The Journal of Immunology, 2001, 167: 4230-4237.
Copyright © 2001 by The American Association of Immunologists
Inhibition of the Death Receptor Pathway by cFLIP Confers Partial Engraftment of MHC Class I-Deficient Stem Cells and Reduces Tumor Clearance in Perforin-Deficient Mice1
Mesha Austin Taylor2,*,
,
Preet M. Chaudhary
,
Jennifer Klem*,
,
Vinay Kumar
,
John D. Schatzle
and
Michael Bennett
*
Graduate Program in Immunology, and Departments of
Pathology, and
Internal Medicine, University of Texas Southwestern Medical Center, Dallas, TX 75390; and
Department of Pathology, University of Chicago, Chicago, IL 60637
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Abstract
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NK cells mediate acute rejection of MHC class I-deficient bone
marrow cell (BMC) grafts. However, the exact cytotoxic mechanisms of NK
cells during acute BMC graft rejection are not well defined. Although
the granule exocytosis pathway plays a major role in NK cell-mediated
rejection, alternative perforin-independent mechanisms also exist. By
analyzing the anti-apoptotic effects of cellular Fas-associated
death domain-like IL-1-converting enzyme-inhibitory protein (cFLIP)
overexpression, we investigated the possible role of death
receptor-induced apoptosis in NK cell-mediated cytotoxicity. In the
absence of perforin, we found that cFLIP overexpression reduces lysis
of tumor cells by NK cells in vitro and in vivo. In addition,
perforin-deficient NK cells were impaired in their ability to acutely
reject cFLIP-overexpressing TAP-1 knockout stem cells. These results
emphasize the importance of NK cell death receptor-mediated killing
during BMC grafts in the absence of perforin.
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Introduction
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Natural
killer cells play a crucial role in innate immune surveillance through
the elimination of infectious agents and tumors (1). They
also are the main effector lymphocytes mediating the acute rejection of
allogeneic and MHC class I-deficient bone marrow cell
(BMC)3 grafts as
predicted by the missing self-hypothesis (2, 3). NK cells
can use various cytotoxic pathways to lyse targets, such as the
calcium-dependent release of perforin and granzymes and the interaction
of ligands with death receptors belonging to the TNF superfamily
(4, 5, 6, 7, 8, 9, 10). However, to date all of the critical effector
components of NK cell cytotoxicity leading to target cell apoptosis
during acute BMC graft rejection are not well defined.
The granule exocytosis (perforin and granzymes) pathway has been shown
to play a major role in NK cell-mediated rejection of MHC class
I-deficient BMC grafts. 129:B6 mice that are deficient in perforin,
either by genetic manipulation or by drug treatment, are unable to
reject TAP-1 knockout (KO) BMC grafts, while C57BL/6 (B6)
perforin-deficient mice are able to reject them (11, 12).
These data emphasize the importance of perforin as a cytotoxic
mechanism involved in the rejection of MHC class I-deficient BMC by NK
cells. However, because B6 perforin-deficient mice can still
efficiently reject incompatible BMC, an alternative
perforin-independent pathway of NK cell-mediated BMC rejection must
also exist.
A possible mechanism is the transmission of apoptotic signals to target
cells through the TNF superfamily of death receptors. Currently, five
different death receptors are known, TNFR-1 (13, 14), Fas
(7, 8), TNF receptor-related apoptosis mediated protein
(TRAMP) (9, 15, 16, 17, 18), and TNF-related
apoptosis-inducing ligand (TRAIL)-R1 and -R2 (19, 20, 21, 22). The
best characterized member is Fas, which initiates an apoptotic signal
in target cells when activated by its ligand, FasL, on the effector
cell (7, 8). Ligand binding induces the recruitment of the
adaptor protein, Fas-associated death domain protein (FADD), which in
turn leads to procaspase-8/Fas-associated death domain-like
IL-1-converting enzyme/recruitment (23, 24, 25, 26).
Autoproteolytic activation of caspase-8 triggers a subsequent caspase
cascade leading to cell death (27, 28, 29).
Blocking death receptor-induced apoptosis during signal transduction is
one way to determine the involvement of the death receptors in acute
BMC graft rejection mediated by NK cells. The anti-apoptotic
protein, cellular Fas-associated death domain-like IL-1-converting
enzyme inhibitory protein (cFLIP), is an enzymatically inactive
homologue of caspase-8, which can bind to the death effector domains of
FADD and caspase-8 (30, 31, 32, 33, 34, 35). This prevents the recruitment
of caspase-8 to FADD and ultimately inhibits apoptosis through
the death receptors (36). cFLIP inhibits
activation-induced cell death in T cells and Fas-dependent CTL-mediated
target cell lysis (37). Moreover, overexpression of cFLIP
in tumor cells results in escape from T cell immunity and promotes
tumor progression (38, 39). cFLIP is also capable of
interacting with TNFR-associated factor 1 and TNFR-associated factor
2, which are components of TNF receptor signaling complexes,
suggesting its importance in TNF signaling. Mouse embryonic fibroblasts
from cFLIP KO mice are highly sensitive to FasL- or TNF-induced
apoptosis and show rapid induction of caspase activity
(40).
The strong inhibitory activity of cFLIP overexpression on death
receptor signaling allowed us to study the role of death receptors in
NK cell-mediated cytotoxicity, using transfected tumor cells and
retrovirally infected stem cells. We found that cFLIP overexpression
reduces lysis of tumor cells by B6 perforin KO (PKO) NK cells in vitro.
In addition, B6 PKO mice were unable to clear cFLIP-overexpressing
tumor cells from the lungs and showed a decrease in their ability to
acutely reject TAP-1 KO stem cells overexpressing cFLIP.
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Materials and Methods
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Reagents and Abs
Anti-Fas ligand mAb (clone MFL3) was purchased from BD
PharMingen (San Diego, CA). Anti-asialo-GM1
antiserum was purchased from WAKO (Richmond, VA). Anti-FLAG M2 Ab was
purchased from Sigma-Aldrich (St. Louis, MO). Human rIL-2 was
obtained from Chiron (Emeryville, CA).
Cell culture, retroviral vector, and constructs
Lymphokine-activated killer (LAK) cells were cultured in 500
U/ml human rIL-2 as described (41). cFLIP-transfected
Jurkat (J.cFLIP) tumor cells were transfected by electroporation (300
V, 960 µF) with 20 µg of MigR1 plasmid DNA encoding murine
FLAG-tagged cFLIP and green fluorescent protein (GFP). Jurkat
and J.cFLIP tumor cells were maintained in RPMI 1640 medium
supplemented with 10% FCS, 1% L-glutamine, 1%
nonessential amino acids, 1% sodium pyruvate, 100 U/ml penicillin, and
100 µg/ml streptomycin.
Mice
TAP-1 KO, B6, and B6 PKO mice (all H-2b)
were obtained from The Jackson Laboratory (Bar Harbor, ME).
Flow cytometry analysis
Fas expression on Jurkat and J.cFLIP tumor cells was evaluated
with biotinylated anti-human Fas mAb (clone APO-1-1) (Kamiya
Biomedical, Seattle, WA) or an isotype-matched control followed with
streptavidin red 670 (Life Technologies, Rockville, MD). Purified TAP-1
KO progenitors were incubated with FITC-labeled anti-mouse Fas mAb
(clone Jo2) (BD PharMingen) or an isotype-matched control. TRAIL-R2
expression on purified TAP-1 KO progenitors was analyzed with purified
rabbit anti-human/mouse TRAIL-R2 (R&D Systems, Minneapolis, MN)
followed by incubation of cells with FITC-labeled goat anti-rabbit
IgG Ab (Jackson ImmunoResearch Laboratories, West Grove, PA).
Stem cell purification, infection, and transplantation
BMC were harvested from TAP-1 KO mice and stained with a
biotinylated-Lineage mixture (Gr1, Mac-1, B220, CD2, NK1.1, and Ter119)
(BD PharMingen) followed by incubation with streptavidin-conjugated
microbeads. Using negative selection, BMC were passed through a MACS
separation column (Miltenyi Biotec, Auburn, CA) for collection of
c-kit+Lin-
progenitors. These progenitors were cultured for 4 days at 3 x
105 cells/ml with 20 ng/ml recombinant murine
(rm)IL-3, 50 ng/ml rmIL-6, and 50 ng/ml rmSCF (Biosource International,
Camarillo, CA) in DMEM containing 10% FCS. After 48 and 72 h,
transduction of stem cells was performed by spinfection (as
reported in Ref. 42) with control (containing GFP only)
and FLIP-expressing (plus GFP) retroviruses that were generated as
described (43). Most recipient mouse groups contained at
least five mice. Recipient mice were lethally irradiated and infused
with 8.5 x 105 infected progenitors. Seven
days later, spleen cells were harvested and the percentage of
GFP-positive cells was analyzed by flow cytometry. Values significantly
different (p < 0.05) from another group by
nonparametric and parametric analyses are indicated in the figure
legends.
Generation of chimeras
TAP-1 KO
c-kit+Lin-
progenitors were isolated and infected (as described
above), then sorted for GFP-positive expression. 5 x
105 cFLIP-positive cells were infused into
lethally irradiated syngeneic hosts. Eight weeks later, chimeras were
checked for BMC reconstitution and cFLIP overexpression.
Lung clearance assay
Details were described previously (44). Most groups
contained at least five mice. Briefly, Jurkat or J.cFLIP target cells
were labeled with 125I-labeled dexoyuridine
(UdR) (Amersham, Arlington Heights, IL), then 5 x
105 cells were injected i.v. into each recipient
mouse. After 4 h, the lungs were excised from the mice, and the
amount of 125I remaining in the lungs was
measured. Where indicated, some mice were treated with 300 µg i.p. of
anti-FasL mAb 1 day before challenging with tumor cells. Results
are expressed as the geometric mean (95% confidence limits) of the
percentage of injected radioactivity remaining in the lungs. The
percentage of 125I-labeled UdR retention is
inversely related to NK cell lytic activity. A high percentage of
retention denotes low NK cell lytic activity, whereas a low percentage
of retention indicates high NK cell lytic activity. The values were
subjected to parametric (Students t test) and
nonparametric (Welchs t test) statistical analyses, using
the UTSTAT program provided by the University of Texas
Southwestern Medical Center (Dallas, TX).
Cytotoxicity assay
As described (44), target cells were radiolabeled
with 100150 µCi of sodium chromate
(51Cr) (Amersham) for 1.5 h at
37°C. At various E:T ratios, effectors and radiolabeled targets were
added to each well in triplicates. Before addition of targets, 10
µg/ml anti-FasL mAb was added to effectors. After a 4-h
incubation, 100 µl of supernatant was removed and the
51Cr release was counted in a liquid
scintillation counter. Specific lysis was expressed as the mean ±
SEM and calculated as follows: percent specific lysis =
51Cr cpm, (ER - SR)/(MR - SR) x
100, where ER is the experimental 51Cr released
in the presence of effectors, SR is the spontaneous
51Cr released in the presence of medium only, and
MR is the maximum 51Cr released in the
presence of 0.5% Triton X-100. The values were subjected to Welchs
t test for statistical analyses.
Western blot analysis
Cells were washed once in PBS, resuspended at
107 cells/ml in lysis buffer (50 mM TrisCl, pH 8;
150 mM NaCl; 1 mM MgCl2; 2% Nonidet P-40), and
incubated on ice for 30 min. Lysates were spun for 15 min at 14,000 rpm
at 4°C and aliquots of 20 µl were resolved by SDS-PAGE on gels of
10% acrylamide. Proteins were transferred to nitrocellulose and
stained with Ponceau dye. Filters were blocked for 30 min in 5% nonfat
dried milk in PBS, 0.1% Tween 20, then incubated with primary Ab
(1/1000) diluted in PBS, 0.1% Tween 20 for 1 h at room
temperature. Filters were washed three times in PBS, 0.1% Tween 20,
then incubated with anti-rat IgG horseradish peroxidase-labeled
secondary Ab (Amersham) for 1 h at room temperature. After
washing, blots were developed with the SuperSignal chemiluminescence
kit from Pierce (Rockford, IL).
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Results
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cFLIP overexpression in Jurkat cells inhibits NK cell activity in
vitro
Previous evidence suggests that elevated cFLIP levels may
correlate with resistance to TRAIL-induced apoptosis (37, 45). Furthermore, tumor targets with increased cFLIP expression
resist Fas-dependent, but not perforin-dependent, CTL killing in vitro
(10). Therefore, we hypothesized that NK cell-mediated
cytotoxicity may also be inhibited by the same mechanism. To analyze
this directly, we stably transfected Jurkat cells, a human T cell
leukemia that is sensitive to both perforin- and Fas-mediated killing
(10, 12), with FLAG-tagged cFLIP (long form,
55 kDa).
Specifically, the cDNA for FLAG-tagged cFLIPL was
introduced into the retroviral vector, MigR1 (46). This
vector expresses a bicistronic mRNA encoding both the test protein and
GFP, which serves as a marker of transfection. Stable transfectants
were shown to express GFP and the exogenous FLAG-tagged cFLIP protein
(Fig. 1
, A and B).
Both untransfected Jurkat cells and J.cFLIP cells express relatively
similar levels of Fas receptor (Fig. 1
C) and TRAIL-R2 (our
unpublished data), indicating that transfection did not diminish
Fas or TRAIL-R2 levels in J.cFLIP cells.

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FIGURE 1. Expression of exogenous cFLIP and Fas in Jurkat and Jurkat transfected
with cFLIP. A, Jurkat tumor cells were transfected with
cFLIP-expressing (cFLIP-transfected) expression construct or were not
transfected (Untransfected). cFLIP-transfected cells showed green
fluorescence when analyzed by flow cytometry. B, The
levels of exogenous cFLIP protein expressed by untransfected or
cFLIP-transfected Jurkat tumor cells were determined by Western blot
analysis. Cell lysates were resolved by SDS-PAGE under reducing
conditions and immunoblotted with an Ab to the flag epitope present at
the C terminus of the retrovirus-encoded cFLIP molecule. The 55-kDa
band corresponds to cFLIPL form. C, The
expression of Fas receptor on untransfected Jurkat (solid line) and
J.cFLIP (dotted line) was determined using an Ab to Fas. Isotype
control Ab is denoted by the filled histogram.
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The effect of cFLIP overexpression on NK cell cytotoxicity was assessed
by a 4-h chromium release assay. IL-2-activated B6 LAK cells are able
to lyse Jurkat and J.cFLIP targets similarly (Fig. 2
A). Overexpression of cFLIP
does not affect NK cell-mediated cytotoxicity in the presence of
perforin. The addition of anti-FasL mAb reduces the lysis of Jurkat
cells slightly, presumably because lysis is primarily mediated through
perforin killing. Lysis of J.cFLIP is not lowered. Assessing
Fas-mediated killing, B6 PKO LAK cells are also able to lyse Jurkat
cells, although killing is reduced when compared with B6 LAK cells
(Fig. 2
B). However, lysis of J.cFLIP by B6 PKO LAK cells is
significantly lowered. In the presence of anti-FasL mAb, NK cell
lytic activity of Jurkat was further lowered, while that of J.cFLIP was
abrogated completely. Consequently, cFLIP overexpression can inhibit
Fas-mediated NK cell cytotoxicity of tumor targets in the absence of
perforin.

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FIGURE 2. cFLIP overexpression in Jurkat cells inhibits NK cell activity. B6
(A) or B6 PKO (B) IL-2-activated LAK
cells were used as effectors in a 4-h 51Cr release assay
against labeled Jurkat or J.cFLIP tumor targets at a 200:1 E:T ratio.
10 µg/ml anti-FasL mAb were added to effectors before addition of
targets, where indicated. A, B6 LAK cell killing of
Jurkat without anti-FasL mAb is significantly different from
killing of Jurkat in the presence of the mAb (p <
0.05). In the absence of anti-FasL mAb, lysis of J.cFLIP is not
significantly different from lysis of Jurkat (p >
0.05). Likewise, lysis of J.cFLIP is statistically identical with or
without anti-FasL mAb addition (p > 0.05).
B, B6 PKO LAK cell lysis of Jurkat cells is
statistically different from the lysis of J.cFLIP in the absence of
anti-FasL mAb (p < 0.05). In the presence of
anti-FasL mAb, lysis of Jurkat is significantly different from
lysis of J.cFLIP (p < 0.05).
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cFLIP overexpression prevents the clearance of Jurkat tumor cells
from the lungs of PKO mice
Given that both perforin- and Fas-dependent mechanisms of killing
must be inhibited to reduce NK cell lysis in vitro, we subsequently
wanted to determine the role of both cytotoxic pathways in vivo.
Testing the ability of NK cells to rapidly clear tumor targets from the
lungs is one alternative in vivo method that assays for NK cell
cytotoxicity (47). Because different tumor targets have
variable retention times in the lungs of mice, we used a time course
lung clearance assay to determine the optimum retention time for Jurkat
cells (Fig. 3
A). B6 mice are
able to rapidly clear Jurkat targets from the lungs because their NK
cells possess normal lytic activity. However, B6 mice treated with
anti-asialo-GM1 Ab are defective in lung clearance
because their NK cells have been depleted, as previously reported
(44). Thus, significantly different lung retention between
NK cell-depleted and untreated mice can be detected at 4 h.
Similar to B6 mice, B6 PKO mice are able to eliminate Jurkat tumor
targets from the lungs (Fig. 3
B, left panel). The
administration of anti-FasL mAb diminished the clearance of Jurkat
tumor targets from the lungs of B6 PKO mice. However, this clearance is
not as defective as that of B6 mice treated with anti-asialo-GM1
Ab, suggesting that other perforin- and Fas-independent mechanisms
(such as TRAIL-R/TRAIL) may contribute to lung clearance of Jurkat
cells. Moreover, the elimination of Jurkat tumor cells by
B6.gld (FasL-deficient) mice was similar to that observed by
B6 PKO mice treated with anti-FasL mAb (data not shown). Together,
these data indicate that in perforin-deficient mice Fas/FasL
interactions are involved in NK cell-mediated lung clearance of Jurkat
tumor cells. Lung clearance of J.cFLIP tumor cells by B6 mice treated
with anti-asialo-GM1 Ab is significantly less than that
of untreated B6 mice (Fig. 3
B, right panel).
Interestingly, B6 PKO mice as well as B6 PKO mice treated with
anti-FasL mAb are similar to NK cell-depleted B6 mice in their
inability to clear J.cFLIP tumor cells from their lungs. Therefore, in
the absence of perforin, increased cFLIP expression in Jurkat tumor
targets prevents clearance by NK cells via death receptor-induced
apoptosis. Similar results were obtained in additional experiments. For
example, the geometric mean values of the B6 PKO group challenged with
Jurkat tumor cells were 0.07 (experiment 1) or 0.23 (experiment 2),
while the B6 PKO group challenged with J.cFLIP tumor cells were 0.30
(experiment 1) or 0.44 (experiment 2) (p <
0.05). In another experiment, the geometric mean values of the
untreated B6 PKO group and B6 PKO group treated with anti-FasL mAb
challenged with Jurkat tumor cells were 0.21 and 0.30, respectively
(p < 0.05); the geometric mean values of the
untreated B6 PKO group and B6 PKO group treated with anti-FasL mAb
challenged with J.cFLIP tumor cells were 0.15 and 0.16, respectively
(p > 0.05).

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FIGURE 3. cFLIP overexpression inhibits NK cell-mediated clearance of Jurkat
tumor from the lungs of PKO mice. A, Where indicated,
one day before infusion, B6 mice were injected i.p. with 15 µl of
anti-asialo-GM1 to deplete NK cells. Mice were infused
with 5 x 105 125I-labeled UdR-labeled
Jurkat tumor cells. Lung clearance capability was assessed at the
indicated time points after injection by determining the percentage of
125I-labeled UdR retention. Results are expressed as
geometric means. B, Histograms show the expression of
retroviral genes as determined by GFP levels in untransfected Jurkat
and cFLIP-transfected Jurkat. One day before infusion, B6 mice were
injected i.p. with 15 µl of anti-asialo-GM1 to
deplete NK cells and B6 PKO mice were injected i.p. with 300 µg of
anti-FasL mAb to inhibit Fas/FasL interactions. Mice were infused
with 5 x 105 125I-labeled UdR-labeled Jurkat
(left panel) or J.cFLIP (right panel)
tumor targets. Lung clearance capability was assessed 4 h after
injection by determining the percentage of 125I-labeled UdR
retention. This experiment is representative of three experiments
performed. Results are expressed as geometric means. Geometric mean
values in the B6 plus anti-asialo-GM1 group challenged
with Jurkat or J.cFLIP tumor targets are significantly
different (p < 0.05) from those of the other
groups, except the untreated and anti-FasL mAb treated B6 PKO
groups challenged with J.cFLIP tumor targets. When challenged with
Jurkat tumor cells, the geometric mean values in the B6 PKO group
treated with anti-FasL mAb are significantly different
(p < 0.05) from those in the B6 or untreated B6
PKO groups.
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cFLIP overexpression in TAP-1 KO stem cells facilitates engraftment
in perforin-deficient mice
Previously, we have observed that B6 PKO mice maintain the ability
to reject TAP-1 KO BMC (11, 12). Because Jurkat tumor
cells overexpressing cFLIP can escape lysis by perforin-deficient NK
cells, we also wanted to test whether retrovirally mediated expression
of cFLIP in TAP-1 KO stem cells could inhibit acute NK cell-mediated
rejection in perforin-deficient mice. To determine whether stem cells
express any of the receptors necessary for death receptor-induced
apoptosis, we purified
c-kit+Lin-
progenitors from TAP-1 KO mice. After culturing for 4 days in rmIL-3,
rmIL-6, and rmSCF, TAP-1 KO progenitors expressed high levels of
Fas receptor and low levels of TRAIL-R2 (Fig. 4
). Subsequently, we retrovirally
infected purified TAP-1 KO progenitors in vitro with the MigR1 vector
containing FLAG-tagged cFLIP and GFP or control vector containing GFP
only and determined transduction efficiency (Fig. 5
A). Approximately 30% of the
cells were transduced with control retrovirus (GFP only) or cFLIP and
GFP (cFLIP) retrovirus. The exogenous cFLIP expression was also
detected by performing a Western blot using anti-FLAG Ab (Fig. 5
B). GFP-only- or cFLIP-transduced TAP-1 KO progenitors were
then injected into various lethally irradiated mice to test for acute
rejection by NK cells (Fig. 5
C). After 7 days, the spleens
of recipient mice were analyzed by flow cytometry to assay for
hematopoietic reconstitution of donor cells. Syngeneic TAP-1 KO hosts
were reconstituted with the same percentage of retrovirally infected
stem cells (cFLIP or GFP alone) that were injected, indicating high
stem cell activity and expression of retrovirus-encoded genes. B6 hosts
rejected both cFLIP- and control vector-infected TAP-1 KO stem cells,
presumably via perforin-mediated cytotoxicity. Rejection of control
vector-infected TAP-1 KO stem cells was also observed by B6 PKO hosts.
However, B6 PKO recipients failed to completely reject cFLIP-expressing
TAP-1 KO stem cells. Therefore, cFLIP overexpression in TAP-1 KO
progenitors can decrease the rejection capacity of B6 PKO mice by
preventing NK cell-mediated cytotoxicity through death receptor-induced
apoptosis.

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FIGURE 4. Expression of Fas and TRAIL-R2 by purified
c-kit+Lin- TAP-1 KO
progenitors. After culturing in rmIL-6, rmIL-3, and rmSCF for 4 days,
the expression of Fas receptor (top histogram) or
TRAIL-R2 (bottom histogram) on purified
c-kit+Lin- TAP-1 KO progenitors
(solid line) was determined using an Ab to Fas or TRAIL-R2,
respectively. Isotype control Ab is denoted by the filled
histogram.
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FIGURE 5. Engraftment in perforin-deficient mice of purified
c-kit+Lin- TAP-1 KO progenitor
expressing exogenous cFLIP. A, Purified
c-kit+Lin- TAP-1 KO progenitors
were cultured in rmIL-6, rmIL-3, and rmSCF for 4 days and infected with
cFLIP-expressing (cFLIP) retrovirus or control (GFP only) retrovirus.
Infected cells showed green fluorescence when analyzed by flow
cytometry. B, The levels of cFLIP protein expressed by
purified and cultured
c-kit+Lin- TAP-1 KO progenitors
that had not been infected (Uninfected) or had been infected with a
cFLIP-expressing (cFLIP-infected) retrovirus were determined by Western
blot analysis. Cell lysates were resolved by SDS-PAGE under reducing
conditions and immunoblotted with an Ab to the flag epitope present at
the C terminus of the retrovirus-encoded cFLIP molecule. The 55-kDa
band corresponds to cFLIPL form. C, Lethally
irradiated hosts were infused with 8.5 x 105 purified
c-kit+Lin- TAP-1 KO progenitors
that had been infected with a cFLIP-expressing (cFLIP) or control (GFP
only) retrovirus in vitro. Host spleens were harvested 7 days after
injection of donor progenitors to assess splenic hematopoietic cell
repopulation. Growth of infected donor cells is represented as the percentage of
GFP-expressing spleen cells. The data shown represent the repopulation
of one mouse of five mice with similar repopulation. The percentage of
repopulation in the TAP-1 KO recipients receiving GFP-only-expressing
stem cells is similar to the percentage of repopulation in the TAP-1 KO
group receiving cFLIP-expressing stem cells (p >
0.05). The percentages of repopulation in the TAP-1 KO recipients
receiving GFP-only- or cFLIP-expressing stem cells is significantly
different from the B6 and B6 PKO groups receiving stem cells infected
with GFP-only or cFLIP retrovirus (p < 0.05). The
percentage of reconstitution in B6 or B6 PKO mice challenged with
GFP-only-expressing stem cells is similar to the percentage of
repopulation in the B6 group receiving cFLIP-expressing stem cells
(p > 0.05). The percentage of reconstitution in B6
PKO mice challenged with control retrovirus-infected stem cells is
significantly less than the percentage of repopulation in the B6 PKO
group challenged with cFLIP-expressing stem cells
(p < 0.05).
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To further support the idea that increased expression of cFLIP can
render BMC resistant to NK cell-induced apoptosis, we analyzed the
ability of various lethally irradiated hosts to reject whole donor BMC
from GFP-only-expressing (
21%) or cFLIP-expressing (
54%) TAP-1
KO radiation BMC chimeras (Fig. 6
, A and B, respectively). After 7 days, the
recipient spleens were harvested and absolute numbers of GFP-only- or
cFLIP-positive donor BMC were determined. As expected, only syngeneic
control recipients were engrafted with donor-derived BMC containing GFP
only, while B6 and B6 PKO mice were not engrafted (Fig. 6
A).
These findings are consistent with previously observed data (11, 12). In Fig. 6
B, the spleens of syngeneic control
mice had 100-fold more cFLIP-expressing donor-derived cells than B6 PKO
recipients. This finding suggests that other killing pathways may exist
or that the levels of cFLIP overexpression were not optimal for
blocking rejection. Reconstitution of cFLIP-expressing TAP-1 KO donor
BMC was 50-fold higher in B6 PKO mice than in B6 mice. These data
confirm that, in the absence of the granule exocytosis pathway, the
partial engraftment of TAP-1 KO BMC can occur with cFLIP
overexpression. Moreover, this impairment in rejection capacity is a
direct result of blocking the signal transduction pathway of death
receptor-induced apoptosis.

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FIGURE 6. Engraftment in perforin-deficient mice of TAP-1 KO donor BMC expressing
exogenous cFLIP. Lethally irradiated TAP-1 KO mice were infused with
5 x 105 purified and sorted
c-kit+Lin- syngeneic
progenitors that had been infected with a control (GFP only)
(A) or cFLIP-expressing (cFLIP) (B)
retrovirus. The percentage of GFP expression (histogram) in the bone
marrow of one chimera was determined by flow cytometry. Lethally
irradiated hosts were then infused with 8 x 106
GFP-only-expressing (A) or cFLIP-expressing
(B) donor BMC. Host spleens were harvested 7 days after
injection of the indicated donor BMC to assess splenic hematopoietic
cell repopulation. The mean ± SEM absolute numbers of GFP-expressing
donor BMC were determined. The percentages of donor-derived BMC
reconstituted in the host groups (five mice per group) are presented in
parentheses. A, The mean value of the B6 and B6 PKO
groups are similar (p > 0.05). The mean value of
the TAP-1 KO group is statistically different from the B6 and B6 PKO
groups (p < 0.05). B, The mean
value of the B6 group is significantly less (p <
0.05) than the B6 PKO and TAP-1 KO groups, and the B6 PKO group is
significantly less (p < 0.05) than the TAP-1 KO
group.
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Discussion
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BMC graft rejection is a major clinical concern. For years, NK
cells have been known to be capable of mediating graft rejection of
incompatible BMC in mouse models. However, the cytolytic mechanisms
used by murine NK cells during BMC graft rejection are not well
defined. Previously, we have shown that the presence of perforin may be
critical for class I-negative BMC rejection by NK cells (11, 12). However, our prior data also indicated that other cytotoxic
mechanisms exist. Therefore, we determined the involvement of death
receptors during BMC graft rejection by murine NK cells. In this study,
we have demonstrated that cFLIP can function as an inhibitor of death
receptor-induced apoptosis by protecting tumor cells from NK cell lysis
and by facilitating engraftment of MHC class I-deficient stem cells in
the absence of perforin. These results provide additional insight into
the cytotoxic effector mechanisms of NK cells, implicating both the
granule exocytosis and the death receptor pathways.
Although it has been suggested that strong allogeneic resistance is
maintained in FasL-deficient mice (48), we have
demonstrated that, in the absence of perforin, death receptors are
involved in the acute rejection of MHC class I-deficient BMC grafts.
Using mice doubly deficient in perforin and a death receptor ligand
(such as FasL) as recipients of incompatible BMC grafts would precisely
determine the involvement of these cytotoxic components in acute BMC
rejection. However, previous studies have shown that these
double-deficient mice (i.e., perforin/FasL) can become extremely ill
and die early (49). Our experiments, which test the
ability of B6 PKO mice to reject MHC class I-negative BMC
overexpressing cFLIP, reveal the contribution of perforin- and death
receptor-mediated pathways of cell death executed during acute NK
cell-mediated rejection. Because rejection of allogeneic BMC is weaker
than that of MHC class I-negative BMC (50), experiments
exploring the resistance of allogeneic BMC overexpressing cFLIP by
perforin-deficient mice should also be completed.
Additional experiments will be required to address which specific death
receptors mediate rejection by NK cells in the absence of perforin.
There are several death receptor candidates. Although the use of
the perforin/granzyme pathway appears to predominate, NK cells have
been shown to use both Fas/FasL (7, 12) and TRAIL-R/TRAIL
(9, 51) interactions to mediate cytotoxicity of tumor
cells. Signaling through the TNF receptor can also be a potent NK cell
cytotoxic component in the lysis of virally infected cells
(52) and tumor cells (53). These findings
illustrate the importance of these death receptors in target cell
apoptosis by NK cells. Therefore, it is feasible that these same death
receptors may also be involved in the acute rejection of MHC class
I-deficient BMC by NK cells.
Our studies implicate the granule exocytosis and death receptor
pathways as the most potent cytolytic components of NK cell-mediated
rejection. However, cytokines may serve as an alternative regulator.
Directly stimulating or suppressing NK cells, bystander cell types can
secrete cytokines that alter the expression of genes encoding other
cytokines, transcription factors, or cytotoxic mediators. Some
cytokines that influence NK cell cytotoxicity are IFN
, IL-2,
IL-12, IL-15, and IL-18 (54, 55, 56, 57, 58). Alternatively, cytokines
secreted by NK cells can modulate hematopoiesis. NK cells can produce
TNF-
and IFN-
, which are potent inhibitors of hemopoietic stem
cell colony-forming ability (59, 60). IFN-
can
also increase the levels of Fas on the surface of target cells, which
may encourage Fas-induced apoptosis (61). NK cells also
secrete TGF
, which is capable of inducing apoptosis in hematopoietic
precursor cells (62, 63). Furthermore, TGF
can
down-modulate the expression of c-kit, the receptor for stem
cell factor in hematopoietic precursor cells, which deprives the cells
of stem cell factor survival signaling (64). Thus, it is
possible that cytokines acting on or secreted by NK cells could be
partially responsible for the rejection of class I-deficient BMC by NK
cells in this study.
We have demonstrated that, in the absence of NK cell-mediated
perforin/granzyme release, incompatible BMC rejection can be reversed
by inhibiting death receptor-induced apoptosis. Clinically,
these results might be simulated by the use of anti-perforin drug
treatment, such as chloroquine, and the transduction of the donor BMC
with an anti-apoptotic molecule, such as cFLIP. Therefore, the
expression of anti-apoptotic molecules in stem cells using
retroviral gene therapy is a possible approach to render donor BMC
resistant to rejection by host NK cells. However, a better
understanding of the individual involvement of various death receptors
in NK cell-mediated BMC rejection is required for the development of
completely effective prevention of NK cell-mediated rejection. These
data set a precedent for an improved immunoregulation of NK cells.
 |
Acknowledgments
|
|---|
We express our appreciation to Dr. Maria Johansson for the critical
reading of this manuscript, Margaret A. Morris for the use of BMC from
a transduced chimera, and Silvio and Maria Peña for the
maintenance of the animal facilities.
 |
Footnotes
|
|---|
1 This work was supported by National Institutes of Health Grants CA36922, CA70134, and AI38938. 
2 Address correspondence and reprint requests to Dr. Mesha Austin Taylor, Department of Pathology, University of Texas Southwestern Medical Center, 5323 Harry Hines Boulevard, Dallas, TX 75390-9072. E-mail address: mesha.taylor{at}utsouthwestern.edu 
3 Abbreviations used in this paper: BMC, bone marrow cell; FLIP, Fas-associated death domain-like IL-1-converting enzyme inhibitory protein; cFLIP, cellular FLIP; KO, knockout; FADD, Fas-associated death domain protein; LAK, lymphokine-activated killer; rm, recombinant murine; J.cFLIP, cFLIP-transfected Jurkat; GFP, green fluorescent protein; TRAIL, TNF-related apoptosis-inducing ligand; PKO, perforin KO; UdR, deoxyuridine. 
Received for publication March 6, 2001.
Accepted for publication August 10, 2001.
 |
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