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The Journal of Immunology, 2001, 166: 2863-2870.
Copyright © 2001 by The American Association of Immunologists

Expression of a Tolerizing Tumor Antigen in Peripheral Tissue Does Not Preclude Recovery of High-Affinity CD8+ T Cells or CTL Immunotherapy of Tumors Expressing the Antigen1

Claes Öhlén2,*, Michael Kalos3,{dagger}, Doley J. Hong*, Aaron C. Shur* and Philip D. Greenberg*,{dagger}

* Department of Immunology and Division of Oncology, University of Washington, Seattle, WA 98195; and {dagger} Fred Hutchinson Cancer Research Center, Seattle, WA 98109


    Abstract
 Top
 Abstract
 Introduction
 Materials and Methods
 Results
 Discussion
 References
 
Transgenic (TG) mice were generated selectively expressing the gag protein of Friend murine leukemia virus (FMuLV) in the liver. FMuLVgag is also expressed by the FBL leukemia, and is the immunodominant tumor Ag of the CD8+ T cell response in C57BL/6 mice. gag-TG mice expressing FMuLVgag in the liver were tolerant to the protein and failed to generate a CTL response to either FBL or FMuLVgag. This tolerance reflected anergy rather than deletion, as CTL responsiveness could be recovered after four cycles of in vitro stimulation. Adoptively transferred gag-specific T cells were not anergized in gag-TG recipients, as revealed by antitumor activity in vivo. Also, such T cells did not induce detectable autoimmune injury in gag-TG liver cells. These results suggest that the requirements for a tissue Ag to provide a tolerizing stimulus are distinct from those for being the target of a T cell-mediated autoimmune response and that the requirements for induction and maintenance of peripheral tolerance are distinct for naive and primed T cells. That anergic T cells reactive with tumor-associated Ags can be recovered by repetitive in vitro stimulation and can mediate tumor therapy suggests strategies that use such Ags to generate CTL for adoptive immunotherapy should be further developed.


    Introduction
 Top
 Abstract
 Introduction
 Materials and Methods
 Results
 Discussion
 References
 
A major obstacle to the development of T cell therapy for human cancers has been the identification of suitable tumor Ags that can be recognized by peripheral T cells from the tumor-bearing host. The ideal tumor Ags are immunogenic proteins uniquely expressed by neoplastic cells. Despite evidence for such Ags in many experimental animal tumors as well as in occasional human cancers, most of the characterized human tumor Ags are more appropriately designated as tumor-associated, based on detectable expression in some normal cells as well as in tumor cells (1, 2). Enthusiasm for prospectively evaluating tumor proteins not restricted in expression to the tumor cell as targets for therapeutic antitumor T cell responses has been dampened largely by two perceived obstacles: 1) the host is likely to be tolerant to most tumor-associated Ags (TAA)4 because they are also normal self-proteins; and 2) if methodologies could be developed to break tolerance and elicit host T cell responses to the TAA, such responses might be pathogenic, mediating not only antitumor activity but also autoimmune damage to the normal tissues expressing the Ag. Despite these concerns, results from recent clinical vaccine trials that use peptide epitopes derived from TAA expressed in melanoma suggest it may be possible to achieve clinical benefit with little or no toxicity to patients (3, 4, 5).

Tolerance to self-proteins has been evaluated in several distinct murine models. Intrathymic expression of a self-protein usually leads to deletion of potentially self-reactive T cells (6, 7, 8), whereas expression of the Ag in peripheral (extrathymic) tissues often induces tolerance by nondeletional mechanisms, leading to clonal nonresponsiveness or anergy (9, 10, 11, 12, 13). In some settings with peripheral expression of the Ag, the function of anergic self-reactive T cells has been recoverable, suggesting that these cells could potentially be available for use in tumor therapy (12, 13, 14, 15). An alternative nondeletional outcome for CD8+ T cells that are specific for a peripherally expressed Ag has been defined as ignorance (16). Mice expressing an lymphocytic choriomeningitis virus (LCMV)-gp transgene in the pancreas showed no signs of autoimmunity and possessed the same T cell response to LCMV-gp after stimulation as wild-type mice. However, the T cells triggered by LCMV infection were no longer ignorant of the normal peripheral tissue and mediated rapid destruction of LCMV-gp-positive pancreatic islet cells leading to diabetes. These data suggest that a low level of a self-Ag in a noninflammatory milieu can be ignored by naive CTL, but raise the concern that activation of the T cells, such as by intentional immunization to a TAA, may alter the threshold for triggering and result in recognition of previously ignored normal tissues and autoimmune injury.

Studies in humans have demonstrated that T cells that recognize epitopes from normal proteins expressed in tumors, including both lineage-specific proteins and overexpressed cellular oncogenes, can be isolated in vitro (1, 17, 18, 19). However, this does not preclude in vivo anergy induction and deletion, as the recovered T cells may be of too low affinity to recognize either tumor or normal targets (20). Thus, models are necessary to define the nature of responsiveness to peripherally expressed TAA, determine the conditions by which nonresponsiveness can be overcome, and elucidate which categories of TAA can be safely and effectively used as targets for T cell therapy of tumors.

We describe here a C57BL/6 (B6)-transgenic (TG) mouse model in which the gag protein from the oncogenic Friend murine leukemia virus (FMuLV) is expressed under the control of the mouse albumin promoter in the liver. This FMuLVgag protein is also expressed by FBL, an FMuLV-induced erythroleukemia of B6 origin, and is the immunodominant target of the CD8+ T cell response in B6 mice to the tumor (21, 22). CD8+ T cells recognizing FMuLVgag can mediate complete eradication of disseminated leukemia following adoptive transfer into tumor-bearing B6 mice, so long as CD4+ T cell help or exogenous IL-2 is provided to sustain the CD8+ response (23, 24). By using the gag-TG mice, we describe a model for immunotherapy against a tolerizing self-tumor Ag and characterize the consequences of transferring tumor-reactive CD8+ T cells that also recognize the transgene as treatment of disseminated leukemia.


    Materials and Methods
 Top
 Abstract
 Introduction
 Materials and Methods
 Results
 Discussion
 References
 
Generation of FMuLVgag TG mice and analysis of FMuLVgag tissue expression

The construct CB16 containing the FMuLVgag sequence from FMuLV clone 57 has been described previously (25). In this construct, a CTG start site at nt 325 encoding glycosylated FMuLVgag and the ATG start site at nt 619 encoding gag have been mutated to prevent translation initiation, and the CTG site at nt 359 encoding glycogag mutated to ATG to optimize translational initiation from this site (25, 26). This construct was selected because the immunodominant CD8+ response to FMuLVgag in B6 mice is contained in the glycogag protein (22). An expression construct, pAlb-int-gag359, was generated in which the FMuLVgag sequence from CB16 was placed under the control of the albumin enhancer/promoter and the rat insulin intron A sequence inserted to improve expression (27). A construct, pAlb-gag359, was generated by the following sequential molecular manipulations: excision of a 2279-bp SpeI/SstI fragment from the CB16 construct, blunt-ending, and subcloning the fragment into the Alb-hgh vector (28) previously digested with BamHI and SmaI (to excise the hgh gene). Correct orientation of the gag sequence relative to the albumin promoter/enhancer was determined by restriction analysis. To generate Alb-int-gag359, a 150-bp rat insulin intron A fragment was excised from the plasmid pUC18/rat insulin II intron A using BamHI and BglII and ligated into the plasmid pAlb-gag359 that had been digested with BamHI. Correct orientation of the insert was determined by restriction analysis.

For injection into mice, pAlb-int-gag was digested with KpnI and ClaI to release the expression cassette from the vector backbone, electrophoresed onto a 1.2% agarose gel, and the sequence purified using QIAEX beads (Qiagen, Chatsworth, CA.). The DNA was resuspended in endotoxin-free dH2O, quantified, and injected into mouse embryos by using standard techniques. FMuLVgag-positive founder mice, as well as subsequent gag-positive offspring, were identified by analysis of tail DNA by using standard PCR protocols with FMuLVgag-specific primers (forward, 5'-GACTAGCTCTGTACCTGGCGGA-3'; reverse, 5'GATCTCTACCGACTGGTTGTGG-3').

Expression of FMuLVgag in gag-TG and control B6 mice was analyzed by semiquantitative RT-PCR of mRNA from the kidney, liver, spleen, and thymus of adult mice. Tissue fragments were snap-frozen on removal from mice, and mRNA was isolated and purified from the tissue fragments as well as positive (4 x 106 in vitro FBL cells) and negative (water) controls, with the Strataprep Total RNA Miniprep Kit (Stratagene, La Jolla, CA). The matrix-bound, isolated mRNA was digested with DNase I to eliminate potential contaminating DNA. Reverse transcription of the purified mRNA was performed with the Thermoscript RT-PCR System (Life Technologies, Grand Island, NY). First-strand synthesis of isolated mRNA was achieved using oligo(dT)20 to prime polyadenylated RNA. To verify the absence of contaminating DNA, the reverse transcription reaction was also conducted in parallel samples without reverse transcriptase. PCR amplification of {beta}-actin was performed on both reverse transcriptase-treated and non-reverse transcriptase-treated first-strand synthesis products, both to provide a standard for the quality of the reverse transcription and to confirm the absence of genomic DNA contamination. Actin was amplified using Platinum Taq Polymerase (provided in the Thermoscript RT-PCR System) and custom actin primers (forward, 5'-GTGGGCGCCCCAGGCACCA-3'; reverse, 5'-GTCCTTAATGTCACGCACGATTTC-3'). First-strand products were normalized by titration of starting material based on the band intensity of the amplified {beta}-actin. PCR amplification of FMuLVgag was conducted on the normalized first-strand products by using the custom FMuLVgag primers. PCR products were then run out on a 2% agarose gel. The PCR protocols for the amplification of {beta}-actin and FMuLVgag were identical: 94°C for 1 min, 60°C for 1 min, and 72°C for 1 min for each of 34 cycles.

The presence of FMuLVgag protein in the liver of gag-TG mice was assessed from snap-frozen liver tissue that was lysed in lysis buffer, run on a 12% SDS-PAGE gel, and blotted to nitrocellulose filter. After blocking in 2% milk, the filters were probed with supernatant from the rat hybridoma R187 (a kind gift of B. Chesebro, Rocky Mountain Laboratories, Hamilton, MT (29)), washed, and specific binding detected by incubation with secondary HRP-conjugated anti-rat Ab and ECL Western blotting detection reagents (Amersham Pharmacia, Piscataway, NJ).

Cell Lines, Medium, and Peptides

FBL-3, a Friend virus-induced erythroleukemia of B6 (H-2b) origin, expresses FMuLV env- and gag-encoded products and MHC class I molecules but does not express MHC class II molecules (23). E10 is a FMuLV negative subline of the B6 EL-4 thymoma. The mapping and the sequence (CCLCLTVFL) of the dominant H-2Db restricted FMuLVgag epitope in FBL in B6 mice has been described (22), and the peptide was synthesized at the University of Washington (Seattle, WA). Unless otherwise stated, all cell culture was performed in RPMI 1640 supplemented with antibiotics, 2-ME, and 10% FCS.

Maintenance and immunization of mice

B6 mice were obtained from The Jackson Laboratory (Bar Harbor, ME) The transgenic B6 mice were established and bred in our animal facility, and all mice were maintained under specific pathogen-free conditions. Six- to 8-wk-old mice were immunized twice with 5 x 106 irradiated FBL (10,000 rad) cells intraperitoneally (i.p.) 2 wk apart. Immune splenocytes were harvested 2–3 wk after the second immunization.

Adoptive chemoimmunotherapy (ACIT)

Adoptive immunotherapy experiments were performed as previously described (23). Briefly, on day 0, recipient mice were inoculated i.p. with 5 x 106 live FBL leukemia cells. On day 5, after the tumor cells have widely disseminated, mice were treated with 180 mg/kg cyclophosphamide (CY) i.p., followed in 6 h by adoptive transfer of splenic donor cells from immune mice, or of FBL-reactive CTL lines or clones grown and expanded in vitro, administered i.p. Splenocytes administered as effector cells were first depleted of CD4+ cells using Dynabeads (Dynal, Lake Success, NY) according to the manufacturer’s protocol, and the contaminating CD4 cells were always < 2% of the injected T cell population. T cells grown in vitro were analyzed by FACS and confirmed to be essentially 100% CD8+.

Analysis of autoimmune injury.

Groups of gag-TG and B6 mice treated with ACIT as above were sacrificed at 2–14 days after T cell transfer. Liver samples were fixed in formaldehyde, paraffin-embedded, sectioned, and stained with hematoxylin/eosin. Coded specimens were analyzed for inflammation and lymphocyte infiltration by a reference pathologist (Phoenix Central Laboratories, Everett, WA). Concurrent peripheral blood samples were analyzed for alanine aminotransferase and aspartate aminotransferase as biochemical indications of liver injury (Phoenix Central Laboratories).

Generation and testing of FBL-specific T cells

A total of 2.5 x 107 immune splenocytes from B6 or gag-TG mice were stimulated with 5 x 106 irradiated FBL cells for 5 days in T25 tissue culture flasks. After 5 days, the CTL were tested in standard 51Cr release assays against labeled FBL, E10 cells alone, or E10 pulsed with FMuLVgag peptide at the indicated concentrations. CTL lines were generated in vitro by repetitive stimulation of 2 x 106 cultured cells with 2 x 106 irradiated (10,000 rad) FBL in T25 flasks containing 5 x 106 irradiated (2,000 rad) B6 splenocytes as feeders and 20 U/ml IL-2 in a total volume of 10 ml. Lines were tested for cytolytic activity 5 days after an in vitro stimulation.


    Results
 Top
 Abstract
 Introduction
 Materials and Methods
 Results
 Discussion
 References
 
Generation of FMuLVgag TG mice

The single FMuLVgag open reading frame codes for two alternative translational products: Pr65gag and gPr75gag. Transcription of the larger gag protein gPr75gag is initiated from a CTG start site at position 355 of the FMuLV sequence, which is upstream and in-frame with the ATG start site for the conventional gag protein Pr65gag at nt 619. The higher m.w. protein, which has been named glycogag, has an additional 98-aa N-terminal leader sequence preceding the amino acid sequence of Pr65gag (25, 26) Because translation is predominantly initiated at the ATG start site at nt 619, the major protein species generated from this open reading frame is Pr65gag (25). However, the dominant CTL epitope elicited in B6 mice in response to FMuLVgag is located in the N-terminal leader segment of the FMuLV gPr75gag protein, encoded by FMuLV nt 577–603 (22). Therefore, the gag transgene was designed to optimize transcription and expression of this immunodominant CTL epitope. An FMuLVgag gene was constructed (kindly provided by Dr. Jean-Luc Darlix, Lyon, France) in which the CTG start site for gPr75gag at nt 355 was mutated to an ATG, and the ATG start site for Pr65gag at nt 619 mutated to an AGC (Fig. 1GoA). In this construct, translation has been demonstrated to occur almost exclusively from nt 355 (25). The construct was subcloned into a vector optimized for selective expression in the liver of transgenic mice off an albumin promoter (kindly provided by Dr. Richard Palmiter, Seattle, WA) (28) (Fig. 1GoB). The construct was microinjected into pronuclei of fertilized eggs from B6 mice according to standard protocols. A founder positive for the transgene was identified by PCR of tail DNA (data not shown), which transmitted the transgene to subsequent generations.



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FIGURE 1. A, Schematic outlines of the translational organization of the wild-type and modified forms of FMuLVgag. To optimize translation of the dominant H-2Db-restricted epitope starting at nt 577, the start sites at nt 325 and nt 619 were silenced by point mutation and the nt 359 start site changed from a CTG to an ATG. B, Schematic outline of the transgene construct. The modified form of FMuLVgag described in A was subcloned into a vector optimized for transgene expression in the liver using the mouse albumin enhancer and promoter and the rat insulin intron A sequence. The resulting construct was microinjected into pronuclei of fertilized eggs from B6 according to standard protocols.

 
FMuLVgag expression in mice was analyzed from cDNA generated from mRNA isolated from kidney, liver, spleen, and the thymus of gag-TG and normal B6 mice (Fig. 2Go top panel), with the amount of cDNA normalized to {beta}-actin as control (Fig. 2Go lower panel). A robust band of the expected size (417 bp) was amplified from cDNA generated from liver tissue of gag-TG mice, whereas cDNA from the liver of nontransgenic littermates was negative. Considerably weaker bands also were detected in other tissues from gag-TG after 34 cycles of PCR, suggesting some leakiness of the promoter. These bands did not appear to result from potentially contaminating DNA, as amplification of RNA samples mock treated without reverse transcriptase failed to generate a signal (data not shown). No FMuLVgag mRNA expression was detected in tissues from B6 mice.



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FIGURE 2. Analysis of FMuLVgag mRNA in different organs of gag-TG and B6 mice (upper panel). RT-PCR was performed on kidney (K), liver (L), spleen (S), and thymus (T) of adult mice. RNA was isolated and purified, and contaminating DNA was digested with DNase I. Purified RNA was reverse transcribed with first-strand synthesis using oligo(dT)20 to prime polyadenylated RNA. PCR amplification of {beta}-actin (lower panel) was conducted on both reverse transcriptase-treated and non-reverse transcriptase-treated first-strand synthesis products to provide a quantitative standard of reverse transcribed mRNA and confirm the absence of genomic DNA. PCR products were run out on a 2% agarose gel.

 
Liver cells were next analyzed for expression of the gag protein by western blotting. Liver tissue from B6 and gag-TG mice was lysed in lysis buffer and resolved on SDS-PAGE. The lysates were transferred to a nitrocellulose filter, and probed with an FMuLVgag reactive mAb (Fig. 3Go). The lane containing the FBL tumor lysate had a strong band of 65 kDa size as well as a weak band at ~75 kDa, presumably reflecting both the Pr65gag and gPr75 gag. Neither band was detectable in lysates from normal B6 mice. The gag-TG liver lysate had a single band at ~75 kDa, consistent with the modification of the transgenic construct to translate only the larger protein species.



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FIGURE 3. Western blotting for FMuLVgag protein expression in liver from gag-TG mice. Liver tissue from B6 and gag-TG mice, as well as FBL tumor cells, were lysed in lysis buffer and run on 12% SDS gel. After blotting on to a nitrocellulose filter and blocking over night, the filters were probed with the R187 mAb to FMuLVgag, washed, and specific binding detected by incubation with secondary HRP-conjugated anti-rat Ab and ECL Western blotting detection reagents.

 
Peripheral expression of FMuLVgag abolishes the anti-FBL CTL response in B6 mice

To investigate the immunological consequences of expressing FMuLVgag as a TAA, gag-TG and normal B6 mice were primed and boosted in vivo with irradiated FBL. Two weeks after the second immunization, spleens were harvested, stimulated in vitro with irradiated FBL, and tested for the presence of FBL-reactive CTL. After in vitro sensitization for 5 days, spleen cells from in vivo-primed normal B6 mice exhibited specific lytic activity for FBL (Fig. 4Go). This CD8+ T cell mediated (Ref. (21) and data not shown) cytotoxic activity recognized the dominant CTL epitope, as demonstrated by pulsing FMuLV- negative targets with the peptide defining this gag epitope. In contrast, no CTL activity to FBL or to targets pulsed with the immunodominant epitope could be detected in cultures derived from gag-TG mice. Thus, the gag-TG mice are not only tolerant to FMuLVgag, but also fail to generate CTL responses to any potentially subdominant MHC class I-restricted epitopes encoded by other genes in FBL.



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FIGURE 4. CTL from gag-TG mice are tolerant to FBL and FMuLVgag. B6 and gag-TG mice were immunized twice with 107 irradiated FBL. Two weeks after the second immunization, spleens were harvested and 2.5 x 107 splenocytes stimulated with 5 x 106 irradiated FBL cells for 5 days in vitro. After 5 days, the CTL were tested at indicated E:T ratios in a standard 51Cr release assay against FBL, a control gag-negative E10 target, or E10 pulsed with 5 µg/ml FMuLVgag peptide.

 
Recovery of fully functional CTL after repeated in vitro stimulation

In a clinical setting, adoptive therapy will require a means to recover and expand potentially tolerant T cells reactive with the TAA. The failure to detect a CTL response in gag-TG animals could be the result of anergy, from which recovery would potentially be possible, or from permanent deletion of the FMuLVgag-specific repertoire. Therefore, we attempted to overcome tolerance and expand FMuLV-reactive CD8+ T cells by removing the cells from the tolerogenic in vivo environment and repetitively stimulating the cells in vitro in the presence of supplemental IL-2.

Mice were primed and boosted in vivo with irradiated FBL, and their splenocytes then stimulated weekly in vitro with irradiated FBL and IL-2. Cell cultures from primed B6 mice expanded with each stimulation cycle, but the cultures from gag-TG mice exhibited an initial contraction, followed by stable cell numbers, and then proliferation after three cycles. Analysis of cytolytic activity after the fourth cycle revealed FBL-reactive CTL in T cell lines from gag-TG animals that killed FBL targets similar to CTL lines from normal B6 animals (Fig. 5Go). No lytic activity was detected from similarly in vitro-stimulated T cells derived from naive B6 mice (data not shown), suggesting that this method does not effectively prime naive CD8+ T cells in vitro. The specificity of the CTL for gag and their relative affinity was assessed by titrating the immunodominant peptide epitope on Ag-negative E10 targets. Only small differences in lytic activity by CTL from gag-TG and normal B6 mice were observed over peptide titrations from 0.01 to 10 µg/ml (Fig. 5Go). Repeat experiments with additional CTL lines at ranging peptide doses suggested no reproducible differences between the CTL lines. Although other factors could contribute to the avidity of these CTL lines for the target, the peptide titration studies suggest that the CTL derived from gag-TG mice are of relatively similar affinity to those from B6 mice. These results suggest that the CTL recovered from the tolerant mice have a repertoire containing some high-affinity and not just residual low-affinity T cells. The recovery of such higher-affinity T cells after repetitive in vitro stimulation likely reflects the reversal of anergy in tolerant cells in this environment rather than just outgrowth of rare T cells that have not undergone deletion, as repetitive in vivo stimulations in the tolerant mice failed to result in detectable expansion of gag-reactive T cells (data not shown).



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FIGURE 5. Tolerance to FMuLVgag can be overcome by repetitive in vitro stimulation. A total of 2.5 x 107 immune splenocytes from B6 (filled symbols) or gag-TG mice (open symbols) were stimulated with 5 x 106 irradiated FBL in T25 flasks in a total volume of 10 ml. The cultures were restimulated every 7 days with 2 x 106 irradiated (10,000 rad) FBL, 5 x 106 irradiated (2,000 rad) B6 splenocytes as feeder cells, and 20 U/ml IL-2. After 4 wk, when proliferating cells had accumulated, cultures from gag-TG mice were tested in 51Cr release assay at an E:T ratio of 20:1, with FBL targets or E10 incubated with the indicated concentration of FMuLVgag peptide.

 
To further evaluate the activity of the recovered gag-specific cells, the cells were tested in adoptive immunotherapy experiments, in a model that requires in vivo proliferation and persistence of the transferred cells for tumor eradication (30). B6 mice were inoculated with FBL tumor cells i.p. on day 0, and on day 5 were treated with CY followed in 6 h by transfer of 107 FMuLVgag-specific CD8+ T cells. Low doses of IL-2 (104 U/day) were provided on days 5–19 to support proliferation and survival of the transferred CD8+ T cells. This specific ACIT regimen has been shown previously to cure the vast majority of mice bearing established disseminated FBL tumor (24). As suggested by analysis of in vitro cytotoxicity, CD4-depleted splenocytes from gag-TG were unable to eradicate the FBL tumor from B6 mice. However, gag-specific CD8+ CTL recovered from gag-TG animals by repetitive in vitro stimulations exhibited efficacy in adoptive therapy similar to the CTL lines established from normal B6 mice (Fig. 6Go).



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FIGURE 6. CTL from gag-TG mice that have functionally recovered by repetitive stimulation in vitro can eradicate FBL in vivo. CD8+ CTL generated from gag-TG and B6 mice as described in Fig. 5Go were used in adoptive transfer experiments. B6 mice were inoculated on day 0 with 5 x 106 live FBL cells i.p. Groups of mice were treated 5 days later with 180 mg/kg CY, followed in 6 h by transfer of 107 effector cells comprised of CD4-depleted splenocytes from primed B6 or primed gag-TG mice or CTL lines expanded for 4 wk from primed B6 or from primed gag-TG mice. Beginning on day 5, all treated mice received 104 U IL-2 i.p. daily through day 19.

 
Expression of FMuLVgag in the liver does not affect the efficacy of transferred FBL specific CTL, or serve as a target for autoimmune injury

Even if T cells reactive with a TAA can be rescued as above, such T cells might still not be useful for therapy. First, the mechanisms operative for maintaining tolerance in gag-TG mice could potentially similarly induce anergy in transferred T cells specific for the TAA and interfere with efficacy. Second, if the tolerizing signals prove incapable of anergizing infused effector T cells, these CTL, which are targeted to a protein shared between the tumor and normal tissues, could potentially lead to severe autoimmunity. Therefore, B6 and gag-TG mice were inoculated with FBL tumor cells on day 0, and received treatment on day 5 with cyclophosphamide followed in 6 h by transfer of 107 FMuLVgag-specific CTL derived from a B6 mouse. The mice then received on days 5–19 104 U IL-2/day i.p. FBL tumor was eradicated by this treatment regimen in both the gag-TG and B6 mice (Fig. 7Go). Thus, the FMuLVgag expressed in the liver did not interfere with the in vivo antitumor activity or tolerize primed activated CTL, at least during the 4-wk time required for tumor eradication (30). The results suggest that primed T cells have a different threshold for tolerance induction than naive T cells.



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FIGURE 7. Adoptively transferred FMuLVgag-reactive CTL can eradicate disseminated FBL tumor in gag-TG mice. B6 and gag-TG mice were inoculated on day 0 with 5 x 106 live FBL cells i.p. Groups of mice were either left untreated or treated 5 days later with 180 mg/kg CY, followed in 6 h by transfer of 107 cloned FMuLVgag-specific CD8+ CTL, or with control B6 splenocytes. All treated mice received 104 U of IL-2 i.p. beginning on day 5 immediately after cell transfer through day 19.

 
The persistence and function for several weeks of transferred effector CTL could result in autoimmune injury to liver cells expressing the FMuLVgag protein. Therefore, blood was drawn from mice at multiple time points after T cell therapy of gag-TG and B6 mice, and serum levels of the liver enzymes AST and ALT measured as indicators of liver injury. Additionally, cohorts of treated mice were sacrificed intermittently from days 7–26 for histological analysis of liver tissue. All B6 and gag-TG animals cured of disseminated tumor by adoptive transfer of FMuLVgag specific CTL appeared healthy. Moreover, neither histologic analysis of liver sections (representative sections obtained on day 12, 1 wk after T cell therapy and IL-2 administration, are shown in Fig. 8Go) nor measurement of AST and ALT serum levels (data not shown) at any time point revealed evidence of autoimmune injury in treated gag-TG animals.



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FIGURE 8. Absence of autoimmune liver injury following adoptive therapy of tumor in gag-TG mice. B6 and gag-TG mice were inoculated on day 0 with 5 x 106 live FBL cells i.p. Groups of mice were either left untreated or treated 5 days later with 180 mg/kg CY, followed in 6 h by transfer of a FMuLVgag specific CD8+ CTL clone. Beginning on day 5, mice received daily injections of 104 U of IL-2 i.p. daily. On day 12, livers from B6 and gag-TG mice were harvested, fixed in formaldehyde, paraffin-embedded, sectioned, stained with hematoxylin/eosin, and analyzed for inflammation and lymphocyte infiltration by a pathologist. Representative sections from B6 (A) and gag-TG (B) mice are shown (magnification, x25).

 

    Discussion
 Top
 Abstract
 Introduction
 Materials and Methods
 Results
 Discussion
 References
 
FBL is a retrovirally transformed leukemia expressing high levels of an immunogenic viral protein, FMuLVgag, that induces an immunodominant CTL response that can eradicate the FBL tumor (22, 24). The transgenic mice described in this report express the gag gene in the liver under the control of the albumin promoter, rendering this potentially immunogenic tumor protein no longer tumor specific. These mice have provided the opportunity to examine the consequences on CTL function and on tumor therapy of the expression of an immunodominant tumor Ag in peripheral tissues. The results presented in this report demonstrate a remarkably selective activity of effector T cells for the tumor and not normal cells expressing the FMuLVgag protein.

A major obstacle to pursuing T cell therapy targeting tumor Ags that also are expressed in normal tissues is the difficulty in isolating such T cells, which is at least in part attributable to tolerance in the host. This obstacle was evident in the gag-TG mice, as initial efforts to immunize the mice with FMuLVgag in vivo to expand the number of gag-specific CTL were unsuccessful. However, FMuLVgag-reactive T cells with efficacy in tumor therapy similar to nontolerant T cells from immunized B6 mice could be recovered from gag-TG mice after removal from the in vivo tolerizing environment. The approach employed, involving repeated cycles of in vitro stimulation in combination with supplemental IL-2, is analogous to methods we have used to isolate human melanoma-reactive T cells specific for normal melanocyte Ags from patients with melanoma (31).

Other studies that used nominal Ags have also suggested that maintenance of the anergic state in self-reactive T cells requires continuous exposure of the T cells to the tolerogen, and that the nonresponsive state can be reversed after withdrawal of the tolerogen. (15, 32, 33). However, the persisting recovered T cells may have a lower affinity than T cells isolated from hosts not expressing the Ag. In a transgenic model in which hemagglutinin from influenza virus was expressed in islet cells in the pancreas, the recovered T cells recognized a transfected renal carcinoma cell line despite exhibiting only low affinity for hemagglutinin (34). These CD8+ T cells were capable of rejecting the tumor in vivo without causing detectable autoimmune injury. Thus, nontolerant low-affinity T cells reactive with TAA may be isolated in settings in which high-affinity T cells have been tolerized and may be effective in vivo without inducing toxicity if the tumor expresses a sufficient amount of Ag to be recognized. However, our results suggest that higher-affinity T cells might also be recoverable in some settings because peptide titrations provided inferential evidence in our model that the recovered TAA-reactive T cells were of similar affinity to those detected from normal immunized hosts.

Another potential obstacle for therapy with tumor-reactive T cells that also recognize normal tissues is that the infused T cells might be tolerized after transfer and fail to mediate antitumor activity. However, the therapeutic efficacy observed after transfer of FMuLVgag-reactive primed T cells suggest that the requirement for tolerizing primed T cells is distinct from the requirements for tolerizing naive T cells. This appears to be the reciprocal of the requirements for activation of primed T cells, which requires lower levels of Ag and is less dependent on costimulatory and accessory molecules than activation of naive T cells (35, 36). Thus, a tolerizing signal for naive T cells may be perceived as a competent activating signal by primed T cells.

If the tolerizing peripheral tissue can actually activate primed but not naive T cells, then transfer of primed cells would be expected to mediate acute and/or chronic injury to the normal tissue expressing the proteins. However, histological and biochemical analysis of liver tissue from gag-TG mice that received immune T cells that were capable of rejecting a tumor challenge, an activity that requires retention of function for at least 30 days (30), failed to reveal evidence of liver injury. Thus, despite expression of FMuLVgag in the liver adequate to induce nonresponsiveness in naive T cells, activated effector cells did not promote injury to normal tissue. This may reflect differential susceptibilities of normal tissues and the tumor to the cytotoxic effector mechanisms and/or be a consequence of quantitatively different levels of Ag expression. Other murine models have also suggested that normal tissues may be more resistant to injury than tumor cells (34, 37, 38). We previously reported that transgenic mice expressing from an Ig promoter the FMuLV-env gene, which is the target for an MHC class II-restricted FBL-specific CD4+ T cell response, were resistant to autoimmune injury despite the ability of adoptively transferred T cells to reject tumor in these mice (39). In that model, however, both the tumor and some self tissues (i.e., T cells) expressing the Ag are MHC class II negative, requiring indirect effector mechanisms to mediate the antitumor activity as well as selected autoimmune injury. In contrast, in the current model both tumor and hepatocytes are MHC class I positive and therefore potentially directly sensitive to the lytic activity of the CD8+ CTL used in ACIT. In the gag-TG mice, liver parenchymal cells may partially resist injury attributable to expression of limited amounts of the counterreceptors, such as CD80 or CD86, that contribute to T cell-target avidity and provide costimulatory signals (40). Additionally, for some targets such as EBV-infected cells, susceptibility to the effector phase of the CD8+ response requires a higher density of the relevant viral Ags than stimulation of CD8+ responses (41).

Induction of tolerance can occur if APC take up self-Ag and then present it to T cells in a draining lymph node. This is analogous to some of the events involved in cross-priming, but presumably reflects failure to activate the APC with resultant delivery of tolerizing rather than activating signals (42, 43). Thus, the gag Ag may not be directly presented to T cells by hepatocytes, but rather by professional APC such as dendritic cells. Uptake of released Ag from uninjured liver cells or phagocytosis of apoptotic liver cells might not be expected to promote dendritic cell maturation. However, we attempted to promote autoreactivity by inducing inflammatory responses in the liver, followed by transfer of FMuLVgag-specific CTL. These experiments included infection of the livers of gag-TG mice with vaccinia or adenovirus, followed by injections of irradiated FBL as a stimulating Ag source, and IL-2 to promote survival and proliferation of the transferred CTL. No evidence of injury to the liver was detectable following resolution of the acute infections (data not shown). This resistance of hepatocytes to autoimmune damage may be a general phenomenon. In a transgenic model in which tolerance was induced by expression of the alloantigen H-2Kb in the liver, hepatocytes were very resistant to autoimmune injury (44), although CTL-mediated liver damage could be induced by infecting the mice with the liver-specific pathogen Listeria monocytogenes. The ability to ultimately induce autoimmune injury in this setting may be due to the tolerizing Ag being an allogeneic class I Ag, which cannot induce tolerance by cross-presentation via host APC and should be recognized by a broader host response.

Additional evidence suggesting liver cells may be insensitive targets for killing by T cells has been provided by studies of viral hepatitis. CD8+ T cells controlled viral replication in infected hepatocytes by release of inflammatory cytokines such as IFN-{gamma} and TNF (45). Surprisingly, this biological activity was not accompanied by a cytopathic effect on hepatocytes. Thus, CD8+ T cells capable of killing targets can recognize liver cells and perform effector functions while not lysing the liver cells. The means by which hepatocytes may be protected from cytolysis are unclear, but similar mechanisms could be operative in our model.

The results of this murine study are consistent with observations following T cell therapy for human melanoma, in which T cells reactive with Ags expressed in both melanoma tumor cells and human melanocytes have been found to be therapeutically effective without mediating toxicity in most patients and inducing partial vitiligo in the remaining fraction (46). Our data validate the hypothesis that therapies based on T cell immunity to TAA overexpressed in tumor cells have the potential to provide significant therapeutic benefit. The ability to isolate and use such tumor-reactive T cells will likely be strongly dependent on the particular tissues that express the self-Ag, as well as the magnitude of normal expression. Further studies in relevant murine models such as the one presented here should help elucidate the principles necessary to facilitate development of this approach for human tumor therapy.


    Acknowledgments
 
We thank Jean-Luc Darlix (Lyon, France) and Richard Palmiter, Seattle WA, for providing DNA constructs; Bruce Chesebro (Rocky Mountain Laboratories, Hamilton MT) for R187 Ab; Benjamin Jacobsen and Christopher Wilson (University of Washington, Seattle WA), for microinjection of the construct and generation of the gag-TG strain; Xaioxia Tan and Jennifer Young for expert technical assistance; Laurence Cheng and Eric Huseby for helpful discussions; and Joanne Factor for her assistance in preparation of this manuscript.


    Footnotes
 
1 This work was supported by Grant CA 33084 from the National Institutes of Health/National Cancer Institute, and M.K. was supported by a grant from the Cancer Research Institute. Back

2 Address correspondence and reprint requests to Dr. Claes Öhlén, Department of Immunology, Box 356527, University of Washington, Seattle, WA 98195. Back

3 Current address: Corixa Corporation, 1124 Columbia Street, Seattle, WA 98104. Back

4 Abbreviations used in this paper: TAA, tumor-associated Ags; LCMV, lymphocytic choriomeningitis virus; B6, C57BL/6; FMuLV, Friend murine leukemia virus; FBL, an FMuLV-induced erythroleukemia of B6 origin; TG, transgenic; ACIT, adoptive chemoimmunotherapy; CY, cyclophosphamide. Back

Received for publication August 24, 2000. Accepted for publication November 27, 2000.


    References
 Top
 Abstract
 Introduction
 Materials and Methods
 Results
 Discussion
 References
 

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