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Division of Rheumatology, Department of Internal Medicine, Mayo Clinic-Foundation, Rochester, MN 55905
| Abstract |
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| Introduction |
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Despite the compellingly large body of evidence documenting the central
role of CD28-CD80/CD86 costimulus in immunity, there is mounting
evidence for CD28-independent T cell-mediated responses. For instance,
murine CD8+ T cells express high levels of CD28;
however, they can undergo activation and differentiation without CD28
ligation (5). Curiously, about one-half of human
CD8+ T cells also lack CD28 without apparent
functional deficits (3). In contrast, virtually all
CD4+ T cells express CD28 and yet certain
effector functions such as IFN-
and IL-4 production have been
indicated to be CD28 independent (6). Studies on
CD28-knockout mice also reveal maintenance of IL-4/IgE-mediated
responses to nematode infection (7) and efficient
rejection of allografts (8). Collectively, these studies
indicate the existence of alternate costimulatory pathways.
A number of molecules expressed on T cells have been suggested to provide the costimulus with TCR/CD3-generated signals (9). Prominent among these are LFA-1 and members of the TNFR family such as 4-1BB, OX40, CD27, and CD30. While the interaction of these molecules with their respective ligands leads to increased proliferation and IL-2 production, it is doubtful whether they can fully replace the CD28 costimulus. LFA-1 and CD27 neither prevent nor rescue T cells from apoptosis. The TNFR molecules are predominantly expressed only on previously activated T cells and are transiently found on the cell surface. Thus, these molecules may not be involved in the initiation of immune responses per se but transiently contribute to the transduction of signals after initial T cell activation.
Therefore, identification of costimulatory receptors that can fully replace CD28 is of paramount importance to understanding CD28-independent responses. Of particular interest are the CD4+CD28null T cells, which are rarely found in healthy individuals but emerge in high frequencies in diseases associated with various forms of immune dysfunction. These unusual cells were first reported among rheumatoid arthritis (RA)5 patients (10) and have now been found in other inflammatory syndromes such as those associated with ischemic heart disease (11), Wegeners granulomatosis (12), and in Chagas disease (13). Moreover, a progressive loss of CD28 expression among CD4+ T cells has also been reported during the early stages of HIV infection (14) and during the normal course of aging (15, 16), two conditions also associated with progressive immune dysfunction.
In RA, CD28null T cells can comprise up to 50% of the CD4 compartment and are found in the inflammatory lesions. They are highly oligoclonal and have autoreactive properties (10). They are also functionally active (17) and are highly resistant to apoptosis (18). These findings raise the issue as to the mechanism that brings about their expansion in vivo. Because of the central role of T cells in the pathogenesis of RA (19), we have begun to evaluate the hypothesis that inflammatory lesions provide a milieu conducive for lymphocyte activation. This is based on findings that the rheumatoid synovium invariably develops follicular structures resembling peripheral lymph nodes (20). These structures consist of lymphocytic aggregates maintained on a stroma of macrophages and fibroblast-like synoviocytes (FLS), some of which have been suspected to have APC function (21). The tissue parenchyma also includes various extracellular matrix (ECM) proteins, which profoundly influence cytokine gene expression by T cells (22).
In the present work, we examined the role of the matricellular protein, thrombospondin-1 (TSP), in the activation of inflammatory T cells. Although TSP is a transient component of the ECM in repairing tissues (23), there is indication of its persistence in the rheumatoid synovium (24). There is a characteristic focal expression of TSP in the follicular structures, among FLS and macrophages of the tissue parenchyma, and on endothelial cells (A. Vallejo et al., unpublished observations). This expression pattern of TSP suggests a functional role beyond passive scaffolding of the synovial tissue architecture. We propose that TSP plays a central role in the recruitment, activation, and retention of T cells in the inflammatory lesions. This is consistent with observations that T cells adhere to TSP-coated substrates in either integrin-independent or -dependent manner (25). Because the C terminus of TSP is also a binding site for CD47 (26), a T cell membrane glycoprotein indicated to be comitogenic with the TCR/CD3 complex (27, 28), we examined whether TSP-CD47 interaction is the relevant costimulatory complex. Unlike the TNFR molecules, CD47 is constitutively expressed on T cells. Thus, tissue-infiltrating T cells may use CD47 as an alternate CD28-independent TCR/CD3 costimulus in the rheumatoid synovium where TSP, a CD47 ligand, is abundantly expressed. Our finding that FLS express TSP permitted the evaluation of this hypothesis. Data presented here show the direct role of TSP-expressing FLS in the activation of autoreactive T cell clones, demonstrating a key role of TSP in the oligoclonal expansion of T cells during chronic inflammation.
| Materials and Methods |
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T cell clones and lines from RA patients and healthy donors were established as described previously (10, 15). Briefly, CD4+CD28null and CD4+CD28+ T cells were isolated from peripheral blood by standard FACS technique. Cells were stimulated with anti-CD3 (OKT3; American Type Culture Collection, Manassas, VA) and gamma-irradiated autologous monocytes for 24 h. In contrast, synovial tissue cells were cultured for 24 h in complete medium supplemented with recombinant human IL-2. Cells were transferred to new tissue culture plates and maintained as a line or subjected to limited dilution cloning. Sublines of CD28+ and CD28null cells were subsequently established by a second round of cell sorting. T cell cloning was conducted in 96-well plates with feeder cells consisting of gamma-irradiated, neuraminidase-treated EBV-transformed B lymphoblastoid cells without additional stimulation. Clones were isolated and phenotypes were ascertained by immunofluorescence staining and flow cytometry (see below). Clones and lines were maintained by weekly stimulation with EBV-transformed B cell feeders and recombinant human IL-2 as described previously (15, 18).
Primary cultures of FLS were established from synovial tissue specimens of RA patients. Fresh tissue (obtained from Surgical Pathology and Orthopedic Surgery, Mayo Clinic) were cut into small pieces and digested with 500 µg/ml collagenase (Sigma, St. Louis, MO). Single-cell suspension was prepared and cultured in DMEM (BioWhittaker, Walkersville, MD) supplemented with 10% FCS (Summit Biotech, Fort Collins, CO), 2 mM L-glutamine, 100 U/ml penicillin, and 100 µg/ml streptomycin sulfate (Life Technologies, Grand Island, NY). Nonadherent cells were washed off after 3 days of culture, and the plastic-adherent cells were collected by trypsin-EDTA (Sigma) treatment. As with human T cells, FLS lines were cultured in a humidified tissue culture incubator at 7.5% CO2.
The mastocytoma cell line P815 expressing murine CD16 (mCD16) was provided by Dr. Paul Leibson (Mayo Clinic). This cell line was transfected with a human CD36 (hCD36) expression plasmid provided by Dr. Douglas Lublin (Washington University of St. Louis). Before transfection, cells were passage at least once in drug-free medium and maintained at a density of 1 x 106 cells/ml. About 50 µg of linearized plasmid was added to a 300-µl serum- and drug-free suspension of 1 x 107 cells in an electroporation cuvette (2 mm gap; BTX, San Diego, CA) and given a single pulse of 250 V for 30 ms using the T820 ElectroSquare Porator (BTX). Cells were incubated on ice for 10 min, transferred to a drug-free DMEM culture medium, and incubated for 48 h. Subsequently, cells were maintained in DMEM culture medium containing 800 µg/ml G418 (Life Technologies). After 2 wk of drug selection, cells were positively sorted for the coexpression of mCD16 and hCD36 by standard FACS technique. Cells were maintained in a humidified tissue culture incubator at 5% CO2.
Flow cytometry
Phenotypes of T cell lines and clones were routinely examined by direct immunofluorescence staining and flow cytometry. Cells were stained with fluorochrome-conjugated Abs to CD3, CD4, and CD28, and analyzed by a FACSCalibur cytometer (Becton Dickinson, San Jose, CA). Cytometric data were analyzed using the WinMDI program (Joseph Trotter, Scripps Research Institute, La Jolla, CA).
CD47 expression on T cells was monitored by indirect immunofluorescence staining with the mAbs 2E11, 2D3, and B6H12 (27, 29, 30) followed by fluorochrome-conjugated anti-mouse Ig (Becton Dickinson). The anti-CD47 Abs were provided by Dr. Frederik Lindberg (Washington University of St. Louis).
Similarly, expression of mCD16 and hCD36 on P815 cells was monitored by indirect immunofluorescence staining with specific Abs (PharMingen, San Diego, CA). Likewise, FLS cultures were stained with Abs to HLA-DR (Becton Dickinson), hCD36 (clone FA6-152), and TSP (clone P12; Beckman Coulter, Westbrook, ME). The U937 promonocytic cell line (American Type Culture Collection) and freshly isolated platelets (Blood Components Laboratory, Mayo Clinic) served as positive controls for hCD36 and TSP, respectively.
RT-PCR assay
The presence of CD36 and TSP transcripts in the FLS lines was monitored by RT-PCR. Total RNA was isolated using Trizol reagent (Life Technologies), treated with DNase I (Roche Molecular Biochemicals, Boehringer Mannheim, Indianapolis, IN), and the first-strand cDNA was synthesized by standard techniques. PCR amplification of specific cDNA fragments was conducted using the following primer pairs, 5'-AATGGTACAGATGCAGCCTC-3' and 5'-CCAATGGTCCCAGTCTCAT-3' for hCD36 (GenBank accession nos. Z32751-65 and Z32770-71); 5'-CACCAACAGCTCCACCA-3' and 5'-CAGGTTGGCATCCTCG-3' for TSP (GenBank accession nos. J04835 and X04665). Parallel PCR experiments were also conducted for ß-actin as a system control using the primer pairs 5'-ATCATGTTTGAGACCTTCAACACCCC-3' and 5'-CAGGAGGAGCAATGATCTTGAT-3' (GenBank accession nos. M10278 and 5016088). PCR products were fractionated by agarose gel electrophoresis. Fidelity of amplification was ascertained by direct sequencing of PCR products using an automated ABI377 DNA sequencer (Applied Biosystems, Foster City, CA).
Proliferation assays
T cell proliferation assays were conducted in three systems. The first system involved cocrosslinking of CD3 and CD47 with specific Abs directly immobilized on plates in the presence or absence of purified endotoxin-free TSP (Calbiochem, La Jolla, CA). At the indicated concentrations, anti-CD3 Ab (affinity-purified culture supernatants of OKT3; American Type Culture Collection) and either anti-CD47 Ab (2E11, 2D3, or B6H12), IgG isotype control, or TSP were diluted in 500 mM sodium bicarbonate buffer, pH 9, and coated onto 96-well plates by overnight incubation at 4°C. Plates were blocked with 10% BSA (Calbiochem) overnight at 4°C and washed with cold 1x PBS. About 2 x 105 T cells were added to the plates in triplicate wells and incubated for 3 days at 37°C and 7.5% CO2. [3H]Thymidine (DuPont NEN, Boston, MA) was added to the cultures at 1 µCi/well 16 h before harvest. Cells were harvested onto XtalScint glass fiber filters (Beckman, Fullerton, CA) and subjected to scintillation spectrometry.
In other experiments, CD3 and CD47 cocrosslinking was achieved by initially incubating cells either with anti-CD47 Ab or IgG isotype controls at 4°C for 1.5 h. Cells were washed in PBS and added to tissue culture plates containing varying amounts of OKT3 captured on immobilized rabbit anti-mouse Ig (PharMingen). About 200 µg/ml anti-mouse Ig was coated onto 96-well plates as described above. Wells coated only with BSA served as controls. [3H]Thymidine incorporation was measured after 3 days of culture.
In Ab blocking experiments, T cells were precoated with either anti-CD47 Ab or IgG control at 200 µg/ml for 1.5 h at 4°C. Cells were washed with cold PBS and added to OKT3-/TSP-coated plates. [3H]Thymidine incorporation was measured after 3 days of culture.
The second system involved the coculture of P815 cells and T cells. Either wild type or hCD36-transfected P815 cells were gamma-irradiated (15,000 rad from a 137Cs source) and incubated with OKT3 in combination with either anti-CD47 Ab, IgG control, TSP, or fibronectin (Calbiochem) at the indicated concentrations for 2 h at 4°C. Cells were washed, and about 5 x 104 P815 cells were added to 2 x 105 T cells. To the appropriate wells, the synthetic peptide 4N1K (KRFYVVMWKK) corresponding to the CD47-binding domain of TSP (26, 31) or its mutated variant peptide 4NGG (KRFYGGMWKK) was added at the indicated concentrations. T cell proliferation was measured by [3H]thymidine incorporation after 3 days of culture. Concentrations of peptides used did not affect cell viability as determined by trypan blue exclusion (data not shown). The ABI431/433 peptide synthesizer (Applied Biosystems) in the Mayo Protein Core Facility was used to generate both peptides.
The third system involved a coculture system of selected T cell clones
with autologous FLS lines. About 5 x 104
cells/well were seeded into tissue culture plates and incubated with
200 U/ml of recombinant human IFN-
(Biosource, Aurora, CO) for 3
days. The wells were washed, and the plate was gamma-irradiated (15,000
rad). A total of 2 x 105 T cells were added
to each well, and either anti-HLA-DR Ab, IgG control, peptide 4N1K,
or peptide 41GG was added at the indicated concentrations.
[3H]Thymidine incorporation was measured after
3 days of culture.
HLA-DR and TCR genotyping
The HLA-DRB1 alleles of donors were determined by PCR and hybridization using the ELPHA HLA DNA typing system (Biotest Diagnostics, Denville, NJ). Direct sequencing of the PCR products authenticated the final HLA-DRB1*04 subtype designation.
Clonality of T cell clones was determined by standard
nested PCR of the CDR3 region of the TCR ß-chain V-J element. PCR
products were ligated into the TA cloning vector (Invitrogen, Carlsbad,
CA) and used to transform E. coli DH5
(Life
Technologies). Each TCR clonotype was authenticated by the sequencing
of recombinant plasmids prepared from at least three randomly selected
bacterial colonies.
| Results |
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CD47 is a known component of the ß3 integrin complex on polymorphonuclear cells (32). In contrast, mammalian T cells express a functional CD47 molecule despite the lack of ß3 integrins (27). Cocrosslinking of CD3 and CD47 has been found to induce T cell proliferation that was unaffected by soluble anti-integrin Abs. In the present study, inflammatory T cells derived from RA patients were indeed found to constitutively express CD47 as detected by immunofluorescence staining and flow cytometry (data not shown). Both CD28+ and CD28null subsets of CD4+ T cells expressed high levels of CD47 in all cell lines and clones examined.
Consistent with previous studies (27, 28), crosslinking of
CD47 by specific Ab augmented the proliferative responses of T cell
lines to suboptimal levels of anti-CD3 Ab, OKT3 (data not shown).
Crosslinking of CD47 with constant amount of Ab (200 ng/well) showed
enhancement of T cell proliferation in the presence of immobilized OKT3
at densities between 50 and 500 ng/well. This enhancement was not
evident with OKT3 immobilized at densities
1000 ng/well. None of the
anti-CD47 Abs used was stimulatory by themselves.
Induction of T cell proliferation by TSP
Although it is a highly chemotactic and adhesive protein
(33), TSP is not known to be mitogenic except for smooth
muscle cells (34). However, in the present study, TSP was
found to induce vigorous proliferation of selected patient-derived T
cells in the presence of suboptimal levels of OKT3 (Fig. 1
). TSP-induced costimulation was a
dose-dependent response. It was as effective as CD47 crosslinked by
specific Ab. Furthermore, TSP-induced costimulation was blocked by
soluble anti-CD47 Abs (Fig. 2
).
Neither TSP nor any of the anti-CD47 Abs was stimulatory in the
absence of OKT3.
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The adhesive property of TSP is attributed to multiple domains
that define binding sites of several cellular receptors. Among these is
CD36 (35), which binds to a region of TSP distinct from
the CD47-binding site (26). CD36 is found coexpressed
abundantly with TSP, particularly on FLS, macrophages, and endothelial
cells in the rheumatoid synovium (A. Vallejo et al., unpublished
observations). Therefore, we examined whether a CD47-TSP-CD36
interaction was the relevant costimulatory complex for T cell
activation. To address this issue, mouse P815 cells expressing
endogenous CD16 were transfected with hCD36 and used as surrogate APC.
As shown Fig. 3
, TSP-coated
hCD36+ P815 cells induced proliferation of T cell
clones in the presence of suboptimal levels of OKT3. The magnitude of
TSP-induced costimulation was equivalent to those seen with P815 cells
coated with anti-CD47. In contrast, P815 cells coated with
fibronectin did not elicit any significant proliferation of T cells. In
the absence of OKT3, neither anti-CD47- nor TSP-coated
hCD36+ P815 cells stimulated T cell
proliferation. As expected, wild-type P815 cells coated with OKT3 and
anti-CD47, but not with TSP or fibronectin, were stimulatory for T
cells.
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To address whether the CD47-TSP-CD36 complex may have a role in
regulating the immune response in chronic inflammatory diseases such as
RA, FLS lines were established from synovial tissues of RA patients. As
shown in Fig. 5
, FLS lines had high
levels of CD36 and TSP expression at both the mRNA and protein levels.
They also expressed significant levels of the HLA-DR Ag-presenting
molecules.
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| Discussion |
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An interesting feature of CD47-mediated costimulation is the
observation that CD47 crosslinking induces the conversion of a TCR
antagonist to an agonist (27). By definition, antagonists
are MHC/peptide complexes that bind the TCR at significantly lower
affinities compared with agonists (36). Because they also
have fast dissociation rates, antagonist ligands do not induce the
proper TCR conformation and consequently fail to trigger activation,
leading to anergy and death even in the presence of costimulatory
signals (37). Therefore, the reversion of antagonism by
CD47 crosslinking suggests that the CD47 costimulus significantly
decreases the threshold activation. By inference, the strength of the
CD47 costimulus may break immune tolerance by permitting low-affinity
TCR-MHC/peptide interactions to trigger T cell activation. Inasmuch as
self-reactive T cells are considered to be low-affinity cells
(38), costimulatory signals may have significant impact on
their selection and/or persistence. Indeed, data presented here show
that autoreactivity of T cells is TSP/CD47 dependent. Primary FLS
lines, derived from RA patients, expressing high levels of TSP, CD36,
and HLA-DR (Fig. 5
) induced vigorous spontaneous proliferation of
autologous T cell clones (Table I
). These autoproliferative activities
are inhibited by Abs to HLA-DR, indicating that they are TCR specific,
and are significantly reduced by the 4N1K peptide, demonstrating the
importance of costimulation mediated through CD47-TSP interaction. The
seemingly incomplete inhibition of FLS-induced T cell autoproliferation
by 4N1K peptide might suggest contribution of other costimulatory
interactions. FLS have been indicated to express a variety of adhesion
molecules (20, 21) that, as an aggregate, could
conceivably provide additional costimulatory signals. Nevertheless, the
observed high levels of inhibition of FLS-induced responses by 4N1K
peptide demonstrates the preeminence of TSP-CD47-derived signals in
these autoproliferative activities by patient-derived T cell
clones.
The present data also show that some T cell clones can recognize
various FLS lines derived from different donors (Table I
). While the
antigenic basis of this cross-reactivity is unknown, it is significant
to note that this phenomenon is also CD47 mediated. This finding
strongly indicates a critical role of CD47 in mediating both
autoreactive and alloreactive immune responses. Therefore, it will be
of interest to examine whether CD47 costimulus plays a role in the
long-term survival of allografts and rejection of tumors, particularly
in cases where CD28 costimulus has no impact in generation of the
appropriate immune response (39, 40).
Whether the CD47 costimulus in T cells is distinct from that of CD28
remains to be examined. However, previous studies show that CD47
crosslinking augments the phosphorylation of CD3
and the signal
transducer ZAP70 (27). When associated with
ß3 integrin as in granulocytes and melanoma
cells, CD47 has also been found to functionally couple to G proteins
(41). Curiously, ligation of CD47 on the Jurkat T cell
lymphoma by soluble 4N1K peptide can induce phosphorylation of
extracellular signal-regulated kinase (42). In contrast,
CD28 is generally associated with the activation of three kinases,
namely phosphatidylinositol 3-kinase, inducible T cell kinase, and
p56Lck (43, 44). Therefore, it
appears that CD47-mediated costimulation may result in T cell effector
functions distinct from those mediated by CD28. This hypothesis is
consistent with observations that the CD28 ligands CD80 and CD86 can
skew certain CD28-dependent Ag-specific immune responses and T cell
effector functions (45, 46, 47). This ligand-dependent
differential function of CD28 costimulation is related to differences
in the tissue expression patterns of CD80 and CD86 (3) and
distinct signal transduction pathways (48). Together,
these observations suggest that the biological outcome of T cell
activation can be modulated by the costimulus accompanying
TCR/CD3-generated signals. Therefore, it will be of interest to examine
whether there are distinguishable CD47- and CD28-dependent effector
functions.
In the context of chronic inflammatory disease, our data are consistent
with the notion that the inflammatory lesions in RA are sites of
lymphocyte activation. Consistent with previous reports (21, 49), our data show that FLS play a central role in T cell
activation (Table I
). FLS-induced proliferation of autologous T cells
indicates that they are important sources of the autoantigen(s) thought
to drive the oligoclonal expansion of inflammatory T cells
(50). Further, FLS also supply a costimulatory molecule in
the form of TSP (Fig. 5
and Table I
). Presumably, TSP is bound to CD36
on the FLS cell surface as indicated by the focal, but not widespread,
colocalization of TSP and CD36 in synovial tissues (A. Vallejo et al.,
unpublished observations). The inhibition of FLS-induced proliferation
of T cells by peptides corresponding to the CD47-binding domain of TSP
indicate that costimulation of T cell activation is likely to be
mediated by a trimolecular interaction of CD47, TSP, and CD36.
Inasmuch as TSP is also expressed on endothelial cells and macrophages (Ref. 24 and A. Vallejo et al., unpublished observations), a model for the broader role of TSP in the recruitment, activation, and retention of infiltrating T cells in the inflammatory lesions can be proposed. Because of the inherent adhesiveness of TSP, its expression on endothelial cells could facilitate adhesion and diapedesis of T cells into the tissue. Subsequent interaction of T cells with APC such as tissue macrophages or FLS would lead to activation and proliferation. Infiltrating CD4+CD28null T cells could use the CD47-TSP-C36 costimulatory pathway, whereas CD4+CD28+ T cells can use either this trimolecular complex or the CD28-CD80/86 pathway. Both of these costimulatory pathways may account for the oligoclonal expansion of T cells in the tissue, a well-documented feature of rheumatoid synovitis (19). The increasing evidence for TSP accumulation in the lesions of other inflammatory and infectious diseases (51, 52, 53, 54) indicates a broader applicability of this model in disease pathogenesis.
| Acknowledgments |
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| Footnotes |
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2 Address correspondence and reprint requests to Dr. Abbe N. Vallejo, Rheumatology Research Laboratories, Mayo Clinic, 200 1st Street Southwest, Rochester, MN 55905. E-mail address: ![]()
3 Current address: Department of Immunology, University of Leipzig, Leipzig, Germany. ![]()
4 Current address: Department of Rheumatology, Medical University of Bialystok, Bialystok, Poland. ![]()
5 Abbreviations used in this paper: RA, rheumatoid arthritis; FLS, fibroblast-like synoviocyte; hCD36, human CD36; ECM, extracellular matrix; mCD16, mouse CD16; TSP, thrombospondin-1. ![]()
Received for publication October 20, 1999. Accepted for publication January 4, 2000.
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