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*Compound via MeSH
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Hazardous Substances DB
*HYDROGEN PEROXIDE
*NICKEL CHLORIDE
*NICKEL, ELEMENTAL
The Journal of Immunology, 2001, 167: 6794-6803.
Copyright © 2001 by The American Association of Immunologists

Tolerance to Nickel: Oral Nickel Administration Induces a High Frequency of Anergic T Cells with Persistent Suppressor Activity1

Suzan Artik2,*,{ddagger}, Karin Haarhuis2,*, Xianzhu Wu*, Jutta Begerow{dagger} and Ernst Gleichmann3,*

Divisions of * Immunology and Allergology and {dagger} Analytical Chemistry, Medical Institute of Environmental Hygiene, and {ddagger} Dermatology Clinic, Heinrich Heine University, Düsseldorf, Germany


    Abstract
 Top
 Abstract
 Introduction
 Materials and Methods
 Results
 Discussion
 References
 
We adapted our mouse model of allergic contact hypersensitivity to nickel for the study of tolerance. Sensitization in this model is achieved by the administration of nickel ions with H2O2; nickel ions alone are unable to prime naive T cells, but can restimulate primed ones. A 4-wk course of oral or i.p. administration of 10 mM NiCl2 to naive mice induced tolerance, preventing the induction of hypersensitivity for at least 20 wk; long term desensitization of nickel-sensitized mice, however, required continuous NiCl2 administration. When splenic T cells of orally tolerized donors, even after a treatment-free interval of 20 wk, were transferred to naive recipients, as with lymph node cells (LNC), they specifically prevented sensitization of the recipients. The LNC of such donors were anergic, because upon in vivo sensitization with NiCl2 in H2O2 and in vitro restimulation with NiCl2, they failed to show the enhanced proliferation and IL-2 production as seen with LNC of mice not tolerized before sensitization. As few as 102 bulk T cells, consisting of both CD4+ and CD8+ cells, were able to specifically transfer tolerance to nickel. A hypothesis is provided to account for this extraordinarily high frequency of nickel-reactive, suppressive T cells; it takes into account that nickel ions fail to act as classical haptens, but form versatile, unstable metal-protein and metal-peptide complexes. Furthermore, a powerful amplification mechanism, such as infectious tolerance, must operate which allows but a few donor T cells to tolerize the recipient.


    Introduction
 Top
 Abstract
 Introduction
 Materials and Methods
 Results
 Discussion
 References
 
Nickel is one of the most common contact sensitizers (1). As a component of a variety of different alloys, including stainless steel, it is contained in a great variety of different items used in the work place and in everyday life (2, 3). By far the most common, stable, ionic form of nickel is Ni2+; it is present, for instance, in NiCl2 and NiSO4, the nickel salts commonly used in allergology. Its ubiquitous occurrence notwithstanding, the majority of people do not suffer from allergy to nickel and fail to react to challenge with nickel ions in the patch test. Exogenous cofactors seem to influence the decision whether exposure to this ubiquitous agent will lead to de novo sensitization. Clinical experience indicates that allergic contact hypersensitivity to nickel preferentially develops in irritated compared with healthy skin. Consistent with this, ear piercing for the purpose of wearing nickel-releasing costume jewelry results in a high rate of nickel allergy (4). Nickel ions are released from different alloys at varying rates, depending on the alloy, when they are exposed to body fluids, such as sweat. In nickel-sensitized individuals, this may be sufficient to elicit allergic contact hypersensitivity reactions (5). Interestingly, however, adolescents having worn nickel-releasing orthodontic braces before ear piercing showed a lower incidence of nickel allergy than those individuals wearing no braces at all or braces after ear piercing (6, 7). These observations suggest that de novo sensitization to nickel was prevented due to prior induction of oral tolerance by nickel ions released from the braces.

The situation in humans is comparable with that seen in mouse models. Whereas administration of nickel ions alone failed to sensitize naive mice, sensitization was achieved by the combined administration of NiSO4 and CFA (8), NiCl2 plus irritant, or NiCl2 and H2O2 (9); the latter is produced at high levels by inflammatory phagocytes and can act as an endogenous adjuvant (10). In mice already sensitized to nickel, however, nickel ions alone sufficed to elicit hypersensitivity reactions (8, 9, 11). Likewise, when T cells from nickel-sensitized mice (9) or men (12, 13, 14, 15, 16) were exposed to nickel ions on APCs in vitro, this sufficed to restimulate them. The collective evidence prompted us to conclude (9) that the combined administration of nickel ions and H2O2 induces both signal 1 and signal 2 required for T cell priming and induction of nickel allergy, whereas nickel ions alone can generate the neoantigens recognized by nickel-specific T cells and thus provide signal 1 but are unable to induce the costimulation, or signal 2.

Two groups of investigators have shown that tolerance to nickel can be induced in naive animals by several weeks of oral exposure to nickel ions, thus preventing subsequent sensitization of the animals (8, 11, 17). In orally tolerized guinea pigs, nickel tolerance lasted up to 24 mo (17); in mice, the maximal duration of the tolerant state has not yet been determined. The mechanism underlying tolerance to nickel has not been elucidated. Based on findings obtained with nickel-specific human T cell clones, new concepts implicate IL-10, immature dendritic cells, and chemokines in nickel tolerance (15, 18, 19); however, it is unclear at present how far these findings may be generalized, because only a relatively small number of T cell clones was analyzed in detail and it is not known to what extent these clones were representative. Both nickel-allergic and nonallergic persons harbor a variety of different subsets of nickel-reactive T cells that are partially identical in both groups (15, 16, 20).

The aim of the present study was first to define the optimal conditions for tolerance induction to nickel in a mouse model (9). Applying these conditions, we determined the minimal number of T cells capable of adoptively transferring tolerance and studied their capacity to proliferate and produce IL-2 after in vivo sensitization with NiCl2 in H2O2 and in vitro restimulation with NiCl2. With respect to a possible therapeutic usage of orally applied nickel ions in men, we determined the duration of tolerance induced in naive mice and of desensitization of sensitized mice, respectively, and the concentration of nickel ions in different organs after administration of NiCl2.


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

NiCl2·6H2O (in the following denoted as NiCl2), and 2,4-dinitrofluorobenzene (DNFB)4 were purchased from Sigma-Aldrich Chemie (Steinheim, Germany), 2,4-dinitrobenzenesulfonic acid (DNBS) was bought from ICN Biomedicals Inc. (Aurora, OH), and H2O2 was from E. Merck (Darmstadt, Germany). Recombinant mouse IL-2 and streptavidin-FITC were obtained from BD PharMingen (Heidelberg, Germany).

Antibodies

PE- or FITC-labeled anti-CD4 (clone RM4-5) and anti-CD8{beta}.2 (clone 53-5.8) mAbs, biotin-labeled anti-CD8{beta}.2 (clone 53-5.8), APC-labeled anti-CD3{epsilon} (clone 145-2C11), FITC-labeled anti-CD19 (clone 1D3), FITC-labeled anti-I-Ab (clone AF6-120.1), biotin-labeled anti-CD11b (clone M1/70), biotin-labeled anti-CD11c (clone HL3), purified anti-mouse IL-2 (capture Ab: clone JES6-1A12), and biotin-labeled anti-mouse IL-2 (detecting Ab: JES6-5H4) were purchased from BD PharMingen (Heidelberg, Germany). CD4 Microbeads and Streptavidin Microbeads were from Miltenyi Biotec (Bergisch Gladbach, Germany).

Mice

Specific pathogen-free female C57BL/6J (H-2b) mice obtained from Janvier (Le Genest St. Isle, France) were used throughout. Animals were 7–10 wk of age at the onset of experiments. They had free access to drinking water (tap water) and standard rodent laboratory chow (no. 1324; Altromin, Lage/Lippe, Germany). Other than in the study by van Hoogstraten et al. (8), no measures were taken to protect the animals from exposure to nickel; cages (made from plastic) were covered by stainless steel covers, and drinking water was provided in glass bottles covered with stainless steel water outlets.

Sensitization of mice

Mice were sensitized, as described previously (9). In the case of nickel, mice were injected intradermally in both flanks (50 µl each) with either 10 mM NiCl2 in sterile, pyrogen-free saline (negative control) or 10 mM NiCl2 in saline containing 1% H2O2. In the case of DNFB, mice were primed by painting 0.5% (w/v) DNFB on the shaved flanks (25 µl each); DNFB was resolved in a 4:1 (v/v) mixture of acetone and olive oil.

Challenge for recall and ear swelling test

Ten days after priming, mice were challenged for recall by injecting 50 µl 10 mM NiCl2 in sterile, pyrogen-free saline into the pinna of each ear or by applying 50 µl 0.2% DNFB onto each ear. Forty-eight hours after challenge with NiCl2 and 24 h after challenge with DNFB, respectively, delayed-type hypersensitivity reactions were determined by measuring the increment in ear thickness compared with prechallenge value. For determination of prechallenge values, mice were anesthetized with ether; for measurement after challenge, the mice were killed by asphyxiation with CO2. Measurements were performed using a micrometer (Oditest D 1000 gauge; Dyer, Lancaster, PA) and in a blinded manner. Data shown represent the mean ear-swelling response of groups comprising five to six mice, expressed in units of millimeters x 10-2 + SEM.

Tolerance induction

For oral tolerization, mice were treated with NiCl2 in the drinking water at the concentrations and for the periods of time specified in Table IGo. Control mice received tap water not enriched with nickel ions. For i.p. tolerization, mice received three weekly i.p. injections (50 µl each) sterile, pyrogen-free saline containing NiCl2 at the concentrations and for the periods of time specified in Table IGo. Control mice received saline only. Based on the data shown in Table IGo, standard treatment protocols for oral and i.p. tolerization were selected, as described under Results.


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Table I. Tolerization of nonsensitized mice: effects of different concentrations of NiCl2, durations of treatment, and routes of administration1

 
Desensitization

Different NiCl2 concentrations, duration of treatment, and routes of administration effective in desensitizing sensitized mice were investigated, as specified in Table IIGo. Mice were first sensitized with NiCl2 in H2O2 and, starting 5 wk later, subjected to the desensitization treatment with oral or i.p. administration of NiCl2 indicated. After a treatment-free interval of 1 wk, the mice were challenged for recall with NiCl2. Two days later, the increase in ear thickness was determined. In one experiment, mice were first sensitized with 10 mM NiCl2 in saline containing 1% H2O2, left untreated for 5 wk, and then treated with 10 mM NiCl2 in the drinking water for 4 wk, followed by a 20-wk oral maintenance treatment with 0.1 and 1 mM NiCl2, respectively. After a treatment-free interval of 1 wk, mice were challenged and their ear-swelling responses were measured.


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Table II. Desensitization of sensitized mice: effects of different concentrations of NiCl2, durations of treatment, and routes of administration1

 
T cell enrichment and sorting for adoptive transfer studies

Single-cell suspensions of erythrocyte-free spleen cells were prepared in RPMI 1640 containing 10% FCS and passed through nylon wool columns once or twice, until the T cell fraction contained 80–85% T cells. In one experiment, T cells enriched by nylon wool were divided into CD4+ and CD8+ cells, respectively, by depleting the opposite subset using magnetic cell sorting (MACS; Miltenyi Biotec), as described (21). The enriched CD4+ and CD8+ T cell fractions were contaminated with <3% CD8+ and <2% CD4+ T cells, respectively. In two other experiments, T cells were further purified by depletion of CD11b+, CD11c+, CD19+, and MHCII+ cells using the sorting unit of the FACSCalibur (BD Biosciences, San Jose, CA). The sorted T cell fractions were contaminated with <0.5% of CD11b+, CD11c+, CD19+, and MHCII+ cells, respectively. Furthermore, in one experiment, enriched splenic T cells (104/ml) from naive donors were incubated in vitro with 100 µM NiCl2 for 30 min at 37°C, washed with sterile, pyrogen-free PBS, and then used for adoptive transfer. In yet another experiment, enriched splenic T cells (102/150 µl) from orally tolerized donors were killed before transfer by three cycles of freezing (-196°C) and thawing (37°C). Finally, in one experiment pooled popliteal, inguinal, and auricular lymph node cells (LNC), instead of enriched or purified T cells, were transferred.

Adoptive transfer

After nylon wool enrichment or MACS sorting, cell suspensions were diluted 1/10 with trypan blue, whereas with FACS sorting dilution was only 1/2. Then either 0.4 or 0.8 µl cell suspensions were counted in a Neubauer counting chamber. T cell fractions to be transferred were serially diluted to the desired concentration in sterile, pyrogen-free PBS with a maximal dilution factor of 10. Cell suspensions (150 µl), containing the type and the number of cells indicated, were injected i.v. into the tail vein of recipient mice. One day later, mice were sensitized intradermally, as described above. Ten days thereafter, they were challenged for recall at the ears, and 48 h later (24 h in the case of DNFB), their ear-swelling response was measured.

In vitro restimulation of LNC

Groups of tolerant and naive mice were injected s.c. into both hindfoot pads (50 µl each) with saline containing 100 µM NiCl2, saline containing 100 µM NiCl2 plus 1% H2O2, or saline alone. For priming to DNFB, mice were painted at both hindfoot pads with 25 µl 0.5% DNFB. Ten days later, mice were sacrificed, draining popliteal and inguinal lymph nodes from each group (2 mice/group) were isolated and pooled, and single-cell suspensions prepared. The cells were pipetted into 96-well round-bottom plates (105 cells/well) in triplicates or quadruplicates and cultured (37°C, 6.5% CO2) either in complete medium alone (200 µl/well) or in complete medium containing 75 µM NiCl2 or 100 µM DNBS. Complete medium contained RPMI 1640 supplemented with 10% FCS, 2 mM glutamine, 1 mM sodium pyruvate, essential and nonessential amino acids, 10 U/ml penicillin/streptomycin, and 5 nl/ml 2-ME. After 3 days, cultures were pulsed with 0.5 µCi/well [3H]thymidine for 16 h. Cells were then harvested onto Ready Filters with Xtalscint (Beckman Coulter, Fullerton, CA) using a PHD Cell Harvester (Cambridge Technology, Cambridge, MA), filters were dried, and [3H]thymidine incorporation was measured with a LS 6000 IC series Liquid Scintillation System (Beckman Coulter). The results are expressed as stimulation index (SI) + SD (SI = mean cpm of restimulated cells/mean cpm of cells cultured in medium only).

Sandwich ELISA for IL-2

IL-2 in the supernatants of cultured LNC (5 x 105/well) was measured using an ELISA with a detection limit of 3–5 pg/ml.

Immune flow cytometry

As control for the separation procedure, enriched T cells and their subsets, respectively, were stained with anti-CD3{epsilon}, anti-CD4, anti-CD8{beta}.2, anti-CD11b, anti-CD11c, anti-CD19, and anti-I-Ab mAbs. Flow cytometry analysis were performed on FACSCalibur (BD Biosciences) and analyzed with CellQuest software.

Determination of nickel ion concentration

After the indicated treatment, the mice were bled by heart puncture, and the indicated organs (Table IIIGo) were isolated with Teflon-coated instruments to avoid nickel ion contamination. Nickel analysis was performed by sector-field inductively coupled plasma mass spectrometry in the medium resolution mode (22). Sample preparation was done by high pressure ashing in the case of tissue samples and by UV photolysis for blood.


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Table III. Tissue concentrations of nickel after treatment for tolerance induction

 
Experimental design of experiments

This is depicted in Fig. 1Go.



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FIGURE 1. Schematic design of experiments. A, Naive mice were tolerized by oral or i.p. administration of 10 mM NiCl2 for 4 wk, unless indicated otherwise (Table IGo). After a treatment-free interval of 1 or 20 wk, mice were sensitized at both flanks. Ten days later, they were challenged for recall at the ears, and the ear-swelling response as an indicator of nickel-allergic reaction was determined. B, Naive mice were sensitized at both flanks by injection of NiCl2 with H2O2. After a treatment-free interval of 5 wk, they were subjected to desensitization treatment by oral or i.p. administration of 10 mM NiCl2 for 4 wk, unless indicated otherwise (Table IIGo). After a treatment-free interval of 1 or 20 wk or a 20-wk period of oral maintenance treatment with 1 or 0.1 mM NiCl2, the mice were challenged for recall at the ears, and the ear swelling was determined. C, Prospective donor mice were tolerized by oral or i.p. administration of 10 mM NiCl2 for 4 wk. After a treatment-free interval of 1–5 wk or 20 wk, splenic T cells, or LNC, were adoptively transferred to naive syngeneic recipients. One day later, the mice were sensitized at both flanks, as indicated. Ten days later, they were challenged for recall at the ears, and the ear swelling was determined. Alternatively (not shown), in one experiment nickel-tolerant mice and control mice, respectively, were sensitized at their hindfeet, as indicated, and their LNC were restimulated in vitro for determination of proliferative response and IL-2 production.

 
Statistical analysis

Statistical significance of results was determined by ANOVA followed by the Newman-Keuls test.


    Results
 Top
 Abstract
 Introduction
 Materials and Methods
 Results
 Discussion
 References
 
Optimal conditions and cumulative dose of NiCl2 needed for oral or i.p. induction of tolerance in naive mice

To determine optimal experimental conditions for induction of tolerance to nickel, we compared a number of different oral and i.p. treatment regimens. The general experimental design is shown in Fig. 1GoA. As can be seen in Table IGo, both oral and i.p. administration of NiCl2 to naive mice decreased the ear-swelling response to NiCl2 in a dose-dependent manner. If the mice were treated with 10 mM NiCl2 in the drinking water for periods of 10, 5, and 4 wk, respectively, complete tolerance was induced. If the animals received 2 mM NiCl2 in the drinking water for 5 wk, partial tolerance was induced. Administration of 10 mM NiCl2 for 4 wk was therefore selected as the standard treatment for oral induction of tolerance. Similarly, three weekly i.p. injections of 10 mM NiCl2 for a period of 4 wk resulted in complete tolerance, whereas i.p. injections of 1 or 0.3 mM NiCl2 for 4 wk only induced partial tolerance. The former treatment protocol was selected as the standard treatment for i.p. induction of tolerance. All other i.p. administration protocols studied failed to cause a statistically significant decrease in ear-swelling response.

The background concentration of nickel ions that mice received via their drinking water was negligible; whereas the concentration of nickel ions in tap water was below the detection limit of 1 nM, it was 8.5 nM after release from the drinking bottles covered with stainless steel outlets. In the case of oral administration of 10 mM nickel ions (m.w. 58.7) for 4 wk, a total dose of 3.3 mg nickel/g body weight (bw) was taken up via the drinking water, assuming a daily intake of 4 ml drinking water and a bw of 20 g/mouse. Since ~27 ± 17% of nickel ions are absorbed from the human intestine (23), the estimated cumulative dose for oral induction of complete tolerance in mice was ~900 µg/g bw. In the case of repeated i.p. injections, a cumulative dose of 17.6 µg nickel/g bw was needed to induce complete tolerance.

Specificity and duration of orally induced tolerance to nickel

Based on the results shown in Table IGo, a 4-wk course of 10 mM NiCl2 in the drinking water was chosen as the standard treatment regimen for induction of oral tolerance. When mice thus treated were sensitized 1 wk after the termination of oral treatment and challenged 10 days later, they only showed a background ear-swelling response to nickel, but a completely normal response to DNFB (Fig. 2GoA, groups 3 and 6). Virtually identical results were obtained when the mice were sensitized and challenged after a treatment-free interval of 20 wk (Fig. 2GoB), indicating that long term tolerance had been induced.



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FIGURE 2. Oral tolerance to nickel induced in naive mice is specific and lasts for at least 20 wk. Nonsensitized mice were treated with 10 mM NiCl2 in the drinking water for a period of 4 wk or were left untreated, as indicated. After a treatment-free interval of 1 wk (A) or 20 wk (B), mice were injected with NiCl2 alone (negative control), NiCl2 in H2O2, or DNFB and challenged for recall as indicated, and their ear-swelling response was determined. In this and the subsequent figures, the symbol Ni denotes NiCl2. Asterisks indicate a significant difference (**, p <= 0.01; ***, p <= 0.001) between the groups compared by brackets. Experiment A was performed five times and experiment B two times, and each time comparable results were obtained.

 
Desensitization of sensitized mice

The results of experiments aiming at desensitization of mice already sensitized to nickel are shown in Table IIGo. As schematically depicted in Fig. 1GoB, mice were first sensitized and left untreated for 5 wk before the different oral and i.p. treatment regimens were started. One week after termination of the desensitization treatment, the mice were challenged at the ears. At that time, treatment with 10 mM NiCl2 in the drinking water for a period of 5 wk had led to complete desensitization (Table IIGo). However, when mice thus treated were not challenged 1 wk after oral desensitization but rested for 20 wk and then challenged with NiCl2 at the ears, they proved to be no longer desensitized (Fig. 3Go, group 3). Only if mice received an additional, continuous treatment with 1 mM NiCl2 in the drinking water after the 4-wk oral treatment with 10 mM NiCl2, their desensitization was maintained for 20 wk (Fig. 3Go, group 5). Partial desensitization was achieved if mice were orally treated with 2 mM NiCl2 for 5 wk or 10 mM and 2 mM, respectively, for 2 wk (Table IIGo). All of the i.p. treatments studied induced only partial desensitization (Table IIGo).



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FIGURE 3. For desensitization to last, continuous administration of an oral maintenance dose of 1 mM NiCl2 is required. Mice were first injected with either NiCl2 alone or NiCl2 in H2O2, as indicated. Starting 5 wk later, groups 3–5 were treated with 10 mM NiCl2 in the drinking water for a period of 4 wk, followed by a 20-wk period of administering either drinking water without additional NiCl2 (group 3) or water containing a maintenance dose of NiCl2 at the concentration indicated (groups 4 and 5). Thereafter, mice were challenged with NiCl2, and the ear-swelling response was determined. Asterisks indicate a significant difference (*, p <= 0.05; ***, p <= 0.001) between the groups compared by brackets. The experiment was performed twice yielding comparable results.

 
Minimal cell number of splenic T cells required for adoptive transfer of orally induced tolerance, and the capacity of LNC for transfer of tolerance

Adoptive transfers of enriched splenic T cells, or LNC, to naive syngeneic recipients were performed according to the general experimental design shown in Fig. 1GoC. We found that 107, 105 (data not shown), 104, 103, and even as few as 102 bulk T cells from nickel-tolerant donors were able to transfer tolerance (Fig. 4GoA, groups 4–6). In contrast, when naive mice were used as donors, transfer of 107 (data not shown) or 104 enriched T cells failed to render the recipients resistant to subsequent sensitization with NiCl2 in H2O2 (Fig. 4GoA, group 7). Tolerance could also be transferred by 102 FACS-sorted (instead of nylon wool-enriched) tolerant T cells (Fig. 4GoB), by 104 peripheral LNC of tolerant mice (Fig. 4GoC, group 6), and by 104 sorted T cells of tolerized mice left untreated for 20 wk before transfer (Fig. 5Go). In contrast, 101 tolerant T cells (Fig. 4GoA, group 3), 102 naive T cells that had been loaded with nickel ions in vitro (Fig. 4GoC, group 3), or 102 killed tolerant T cells (Fig. 4GoC, group 4) failed to transfer tolerance to the recipients. The results obtained with the last two groups show that tolerance to nickel could be transferred only by living cells, and they exclude the possibility that the observed transfer of tolerance was merely due to inadvertently transferred tolerogen rather than specific T cell activity. The tolerance induced by transfer of nickel-tolerant T cells was specific for nickel ions, because recipients of such T cells showed a normal immune response to DNFB (Fig. 4GoC, group 7).



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FIGURE 4. As few as 102 live T cells from orally tolerized donors are sufficient for adoptive transfer of tolerance. Prospective donor mice were treated with 10 mM NiCl2 in the drinking water for a period of 4 wk or left untreated, as indicated. A, Four weeks after termination of tolerance treatment, the indicated numbers of enriched splenic T cells were transferred to syngeneic recipients. B, Two weeks after termination of tolerance treatment, the enriched splenic T cells of tolerant and naive donors were further purified by depletion of CD11b+, CD11c+, CD19+, and MHCII+ cells using the FACSCalibur, and the indicated numbers of T cells were transferred to syngeneic recipients. C, Four weeks after termination of tolerance treatment, indicated numbers of enriched splenic T cells or LNC were transferred to syngeneic recipients. The cells were obtained from donors that had or had not been treated orally with 10 mM NiCl2 for 4 wk, as indicated. The donor cells in group 3 were pulsed with 10 mM NiCl2 in vitro, and those in group 4 were killed by repeated freezing and thawing before transfer. One day after transfer, the recipients were sensitized and challenged for recall, as indicated. After challenge their ear-swelling response was determined. Asterisks indicate a significant difference (**, p <= 0.01; ***, p <= 0.001) between the groups compared by brackets. The transfer of 102 enriched splenic T cells from tolerized and nontolerized donors, respectively, was performed five times, and the experiments shown in the other groups were performed at least twice, yielding comparable results each time.

 


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FIGURE 5. Persistence of the suppressive capacity of T cells obtained from orally tolerized donors. Prospective donor mice were treated with 10 mM NiCl2 in the drinking water for a period of 4 wk or were left untreated, as indicated. After a treatment-free interval of 20 wk (group 1) or 1 wk (group 2), 104 sorted splenic T cells of tolerized and naive donors, respectively, were transferred to syngeneic recipients. One day after transfer, the recipients were sensitized with NiCl2 in H2O2, 10 days later they were challenged for recall with NiCl2, and after 2 days the ear-swelling response was determined. Asterisks indicate a significant difference (***, p <= 0.001) between the groups compared by brackets. Values are representative of two independent experiments.

 
Both CD4+ and CD8+ T cells are needed to transfer orally induced tolerance to nickel

Next, we asked which T cell subset was able to adoptively transfer tolerance to nickel. Whereas 102 enriched splenic T cells from nontolerized donors failed to induce tolerance in the recipient as expected, 102 cells from orally tolerized donors again proved able to do so (Fig. 6Go, groups 1 and 2). In contrast, neither 102 CD4+- nor 102 CD8+-sorted T cells of tolerized donors were sufficient to transfer the tolerance (Fig. 6Go, groups 4 and 6). However, when 50 CD4+ and 50 CD8+ T cells were recombined after sorting, the mixed cells were able to transfer tolerance, just like 102 unseparated T cells (Fig. 6Go, group 8).



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FIGURE 6. Both CD4+ and CD8+ cells are required for adoptive transfer of oral tolerance. Prospective donor mice were treated with 10 mM NiCl2 in the drinking water for a period of 4 wk or left untreated, as indicated. Five weeks after termination of the tolerance treatment, 102 enriched splenic T cells from these donors were transferred to syngeneic recipients. The enriched T cells were sorted for either CD8+ cells (groups 3 and 4) or CD4+ cells (groups 5 and 6). In groups 7 and 8, 50 sorted CD8+ and 50 sorted CD4+ T cells of naive and tolerant donors, respectively, were recombined, and 102 cells of this pool were transferred, as described above. One day after transfer, the recipients were sensitized with NiCl2 in H2O2 and after challenge with NiCl2 their ear-swelling response was determined. Asterisks indicate a significant difference (***, p <= 0.001) between the groups compared by brackets. Similar results were obtained in two independent experiments.

 
Induction and transfer of i.p. tolerance

Tolerance to nickel could also be induced by three weekly i.p. injections of 10 mM NiCl2 (Table IGo). The tolerance thus induced was specific for nickel ions (Fig. 7GoA, cf. groups 4 and 7), comparable with orally induced tolerance (Fig. 2Go). A difference between the oral and i.p. tolerance is that 20 wk after termination of the tolerization treatment orally induced tolerance was still complete (Fig. 2GoB), whereas i.p. induced tolerance was only partial (Fig. 7GoA, group 6). As with oral tolerance, the i.p. induced tolerance could specifically be transferred by enriched splenic T cells (Fig. 7GoB). This result was again comparable with orally induced tolerance to nickel except that 104 enriched T cells from i.p. tolerized donors were needed for the transfer of tolerance (Fig. 7GoB, group 3), whereas only 102 cells were needed in the case of orally induced tolerance.



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FIGURE 7. Features of the tolerance induced by repeated i.p. injections of NiCl2. A, Mice received three weekly i.p. injections of either saline containing 10 mM NiCl2 or saline alone for a period of 4 wk. After a treatment-free interval of 1 or 20 wk, the mice were sensitized and challenged for recall, as indicated, and the ear-swelling response was determined. B, Prospective donor mice received three weekly i.p. injections of either saline containing 10 mM NiCl2 or saline alone for a period of 4 wk. Three weeks after termination of i.p. tolerization of donor mice, the number of enriched splenic T cells indicated was transferred to syngeneic recipients. For control, donor mice in group 4 received 10 mM NiCl2 in the drinking water for 4 wk. One day later, the recipients were sensitized with NiCl2 in H2O2 or with DNFB, as indicated, and after challenge for recall, their ear-swelling response was determined. Asterisks indicate a significant difference (**, p <= 0.01; ***, p <= 0.001) between the groups compared by brackets. The experiment was performed twice yielding comparable results.

 
LNC of orally tolerized mice, which were subjected to nickel sensitization in vivo and restimulation in vitro, failed to proliferate and produce IL-2 in response to NiCl2

The capacity of T cells from orally tolerized donors to actively transfer specific tolerance ( Figs. 4–7GoGoGoGo) indicated that the tolerized cells, at least some of them, had not been deleted but were able to exert specific suppressor function. We then asked whether the T cells of tolerized mice were anergic in the presence of NiCl2. To this end, we tested their capacity for proliferation and IL-2 production after in vivo sensitization with NiCl2 plus H2O2 and restimulation with nickel ions in vitro (Fig. 8Go). Tolerized and nontolerized groups of mice were sensitized with either saline, NiCl2 alone, NiCl2 in H2O2, or DNFB. Ten days later, LNC were restimulated in vitro with NiCl2 and DNBS, respectively. As expected, LNC of nontolerized mice sensitized with NiCl2 in H2O2 showed an enhanced cell proliferation and IL-2 production (group 4 in both Fig. 8GoA and Fig. 8GoB). In contrast, LNC of tolerized animals completely failed to do so (group 5 in both Fig. 8GoA and Fig. 8GoB). Their anergic state was specific for NiCl2, because they did respond to DNFB sensitization and restimulation with DNBS (group 10 in both Fig. 8GoA and Fig. 8GoB). These results obtained in vitro parallel those obtained in vivo, demonstrating nickel-specific unresponsiveness (cf. groups 3 and 6 in both Fig. 2GoA and Fig. 2GoB, and groups 2 and 7 in Fig. 4GoC). When the LNC of nickel-tolerant mice were tested by adoptive transfer, they prevented sensitization to nickel (Fig. 4GoC, group 6). Taken together, these data indicate that the LNC from tolerant donors were both anergic and suppressive.



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FIGURE 8. LNC of nickel-tolerized mice fail to proliferate and produce IL-2 in response to nickel ions but respond normally to DNFB. Nonsensitized mice were treated with 10 mM NiCl2 in the drinking water for a period of 4 wk or left untreated, as indicated. Six weeks after the termination of tolerance treatment, they were injected with saline, NiCl2 alone, NiCl2 in H2O2, or DNFB. Ten days later, pooled cells from the draining lymph nodes of these mice were restimulated in vitro with nickel ions or DNBS, and cell proliferation and IL-2 secretion, respectively, were determined. In the proliferation assay (A), cultures were pulsed with [3H]thymidine 3 days after restimulation, and the isotope incorporation was determined. Background values obtained from cells cultured in medium only varied between 310 ± 16.3 and 825 ± 106 cpm. In the IL-2 secretion experiments (B), after 24 h of culture, the supernatants were transferred to ELISA plates to measure their IL-2 levels. Asterisks indicate a significant difference (*, p <= 0.05, **, p <= 0.01; *** p <= 0.001) between the groups compared by brackets. A representative result of four independent experiments is shown.

 
Nickel ion concentrations in different tissues after 4 wk of oral NiCl2 treatment

For toxicological assessment of treatment risk, nickel ion concentrations in six different organs and blood were determined after 4 wk of oral treatment with 10 mM NiCl2. Except for liver, in the other organs and in blood, the nickel ion content of treated mice was increased by a factor of 2–223 when compared with that of untreated mice (Table IIIGo). The highest increase in nickel ion content was found in the small intestine and blood (factor of 124–223).


    Discussion
 Top
 Abstract
 Introduction
 Materials and Methods
 Results
 Discussion
 References
 
We showed that oral administration of NiCl2 to naive mice prevented subsequent sensitization to this common contact allergen, but not to the control Ag used, confirming previous investigations (8, 11). We selected a 4-wk treatment regimen with 10 mM NiCl2 in the drinking water as the standard treatment because it was found to induce complete tolerance. These treatment modalities differ from those of Ishii et al. (11), who used a 7- to 10-wk period of 20 mM NiSO4 in the drinking water, and of van Hoogstraten et al. (8) who used a 3-wk period of 0.75 mM NiSO4 in the drinking water as standard treatment. Assuming a daily intake of 4 ml drinking water, a bw of 20 g/mouse, and an absorption rate comparable with the human absorption rate of 27 ± 17% (23), the cumulative dose of absorbed nickel ions was as high as 4 mg/g bw in the study of Ishii et al. (11), only 50 µg/g bw in that of van Hoogstraten et al. (8), and 900 µg/g bw in the present investigation. All tested nickel concentrations lower than 10 mM and all treatment periods shorter than 4 wk were also effective, but they only induced partial tolerance or a statistically insignificant decrease in ear swelling.

It is easier to induce tolerance in nonsensitized than in sensitized individuals. Confirming this rule, oral administration of NiSO4 induced long-lasting tolerance in naive guinea pigs, but only a transient desensitization of guinea pigs already sensitized to nickel (17). The present investigation confirmed this in mice. Moreover, we found that desensitization persisted if the mice sensitized to nickel continued to receive 1 mM NiCl2 in the drinking water. The concentration of 1 mM NiCl2 used for maintenance treatment was ~105–106 times higher than the background concentration of nickel ions routinely received via the drinking water by mice housed in our animal facility.

Continuous delivery of signal 1 in the absence of signal 2 induces T cell tolerance and anergy (24, 25). This concept helps to understand our observation that prolonged administration of nickel ions, which lack intrinsic adjuvanticity (9), succeeded to induce tolerance and anergy among the T cells reacting to this allergen. This view is further supported by our finding that tolerance induction to nickel was not dependent on the oral route of administration, which is known to favor tolerance (26), but could also be achieved by i.p. administration. Nonetheless, oral administration of nickel ions apparently induced a more profound state of tolerance than i.p. administration, because after a treatment-free period of 20 wk the i.p. induced nickel tolerance remained only partially, whereas it was still complete after oral administration (cf. Figs. 2GoB and 7A). Moreover, the minimal number of T cells capable of transferring tolerance was only 102 after oral administration, but 104 after i.p. administration (cf. Figs. 4GoA and 7B). In addition to the two routes of administration used, however, there also was a difference in the cumulative nickel ion doses received after i.p. and after oral administration. The estimated total dose of nickel ions taken up after oral administration (~900 µg/g bw) was 50 times higher than that received via the i.p. injections (17.6 µg/g bw). Because the level of peripheral T cell tolerance that can be achieved is known to be dose dependent (27, 28, 29), the more complete and persistent state of tolerance seen after oral NiCl2 administration might also be explained by the higher dose of tolerogen received via this route.

Several mechanisms that may underlie oral Ag-induced tolerance have been proposed: clonal deletion (30); anergy (31); active suppression (32); altered trafficking (33); and immune deviation due to a Th1-Th2 cytokine shift (34). Clonal deletion cannot be the mechanism responsible for the oral tolerance to nickel reported here, because the existence of nickel-specific T suppressor cells was demonstrated by adoptive transfer of splenic T cells and LNC, respectively, obtained from tolerized donors. When the LNC of orally tolerized and subsequently sensitized mice were restimulated in vitro with NiCl2, they failed to show the enhanced proliferation and IL-2 production seen with the LNC of mice that were not tolerized, but only sensitized before restimulation (Fig. 8Go). Apparently, the nickel-specific T cells of the tolerized mice were anergic. A congruence between a state of T cell anergy and suppressive activity has been also observed in other tolerance models (25, 35, 36, 37). In their in vitro studies of autoreactive T cell clones, in which anergy was induced with increasing doses of peptide, Taams and Wauben (27, 28) observed three distinct anergic phenotypes, ranging from simple unresponsiveness, to an unresponsive suppressive phenotype, to an unresponsive suppressive phenotype that was persistently present. In our in vivo model, the nickel-specific, primed suppressor T cells transferred after a treatment-free interval of 20 wk would seem to belong to the latter phenotype accounting for long term tolerance.

T cell anergy toward nickel has not been reported in nonallergic, patch test-negative humans (15, 16, 38, 39). This might be explained by the assumption that the average level of human exposure to tolerogenic nickel ions is considerably lower than that used in our mouse experiments resulting in less profound T cell tolerance (27, 28). This assumption is indirectly supported by the different concentrations of nickel ions detected in the tissues of men and of the mice studied by us. At the time of autopsy, the mice treated for tolerization by exogenous NiCl2 showed nickel ion concentrations in whole blood that were ~110–230 times higher than those found in untreated mice or humans not occupationally exposed to nickel (40), and were still ~10 times higher than those found in workers in a nickel refinery (41). However, humans showing transient intoxication after hemodialysis against nickel-contaminated dialysate had a 25- to 30-fold higher level of nickel ions in the blood (42). Apart from blood and the small intestine, the nickel ion content in different tissues of mice treated with NiCl2 was not considerably different from that in naive mice, and for unknown reason, the nickel ion content in the liver of NiCl2-treated mice was even lower than that of untreated mice.

A different question concerns the phenotype of the cells preventing nickel hypersensitivity. In our experiments, we used T cells either enriched by nylon wool passage (purity of 80–85%) or sorted by FACSCalibur (>98% pure). Numerous reports have described T cell-mediated suppression of cellular immune responses (43, 44, 45, 46), but a uniform phenotype of the pertinent T suppressor cells has not emerged. The various T cell subsets include CD4+CD25+CTLA-4+ cells (47, 48) and CD8+ cells (32, 49). Apparently, several different T cell subsets may be involved, and conceivably this varies with both the level of tolerance achieved (27, 28) and the type of Ag studied. We found that among the 102 T cells transferred, both CD4+ and CD8+ T cells were needed for adoptive transfer of nickel tolerance. This differs from the results of van Hoogstraten et al. (8), who reported successful transfer of nickel tolerance with CD8+ cells from spleen and lymph nodes; however, they transferred 107 instead of 102 cells. In other mouse models, such as the anterior chamber-associated immune deviation model, it was shown that CD4+ T cells alone as well as CD8+ T cells alone were capable of transferring tolerance: afferent-regulatory CD4+ T cells suppressing the induction; and efferent-regulatory CD8+ T cells suppressing the elicitation of delayed-type hypersensitivity (50). Similarly, in murine EAE both CD4+ T cells alone and CD8+ T cells alone were capable of transferring the suppression induced by oral tolerance (32).

An unexpected finding was that the orally induced nickel tolerance could be adoptively transferred by as few as 102 T cells. This was not due to inadvertent carryover of nickel ions, the tolerizing agent, but required an active role of live T cells. To our knowledge, the successful transfer of tolerance with as few as 102 T cells has no precedence in the literature. In other mouse models, the number of T cells used for adoptive transfer of tolerance was several orders of magnitude higher. For instance, in the anterior chamber-associated immune deviation model, 5 x 107 spleen cells from intraocularly treated donors were used (50), in the UV light-induced tolerance to the hapten DNFB 108 unsorted or 5 x 105 CTLA-4+ spleen and regional lymph node cells were used (43), in a model of transplantation tolerance toward heart allografts 3.5 x 105 CD4+ cells from tolerized donors were used (51), and even in a model using TCR-transgenic mice orally tolerized to OVA peptide 5 x 106 splenic T cells were used (52). Although this has not been explicitly reported, for the sake of the argument we suppose that transfers of smaller cell inocula were unsuccessful in those models. What then is special about nickel ions as a tolerogen and the manner it was used here when compared with foreign proteins, cells, or tissue grafts acting as tolerogens?

Our finding that as few as 50 CD4+ plus 50 CD8+ T cells were able to transfer the tolerance indicates that at least 2% of both subsets were able to react to nickel ions. Such an extraordinarily high frequency of Ag-reactive, primed T cells can hardly be explained in terms of conventional concepts of T cell specificity, even though it is realized now that the {alpha}{beta}-TCR does not possess the exquisitely narrow specificity as previously assumed but shows considerable cross-reactivity to different peptides (53, 54) and haptens5 tested. Instead, it should be pointed out that nickel ions differ from the above-mentioned classical Ags, or tolerogens, by the high tissue concentrations they can achieve and by their promiscuous behavior with regard to protein and peptide binding (55, 56). Moreover, unlike foreign proteins, cells, and tissues, nickel ions need not be processed to generate neoantigens, but can directly attach to MHC-embedded self peptides on the cell surface (9, 14). The basis of neoantigen formation by this metal appears to be its ability to form reversible metal-protein and metal-peptide coordination complexes (9, 55, 56, 57, 58). In doing so, nickel ions can engage a variety of different protein side-chains as ligands, and these may vary both within each complex and from complex to complex (55, 57). The number of ligands engaged in nickel-protein and nickel-peptide complexes, respectively, also can vary from complex to complex (58, 59). In all likelihood, complexes formed by nickel ions may comprise more than one protein or peptide molecule. If so, nickel ions might act like a bioinorganic glue sticking together two different molecules. This could affect, for instance, appropriate MHC-embedded self peptides and certain TCRs (56, 59). In this context, it should be realized that the T cells rescued from thymic death are those with TCR that possesses a certain degree of low affinity for self peptides-MHC complexes. According to the affinity-threshold concept of T cell activation (61), the TCR of peripheral T cells must not be engaged by unmodified self peptides but will be engaged by even slightly modified ones, if these increase the binding affinity of the TCR and the overall avidity of a given T cell for those peptides. The ability of nickel ions for complex formation, their poorly selective chemical behavior in this process, and their potentially high tissue concentrations should enable them to generate a great diversity of changes, which enhance the avidity of a large variety of different T cell clones for the self peptides displayed in the periphery and prompt them to react.

In fact, some authors (62, 63) previously hypothesized that nickel ions would act as mitogens, since bulk T cells from the vast majority of human subjects tested, including those who did not suffer from contact hypersensitivity to nickel and were patch test negative, did proliferate in response to nickel ions (38, 39, 64). For the following reasons the mitogen hypothesis is unlikely: 1) T cell clones reacting to nickel ions do so by using their {alpha}{beta}-TCR (58); 2) they must be able to see MHC molecules on the APCs pulsed with nickel ions (9, 14, 65); and 3) the majority of T cell clones in a given individual fail to react to nickel ions (9, 14, 16, 66). Nonetheless, the original observation remains valid that there is an unusually broad T cell reactivity toward this versatile, complex-building metal (16, 39, 64).

A high frequency of nickel-reactive T cells cannot, of course, be the only explanation for the ability of only 102 bulk T cells to transfer the tolerant state. In addition, there must be a powerful amplification mechanism enabling so small a number of nickel-specific, primed T suppressor cells of the donor to become dominant in the recipient, inactivating the numerous nickel-specific T cells of the latter. A candidate mechanism here is infectious tolerance (67), and, indeed, there is evidence that infectious tolerance operates in our model, involving both the tolerant T cells reported here and tolerogenic APCs (K. Haarhuis et al., manuscript in preparation).

To conclude, we found that oral NiCl2 administration to naive mice induced a profound state of immunological tolerance due to the persistent suppressor activity exerted by an unusually high number of specific T cells.


    Acknowledgments
 
We thank Erkan Elieyioglu for help in performing some of the experiments reported here. We are grateful to Peter Griem for advice and thank him as well as Charlotte Esser, Michael Nowak, and Marty Wulferink for critical reading of the manuscript.


    Footnotes
 
1 This work was supported by a grant from NiPERA, Durham, NC. K.H. was supported by a grant from the Postgraduate College "Toxicology and Environmental Hygiene" granted to Duesseldorf University by Deutsche Forschungsgemeinschaft. Back

2 S.A. and K.H. contributed equally to this paper. Back

3 Address correspondence and reprint requests to Dr. Ernst Gleichmann, Division of Immunology and Allergology, Medical Institute of Environmental Hygiene, Auf’m Hennekamp 50, D-40225 Düsseldorf, Germany. E-mail address: Ernst.Gleichmann{at}uni-duesseldorf.de Back

4 Abbreviations used in this paper: DNFB, 2,4-dinitrofluorobenzene; DNBS, 2,4-dinitrobenzenesulfonic acid; bw, body weight; LNC, lymph node cells. Back

5 M. Wulferink, S. Dierkes, and E. Gleichmann. Cross-sensitization to haptens can be due to different mechanisms: formation of common metabolites, T cell recognition of cryptic peptides, and true cross-reactivity. Submitted for publication. Back

Received for publication July 19, 2001. Accepted for publication October 9, 2001.


    References
 Top
 Abstract
 Introduction
 Materials and Methods
 Results
 Discussion
 References
 

  1. Mortz, C. G., J. M. Lauritsen, C. Bindslev-Jensen, K. E. Andersen. 2001. Prevalence of atopic dermatitis, asthma, allergic rhinitis, and hand and contact dermatitis in adolescents. The Odense Adolescence Cohort Study on Atopic Diseases and Dermatitis. Br. J. Dermatol. 144:523.[Medline]
  2. Meding, B.. 2001. Differences between the sexes with regard to work-related skin disease. Contact Dermatitis 43:65.
  3. Liden, C., T. Menné, D. Burrows. 1996. Nickel-containing alloys and platings and their ability to cause dermatitis. Br. J. Dermatol. 134:193.[Medline]
  4. Schubert, H., N. Berova, A. Czernielewski, E. Hegyi, L. Jirasek, V. Kohanka, S. Korossy, P. Michailov, L. Nebenfuhrer, E. Prater. 1987. Epidemiology of nickel allergy. Contact Dermatitis 16:122.[Medline]
  5. Menné, T.. 1996. Prevention of nickel allergy by regulation of specific exposures. Ann. Clin. Lab. Sci. 26:133.[Abstract]
  6. van Hoogstraten, I. M., K. E. Andersen, B. M. von Blomberg, D. Boden, D. P. Bruynzeel, D. Burrows, J. G. Camarasa, A. Dooms Goossens, G. Kraal, A. Lahti, et al 1991. Reduced frequency of nickel allergy upon oral nickel contact at an early age. Clin. Exp. Immunol. 85:441.[Medline]
  7. Kerosuo, H., A. Kullaa, E. Kerosuo, L. Kanerva, A. Hensten Pettersen. 1996. Nickel allergy in adolescents in relation to orthodontic treatment and piercing of ears. Am. J. Orthod. Dentofacial Orthop. 109:148.[Medline]
  8. van Hoogstraten, I. M., C. Boos, D. Boden, M. E. von Blomberg, R. J. Scheper, G. Kraal. 1993. Oral induction of tolerance to nickel sensitization in mice. J. Invest. Dermatol. 101:26.[Medline]
  9. Artik, S., C. von Vultée, E. Gleichmann, T. Schwarz, P. Griem. 1999. Nickel allergy in mice: enhanced sensitization capacity of nickel at higher oxidation states. J. Immunol. 163:1143.[Abstract/Free Full Text]
  10. Rutault, K., C. Alderman, B. M. Chain, D. R. Katz. 1999. Reactive oxygen species activate human peripheral blood dendritic cells. Free Radic. Biol. Med. 26:232.[Medline]
  11. Ishii, N., N. Moriguchi, H. Nakajima, S. Tanaka, F. Amemiya. 1993. Nickel sulfate-specific suppressor T cells induced by nickel sulfate in drinking water. J. Dermatol. Sci. 6:159.[Medline]
  12. Kapsenberg, M. L., P. Res, J. D. Bos, A. Schootemijer, M. B. Teunissen, W. Van Schooten. 1987. Nickel-specific T lymphocyte clones derived from allergic nickel- contact dermatitis lesions in man: heterogeneity based on requirement of dendritic antigen-presenting cell subsets. Eur. J. Immunol. 17:861.[Medline]
  13. Werfel, T., M. Hentschel, H. Renz, A. Kapp. 1997. Analysis of the phenotype and cytokine pattern of blood- and skin-derived nickel specific T cells in allergic contact dermatitis. Int. Arch. Allergy Immunol. 113:384.[Medline]
  14. Moulon, C., J. Vollmer, H. U. Weltzien. 1995. Characterization of processing requirements and metal cross-reactivities in T cell clones from patients with allergic contact dermatitis to nickel. Eur. J. Immunol. 25:3308.[Medline]
  15. Cavani, A., D. Mei, E. Guerra, S. Corinti, M. Giani, L. Pirrotta, P. Puddu, G. Girolomoni. 1998. Patients with allergic contact dermatitis to nickel and nonallergic individuals display different nickel-specific T cell responses: evidence for the presence of effector CD8+ and regulatory CD4+ T cells. J. Invest. Dermatol. 111:621.[Medline]
  16. Lisby, S., L. H. Hansen, T. Menné, O. Baadsgaard. 1999. Nickel-induced proliferation of both memory and naive T cells in patch test-negative individuals. Clin. Exp. Immunol. 117:217.[Medline]
  17. van Hoogstraten, I. M., D. Boden, M. E. von Blomberg, G. Kraal, R. J. Scheper. 1992. Persistent immune tolerance to nickel and chromium by oral administration prior to cutaneous sensitization. J. Invest. Dermatol. 99:608.[Medline]
  18. Cavani, A., F. Nasorri, C. Prezzi, S. Sebastiani, C. Albanesi, G. Girolomoni. 2000. Human CD4+ T lymphocytes with remarkable regulatory functions on dendritic cells and nickel-specific Th1 immune responses. J. Invest. Dermatol. 114:295.[Medline]
  19. Sebastiani, S., P. Allavena, C. Albanesi, F. Nasorri, G. Bianchi, C. Traidl, S. Sozzani, G. Girolomoni, A. Cavani. 2001. Chemokine receptor expression and function in CD4+ T lymphocytes with regulatory activity. J. Immunol. 166:996.[Abstract/Free Full Text]
  20. Cederbrant, K., P. Hultman, J. A. Marcusson, L. Tibbling. 1997. In vitro lymphocyte proliferation as compared to patch test using gold, palladium and nickel. Int. Arch. Allergy Immunol. 112:212.[Medline]
  21. Stanciu, L. A., R. Djukanovic. 2000. Isolation of T-cell subsets by magnetic cell sorting (MACS). Methods Mol. Biol. 134:133.[Medline]
  22. Latkoczy, C., T. Prohaska, G. Stingeder, W. W. Wenzel. 2000. Simultaneous multi-element analysis of trace elements in soil samples by means of high-resolution inductively coupled plasma sector field mass spectrometry (SF-ICP-MS). Fresenius J. Anal. Chem. 368:256.[Medline]
  23. Sunderman, F. W., S. M. Hopfer, K. R. Sweeney, A. H. Marcus, B. M. Most, J. Creason. 1989. Nickel absorption and kinetics in human volunteers. Proc. Soc. Exp. Biol. Med. 191:5.[Medline]
  24. Guerder, S., R. A. Flavell. 1995. Costimulation in tolerance and autoimmunity. Int. Rev. Immunol. 13:135.[Medline]
  25. Schwartz, R. H.. 1996. Models of T cell anergy: is there a common molecular mechanism?. J. Exp. Med. 184:1.[Free Full Text]
  26. Weiner, H. L.. 1997. Oral tolerance: immune mechanisms and treatment of autoimmune diseases. Immunol. Today 18:335.[Medline]
  27. Taams, L. S., W. van Eden, M. H. Wauben. 1999. Dose-dependent induction of distinct anergic phenotypes: multiple levels of T cell anergy. J. Immunol. 162:1974.[Abstract/Free Full Text]
  28. Taams, L. S., M. H. Wauben. 2000. Anergic T cells as active regulators of the immune response. Hum. Immunol. 61:633.[Medline]
  29. Fowler, E., H. L. Weiner. 1997. Oral tolerance: elucidation of mechanisms and application to treatment of autoimmune diseases. Biopolymers 43:323.[Medline]
  30. Chen, Y. H., H. L. Weiner. 1996. Dose-dependent activation and deletion of antigen-specific T cells following oral tolerance. Ann. NY Acad. Sci. 778:111.[Medline]
  31. Whitacre, C. C., I. E. Gienapp, C. G. Orosz, D. M. Bitar. 1991. Oral tolerance in experimental autoimmune encephalomyelitis. III. Evidence for clonal anergy. J. Immunol. 147:2155.[Abstract]
  32. Chen, Y., J. Inobe, H. L. Weiner. 1995. Induction of oral tolerance to myelin basic protein in CD8-depleted mice: both CD4+ and CD8+ cells mediate active suppression. J. Immunol. 155:910.[Abstract]
  33. Hurst, S. D., H. O. Lee, M. P. Smith, J. G. Rosenberg, T. A. Barrett. 1996. Effects of oral antigen in T-cell receptor transgenic mice. Ann. NY Acad. Sci. 778:163.[Medline]
  34. Chen, Y., J. Inobe, V. K. Kuchroo, J. L. Baron, C. A. Janeway, H. L. Weiner. 1996. Oral tolerance in myelin basic protein T-cell receptor transgenic mice: suppression of autoimmune encephalomyelitis and dose-dependent induction of regulatory cells. Proc. Natl. Acad. Sci. USA 93:388.[Abstract/Free Full Text]
  35. Marshall, S. E., S. P. Cobbold, J. D. Davies, G. M. Martin, J. M. Phillips, H. Waldmann. 1996. Tolerance and suppression in a primed immune system. Transplantation 62:1614.[Medline]
  36. Lombardi, G., S. Sidhu, R. Batchelor, R. Lechler. 1994. Anergic T cells as suppressor cells in vitro. Science 264:1587.[Abstract/Free Full Text]
  37. Taams, L. S., A. J. van Rensen, M. C. Poelen, C. A. van Els, A. C. Besseling, J. P. Wagenaar, W. van Eden, M. H. Wauben. 1998. Anergic T cells actively suppress T cell responses via the antigen-presenting cell. Eur. J. Immunol. 28:2902.[Medline]
  38. Lisby, S., L. H. Hansen, L. Skov, T. Menné, O. Baadsgaard. 1999. Nickel-induced activation of T cells in individuals with negative patch test to nickel sulphate. Arch. Dermatol. Res. 291:247.[Medline]
  39. Zollner, T. M., C. Neubert, A. Wettstein, W. H. Boehncke, B. Manfras, B. O. Bohm, W. Sterry. 1998. The T-cell receptor V{beta} repertoire of nickel-specific T cells. Arch. Dermatol. Res. 290:397.[Medline]
  40. Case, C. P., L. Ellis, J. C. Turner, B. Fairman. 2001. Development of a routine method for the determination of trace metals in whole blood by magnetic sector inductively coupled plasma mass spectrometry with particular relevance to patients with total hip and knee arthroplasty. Clin. Chem. 47:275.[Abstract/Free Full Text]
  41. Norseth, T., M. Piscator. 1979. Nickel. L. Friberg, and G. F. Nordberg, and V. B. Vouk, eds. Handbook on the Toxicology of Metals 1st ed.541. Elsevier/North-Holland Biomedical Press, Amsterdam.
  42. Webster, J. D., T. F. Parker, A. C. Alfrey, W. R. Smythe, H. Kubo, G. Neal, A. R. Hull. 1980. Acute nickel intoxication by dialysis. Ann. Intern. Med. 92:631.
  43. Schwarz, A., S. Beissert, K. Grosse Heitmeyer, M. Gunzer, J. A. Bluestone, S. Grabbe, T. Schwarz. 2000. Evidence for functional relevance of CTLA-4 in ultraviolet-induced tolerance. J. Immunol. 165:1824.[Abstract/Free Full Text]
  44. Enk, A. H., J. Knop. 2000. T cell receptor mimic peptides and their potential application in T-cell-mediated disease. Int. Arch. Allergy Immunol. 123:275.[Medline]
  45. Groux, H., F. Powrie. 1999. Regulatory T cells and inflammatory bowel disease. Immunol. Today 20:442.[Medline]
  46. Zhai, Y., J. W. Kupiec-Weglinski. 1999. What is the role of regulatory T cells in transplantation tolerance?. Curr. Opin. Immunol. 11:497.[Medline]
  47. Read, S., V. Malmstrom, F. Powrie. 2000. Cytotoxic T lymphocyte-associated antigen 4 plays an essential role in the function of CD25+CD4+ regulatory cells that control intestinal inflammation. J. Exp. Med. 192:295.[Abstract/Free Full Text]
  48. Takahashi, T., T. Tagami, S. Yamazaki, T. Uede, J. Shimizu, N. Sakaguchi, T. W. Mak, S. Sakaguchi. 2000. Immunologic self-tolerance maintained by CD25+CD4+ regulatory T cells constitutively expressing cytotoxic T lymphocyte-associated antigen 4. J. Exp. Med. 192:303.[Abstract/Free Full Text]
  49. Binder, J., M. Lehmann, E. Graser, W. W. Hancock, B. Watschinger, K. Onodera, M. H. Sayegh, H. D. Volk, J. W. Kupiec-Weglinski. 1996. The effects of nondepleting CD4 targeted therapy in presensitized rat recipients of cardiac allografts. Transplantation 61:804.[Medline]
  50. Streilein, J. W., J. Y. Niederkorn. 1985. Characterization of the suppressor cell(s) responsible for anterior chamber-associated immune deviation (ACAID) induced in BALB/c mice by P815 cells. J. Immunol. 134:1381.[Abstract]
  51. Chen, Z. K., S. P. Cobbold, H. Waldmann, S. Metcalfe. 1996. Amplification of natural regulatory immune mechanisms for transplantation tolerance. Transplantation 62:1200.[Medline]
  52. Chen, Y., J. Inobe, H. L. Weiner. 1997. Inductive events in oral tolerance in the TCR transgenic adoptive transfer model. Cell. Immunol. 178:62.[Medline]
  53. Mason, D.. 1998. A very high level of crossreactivity is an essential feature of the T-cell receptor. Immunol. Today 19:395.[Medline]
  54. Grogan, J. L., A. Kramer, A. Nogai, L. Dong, M. Ohde, J. Schneider-Mergener, T. Kamradt. 1999. Cross-reactivity of myelin basic protein-specific T cells with multiple microbial peptides: experimental autoimmune encephalomyelitis induction in TCR transgenic mice. J. Immunol. 163:3764.[Abstract/Free Full Text]
  55. Griem, P., C. F. Shaw, E. Gleichmann. 1997. Chemically-induced allergy and autoimmunity: what do T cells react against?. I. G. Sipes, and C. A. McQueen, and A. J. Gandolfi, eds. Comprehensive Toxicology 323. Pergamon Press, New York.
  56. Gamerdinger, K., C. Moulon, H. U. Weltzien. 2001. Potential nickel coordination sites in a MHC-Ni2+-TCR complex. Immunobiology 204:116. (Abstr.).
  57. Basketter, D. A., A. Dooms-Goossens, A.-T. Karlberg, J.-P. Lepoittevin. 1995. The chemistry of contact allergy; why is a molecule allergenic?. Contact Dermatitis 32:65.[Medline]
  58. Roberts, D. W., and J.-P. Lepoittevin. 1998. Hapten-protein interactions. In Allergic Contact Dermatitis. A.-T. Karlberg, ed. Springer, Berlin, p. 81.
  59. Vollmer, J., H. U. Weltzien, K. Gamerdinger, S. Lang, Y. Choleva, C. Moulon. 2000. Antigen contacts by Ni-reactive TCR: typical {alpha}ss chain cooperation versus {alpha} chain-dominated specificity. Int. Immunol. 12:1723.[Abstract/Free Full Text]
  60. Moulon, C., J. Vollmer, D. Wild, H. U. Weltzien. 1998. Peptide sequence-independent activation of nickel-specific T cells from nickel-allergic donors?. Immunobiology 199:411. (Abstr.).
  61. Sandberg, J. K., L. Franksson, J. Sundback, J. Michaelsson, M. Petersson, A. Achour, R. P. Wallin, N. E. Sherman, T. Bergman, H. Jornvall, et al 2000. T cell tolerance based on avidity thresholds rather than complete deletion allows maintenance of maximal repertoire diversity. J. Immunol. 165:25.[Abstract/Free Full Text]
  62. Räsänen, L., M. L. Tuomi. 1992. Diagnostic value of the lymphocyte proliferation test in nickel contact allergy and provocation in occupational coin dermatitis. Contact Dermatitis 27:250.[Medline]
  63. Svejgaard, E., N. Morling, A. Svejgaard, N. K. Veien. 1978. Lymphocyte transformation induced by nickel sulphate: an in vitro study of subjects with and without a positive nickel patch test. Acta Dermatol. Venereol. 58:245.[Medline]
  64. von Blomberg-van der Flier, M., C. K. van der Burg, O. Pos, E. M. van de Plassche-Boers, D. P. Bruynzeel, G. Garotta, R. J. Scheper. 1987. In vitro studies in nickel allergy: diagnostic value of a dual parameter analysis. J. Invest. Dermatol. 88:362.[Medline]
  65. Vollmer, J., H. U. Weltzien, A. Dormoy, F. Pistoor, C. Moulon. 1999. Functional expression and analysis of a human HLA-DQ restricted, nickel-reactive T cell receptor in mouse hybridoma cells. J. Invest. Dermatol. 113:175.[Medline]
  66. Emtestam, L., J. A. Marcusson, E. Moller. 1988. HLA class II restriction specificity for nickel-reactive T lymphocytes. Acta Dermatol. Venereol. 68:395.[Medline]
  67. Cobbold, S., H. Waldmann. 1998. Infectious tolerance. Curr. Opin. Immunol. 10:518.[Medline]



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