduced to 0.08.

 
Stringent heat treatment of LPMC supernatants added to PB-PHA results in markedly reduced overall IFN-{gamma} production, but the differential augmentation of IFN-{gamma} in the TNF-{alpha} condition is maintained

From our results it is apparent that TNF-{alpha} augments IFN-{gamma} production from T cells independently of cytokines known to be involved in regulation of IFN-{gamma} production. To begin to identify the nature of the cofactor involved, LPMC supernatants were heated to 75°C for 40 min, treatment known to eliminate the functions of most, but not all, bioactive proteins (23, 24). Heated supernatants were then tested on PB-PHA cells with and without TNF-{alpha}, as before (Fig. 7Go). Although IFN-{gamma} production was reduced, in four of four experiments, some TNF-{alpha} augmentation of IFN-{gamma} production still occurred. These results support the hypothesis that at least part of the IFN-{gamma} augmenting TNF-{alpha} cofactor activity is mediated by a heat-stable soluble factor, which could be an unusually stable protein, a peptide, or other organic molecule.


    Discussion
 Top
 Abstract
 Introduction
 Materials and Methods
 Results
 Discussion
 References
 
In a recent clinical trial, use of anti-TNF-{alpha} Ab in treating Crohn’s disease resulted in marked prolonged amelioration of symptoms in most patients, and focused attention on TNF-{alpha} as a key factor sustaining inflammation. In experiments designed to examine this effect of TNF-{alpha}, we have identified a pro-inflammatory action of TNF-{alpha} in LPMC cultured in vitro: potentiation of IFN-{gamma} production. Here we present evidence that the magnitude of the effect is larger than previously reported (5) due to endogenous production of low levels of TNF-{alpha} in control incubations, which significantly enhanced IFN-{gamma} production. In addition, this potentiation of IFN-{gamma} by TNF-{alpha} in LPMC was independent of IL-12 and IL-18, the most well-documented potentiators of IFN-{gamma} expression. Further, the effect of TNF-{alpha} could not be reproduced in PBMC, whether resting or preactivated by any of several stimuli, using multiple donors. However, PHA-activated PB-T cells incubated in supernatants from LPMC became responsive to TNF-{alpha} by increasing IFN-{gamma} output upon stimulation. Heating of supernatants did not abolish the activity, although the activity of TNF-{alpha} itself was abolished by this treatment in control experiments (data not shown). These results are consistent with a model in which LPMC, but not PBMC, release an unidentified factor when cultured in vitro with low dose IL-2 for 2 days. In the presence of this factor, preactivated peripheral T cells, as well as LP T cells, respond to incubation with TNF-{alpha} by increased IFN-{gamma} output upon stimulation.

Expression of such a factor specifically in the mucosa may account for an increased pro-inflammatory effect of TNF-{alpha} via augmentation of IFN-{gamma} production in the gut. In light of the normalization of IFN-{gamma} production by stimulated LPMC from anti-TNF-{alpha}-treated patients, the presence of such a protein in the gut mucosa may explain, at least in part, the strong anti-inflammatory action of TNF-{alpha} blockade (5). If expression of the factor is largely specific to the mucosa, as our data suggest, its role and even its identity may not have been evident from studies on cells from PB. Indeed, the lack of effect of TNF-{alpha} on IFN-{gamma} production in preactivated PBMC implies that factors known to be produced by activated PBMC are probably not responsible for the effect seen in LPMC. These factors include the chemokine IP-10, expected to be produced by activated PBMC (7), and for which a high percentage of PB T cells possess receptors (25). However, because preactivated PB cells can respond to the factor, a convenient assay is at hand to aid in its identification.

Accumulating evidence points to a primary role for TNF-{alpha} in the pathogenesis of Crohn’s disease as well as in the maintenance of inflammation in Crohn’s disease patients (1, 26, 27, 28), and this role for TNF-{alpha} is supported by findings in several animal models of intestinal inflammation (2, 3, 4, 20). A strong case can now be made that TNF-{alpha} acts by shifting the mucosal immune response away from production of anti-inflammatory factors such as IL-10 and TGF-ß (29) and toward production of pro-inflammatory factors, IFN-{gamma} (as we have documented) and chemokines, such as RANTES (30). Interestingly, several studies have demonstrated that shorter-term exposure to TNF-{alpha} can enhance T cell responses (Ref. 31 and references therein). Direct effect of TNF-{alpha} on T cell activation has been shown by studies in which TNF-{alpha} enhanced the expression of CD69 (32) or CD70 (CD27 ligand) (33) during acute activation. Furthermore, it has been shown that TNF-{alpha} can enhance T cell cytotoxic activity by inhibiting TGF-ß, a cytokine known to inhibit cytotoxic function (34, 35). The results of these studies suggested the possibility that TNF-{alpha} augments Th1 cytokine secretion and IFN-{gamma} production by modulating accessory populations, or by selectively down-regulating inhibitory cytokine(s). The present study demonstrates a direct effect of TNF-{alpha} on IFN-{gamma} production by cells stimulated via CD2, a predominantly T cell stimulatory receptor. However, this direct effect required another factor, produced by LPMC during culture. This factor alone does not promote increased IFN-{gamma} production, because LPMC supernatants containing anti-TNF-{alpha} Ab added to PB-PHA did not increase IFN-{gamma} over control (data not shown). But because the strong stimulation of the Th1 arm (as measured by IFN-{gamma} production) of regulatory T cells by TNF-{alpha} requires the factor, its identification and further study will provide further insight into an important factor involved in mucosal immunoregulation.


    Acknowledgments
 
We thank Richard L. Deem for constructing Figs. 5Go and 6Go.


    Footnotes
 
1 This work was supported by a grant from the Crohn’s and Colitis Foundation of America, U.S. Public Health Service Grants DK-46763 and DK-43211, and Cedars-Sinai Medical Center Feintech Family Chair in IBD Research Funds. Back

2 Address correspondence and reprint requests to Dr. Stephan R. Targan, Inflammatory Bowel Disease Research Center, Cedars-Sinai Medical Center, 8700 Beverly Boulevard, D4063, Los Angeles, CA 90048. E-mail address: Back

3 Abbreviations used in this paper: LP, lamina propria; LPMC, LP mononuclear cells; IBD, inflammatory bowel disease; PB, peripheral blood. Back

Received for publication December 22, 1998. Accepted for publication August 9, 1999.


    References
 Top
 Abstract
 Introduction
 Materials and Methods
 Results
 Discussion
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