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The Journal of Immunology, 2002, 168: 5558-5565.
Copyright © 2002 by The American Association of Immunologists

Both CD4+CD25+ and CD4+CD25- Regulatory Cells Mediate Dominant Transplantation Tolerance1

Luis Graca2, Sara Thompson, Chun-Yen Lin, Elizabeth Adams, Stephen P. Cobbold and Herman Waldmann

Sir William Dunn School of Pathology, University of Oxford, Oxford, United Kingdom


    Abstract
 Top
 Abstract
 Introduction
 Materials and Methods
 Results and Discussion
 References
 
CD4+CD25+ T cells have been proposed as the principal regulators of both self-tolerance and transplantation tolerance. Although CD4+CD25+ T cells do have a suppressive role in transplantation tolerance, so do CD4+CD25- T cells, although 10-fold less potent. Abs to CTLA-4, CD25, IL-10, and IL-4 were unable to abrogate suppression mediated by tolerant spleen cells so excluding any of these molecules as critical agents of suppression. CD4+CD25+ T cells from naive mice can also prevent rejection despite the lack of any previous experience of donor alloantigens. However, this requires many more naive than tolerized cells to provide the same degree of suppression. This suggests that a capacity to regulate transplant rejection pre-exists in naive mice, and may be amplified in "tolerized" mice. Serial analysis of gene expression confirmed that cells sorted into CD4+CD25+ and CD4+CD25- populations were distinct in that they responded to TCR ligation with very different programs of gene expression. Further characterization of the differentially expressed genes may lead to the development of diagnostic tests to monitor the tolerant state.


    Introduction
 Top
 Abstract
 Introduction
 Materials and Methods
 Results and Discussion
 References
 
Ever since the description of classical transplantation tolerance by Medawar and colleagues (1), the attainment of clinical transplantation tolerance has been considered the Holy Grail of immunology. In rodents, the therapeutic administration of nondepleting mAbs (2), such as the combination of anti-CD4 and anti-CD8, at the time of transplantation can lead to a robust form of peripheral tolerance (2, 3, 4, 5, 6). The tolerant state so achieved creates an environment in the host which can disarm nontolerant naive cells from rejecting the transplant (dominant tolerance), as well as enabling the emergence of novel regulatory cells from the naive lymphocyte population (infectious tolerance). This has been observed not only with tolerance induced following coreceptor blockade of CD4 and CD8 (3), but also with tolerance resulting from costimulation blockade with nondepleting anti-CD40L (CD154) mAb (7). Thus far, the regulatory cells mediating dominant tolerance have been identified as CD4+ T cells in all the models studied (3, 8, 9, 10, 11).

In parallel studies, animal models of autoimmune disease and inflammatory bowel disease have provided compelling evidence of CD4+ regulatory cells that prevent immunopathology (12, 13, 14, 15). The phenotype of these regulatory T cells has been further refined, so that CD4+CD25+CD45RBlow T cells are now considered the principle exponents (16, 17, 18). These cells have been shown capable of regulating CD4+CD25- or CD4+CD45RBhigh nontolerant cells both in vitro and in vivo, preventing the onset of autoimmunity and gut immunopathology (19, 20, 21, 22). They have also been shown capable of suppressing in vitro proliferation and IFN-{gamma} secretion by CD8+ T cells (23).

To establish the relationship, if any, between the T cells that regulate transplant rejection and those that regulate self-immunopathology, we compared the suppressive ability of CD4+CD25+ and CD4+CD25- T cells from mice rendered tolerant to skin transplants, as well as from naive mice with no previous experience of those particular transplantation alloantigens. We found that both CD4+CD25+ and CD4+CD25- cells from tolerant mice could mediate suppression, although the CD4+CD25- cells were required in larger numbers. However, as mice have 10 times more CD4+CD25- than CD4+CD25+ T cells, we are led to conclude that regulatory cells within both populations are involved in suppression, perhaps acting in concert. In contrast, it was only the CD4+CD25+, but not the CD4+CD25-, cells from naive mice that could prevent naive splenocyte cells from rejecting a skin graft, although at least 5-fold more cells were required than from tolerant donors. This could mean that tolerance-inducing protocols either drive an expansion of regulatory T cells (both CD4+CD25+ and CD4+CD25-), or that they bring about selective deletion of nontolerant cells; or indeed both—the outcome being a tolerance-permissive regulator to immune-effector ratio. These results appear to differ from previously published work (24, 25) where only the CD4+CD25+ cells from tolerant animals have been shown to be regulatory. These differences may be apparent rather than real, simply reflecting insufficient cell doses in the previous studies.

Transcriptional profiling by serial analysis of gene expression (SAGE)3 (26) of CD4+CD25+ and CD4+CD25- T cells from naive mice was used to establish that the two populations have very distinct gene profiles. These may reflect the differing functions of such populations, and with further characterization, may provide diagnostics to allow monitoring of the contributions of each CD4+ subpopulation in circumstances where therapeutic tolerance is desirable.


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

CBA/Ca (H-2k), human-CD52 transgenic CP1-CBA/Ca (H-2k) (27), and B10.BR (H-2k) mice were bred and maintained in the specific pathogen-free facilities of the Sir William Dunn School of Pathology (Oxford, U.K.). All groups were age- and sex-matched. All procedures were conducted in accordance with the Home Office Animals (Scientific Procedures) Act of 1986.

Thymectomy and skin grafting

Mice were anesthetized with a mixture of 10 mg/ml Hypnodil and 2 µg/ml Sublimaze (Janssen Pharmaceutica, Tilburg, The Netherlands). A total of 0.12 ml/20 g of body weight was injected i.p. Thymectomy was conducted as described by Monaco et al. (28). In short, a longitudinal incision was made on the anterior surface of the neck, and the thymus was removed as two intact lobes by the application of negative pressure through a glass tip inserted in the anterior mediastinum. Skin grafting was conducted according to a modified technique of Billingham et al. (1). Briefly, full thickness tail skin (1 x 1 cm) was grafted on the lateral flank. Grafts were observed on alternate days after the removal of the bandage at day 8 and considered rejected when no viable donor skin was present. Statistical analysis of graft survival was made by the log rank method (29).

Cell separation and adoptive cell transfer

Cells were obtained from spleens of adult CBA/Ca mice. A single-cell suspension was obtained by passing the splenocytes through a 70-µm cell strainer (BD Biosciences, Oxford, U.K) and the erythrocytes were depleted by water lysis. Cells were counted, diluted in PBS, and injected i.v. into the tail vein. Cell separation was performed by negative selection of CD8+ cells, MHC class II+ cells, and B cells by incubation with the mAbs M5/114, 187.1, and YTS156.7, and subsequent incubation with goat-anti-rat IgG Dynabeads (Dynal Biotech, Oslo, Norway) and magnetic removal. For CD4+ separation, cells were incubated with anti-CD4 microbeads (Miltenyi-Biotech, Bergisch Gladbach, Germany) according to manufacturer’s instructions, and positively selected over two magnetic columns using the "posseld" program of AutoMACS (Miltenyi-Biotech). For separation of CD4+CD25+ T cells, the CD8, class II, and B cell-depleted single-cell suspension was incubated 45 min at 4°C with 7D4-biotin (BD PharMingen, San Diego, CA) 1:100 in PBS, 1% w/v BSA, 5% v/v heat-inactivated normal rabbit serum, and 0.1% w/v sodium azide. Following washing, the cells were incubated 15 min at 4°C with 2 µl/107 cells streptavidin-microbeads (Miltenyi Biotech), and positively selected over two columns using AutoMACS posseld program. CD4+CD25- cells were sorted from the negative fraction obtained following CD4+CD25+ separation, by incubation with 100 µl/107 cells with streptavidin-microbeads, and subsequent negative selection of any remaining CD25+ cells using AutoMACS "possels", and finally, a positive selection step with anti-CD4 microbeads as described above. All sorted fractions were labeled with CD8(YTS156.7)-FITC, CD25(PC61)-PE (BD PharMingen), and CD4(H129.19)-CyCr (BD PharMingen); and assessed in a flow cytometer. Typical purity of CD4+ cells and CD4+CD25- cells was >98%, and purity of CD4+CD25+ >90%. Cells were counted, diluted in PBS, and injected i.v. into the tail vein.

Cell depletion, tolerance induction, and mAbs

For depletion of CP1-CBA T cells, 0.2 mg of CAMPATH-1H (30) was injected i.p. Tolerance was induced in CBA/Ca mice by treatment with 1 mg YTS177.9 (2) and 1 mg YTS105.18 (2) at days 0, 2, and 4 after B10.BR skin transplantation. These mAbs, as well as M5/114 (31), 187.1 (32), YTS156.7 (33), PC61 (34), 4F10 (35), JES5 (36), 11B11 (37), and YCATE55.9 (3) were produced in our laboratory by culture in hollow fiber bioreactors, purified from culture supernatants by 50% ammonium sulfate precipitation, dialysed against PBS, and purity checked by native and SDS gel electrophoresis (PhastGel; Pharmacia, St. Albans, U.K.).

Flow cytometry analysis

Peripheral blood samples were depleted of erythrocytes by water lysis, washed, and resuspended in PBS, 1% w/v BSA, 5% v/v heat-inactivated normal rabbit serum, and 0.1% w/v sodium azide. Cells were incubated for 45 min at 4°C with directly conjugated CAMPATH-1H-FITC, CD8{alpha} (53-6.7)-PE (BD PharMingen), and CD4-CyCr. The cells were washed, resuspended in PBS, 1% w/v BSA, 0.1% w/v sodium azide, and fixed in 2% v/v formaldehyde solution. Three-color FACSCaliber analysis (BD Biosciences) was performed using CellQuest (BD Biosciences) software.

SAGE libraries and differential analysis of gene expression

CD4+CD25+ and CD4+CD25- cells were sorted from naive CBA/Ca mice and activated with overnight incubation with solid-phase anti-CD3 mAb (KT3) at 37°C. T cell populations were pelleted and resuspended in Promega SV total RNA isolation system (Promega Z3100; Promega, Madison, WI) lysis buffer (175 µl/2 x 106 cells), and total RNA was isolated according to the manufacturer’s instructions. First strand cDNAs were prepared from 1 µg of total RNA from each cell fraction using Superscript II (Life Technologies, Gaithersburg, MD). Reverse transcription was initiated using the anchoring primer 5'-GACTCGAGTTGACATCGAGG(T)20V-3' with incorporation of the SMARTII oligonucleotide (Clontech Laboratories, Palo Alto, CA) 5'-AAGCAGTGGTAACAACGCAGAGTACGCGGG-3'at the 5' end. The cDNAs were preamplified with the forward 5'-AGTGGTAACAACGCAGAGTAC-3' and reverse 5'-GACTCGAGTTGACATCGAG-3' primers using the Advantage-GC cDNA PCR kit (Clontech Laboratories) with 1 M of the GC-Melt, following the manufacturer’s protocol. cDNAs were subjected to 16 cycles of preamplification, 94°C for 30 s, 68°C for 7 min. The preamplification steps were monitored by PCR using various housekeeping and cytokine primers as tests. SAGE was performed using NlaIII as the anchoring enzyme, BsmF1 as the tagging enzyme, and SphI as the cloning enzyme, as described (26). DNA sequencing was performed using the Megabase 1000 (Molecular Dynamics, Sunnyvale, CA). Sequence analysis software SAGE 3.04 {beta} was provided by K. W. Kinzler (Johns Hopkins Oncology Center, Baltimore, MD). A conservative estimate of the differential up-regulation of each gene within the given library, compared with a pool of other libraries, was calculated using a Bayesian statistics model (38).

Identification of mAbs in the serum

Serum concentrations of JES5 and 11B11 were determined by ELISA. 96-well plates were coated with 10 µg/ml JES5 or 11B11 in 0.1 M NaHCO3, and blocked with 50 µl PBS, 1% BSA. Serum samples from the mice were diluted 1/20 in PBS, 1% BSA containing either rIL-10 (10 ng/ml) or rIL-4 (2 ng/ml), and preincubated for 60 min at room temperature before being transferred into the JES5- or 11B11-coated plates, where the samples were incubated for a further 60 min. After washing with PBS, 0.05% Tween, the plates were incubated 60 min with anti-IL10 (SXC-1) biotin or anti-IL-4 (BVD6-24G2) biotin (both from BD Biosciences). The plates were then incubated with extravidin-peroxidase (Sigma-Aldrich, Poole, U.K.) for 30 min, and developed with substrate buffer and absorbance at 492 nm analyzed with a microplate reader (Labsystems, Helsinki, Finland). Serum 4F10 was determined by incubating serum samples in anti-hamster IgG (HIG-29) (BD Biosciences) coated plates, and detecting any bound hamster Ab with biotin-conjugated HIG-29. Serum PC61 was determined by flow cytometry by incubating CD25+ Con A blasts with the experimental serum diluted 1/5 in PBS, 1% BSA for 30 min at 4°C, followed by addition of anti-CD25 (PC61) PE-conjugated (BD Biosciences), as well as anti-CD4 CyChrome. Three-color FACSCaliber analysis was performed using CellQuest software. In all cases, the experimental serum samples were compared with serum from untreated animals, and serum spiked with mAb to known concentrations.


    Results and Discussion
 Top
 Abstract
 Introduction
 Materials and Methods
 Results and Discussion
 References
 
Spleen cells from "tolerized" mice abrogate skin graft rejection by spleen cells from naive mice

Regulatory cells that suppress graft rejection by naive spleen cells can be found in the spleens of mice made tolerant to an allograft with therapeutic mAbs (3). We confirmed that 107 spleen cells from naive CBA/Ca mice were, upon adoptive transfer, sufficient to reject B10.BR skin grafts in T cell-depleted hosts (39). An equal number of spleen cells from mice tolerant to B10.BR skin grafts could prevent graft rejection when coadministered with the naive cells.

Tolerance was induced in CBA/Ca mice by treatment with 3 mg of the combination of nondepleting CD4 and CD8 mAbs administered over 1 wk following the transplantation of B10.BR skin grafts. We used CP1-CBA mice as T cell-depleted hosts for cell transfusion (27). This transgenic strain is histocompatible with CBA/Ca and allows selective T cell depletion with the human-CD52 mAb CAMPATH-1H (7), as human CD52 is expressed under the control of the CD2 promoter in all T cells. CP1-CBA mice were thymectomized at 4 wk of age, and depleted of T cells with CAMPATH-1H 1 wk before cell transfer (designated as "empty" mice). The empty mice were transfused with 107 spleen cells from tolerant mice, 107 spleen cells from naive CBA/Ca, or an equal number (107) of spleen cells from both tolerant and naive mice. All animals were grafted with B10.BR skin the following day. Rejection was only observed in the mice transfused with cells from naive CBA/Ca (Fig. 1Go). Spleen cells from tolerant mice not only failed to reject the skin grafts, but also abrogated rejection by naive T cells, so demonstrating dominant tolerance. Similar results were obtained in experiments where 2 x 107 and 4 x 107 spleen cells from both tolerant and naive mice were transfused. We decided to use 107 spleen cells from naive CBA/Ca as the target population to assess the number and phenotype of regulatory cells able to prevent rejection.



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FIGURE 1. Spleen cells from tolerant mice prevent rejection mediated by nontolerant cells. CP1-CBA mice were thymectomized at 4 wk of age, and depleted of T cells with 0.1 mg CAMPATH-1H at days -7 and -8. At day -1, these mice received an i.v. injection of 107 ({blacktriangleup}) or 2 x 107 ({triangledown}) spleen cells from naive CBA/Ca;107 ({blacksquare}) or 2 x 107 ({triangleup}) spleen cells from CBA/Ca mice tolerant of B10.BR skin grafts; 107 or 2 x 107 spleen cells from the same naive CBA/Ca donors, together with an equal number of spleen cells tolerant donors ({blacktriangledown} and {square}); and a final group was not injected ({diamondsuit}). All animals received a B10.BR skin graft on the following day (day 0). Only mice transfused with cells from naive donors rejected the skin grafts, the rejection being slightly faster when more cells were transfused. The spleen cells from tolerant donors not only allowed indefinite graft survival, but were also able to suppress rejection mediated by the naive cells injected at the same time.

 
CD4+CD25+ cells from naive mice prevent graft rejection upon adoptive transfer

We investigated whether the capacity to suppress transplant rejection pre-existed in naive mice. We isolated CD4+CD25+ and CD4+CD25- T cells from the spleens of naive CBA/Ca mice. Empty CP1-CBA mice were injected with 107 unsorted spleen cells from naive CBA/Ca, together with 106 of either CD4+CD25+ or CD4+CD25- T cells, also from naive CBA/Ca. All mice were transplanted with B10.BR skin on the following day. Delayed graft rejection was observed in the group transferred with the CD4+CD25+ cells, with 6 of the 10 mice showing indefinite graft survival (Fig. 2Go). The animals injected with unsorted spleen cells alone rejected the skin grafts at a rate similar to the group receiving CD4+CD25- T cells. To rule out an artifact of the sorting procedure, a control experiment was performed where spleen cells from naive CBA/Ca were sorted and subsequently remixed to the exact starting proportions. These cells failed to prevent skin graft rejection upon adoptive transfer (data not shown). One interpretation for these results is that aggression and tolerance are the outcome of situations dictated by the numerical balance between regulatory and effector cells.



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FIGURE 2. CD4+CD25+ cells from naive mice prevent graft rejection upon adoptive transfer. CD4+CD25+ and CD4+CD25- cells were sorted from spleens of CBA/Ca mice. Empty CP1-CBA mice were injected i.v. with 106 of either CD4+CD25+ or CD4+CD25- cells together with 107 unsorted spleen cells. All mice were transplanted with B10.BR skin the following day. The group injected with CD4+CD25- cells ({blacktriangleup}, n = 10, median survival time (MST) = 19 day) rejected the skin grafts at a similar rate as the control group where only 107 unsorted spleen cells were transferred ({blacksquare}, n = 9, MST = 18 days). However, when the CD4+CD25+ cells were coinjected with the unsorted cells, graft rejection was significantly delayed, and several mice accepted the transplanted skin indefinitely ({blacktriangledown}, n = 10, MST > 100, p < 0.0001). This figure represents pooled results from two different experiments.

 
This outcome differs from previously published data (24, 25, 40). However, in our experiments, the number of CD4+CD25+ cells injected into each recipient was much higher than the numbers used in those studies. We suggest that the optimal regulator-effector ratio can only be reached when such high numbers of regulatory cells are transferred. In fact, one previous study demonstrated that purified CD4+CD25+ from naive animals were incapable of making a graft vs host allogeneic response upon transfer into a mismatched immunodeficient recipient (40). In another study, analyzing islet graft rejection, CD4+CD45RBlow cells from naive donors could, when coadministered at an appropriate ratio, prevent graft rejection by CD4+CD45RBhigh cells (41). This is also consistent with the observation of Sakaguchi et al. (19) that depletion of the CD25+ T cells increases the speed of first-set allograft rejection.

The Ag specificity of the CD4+CD25+ T cells from naive animals that suppress transplant rejection is currently unknown. CD4+CD25+ cells have been shown to inhibit the proliferation of CD4+CD25- cells to different alloantigens in vitro, as long as the CD4+CD25+ cells are themselves preactivated (42). It may be that their repertoire contains receptors directed toward self-Ags (43). If so, then there is the possibility that self-reactive regulators mediate graft acceptance through "linked suppression", where they are brought into the local microenvironment of the alloreactive cell. Alternatively, the receptor repertoire of CD4+CD25+ T cells may show cross-reactivity to alloantigens present in the graft. Given the finding that suppression involves indirect presentation of Ag (44), the "alloantigens" in question are likely to be donor-type peptides presented in conjunction with host-type MHC.

CD4+CD25+ T cells from tolerized mice are more efficient than CD4+CD25- cells as mediators of dominant transplantation tolerance

Having established that CD4+CD25+ T cells from naive animals suppress graft rejection, we compared the potency of both CD4+CD25+ and CD4+CD25- populations from tolerized mice in preventing rejection. The CD4+CD25+ and CD4+CD25- populations were purified from the spleens of CBA/Ca mice made tolerant to B10.BR skin transplants 100–120 days earlier (Fig. 3GoA). Different numbers of CD4+CD25+ and CD4+CD25- T cells were transferred with the fixed number 107 of naive spleen cells into empty CP1-CBA recipients. All recipients received B10.BR skin grafts on the following day. When 105 CD4+CD25+ cells were transferred together with 107 spleen cells from naive CBA/Ca, a delay in graft rejection was observed when compared with the groups transferred with the same number of CD4+CD25- cells, or with controls which had received naive spleen cells only (Fig. 3GoB). However, when the number of CD4+CD25- T cells was increased 10-fold to 106, graft rejection was delayed to an extent comparable to the 105 CD4+CD25+ group. No skin graft rejection by the naive cells was observed in the groups transferred with 106 CD4+CD25+ or 107 CD4+CD25- T cells. These results suggest that both CD4+CD25+ and CD4+CD25- cells can mediate transplantation tolerance, the CD4+CD25+ T cells being 10 times more potent than CD4+CD25- cells. However, as the number of CD4+CD25- T cells in tolerant mice is ~10 times higher than that of CD4+CD25+ cells, it is likely that both populations have a significant role in maintaining transplantation tolerance.



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FIGURE 3. CD4+CD25+ T cells from tolerant mice are more efficient than CD4+CD25- cells as mediators transplantation tolerance. CD4+CD25+ and CD4+CD25- cells were sorted from the spleens of CBA/Ca mice tolerant to B10.BR skin transplants as described in Materials and Methods. Different numbers of these cells were cotransferred i.v. with 107 unsorted spleen cells from naive CBA/Ca into empty CP1-CBA mice. A, FACS profiles of the transferred CD4+CD25+ and CD4+CD25- cells. B, All mice were transplanted with B10.BR skin the day following cell transfer. When unsorted spleen cells were transferred in the absence of cells from tolerant mice, the grafts were readily rejected ({blacksquare}, n = 11, MST = 22 days). A similar rate of rejection was observed when 105 CD4+CD25- cells were added ({square}, n = 9, MST = 22 day). When the number of CD4+CD25- cells was increased to 106 (•, n = 15, MST = 89 day), or when 105 CD4+CD25+ cells were transferred ({blacktriangledown}, n = 9, MST = 42 day), rejection was significantly delayed and several animals accepted the grafts indefinitely. No rejection was observed in the groups injected with 106 CD4+CD25+ cells ({blacktriangleup}, n = 13, MST > 100) or 107 CD4+CD25- cells ({diamondsuit}, n = 4, MST > 100). This figure represents pooled results from three different experiments.

 
These findings contrast with previous reports describing a lack of regulatory capacity within the CD4+CD25- population in transplantation tolerance (24, 25). Although our experimental system is different to those used by Hara et al. (24) and Gregori et al. (25) in many respects, they may not have reached the appropriate cell doses of CD4+CD25- cells required for suppression. Experiments in animal models of autoimmunity have also described a regulatory role for CD4+CD25- peripheral T cells (14, 45, 46, 47). In one of these reports, the difference in cell numbers between CD4+CD25+ and CD4+CD25- cells required to achieve equivalent suppression is comparable to our findings (45).

The observation that the potency of the CD4+CD25+ population seems to increase following induction of transplantation tolerance is intriguing. It is not clear at this time whether this is due to an expansion of the regulatory cells from pre-existing regulators, whether it results from de novo formation of regulatory cells, or whether this reflects selective inactivation or death of nontolerant cells; so shifting the functional bias of the population toward regulation. It is equally interesting that the CD4+CD25- population is only seen to regulate if derived from tolerant, but not naive, populations. It may be that some "tolerant" CD25+ regulatory cells loose the expression of CD25 and endow the CD4+CD25- population with new regulatory powers, as it has been suggested following homeostatic expansion of CD4+CD25+ T cells (48). Alternatively, activation induced cell death previously reported to occur in the induction of transplantation tolerance (49, 50) may selectively remove effector cells from the CD25- population, unmasking residual regulatory cell activity.

Of interest was the finding that the "potency" of unseparated tolerized CD4+ cells (containing both CD4+CD25+ and CD4+CD25- subpopulations) seemed greater than the separated populations. CD4+ cells were sorted from spleens of CBA/Ca mice tolerant to B10.BR skin grafts using magnetic microbeads, and different numbers of these cells were injected together with the fixed number of 107 splenocytes from naive CBA/Ca mice into empty CP1-CBA recipients (Fig. 4GoA). All animals received a B10.BR skin graft on the following day. When 105 or less CD4+ spleen cells were transfused, the outcome was rejection (Fig. 4GoB). However, adoptive transfer of 5 x 105 or more CD4+ spleen cells from tolerant mice resulted in graft acceptance. In the CBA/Ca mouse strain, ~10% of CD4+ cells coexpress CD25 in both naive and tolerant animals. On the basis of these figures, we can calculate that it takes ~5 x 104 CD4+CD25+ cells combined with 4.5 x 105 CD4+CD25- cells from tolerant mice to suppress 107 naive spleen cells. However, we found that neither 105 CD4+CD25+ nor 106 CD4+CD25- cells alone could provide this degree of suppression (see Fig. 3Go). This suggests that the "unseparated" CD4+ cell population shows greater potency than the equivalent numbers of sorted CD4+CD25+ or CD4+CD25- T cells. Such a result could possibly reflect impairment of regulatory function from the cell separation manipulations, or perhaps the enhanced regulation from CD4+CD25+ and CD4+CD25- regulatory cells operating together. Additional experiments are needed to clarify this.



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FIGURE 4. CD4+ T cells from tolerant mice prevent rejection by spleen cells from naive mice in a dose-dependent way. Splenic CD4+ cells were sorted from CBA/Ca mice tolerant to B10.BR skin grafts, as described in Materials and Methods, and injected i.v. with 107 spleen cells from naive CBA/Ca mice into empty CP1-CBA mice. A, FACS profiles of the sorted CD4+ cells and the unsorted CBA/Ca spleen cells. B, All mice were grafted with B10.BR skin the day following adoptive cell transfer. The group injected with spleen cells in the absence of CD4+ cells from tolerant mice readily rejected the skin grafts ({blacksquare}, n = 5, MST = 26 day). The rejection rate was not significantly delayed in the groups where 5 x 104 ({blacktriangledown}, n = 5, MST = 28 day) or 105 ({diamondsuit}, n = 5, MST = 37 day) CD4+ cells were added to the 107 spleen cells from naive CBA/Ca mice. However, when 5 x 105 (•, n = 5, MST>100, p = 0.0027) and 106 ({square}, n = 5, MST>100, p = 0.0027) CD4+ cells were added, the grafts were accepted indefinitely, these results being statistically significant when compared with the control group ({blacksquare}).

 
We had observed that CD4+CD25+ T cells from tolerized mice had a greater regulatory potency than CD4+CD25+ T cells from naive donors. However, the proportion of CD25+ cells among the CD4+ T lymphocytes from spleen, draining lymph nodes, and peripheral blood remained constant within the two populations at any of days 7, 14, 30, and 60 into the study (our unpublished observations). Such results contrast with published data from Gregori et al. (25). This difference in outcome may be due to the different tolerance inducing protocol used, or to the greater degree of mismatch between the host and the tolerated tissue in that study.

CD4+CD25+ and CD4+CD25- cells differ in gene expression

To validate the separation procedures adopted to isolate CD4+CD25- and CD4+CD25+ T cells, we examined the nature of genes expressed in each population, either resting or activated with solid-phase CD3 mAbs, using SAGE. A differential analysis of the four SAGE libraries is displayed in Fig. 5Go as scatter plots comparing CD4+CD25- spleen cells with CD4+CD25+ spleen cells before and after stimulation. A number of transcripts that do not differ between the two populations before activation are highlighted in Fig. 5GoA. These include the housekeeping genes EF-1{alpha} and GAPDH, the T cell-specific genes CD3{delta} and Ly116 (a Th1 marker), the activation marker OX40, together with {beta}2 microglobulin and MHC-I (K, D, and L, although this latter tag is slightly higher in CD4+CD25- cells). Very few tags appear to be specific to either one of the populations; but 28 tags are significantly up-regulated in CD4+CD25+ cells (most of which we have as yet been unable to assign to known genes), and 97 tags significantly up-regulated in CD4+CD25- cells. The majority of the latter tags (at least 58) map to transcripts normally considered housekeeping genes (shown in gray, and defined as being nondifferential (i.e., SD < mean) across 16 other SAGE libraries, including ribosomal proteins and essential metabolic enzymes (38, 51). This relative loss of housekeeping transcripts is further exemplified after CD3 stimulation of the two populations (Fig. 5GoB), and includes GAPDH, EF-1{alpha}, and also {beta}2 microglobulin (while CD3{delta}, MHC-I, and OX40 change little). This apparent loss of housekeeping gene expression may be explained by the different capacities of the two populations to proceed through the cell cycle; it may be that CD4+CD25+ cells that do not proliferate in response to TCR ligation do not require many of the synthetic and metabolic enzymes, but express a set of new functional proteins without any cell division. It is clear that CD4+CD25+ cells have indeed expressed at least 103 new transcripts as a result of their activation (Fig. 5GoB); and therefore, are behaving in a manner that is quite distinct from CD4+CD25- cells. Most of these tags are unique among the SAGE libraries we have constructed so far (38, 51), and have not yet been assigned to known genes. Although we used SAGE results exclusively to confirm the distinctiveness of the CD4+CD25+ and CD4+CD25- T cells, we have thus far identified four novel candidate genes from the Celera Discovery System mouse gene database (marked as transcripts mCT5392, mCT2519, mCT6469, and mCT4200), whose roles are currently under investigation.



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FIGURE 5. CD4+CD25+ and CD4+CD25- cells express different genes. A, Comparison of gene expression profile of CD4+CD25+ and CD4+CD25- cells sorted from naive CBA/Ca mice. B, Comparison of gene expression profile of CD4+CD25+ and CD4+CD25- cells following activation with solid-phase anti-CD3 mAb. SAGE libraries were compared using scatter plots where each SAGE gene tag is represented by a point plotted at the coordinates corresponding to the tag frequency per 10,000 tags (note logarithmic scale). Tags corresponding to genes whose expression is not differential are represented inside the diagonal area shown. Tags with a statistically differential expression (95% confidence of >1.2-fold up-regulation) are those plotted outside the diagonal area. Housekeeping genes are defined as tags that are nondifferentially expressed across a group of 20 SAGE libraries from different cell types (defined by SDev <= Mean) and are depicted in gray. For clarity, most of differentially expressed tags are represented in black, and the nondifferential in white. The following gene transcripts were identified by their SAGE tags as follows: {beta}2 microglobulin, TTTTCAAAAA; CD3{delta}, AGACCGGAAG; EF-1{alpha}, AGGCAGACAG; GAPDH, GCCTCCAAGG; Ly116, GCAGTGGTTC; MHC-I (K, D, and L), GATTGAGAAT; OX40, CTAGCAGCTG; mCT5392, CCCAGCATCC; mCT2519, AAGGCTATGT; mCT6469, CTTCTACCAA; and mCT4200, GTGGCAGGAG.

 
Dominant tolerance is not compromised by administration of mAbs targeting IL-10, IL-4, CTLA-4, and CD25

There are several conflicting reports in the literature implicating particular cytokines and cell surface molecules in dominant tolerance. In some in vivo and in vitro studies, Abs to CTLA-4 (4F10) and CD25 (PC61) have interfered with suppression (52, 53), although others did not find a role for CTLA-4 in vitro (54). We could not implicate CTLA-4 in our readout of suppression (see below). Other studies have also described a role for IL-10, IL-4, and TGF{beta} in suppression by regulatory T cells, where high doses of mAbs were used in an attempt to neutralize the effect of the target cytokines (24, 39, 43, 55, 56). We could not implicate these same molecules in our own studies.

We transfused 20 x 106 spleen cells from CBA/Ca mice tolerant to B10.BR skin into empty CP1-CBA mice, together with the same number of spleen cells from naive CBA/Ca animals (as described in Fig. 1Go). Separate groups of these animals were treated with high doses of anti-IL4 mAb (11B11), anti-IL10 mAb (JES5), or both in combination; anti-CD25 mAb (PC61), anti-CTLA-4 (4F10), or both in combination. One control group was treated with anti-canine CD8 (YCATE55), and another control group received naive spleen cells in the absence of spleen cells from tolerant mice. The mAbs were administered in doses of 2 mg at days -4, -2, 0, 5, and then weekly until rejection. The adoptive cell transfer was performed at day -1, and B10.BR skin transplants at day 0. Blood samples from all mice were collected at days 20 and 60 to determine the level of the injected mAbs in the sera. The serum concentration of the injected Abs, as determined by binding inhibition, was >100 µg/ml in all PC61-treated mice (two mice injected with PC61 + 4F10 had serum levels between 1 and 10 µg/ml at day 60); all JES5-treated mice had serum concentrations of the mAb between 10 and 100 µg/ml; all 11B11-treated mice had serum concentrations of the mAb >100 µg/ml (except four mice also injected with JES5 where the mAb concentrations were between 10 and 100 µg/ml at days 20 and 60). The serum concentration of 4F10 was determined through an anti-hamster IgG ELISA. All mice had a serum concentration of hamster Ab between 1 and 10 µg/ml at day 20, dropping to <1 µg/ml at day 60.

The group transferred with cells from naive mice readily rejected the test skin grafts (Fig. 6GoA). However, indefinite graft survival was observed in all other groups, suggesting that those particular targeted molecules do not play a critical role in dominant transplantation tolerance in this model. A similar experiment focused on the naive CD4+CD25+ population. We transferred 106 sorted CD4+CD25+ spleen cells from naive CBA/Ca mice, together with 107 splenocytes from naive CBA/Ca mice, as described. Some of the mice were treated with a combination of anti-CTLA-4 and anti-IL-10 mAbs in the doses mentioned above. Treatment with these mAbs did not result in any significant difference in tolerance induced by CD4+CD25+ cells (Fig. 6GoB). A similar experiment with sorted CD4+CD25+ spleen cells from tolerized mice had a comparable result, with none of the mice treated with the mAbs rejecting their grafts (data not shown). Therefore, we can exclude a role for the targeted molecules as mediators of regulation in the experimental system we studied. Previous demonstrations of roles for these molecules in other experimental readouts suggest: 1) that regulation may involve diverse molecular mediators depending on the precise microenvironment where it operates; or 2) that dominant tolerance exploits multiple redundant suppressive pathways where blockade of any one would not impact the outcome; or 3) that some of the effects seen are on the effector population in rendering them more sensitive to Ag-mediated signals–this may be a very plausible explanation for the effects of CTLA-4 mAbs, which should in principle enhance signaling (57, 58); or 4) that regulation takes place in a compartment which the injected mAb cannot easily access, such as the transplanted skin graft itself.



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FIGURE 6. Dominant tolerance operates despite treatment with high-dose mAbs targeting IL-10, IL-4, CTLA-4, and CD25. A total of 20 x 106 spleen cells from naive CBA/Ca were injected into empty CP1-CBA mice i.v., either alone (N) or together with the same number of spleen cells from CBA/Ca tolerant to B10.BR skin (N + T). Mice were injected i.p. with 2 mg of mAbs targeting CD25, CTLA-4, IL-4, IL-10, and canine CD8 (control) at days -4, -2, 0, 2, 5, and then weekly until rejection. Cells were injected i.v. at day -1, and all animals received B10.BR skin transplants at day 0. Animals transferred with 20 x 106 spleen cells from naive CBA/Ca in the absence of mAb treatment readily rejected the grafts ({blacksquare}, n = 5, MST = 21 day). However, in all other groups, grafts were accepted indefinitely (n = 5, MST > 100, p = 0.0198 for {blacktriangledown}, p = 0.0017 for any other group). Blood samples were collected at days 20 and 60 to confirm the presence of the injected mAb in the sera. B, Empty CP1-CBA mice were transfused with 107 spleen cells from naive CBA/Ca mice, alone ({blacksquare}, n = 10, MST = 21 day) or in combination with 106 CD4+CD25+ spleen cells also from naive CBA/Ca donors ({blacktriangledown} and {blacktriangleup}, n = 5 in each group). All mice were transplanted with B10.BR skin on the following day. Some mice transfused with CD4+CD25+ T cells were treated with 2 mg of each of anti-IL10 and anti-CTLA-4 as described above ({blacktriangledown}). There was no significant difference in graft survival between the mAb treated and untreated groups.

 
Our results confirm that where transplantation tolerance was induced with therapeutic mAbs, the subpopulation most potent in maintaining tolerance are the CD4+CD25+ T cells. However, regulatory activity can also be demonstrated within the CD4+CD25- population. It is not clear whether this is a result of redundant tolerogenic strategies mediated by different cell populations, or whether it reflects the fact that a proportion of the regulatory T cell population does not express CD25 constitutively. Either way, the characterization of genes differentially expressed by CD4+CD25+ and CD4+CD25- cells may certainly contribute to a better understanding of their physiology, may provide new markers that better define regulatory T cells, and may lead to the development of diagnostic tests for monitoring T cell population changes in autoimmunity or therapeutic tolerance.


    Acknowledgments
 
We thank K. Nolan and P. Fairchild for helpful comments, S. Humm for preparing many of the mAbs used in vivo, and the PSB staff, especially M. Coates and S. Laynes, for excellent animal care.


    Footnotes
 
1 This work was funded by a program grant from the Medical Research Council (U.K.). L.G. was supported by the Calouste Gulbenkian Foundation’s PhD Program in Biology and Medicine and the Portuguese Foundation for Science and Technology/Praxis XXI. Back

2 Address correspondence and reprint requests to Dr. Luis Graca, Sir William Dunn School of Pathology, University of Oxford, South Parks Road, Oxford OX1 3RE, U.K. E-mail address: luis.graca{at}pathology.oxford.ac.uk Back

3 Abbreviations used in this paper: SAGE, serial analysis of gene expression; MST, median survival time. Back

Received for publication January 11, 2002. Accepted for publication March 29, 2002.


    References
 Top
 Abstract
 Introduction
 Materials and Methods
 Results and Discussion
 References
 

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Genetic Disassociation of Autoimmunity and Resistance to Costimulation Blockade-Induced Transplantation Tolerance in Nonobese Diabetic Mice
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DiabetesHome page
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Accelerated Diabetes in Rat Insulin Promoter-Tumor Necrosis Factor-{alpha} Transgenic Nonobese Diabetic Mice Lacking Major Histocompatibility Class II Molecules
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