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The Journal of Immunology, 2001, 166: 5889-5897.
Copyright © 2001 by The American Association of Immunologists

CD44-Deficient Mice Exhibit Enhanced Hepatitis After Concanavalin A Injection: Evidence for Involvement of CD44 in Activation-Induced Cell Death1

Dawei Chen2,{dagger}, Robert J. McKallip2,*, Ahmet Zeytun*, Yoonkyung Do*, Catherine Lombard*, John L. Robertson{dagger}, Tak W. Mak{ddagger}, Prakash S. Nagarkatti* and Mitzi Nagarkatti3,*

* Departments of Microbiology and Immunology and Pharmacology and Toxicology, Medical College of Virginia, Virginia Commonwealth University, Richmond, VA 23298; {dagger} Department of Biomedical Sciences and Pathobiology, Virginia-Maryland College of Veterinary Medicine, Virginia Polytechnic Institute and State University, Blacksburg, VA 24061; and {ddagger} Department of Medical Biophysics and Immunology, Ontario Cancer Institute, Toronto, Ontario, Canada


    Abstract
 Top
 Abstract
 Introduction
 Materials and Methods
 Results
 Discussion
 References
 
Administration of Con A induces severe injury to hepatocytes in mice and is considered to be a model for human hepatitis. In the current study, we investigated the role of CD44 in Con A-induced hepatitis. Intravenous administration of Con A (20 mg/kg) caused 100% mortality in C57BL/6 CD44-knockout (KO) mice, although it was not lethal in C57BL/6 CD44 wild-type (WT) mice. Administration of lower doses of Con A (12 mg/kg body weight) into CD44 WT mice induced hepatitis as evident from increased plasma aspartate aminotransferase levels accompanied by active infiltration of mononuclear cells and neutrophils, and significant induction of apoptosis in the liver. Interestingly, CD44 KO mice injected with similar doses of Con A exhibited more severe acute suppurative hepatitis. Transfer of spleen cells from Con A-injected CD44 KO mice into CD44 WT mice induced higher levels of hepatitis when compared with transfer of similar cells from CD44 WT mice into CD44 WT mice. The increased hepatitis seen in CD44 KO mice was accompanied by increased production of cytokines such as TNF-{alpha}, IL-2 and IFN-{gamma}, but not Fas or Fas ligand. The increased susceptibility of CD44 KO mice to hepatitis correlated with the observation that T cells from CD44 KO mice were more resistant to activation-induced cell death when compared with the CD44 WT mice. Together, these data demonstrate that activated T cells use CD44 to undergo apoptosis, and dysregulation in this pathway could lead to increased pathogenesis in a number of diseases, including hepatitis.


    Introduction
 Top
 Abstract
 Introduction
 Materials and Methods
 Results
 Discussion
 References
 
Recently, a new experimental model of hepatitis has been described that can be induced in mice by a single i.v. injection of Con A (1). Unlike other commonly used models of immunoinflammatory liver injury such as LPS-induced hepatitis and the autoimmune hepatitis provoked by immunization with syngeneic liver Ags (2), which require the use of hepatotoxic agents (D-galactosamine and CFA) for disease induction (3), the sole injection of Con A is sufficient for liver lesions to develop. Within 8–24 h, clinical and histological evidence of hepatitis occurs, with elevation of transaminase activities in the plasma and hepatic lesions characterized by massive granulocyte accumulation and hepatic necrosis (1). Thus, Con A-induced hepatitis is considered to be an experimental model for human autoimmune hepatitis (4). Con A-induced hepatitis is both T cell- and macrophage-dependent inasmuch as it cannot be induced in nude athymic mice lacking immunocompetent T cells, and it is prevented by immunosuppressants such as cyclosporin A and FK506, or by blockade of macrophage functions with silica particles (1).

The precise mechanism(s) by which T cells and macrophages induce hepatitis is not known. Because a massive release of macrophage and T cell-derived cytokines, including IL-2, IL-1, IL-6, TNF-{alpha}, IFN-{gamma}, and GM-CSF, occurs with different kinetics in response to Con A, a role has been envisaged for these cytokines in the development of the hepatic lesions (5, 6). Nonetheless, the precise role of cytokines in the pathogenesis of this immunoinflammatory condition remains to be defined.

CD44 is an acidic, sulfated integral membrane glycoprotein ranging in molecular mass from 80 kDa up to 200 kDa (7, 8). Hyaluronic acid (HA)4 has been shown to be an important ligand for CD44 (8). CD44 is expressed by various lymphoid and nonlymphoid tissues (8, 9). The CD44 molecule has been demonstrated to participate in lymphocyte adhesion to the matrix, lymph node homing, and lymphopoeisis (8, 10). Studies from our laboratory have shown that on activation, T cells express increased levels of CD44, which can act as a signaling molecule in effector functions such as induction of cytotoxicity (11, 12). Similarly, mAbs against CD44 were shown to induce B cell growth and differentiation (13). Other studies have shown that mAbs directed against CD44 molecules can either up-regulate (14) or down-regulate (15) anti-CD3 and anti-CD2 mAb-induced proliferation of T cells. Recent studies from our laboratory also demonstrated that IL-2-induced vascular leak and damage to the endothelial cells is mediated by CD44 (16). Together, the above studies demonstrated that CD44 expressed on activated lymphocytes can interact with HA expressed on target cells and participate in cell injury leading to autoimmune reactions. In the current study, we used CD44 knockout (KO) mice to study Con A-induced hepatitis, speculating that such mice would be resistant to development of hepatitis. In contrast, we observed that CD44 KO mice exhibited enhanced pathogenesis in Con A-induced hepatitis. The enhanced hepatitis seen in these mice primarily resulted from inability of Con A-activated CD44-deficient T cells to undergo apoptosis. The current study demonstrates that CD44 plays an important regulatory role in the pathogenesis of Con A-induced hepatitis.


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

Adult female C57BL/6 (CD44) wild-type (WT) mice were purchased from the National Institutes of Health (Bethesda, MD). CD44 KO mice on C57BL/6 background were kindly provided by Amgen Institute (Toronto, Ontario) and bred in our animal facilities and screened for the CD44 mutation. These mice were back-crossed for 12 generations onto the C57BL/6 background and were susceptible to syngeneic tumors of C57BL/6 origin. The phenotype of these mice has been described elsewhere (16, 17).

Con A-induced hepatitis and its evaluation

To induce hepatitis, female CD44 WT and CD44 KO mice weighing 20–23 g were challenged with Con A (12 mg/kg body weight i.v. in 100 µl of saline). Control mice received 100 µl saline (i.v.). Plasma from individual mice was separated from blood obtained through the orbital plexus under anesthesia with IsoFlo (Abbott Laboratories, North Chicago, IL) at various time intervals after Con A injection. Plasma aspartate aminotransferase activity (AST) levels were measured with a commercial kit (Sigma, St. Louis, MO).

For histopathological studies, the harvested livers were fixed in 10% buffered formalin and embedded in paraffin. Five-micrometer sections were affixed to slides, deparaffinized, and stained with hematoxylin-eosin to assess morphologic changes, as described (16).

Isolation of lymphocytes infiltrating the liver

The isolation of liver-infiltrating mononuclear cells (MNC) was conducted as described by others (18, 19). Briefly, livers obtained 16 h after Con A injection from CD44 WT and CD44 KO mice were pressed through a 200-gauge stainless steel mesh (18) and suspended in RPMI 1640 medium supplemented with 5% FCS. After one washing with the medium, the cells were resuspended in 30 ml of medium, and infiltrating lymphocytes were separated from parenchymal hepatocytes and Kupffer cells by Histopaque density (1.09) gradient centrifugation. The cell suspension (35 ml) was overlaid on 15 ml of the Ficoll-Isopaque in a 50-ml conical plastic tube. Centrifugation was performed at 2500 x g for 30 min at room temperature. After centrifugation, 10 ml of the interface was aspirated, mixed with 20 ml of the medium in a 50-ml conical tube, and the cells were washed twice. The liver MNC were studied for the expression of cell surface markers. Also, the liver MNC were studied for their ability to undergo apoptosis with annexin V/propidium iodide (PI) assay as described below.

In vivo Con A-induced apoptosis in T cells

At different time points after Con A injection, spleen cells were harvested. T cells from spleen were purified with nylon wool. Next, T cells were studied for apoptosis by TUNEL (20) and annexin/PI assays as described (21). To study apoptosis by TUNEL assay, the cells were fixed with 4% p-formaldehyde for 30 min at room temperature. The T cells were washed with PBS, permeabilized on ice for 2 min, and incubated with FITC-dUTP for 1 h at 37°C. To study apoptosis by annexin/PI assay, the T cells were stained and analyzed as outlined by the manufacturer (Roche, Indianapolis, IN). Briefly, the T cells were washed with PBS and stained with annexin V and PI for 20 min at room temperature. The cells were washed twice with PBS, and the fluorescence of the cells was measured by flow cytometry as described previously (21). The analysis was performed by a Coulter Epics V flow cytometer (Coulter, Miami, FL). Cells (5000) were analyzed per sample.

Con A-induced apoptosis in vitro

Spleens were harvested from CD44 WT and CD44 KO mice. T cells were enriched by nylon wool separation. The T cells (5 x 105) were stimulated with Con A (5 µg/ml) for 8, 16, or 24 h, after which the T cells were harvested, washed in PBS, and analyzed for apoptosis by the TUNEL assay.

TCR-induced activation and apoptosis

TCR-induced apoptosis was studied as described by Radvanyi et al. (22). Spleen cells were isolated from CD44 WT and CD44 KO mice. The spleens were placed into a stomacher bag containing RPMI 1640 medium supplemented with 5% FCS and prepared into a single-cell suspension with a laboratory homogenizer (Stomacher; Tekmar, Cincinnati, OH). Contaminating RBCs were lysed by resuspending the pellet in 3 ml of RBC lysing buffer (Sigma), and the splenocytes were washed and resuspended in RPMI 1640 medium supplemented with 10% FCS. The splenocytes (5 x 105) were stimulated with anti-CD3 mAb (5 µg/ml) for 48 h in 24-well plates. Next, the cells were harvested, and viable cells were purified by density gradient centrifugation over Histopaque (Sigma) The cells were added to 96-well tissue culture plates (5 x 105 cells/well) that had been precoated overnight (4°C) with 50 µl of anti-CD3 mAbs (5 µg/ml in PBS) and cultured with 50 U/ml IL-2 for 48 h. The cells were harvested, washed, and analyzed for apoptosis by annexin/PI staining as described above.

T cell proliferative responsiveness to mitogens

Splenocytes (5 x 105) from CD44 WT and CD44 KO mice were cultured in RPMI 1640 supplemented with 10% FCS and stimulated with Con A (5 µg/ml) or anti-CD3 (5 µg/ml) for 48 h in 96-well tissue culture plates (13). During the final 8 h, the cells were pulsed with 2 µCi of [3H]thymidine. DNA synthesis was determined by [3H]thymidine incorporation with a liquid scintillation counter.

Analysis of cell surface markers

CD44 WT and CD44 KO mice were injected with Con A (12 mg/kg body weight i.v. in 100 µl of saline). Twenty-four hours later, spleen cells were harvested and the lymphocyte population was screened for various cell surface markers by flow cytometry. Briefly, 1 x 106 spleen cells were incubated with Fc receptor block (BD PharMingen, San Diego, CA) followed by culture with PE-conjugated anti-mouse CD3, anti-mouse CD8, anti-mouse CD4, anti-mouse Mac3 (macrophages), or anti-CD45/B220 mAbs (B cells; BD PharMingen) on ice for 30 min. The cells were washed with PBS three times and analyzed for fluorescence with a Coulter Epics V flow cytometer (11).

Detection of Fas, Fas ligand (FasL), TNF-{alpha}, IFN-{gamma}, and IL-2 expression by semiquantitative RT-PCR

RT-PCR was conducted to detect Fas, FasL, TNF-{alpha}, IFN-{gamma}, and IL-2 gene expression in a similar way as described previously (12). The primers used were as follows: Fas primer, 5'-GCACAGAAGGGAAGGAGTAC-3' and 5'-GTCTTCAGCAATTCTCGGGA-3'; FasL primer, 5'-GAGAAGGAAACCCTTTCCTG-3' and 5'-ATATTCCTGGTGCCCATGAT-3'; IFN-{gamma} primer, 5'-TGCATCTTGGCTTTGCAGCTCTTCCTCATGGC-3' and 5'-TGGACCTGTGGGTTGTTGACCTCAAACTTGGC-3'; TNF-{alpha} primer, 5'-TTCTGTCTACTGAACTTCGGGGTGATCGGTCC-3' and 5'-GTATGAGATAGCAAATCTGGCTGACGGTGTGGG-3'; IL-2 primer, 5'-TTCAAGCTCCACTTCAAGCTCTACAGCGGAAG-3' and 5'-GACAGAAGGCTATCCATCTCCTCAGAAAGTCC-3'; and mouse {beta}-actin primer, 5'-ATCCTGACCCTGAACTACCCCATT-3'; and 5'-GCACTGTAGTTTCTCTTCGACACGA-3'. PCR amplification products were visualized in 1.5% agarose gels after staining with ethidium bromide. The density of the PCR products for various cytokines was compared, with {beta}-actin used as an internal control. Briefly, the spot density of each band in the gel was measured with the AlphaImager 2000 digital imaging system (Alpha Innotech, San Leandro, CA). The percent cytokine expression was calculated as follows: (density of cytokine product/density of {beta} actin product) x 100.

Detection of cytokines in the serum by ELISA

CD44 WT and CD44 KO mice were injected with Con A (12 mg/kg body weight i.v.). At 8 or 24 h after injection, serum was separated from blood collected from the orbital plexus and allowed to clot. The serum was obtained by centrifugation at 2000 x g for 20 min. The serum levels of various cytokines (IL-2, IFN-{gamma}, and TNF) were determined by the methods described in the Quantikine M ELISA kits (R&D Systems, Minneapolis, MN).

Detection of apoptosis in the liver by the TUNEL method

In situ apoptosis in liver was detected as described elsewhere (23). To this end, liver from control and Con A-injected mice were aseptically removed and fixed in 10% neutral formalin solution. Paraffin-embedded sections measuring 5 µm were adhered to slides. Deparaffinization was done by heating the sections at 60°C for 25 min. Rehydration was conducted by transferring the slides through the following solutions: twice in xylene for 5 min, twice in 95% ethanol for 5 min, twice in 70% ethanol for 5 min, and 10 min in distilled water. The tissues were treated with 20 µg/ml proteinase K (Sigma) in 10 mmol Tris-HCl, pH 8, for 30 min at 37°C and then washed with PBS twice for 10 min. Endogenous alkaline-phosphatase were inactivated by treating the slides with 10 mmol levamisole (Sigma) at room temperature for 1 h. The sections were washed with PBS for 10 min and covered with TdT-FITC-dUTP enzyme-labeling solution and then incubated at 37°C in a humidified incubator for 1.5 h. The slides were rinsed for 10 min in PBS and covered with alkaline phosphatase converter solution. After 1 h of incubation, the slides were washed twice with PBS for 10 min and purple substrate (5-bromo-4-chloro-3-indolyl phosphate/nitroblue tetrazolium) was added. Dark purple color was visible in 15–25 min. The slides were washed and counterstained with eosin, and the cover-slip was placed on mounting medium. The nuclear staining was evaluated under a light microscope. Similar slides also were also stained with hematoxylin-eosin to detect lymphocyte infiltration and to evaluate tissue structure.

Adoptive cell transfer

Groups of five female CD44 WT and CD44 KO mice were challenged with Con A (12 mg/kg body weight i.v. in 100 µl of saline). Control mice received 100 µl of saline. Twenty-four hours later, the spleen cells were harvested and washed with PBS. The RBC were lysed, and the spleen cells were washed three times with PBS before adoptive transfer. Spleen cells (1 x 108 cells by i.v. route) from CD44 WT or CD44 KO mice were adoptively transferred into CD44 WT or CD44 KO mice. Plasma from individual mice was collected 24 h after the adoptive transfer. Plasma AST levels were measured with a commercial kit as described above.

Statistical analysis

The statistical comparison between experimental and control groups was conducted by Student’s t test, and p < 0.05 was considered to be significant.


    Results
 Top
 Abstract
 Introduction
 Materials and Methods
 Results
 Discussion
 References
 
CD44 KO mice exhibit increased hepatocellular damage after Con A injection

To investigate the nature of hepatocellular damage seen after administration of Con A, CD44 WT and CD44 KO mice were initially injected with 20 mg/kg body weight of Con A i.v. in 100 µl of saline. At this dose, all CD44 KO mice died within a few hours, whereas CD44 WT mice survived. To further address the mechanism by which Con A triggers increased toxicity in CD44 KO mice, we used a lower nonlethal dose (12 mg/kg) in all subsequent experiments. To investigate the extent of hepatitis, plasma AST levels were measured at different time points after Con A injection. As shown in Fig. 1Go, in both CD44 WT and CD44 KO mice, there was a significant increase in the plasma AST level, thereby indicating that hepatitis was induced after Con A injection. Increased AST levels were seen as early as 6 h after Con A injection, reaching a peak at 12 h and declining thereafter. At 48 h, the plasma AST reached normal levels. Although, CD44 WT and CD44 KO mice exhibited similar kinetics, CD44 KO mice exhibited higher plasma AST levels, particularly at 12 and 24 h after Con A injection. These data indicated that CD44 KO mice may develop more severe acute suppurative hepatitis than the CD44 WT mice (Fig. 1Go). Similar results also were obtained by histological studies and in situ apoptosis staining (Fig. 2Go). Hematoxylin-eosin staining of liver section was conducted 48 h after Con A challenge because of significant liver damage seen at this time point. Damage to hepatocytes and presence of mixed inflammatory infiltrate consisting of lymphocytes, macrophages, and neutrophils was observed in both CD44 WT and CD44 KO mice. However, in CD44 KO mice, the liver damage was more severe than WT mice because of the larger areas of liver destruction. In contrast, the degree and the nature of inflammation was similar in CD44 WT and CD44 KO mice. Next, the liver sections were examined for apoptosis with TUNEL assay. Because apoptosis occurs at earlier time points, it was studied at 16 h after Con A injection. The dark purple area demonstrated nuclei positive for DNA fragmentation (Fig. 2Go). It was noted that CD44 KO mice had a higher number of nuclei positive for DNA fragmentation when compared with CD44 WT mice (Fig. 2Go). Together, the above data demonstrated that CD44 KO mice exhibited increased susceptibility to Con A-induced hepatitis when compared with the CD44 WT mice.



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FIGURE 1. Plasma AST levels after Con A treatment. CD44 WT and CD44 KO mice were injected with Con A (12 mg/kg body weight i.v. in 100 µl of saline). Control mice received 100 µl saline (i.v.). Plasma AST levels were measured at 2, 6, 12, 24, and 48 h after Con A injection.

 


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FIGURE 2. Hepatocellular damage in Con A-induced hepatitis. CD44 WT or CD44 KO mice were injected with Con A or saline as a control and examined for histological changes and apoptosis. Top, Hematoxylin-eosin staining of liver section harvested 48 h after Con A challenge (magnification, x200). Con A injection led to marked acute inflammation and infiltration of lymphocytes, macrophages, and neutrophils in both CD44 WT and CD44 KO mice. The degree of infiltration was similar in these two groups of mice. However, hepatic cell damage was more pronounced in CD44 KO mice compared with the CD44 WT mice after Con A injection. Bottom, TUNEL assay to detect apoptotic nuclei (magnification, x200) was conducted 16 h after Con A challenge. Dark purple area is indicative of apoptosis. Increased apoptosis was seen in the livers of CD44 KO mice when compared with CD44 WT mice after Con A injection. CD44 KO mice treated with saline showed normal morphology and no apoptosis (data not show) similar to CD44 WT mice injected with saline.

 
Expression of TNF-{alpha}, IFN-{gamma}, IL-2, Fas, and FasL mRNA in the liver after Con A treatment

Increased mRNA expression of cytokines such as TNF-{alpha}, IFN-{gamma}, and IL-2 have been considered to play a key role in the development of Con A-induced hepatitis (24). To this end, total liver RNA was isolated from CD44 WT and CD44 KO mice 2 and 8 h after treatment of mice with Con A. mRNA was reverse transcribed and amplified by PCR with primers specific for TNF-{alpha}, IFN-{gamma}, IL-2, Fas, and FasL. Mouse {beta}-actin was used as a housekeeping gene in the experiment. In these experiments, CD44 KO mice were found to exhibit higher levels of mRNA for TNF-{alpha}, IFN-{gamma}, and IL-2 when compared with CD44 WT mice (Fig. 3Go). However, mRNA of Fas and FasL expression in CD44 WT and CD44 KO mice was very similar. To quantitatively measure the mRNA expression in liver tissue, a semiquantitative PCR was conducted with the AlphaImager 2000 digital imaging system. At 2 h (Fig. 4GoA) and 8 h (Fig. 4GoB) after Con A injection, the percentage of various cytokine mRNA when compared with {beta}-actin levels was measured. The data shown in Fig. 4Go suggested that CD44 KO mice had increased levels of TNF-{alpha}, IFN-{gamma}, and IL-2 mRNA expression but not Fas and FasL when compared with the CD44 WT mice.



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FIGURE 3. Detection of TNF-{alpha}, IFN-{gamma}, IL-2, Fas, and FasL mRNA in the liver. Total liver RNA was isolated from CD44 WT and CD44 KO mice 2 and 8 h after treatment with Con A. mRNA was reverse transcribed and amplified by PCR with primers specific for TNF-{alpha}, IFN-{gamma}, IL-2, Fas, and FasL. A photograph of ethidium bromide-stained amplicons is depicted. Lanes 1–4, {beta}-actin in CD44 KO or CD44 WT mice at 2 or 8 h after Con A treatment. Lanes 5–8, Various cytokines/markers as identified in the right-hand column in CD44 KO or CD44 WT mice at 2 or 8 h after Con A injection. M, Molecular marker.

 


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FIGURE 4. Semiquantitative PCR analysis for TNF-{alpha}, IFN-{gamma}, IL-2, Fas, and FasL mRNA in the liver of CD44 WT and CD44 KO mice. Two (A) and 8 h (B) after Con A treatment, the percentage of cytokine mRNA expression when compared with {beta}-actin was measured with the AlphaImager 2000 digital imaging system as described in Material and Methods. Vertical bars represent mean ± SEM of five experiments. *, Statistically significant difference when compared with the CD44 WT mice (p < 0.05).

 
CD44 KO mice show increased levels of IL-2, IFN-{gamma}, and TNF-{alpha} in response to in vivo Con A treatment

To further corroborate the increased levels of TNF-{alpha}, IFN-{gamma}, and IL-2 in CD44 KO mice at the protein level, serum samples from Con A-injected mice were collected 8 and 24 h after Con A administration. The sera were tested for the presence of cytokines by ELISA. As seen from Fig. 5Go, the IFN-{gamma} and IL-2 levels were similar in both the CD44 WT and CD44 KO mice 8 h after Con A injection. However, at 24 h, the CD44 KO mice exhibited significantly higher levels of IFN-{gamma} and IL-2 when compared with the CD44 WT mice. The TNF-{alpha} levels also were significantly higher in CD44 KO mice at 8 h after Con A injection. However, at 24 h, both the CD44 WT and CD44 KO mice exhibited undetectable levels of TNF. This may result from use of the TNF produced in hepatitis induction as suggested by other studies (25, 26). These data confirmed the transcriptional analysis of cytokine production and suggested that CD44 KO mice exhibited more cytokine production than CD44 WT mice in response to Con A.



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FIGURE 5. Analysis of serum levels of IL-2, IFN-{gamma}, and TNF-{alpha} in Con A-injected CD44 WT and CD44 KO mice. Eight and 16 h after Con A injection, levels of IL-2, IFN-{gamma}, TNF-{alpha} in the serum were determined by ELISA. Vertical bars represent the mean ± SEM. *, Statistically significant difference when compared with the CD44 WT mice (p < 0.05).

 
Deficiency of CD44 does not affect the proportion of T cells, B cells, or macrophages

To rule out the possibility that the increased susceptibility of CD44 KO mice to hepatitis was caused by differential activation of T cell subsets when compared with the CD44 WT mice, lymphocyte subpopulations in spleen and liver infiltration were determined by flow cytometry (Fig. 6Go). At different time points after Con A treatment, spleen cells or liver infiltrating MNC from CD44 WT and CD44KO mice were harvested and the lymphocyte subpopulations were screened by flow cytometry (Fig. 6Go, AE). There was statistically no significant difference in the proportions of T cells (CD4+, CD8+, CD3+), B cells, and macrophages in the spleen when analyzed 0–36 h after Con A injection between CD44 WT and CD44 KO mice. Similar results also were obtained when cells infiltrating the liver were screened (Fig. 6GoF). These data suggested that the increased hepatitis seen in CD44 KO mice was not caused by altered presence of lymphocyte/macrophage subpopulations.



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FIGURE 6. Enumeration of lymphocytes and macrophage in spleen and liver. AE, At different time points after Con A treatment, spleen cells from CD44 WT and CD44 KO mice were harvested and percentages of lymphocyte subpopulation and macrophages were determined by flow cytometry. F, Sixteen hours after Con A treatment, MNC infiltrating the liver were isolated as described in Material and Methods, and the percentage of lymphocyte subsets and macrophages was determined by flow cytometry. Vertical bars represent mean ± SEM of three experiments.

 
T cells from CD44 KO mice are resistant to Con A-induced apoptosis

Recent studies from our laboratory have demonstrated that CD44-deficient T cells are more resistant to activation-induced cell death (AICD; unpublished data). Therefore, we tested the hypothesis that CD44 KO mice are more susceptible to Con A-induced hepatitis because the Con A-activated T cells fail to undergo apoptosis, thereby continuing to elicit hepatitis. To this end, CD44 WT and CD44 KO mice were injected with Con A, and 8–48 h later, T cells purified from the spleen were tested for apoptosis by TUNEL assay. In both groups of mice, early signs of apoptosis were detected at 8 h after Con A injection (Fig. 7GoA). The apoptosis induction peaked at 24 h and declined by 48 h. Interestingly, at 16 and 24 h after Con A injection, the apoptosis induction in T cells was markedly higher in CD44 WT mice when compared with the CD44 KO mice (Fig. 7GoA). A representative experiment conducted 24 h after Con A injection has been depicted in Fig. 7GoB that indicated clearly that CD44 KO mice had a significantly lower percentage of apoptotic cells (27.8%) when compared with CD44 WT mice (60.2%).



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FIGURE 7. Detection of apoptosis in vivo after Con A treatment. At the indicated time points after Con A injection, T cells were purified from the spleens of CD44 WT and CD44 KO mice. Next, 106 cells were analyzed for apoptosis by TUNEL and annexin/PI assays. A, Percentage of apoptotic splenic T cells at various time intervals after Con A injection, assayed by the TUNEL assay. Vertical bars represent mean ± SEM of three experiments. *, p < 0.05 when compared with the CD44 WT mice. B, representative histogram generated by the TUNEL method in which apoptosis in T cells was studied 24 h after Con A injection. Bold histogram represents T cells stained with TdT alone and broken histogram shows T cells stained with TdT plus FITC-dUTP. Percentage of apoptotic cells has been depicted in each histogram. C, Dual staining with annexin V and PI to detect the percentage of apoptotic splenic T cells 24 h after Con A injection as described in Materials and Methods.

 
To further corroborate these results, we used annexin/PI staining to detect apoptosis. This assay detects early apoptotic (annexin+ and PI-) and late apoptotic/necrotic (annexin+ and PI+) cells (21). As seen from Fig. 7GoC, when T cells from Con A-injected mice were analyzed at 24 h, the WT mice had a significantly higher proportion of annexin+ and annexin+/PI+ cells when compared with the CD44 KO mice. Furthermore, when purified liver MNC were analyzed 16 h after Con A injection, the cells from the CD44 KO mice exhibited decreased levels of apoptosis when compared with the CD44 WT mice (Fig. 8Go).



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FIGURE 8. Detection of apoptosis in infiltrating MNC found in the liver after injection with Con A. MNC were isolated from the livers of CD44 WT and CD44 KO mice 24 h after in vivo injection of Con A (12 mg/kg body weight i.v.). The percentage of apoptotic cells was determined by dual staining with annexin/PI followed by flow cytometric analysis.

 
Mitogen-induced T cell proliferation is similar in CD44 WT and CD44 KO mice

It was possible that T cells from CD44 KO mice were more resistant to Con A-induced apoptosis because they exhibited decreased responsiveness to Con A stimulation. To address this, spleen cells from CD44 WT and CD44 KO mice were stimulated with Con A or anti-CD3 mAbs, and T cell proliferation was measured. As shown in Fig. 9Go, there was no significant difference in the ability of T cells from CD44 KO mice to proliferate when compared with T cells from CD44 WT mice.



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FIGURE 9. The proliferative response of CD44 WT and CD44 KO splenocytes to stimulation with Con A and anti-CD3 mAb in vitro. Splenocytes (5 x 105) from CD44 WT and CD44 KO mice were cultured in the presence of either Con A (5 µg/ml) or anti-CD3 mAb (5 µg/ml) for 48 h. During the final 8 h of culture, the cells were pulsed with 2 µCi [3H]thymidine. Thymidine incorporation was determined by {beta}-scintillation counting. The vertical bars represent mean ± SEM of triplicate wells.

 
CD44-deficient splenocytes are more resistant to activation-induced apoptosis in vitro

To further corroborate that T cells from CD44 KO mice were more resistant to apoptosis, T cells from CD44 WT and CD44 KO mice were cultured in vitro with Con A and the ability of cells to undergo AICD was studied. The results demonstrated that at 8, 16, and 24 h after incubation with Con A, more apoptosis was seen in CD44 WT when compared with CD44 KO mice (Fig. 10Go).



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FIGURE 10. Detection of apoptosis after activation of T cells in vitro with Con A. Purified T cells from the spleens of normal CD44 WT or CD44 KO mice were cultured with Con A (5 µg/ml) for 8–24 h. At each time point, the cells were harvested and analyzed for apoptosis by TUNEL assay. Top panels, percentage of apoptotic T cells at various time points. Vertical bars represent mean ± SEM of triplicate cultures. *, Statistically significant difference (p < 0.05) when compared with CD44 WT mice. Bottom panels, Representative histogram showing apoptosis in T cells cultured in vitro with Con A. The data are presented as described in Fig. 7BGo.

 
Studies also were undertaken to address whether resistance to apoptosis seen in T cells from CD44 KO mice was restricted only to stimulation with Con A or whether such cells showed decreased apoptosis to stimulation through TCR. To investigate this, spleen cells from CD44 WT and CD44 KO mice were stimulated with anti-CD3 mAbs for 2 days, harvested, and cultured with immobilized anti-CD3 mAb plus IL-2 for an additional 2 days (22). Next, the cells were analyzed for apoptosis. As seen from Fig. 11GoB, the CD44 WT T cells exhibited an increased percentage of apoptotic cells when compared with T cells from CD44 KO mice. This difference did not result from altered expression of CD3 because T cells from CD44 KO and CD44 WT mice exhibited similar levels of CD3 (Fig. 11GoA). These data suggested that T cells from CD44 KO mice were more resistant to TCR-based apoptosis when compared with T cells from CD44 WT mice.



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FIGURE 11. Levels of CD3 expression and anti-CD3 mAb-induced apoptosis in CD44 WT and CD44 KO splenocytes. A, Level of expression of CD3 on CD44 WT and CD44 KO T cells. Nylon-enriched splenic T cells from CD44 WT and CD44 KO mice were stained for 30 min with FITC-conjugated anti-CD3 mAb and analyzed by a flow cytometer. The percentage of CD3+ T cells and the mean intensity of fluorescence (MFI) has been depicted in each histogram. B, Levels of apoptosis induced in splenocytes after restimulation with anti-CD3 mAb. Splenocytes from CD44 WT and CD44 WT mice were stimulated for 48 h with anti-CD3 mAbs (5 µg/ml), harvested, and restimulated with anti-CD3 mAbs (5 µg/ml) and IL-2 (50 U/well) for 48 h. The levels of apoptosis were determined by annexin/PI staining followed by flow cytometric analysis. The percentage of apoptotic cells has been depicted in each histogram.

 
Adoptive transfer of T cells from Con A-treated CD44 KO mice induces increased hepatitis in normal CD44 WT mice

It was not clear from the previous experiments whether CD44 expression on immune cells or hepatic cells was playing a critical role in hepatitis induction. To investigate this, adoptive transfer experiments were conducted. Twenty-four hours after Con A treatment, purified T cells from CD44 WT or CD44 KO mice were adoptively transferred into normal CD44 WT mice (1x108 cells/mouse i.v.). AST levels were measured 24 h after the adoptive transfer. Transfer of Con A-activated T cells from CD44 WT mice into normal CD44 WT mice triggered increased AST levels, thereby indicating that Con A-activated T cells were capable of inducing hepatitis. Interestingly, similar transfer of Con A-activated T cells from CD44 KO mice into normal CD44 WT mice induced higher levels of AST when compared with the WT->WT group (Fig. 12Go). Transfer of Con A-activated CD44 WT cells into CD44 KO mice induced similar AST levels as the WT->WT group (data not shown). Together, these data demonstrated that Con A-activated CD44-deficient T cells were able to induce increased levels of AST when compared with Con A-activated CD44+ T cells. Also, when Con A-activated CD44+ T cells were transferred into CD44 WT or CD44 KO mice, the levels of AST were similar, thereby suggesting that the CD44 expression in the liver did not influence the hepatitis induction. Thus, CD44 expression on T cells rather than hepatocytes played a crucial role in Con A-induced hepatitis.



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FIGURE 12. Effect of adoptive transfer of Con A-activated T cells on induction of hepatitis. CD44 WT and CD44 KO mice were injected with Con A (12 mg/kg body weight i.v. in 100 µl of saline). Twenty-four hours later, spleen cells were transferred into normal CD44 WT mice. Plasma AST levels from individual mice were determined at 24 and 48 h after the adoptive transfer. Vertical bars represent mean ± SEM of five samples. *, Statistically significant difference (p < 0.5) when compared with CD44 WT ->CD44 WT group.

 

    Discussion
 Top
 Abstract
 Introduction
 Materials and Methods
 Results
 Discussion
 References
 
In the current study, we demonstrated with CD44 KO mice that CD44 plays a crucial role in Con A-induced hepatitis. CD44 KO mice exhibited increased hepatitis when compared with CD44 WT mice. CD44-deficient T cells showed increased resistance to undergoing apoptosis after Con A activation. Thus, prolonged survival of these cells may account for increased levels of cytokines such as IL-2, IFN-{gamma}, and TNF-{alpha}, which may contribute to more severe liver damage, as seen in CD44 KO mice when compared with the CD44 WT mice. Furthermore, adoptive transfer experiments corroborated this observation by demonstrating that transfer of activated CD44-deficient spleen cells into WT mice could induce higher levels of AST when compared with transfer of Con A-activated CD44 WT spleen cells into CD44 WT mice. These data together demonstrated that CD44 is actively involved in the Con A-induced hepatitis.

Con A is a potent T cell mitogen with tropism for the liver. In mice, Con A induces an acute hepatitis that is a model of T lymphocyte-mediated liver injury (1). Previous studies have shown that Con A-induced hepatitis requires IL-2, IFN-{gamma}, and TNF-{alpha} (25, 27). In addition, Fas-FasL interaction (26) and perforin-granzyme system (28) also were shown to play an important role in Con A-induced hepatitis. In this study, we observed that the increased hepatitis seen in CD44 KO mice correlated with increased production of cytokines such as TNF-{alpha}, IL-2, and IFN-{gamma}, but not Fas or FasL. This increased cytokine production in CD44 KO mice may result from the fact that Con A-activated T cells from CD44 KO mice were more resistant to apoptosis when compared with similar cells from CD44 WT mice. In the current study, it was noted that the livers from Con A-injected mice exhibited marked induction of apoptosis. These data are consistent with the previous studies that FasL is involved in Con A-induced hepatitis (27). In addition, TNF-{alpha} also has been shown to induce hepatotoxicity after Con A injection (26).

CD44 is a family of cell surface glycoproteins with proposed functions in extracellular matrix binding, cell migration, lymphopoeisis, and lymphocyte homing (8). Gantner et al. (25) proposed that in Con A-induced hepatitis, liver-infiltrating T lymphocytes are recruited from the spleen and migrate to the liver where either activated macrophages or T cells may directly cause hepatocyte death. In the current study, we screened different subsets of lymphocytes in spleen and liver. However, we did not find any significant changes in CD44 KO mice when compared with CD44 WT mice. These data excluded the possibility that increased hepatitis seen in CD44 KO mice was caused by the presence of activated lymphocyte subsets. Previous studies have shown that CD44 is involved in the migration of lymphocytes to organs, including the liver (8). However, in an earlier study with CD44 KO mice, we observed in IL-2-induced vascular leak syndrome that the lymphocyte infiltration in lungs and liver was similar to CD44 WT mice (16). A histological study in the current investigation also showed that similar levels of infiltration of cells were seen in the livers of Con A-injected CD44 WT and CD44 KO mice. These data suggested that increased hepatitis seen in CD44 KO mice was not caused by altered migration of lymphocytes to the liver. When liver MNC from Con A-injected mice were screened for apoptosis, cells from CD44 KO mice were found to be more resistant to apoptosis when compared with the cells from CD44 WT mice. It is possible that such resistant cells may contribute toward increased hepatitis as seen in CD44 KO mice.

T cells on activation undergo apoptosis, a process termed as AICD (29, 30). The role of AICD in Con A-induced hepatitis has not been studied previously. In the Con A-induced hepatitis model, how T cells undergo apoptosis on Con A activation may be crucial for mice to recover from the disease. CD44 has been shown to be up-regulated after T cell activation after Con A injection, thereby suggesting that CD44 could be a good candidate for inducing apoptosis. Indeed, we found that CD44-deficient T cells showed increased resistance to apoptosis both in vivo and in vitro, which could lead to prolonged survival of Con A-activated T cells in CD44 KO mice when compared with CD44 WT mice. These data also indicated that CD44 expressed on activated T cells may play a crucial role in AICD. The mechanism by which CD44 participates in AICD is not clear. We have shown previously that T cells on activation express increased levels of CD44 (11, 12). HA has been shown to serve as an important ligand for CD44 (8). Thus, interaction between CD44 and HA on activated T cells may trigger apoptosis. Therefore, T cells deficient in CD44 may fail to undergo apoptosis and continue to produce cytokines, thereby causing enhanced hepatitis. To this end, we recently have generated mice that are deficient in CD44 and Fas. We found that such mice develop more severe lymphoproliferative disease than mice that are CD44+ but Fas-deficient (unpublished data). Furthermore, we have observed that T cells from CD44- Fas- mice are more resistant to AICD than CD44+Fas- mice. In the current study, we also noted that T cells from CD44 KO mice were more resistant to AICD when stimulated with anti-CD3 mAbs. Together, these studies suggested that CD44 may play an important role in AICD.

CD44 is expressed on a wide range of lymphoid and nonlymphoid cells (8). Thus, it was not clear whether CD44 expression in the liver tissue or on lymphocytes was playing a role in Con A-induced hepatitis. To this end, we conducted the adoptive transfer experiment and found that Con A-activated T cells were capable of inducing hepatitis in both WT and CD44 KO mice. In fact, T cells from Con A-injected CD44 KO mice, when transferred into CD44 WT mice, induced increased plasma AST levels when compared with similar cells transferred from CD44 WT mice into CD44 WT mice. It should be noted that the plasma AST levels in adoptive transfer experiments were not as high as the AST levels seen in mice injected directly with Con A. This may be because the transferred cells may not home well. In fact, in a recent report, the authors injected the cells into the spleen to induce significant degree of hepatitis (4). Other investigators have suggested that in addition to the T cells from the spleen (1), NK1+ T cells may play a role in Con A-induced hepatitis in the liver (31). Consistent with the current study, Con A-induced hepatitis has been associated with the infiltration of lymphocytes, monocytes, and neutrophils (32). Although the role of T lymphocytes and macrophages in the pathogenesis of Con A-induced hepatitis has been clearly established (1), the exact role played by neutrophils is not clear. It is possible that neutrophils may accumulate because of the plethora of cytokines produced by Con A-activated T cells.

In summary, the current study demonstrates for the first time that activated T cells may use CD44 to undergo apoptosis. Thus, dysregulation in the expression of CD44 may lead to increased survival of activated T cells, which in turn may trigger enhanced autoimmune reactions.


    Acknowledgments
 
We thank Dr. Mona Hassuneh for helpful discussions and reviewing the manuscript.


    Footnotes
 
1 This work was supported in part by grants from National Institutes of Health (AI 01392, HL058641 and ES 09098). Back

2 D.C. and R.J.M. contributed equally to this work. Back

3 Address correspondence and reprint requests to Dr. Mitzi Nagarkatti, Department of Microbiology and Immunology and Massey Cancer Center, Medical College of Virginia, Virginia Commonwealth University, Box 980678, Richmond, VA 23298-0678. Back

4 Abbreviations used in this paper: HA, hyaluronic acid; KO, knockout; WT, wild type; AST, aspartate aminotransferase activity; MNC, mononuclear cells; PI, propidium iodide; FasL, Fas ligand; AICD, activation-induced cell death. Back

Received for publication July 7, 2000. Accepted for publication February 26, 2001.


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 Materials and Methods
 Results
 Discussion
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