The Journal of Immunology, 2003, 170: 805-815.
Copyright © 2003 by The American Association of Immunologists
The Intracellular Granzyme B Inhibitor, Proteinase Inhibitor 9, Is Up-Regulated During Accessory Cell Maturation and Effector Cell Degranulation, and Its Overexpression Enhances CTL Potency1
Claire E. Hirst*,
Marguerite S. Buzza*,
Catherina H. Bird*,
Hilary S. Warren
,
Paul U. Cameron
,
Manling Zhang
,
Philip G. Ashton-Rickardt
and
Phillip I. Bird2,*
* Department of Biochemistry and Molecular Biology, Monash University, Clayton, Australia;
Division of Immunology and Cell Biology, John Curtin School of Medical Research, Australian National University, Canberra City, Australia;
Department of Microbiology and Immunology, University of Melbourne, Parkville, Australia; and
Department of Pathology, Ben May Institute for Cancer Research and Gwen Knapp Center for Lupus and Immunology Research, University of Chicago, Chicago, IL 60637
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Abstract
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Granzyme B (grB) is a serine proteinase released by cytotoxic
lymphocytes (CLs) to kill abnormal cells. GrB-mediated apoptotic
pathways are conserved in nucleated cells; hence, CLs require
mechanisms to protect against ectopic or misdirected grB. The
nucleocytoplasmic serpin, proteinase inhibitor 9 (PI-9), is a potent
inhibitor of grB that protects cells from grB-mediated apoptosis in
model systems. Here we show that PI-9 is present in CD4+
cells, CD8+ T cells, NK cells, and at lower levels in B
cells and myeloid cells. PI-9 is up-regulated in response to grB
production and degranulation, and associates with grB-containing
granules in activated CTLs and NK cells. Intracellular complexes of
PI-9 and grB are evident in NK cells, and overexpression of PI-9
enhances CTL potency, suggesting that cytoplasmic grB, which may
threaten CL viability, is rapidly inactivated by PI-9. Because
dendritic cells (DCs) acquire characteristics similar to those of
target cells to activate naive CD8+ T cells and therefore
may also require protection against grB, we investigated the expression
of PI-9 in DCs. PI-9 is evident in thymic DCs (CD3-,
CD4+, CD8-, CD45+), tonsillar DCs,
and DC subsets purified from peripheral blood (CD16+
monocytes and CD123+ plasmacytoid DCs). Furthermore, PI-9
is expressed in monocyte-derived DCs and is up-regulated upon
TNF-
-induced maturation of monocyte-derived DCs. In conclusion, the
presence and subcellular localization of PI-9 in leukocytes and DCs are
consistent with a protective role against ectopic or misdirected grB
during an immune response.
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Introduction
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Natural
killer cells and
CTLs kill virus-infected and tumor cells by inducing apoptosis through
exocytosis of cytotoxic granule contents or ligation of death receptors
(reviewed in Ref. 1). Granzyme B
(grB)3 is a key
cytotoxic granule proteinase that is endocytosed by the target cell
following cytotoxic lymphocyte (CL) degranulation, probably by binding
to the mannose-6-phosphate receptor (M6PR) (2). The
cytotoxic pore-forming protein, perforin, is also internalized and
mediates the release of grB into the cytoplasm of the target cell. GrB
then rapidly induces apoptosis by cleaving one or more cytoplasmic or
nuclear proteins. These include Bid (3, 4, 5, 6), caspases
(7, 8), components of the DNA repair machinery (7, 9), and inhibitor of caspase-activated DNase (10, 11).
Although CL granule contents are efficiently directed into the target
cell via the immunological synapse (12), some grB may
escape from granules or the synaptic zone into the cytoplasm of the CL
or into the extracellular milieu. For example, free grB is evident in
the sera of patients with elevated CTL responses (13) or
severe Gram-negative bacterial infections (14). Given its
cytotoxic potency and ability to degrade extracellular proteins
(13, 15, 16, 17, 18), it is likely that protective mechanisms
exist to counter misdirected or ectopic grB.
GrB is efficiently inhibited by the nucleocytoplasmic serpin,
proteinase inhibitor 9 (PI-9) (19, 20), with transfection
studies demonstrating that PI-9 protects cells from grB-mediated
apoptosis (21). PI-9 is present in cells at
immune-privileged sites such as testis and placenta (22, 23), and the expression of PI-9 in endothelial and mesothelial
cells suggests that it protects bystander cells from grB released
during an immune response (24). Here we show that PI-9 is
up-regulated in CTLs in response to grB production and degranulation,
that it associates with grB-containing granules in activated CTLs and
NK cells, and that overexpression increases CTL potency. We also show
that PI-9 is present in several dendritic cell (DC) types. The
localization and regulated expression of PI-9 in these leukocyte
subsets strongly support the hypothesis that PI-9 protects effector,
accessory, and bystander cells from ectopic grB during an immune
response.
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Materials and Methods
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Antibodies
PI-9 was detected with the specific mAb 7D8 (22) or
with rabbit 12 or rabbit 15 polyclonal antisera raised against
recombinant PI-9 (19). PI-6 was detected with mAb 3A
(25). GrB was detected with 2C5 (26) or
rabbit anti-grB/grH polyclonal antiserum (27), both
provided by J. Trapani (The Peter MacCallum Cancer Institute, East
Melbourne, Australia), or GrB-7 (Chemicon, Temecula, CA). CD markers
were detected with hybridoma supernatants from 3C10 (CD14; provided by
R. Steinmann, Rockefeller Institute, New York), FMC63 (CD19; provided
by H. Zola, Child Health Research Institute, Adelaide, Australia), and
OKT3 (CD3) and OKT8 (CD8; both from American Type Culture Collection
(Manassas, VA). Anti-CD4 and anti-CD56 were obtained from BD
Biosciences (Franklin Lakes, NJ). Actin was detected with
anti-actin (I-19) from Santa Cruz Biotechnology (Santa Cruz,
CA).
Intracellular flow cytometry
Intracellular flow cytometry was performed using peripheral
blood drawn from healthy volunteers. Erythrocytes were removed from
whole blood by lysis in 167 mM NH4Cl, 10 mM
KHCO3, and 0.1 mM EDTA for 5 min at room
temperature, centrifugation at 100 x g for 5 min, then
washing twice in PBS containing 1% FCS and 0.02% sodium azide
(repeated for all subsequent washes). Approximately 2.5 x
106 PBLs were fixed in 4% formaldehyde in PBS
for 10 min at room temperature, centrifuged, resuspended in FACS
Permeabilizing Solution (BD Biosciences) for 10 min, centrifuged,
washed, and incubated with 7D8 or isotype control Ab (IgG1; BD
Biosciences) for 30 min. Cells were washed twice, then incubated with
FITC-conjugated anti-mouse Ig (Chemicon). After two more washes the
cells were analyzed using a FACSCalibur and CellQuest software (BD
Biosciences).
Localization of ov-serpins in peripheral blood leukocytes
Highly purified B, CD4+,
CD8+, monocyte, and NK cell populations were
obtained from whole blood using RosetteSep Enrichment cocktails
(StemCell Technologies, Vancouver, Canada) according to the
manufacturers instructions. Cells were plated on
poly-L-lysine-coated slides, fixed in 4% formaldehyde for
20 min, then permeabilized in 0.5% Triton X-100 for 5 min. PI-9 and
PI-6 were detected with 7D8 hybridoma supernatant or 3A hybridoma
supernatant, respectively. Bound Ab was detected with anti-mouse Ig
conjugated to FITC. Cells were counterstained with propidium iodide (1
µg/ml), and cross-sections through the nucleus were obtained using
laser scanning confocal microscopy (TCS-NT; Leica, Wetzlar, Germany).
The purity of each cell population and the presence of any
contaminating cell types were assessed using Abs to CD3, CD4, CD8,
CD14, CD19, and CD56.
Retroviral transduction of human CTLs
A cDNA encoding PI-9 (19) was subcloned into the
MIGR1 retroviral vector in the forward or reverse orientation. PI-9
mRNA was transcribed as a bicistronic message with green fluorescence
protein (GFP) (28). Viral supernatant for transduction was
obtained by transient transfection of the 293GP packaging cell line
(29) using Lipofectamine Plus (Invitrogen, Carlsbad, CA).
Supernatant was tested for transduction efficiency on Jurkat cells.
PBLs were obtained from normal healthy donors and were cultured in for
2 days with PHA and human IL-2 (300 U/ml), then transduced with
retrovirus (29). After transduction, PBLs underwent one
round of rapid expansion with irradiated feeder cells (BRT
Laboratories, Baltimore, MD), and the brightest GFP-expressing PBLs
were purified by FACS. Sorted PBLs (72% GFP+,
7580% CD8+) were then kept in culture by rapid
expansion every 3 days. PI-9 mRNA was quantitated by real-time PCR on
cDNA (30) using primers and probes specific for PI-9 and
GAPDH, respectively (MegaBases, Evanston, IL). Retrovirally transduced
PBLs were analyzed in 51Cr release assays (in
triplicate wells) with hybridoma targets that express the
anti-human CD3 mAb OKT3 (31). The percent specific
lysis of JY cells, a human B lymphoblastoid cell line, was determined
in parallel (<6% specific lysis) and subtracted from the lysis of the
OKT3 hybridoma to report CTL killing only.
Expression of PI-9 in stimulated cytotoxic lymphocytes
YT cells (32) were cultured as previously described
(20). PBMCs were isolated from whole blood using
Ficoll-Paque Plus. PBMCs (depleted of monocytes by adherence to
plastic) were cultured in IL-2 (Sigma-Aldrich, St. Louis, MO) or a
combination of Con A and PMA (both from Sigma-Aldrich) as previously
described (33). Culture-generated quiescent NK cells were
cultured and activated as described previously (34, 35).
At the indicated time points, activated cells were harvested, and cell
lysates were prepared by lysis in Nonidet P-40 (NP40) lysis buffer (1%
NP-40 in 50 mM Tris-HCl (pH 8.0), and 10 mM EDTA (pH 8.0)). To prevent
postlysis association of PI-9 and grB, cells were lysed on ice in the
presence of protease inhibitors (1 mM PMSF, 1 µg/ml aprotinin, 1
µg/ml leupeptin, and 1 µg/ml pepstatin). Lysates from 0.5 x
106 cells were resolved by reducing 12.5%
SDS-PAGE, transferred to nitrocellulose, immunoblotted for PI-9 with
7D8, and detected with HRP-conjugated anti-mouse Ig (Chemicon)
using ECL (NEN, PerkinElmer, Boston, MA). The membranes were stripped
(62.5 mM Tris-HCl (pH 6.8), 2% SDS, and 0.1 M 2-ME for 30 min at
50°C), then reprobed for grB (2C5) and actin (diluted 1/1000).
Densitometric analysis of PI-9 levels was determined using MCID Image
Analysis software (BD Biosciences).
Formation of PI-9/grB complexes
Lysate from COS-1 cells transfected with PI-9 (20)
was incubated with or without 100 ng of recombinant grB
(36) at 37°C for 10 min. Samples were resolved by
reducing 12.5% SDS-PAGE, transferred to nitrocellulose, and
immunoblotted with rabbit 12 and rabbit 15 antisera (PI-9) or 2C5
(grB). YT cells (1 x 106) were cultured for
20 h with or without 25 µM calpain inhibitor I
(N-acetyl-Leu-Leu-Norleu; Sigma-Aldrich). Cells were lysed
in NP-40 lysis buffer or modified Laemmli sample buffer (60 mM Tris-HCl
(pH 6.8), 2% SDS, and 10% glycerol) (37) and passed
through a 26-gauge needle to shear the DNA. Twenty micrograms of cell
lysate was resolved by reducing 12.5% SDS-PAGE, transferred to
nitrocellulose, immunoblotted with rabbit 12 antiserum, then stripped
and reprobed with rabbit 15 antiserum.
Colocalization of PI-9 and grB
Activated CTLs were attached to
poly-L-lysine-treated slides, fixed and permeabilized in
1/1 acetone/methanol for 2 min at room temperature, and stained for
PI-9 (7D8), grB (rabbit anti-grB antiserum, diluted 1/200), or
cathepsin A (rabbit antiserum, diluted 1/500, obtained from A.
Pshezhetsky, University of Montreal, Montreal, Canada). Activated NK
cells were cultured on irradiated MM-170 cells for 4 h,
fixed in 4% formaldehyde, then permeabilized in 100% methanol and
stained for PI-9 (7D8) and grB (rabbit anti-grB antiserum, diluted
1/200). YT cells were attached to poly-L-lysine-treated
slides, fixed and permeabilized in acetone/methanol, and stained for
PI-9 (rabbit anti-PI-9 antiserum, diluted 1/2000) and grB (2C5,
diluted 1/200). BeWo cells were cultured and handled for microscopy as
previously described (20). Primary Abs were detected with
the appropriate secondary Ab conjugated to FITC or rhodamine B
isothiocyanate (Chemicon). Two-color images were obtained using
laser scanning confocal microscopy.
Tissue localization of PI-9
Human tissues fixed in neutral buffered formalin were obtained
from the archive of the Pathology Department of Box Hill Hospital
(Melbourne, Australia). Immunohistochemistry was performed as
previously described (22). Cryopreserved normal human
thymus was provided by R. Boyd (Department of Pathology and Immunology,
Monash University, Prahran, Australia). Sections (6 µm) of tissue
were air-dried onto silanized slides. Sections were washed and blocked
in normal goat serum before incubation with 7D8 or an isotype-matched
control Ab (IgG1). Bound Ab was detected with anti-mouse Ig
conjugated to FITC. Sections were then stained with anti-CD3, -CD4,
or -CD45 mAbs directly conjugated to PE (Diatec, Oslo, Norway).
Two-color images were obtained using laser scanning confocal
microscopy.
Dendritic cell purification
PBMCs were isolated from normal donors over Ficoll-Paque
gradients (Red Cross Blood Transfusion Service, Melbourne, Australia).
Monocytes were prepared by elutriation at 2100 rpm using a Beckman J6 M
(Palo Alto, CA) with a standard chamber. Monocytes were further
purified by sorting using a MoFlo CLS cell sorter (Cytomation, Fort
Collins, CO) based on forward and side light scatter and subpopulations
sorting for CD16+ and CD14+
expression. Lineage-negative DCs were purified from the monocyte
elutriation fractions by negative selection with Abs to CD3, CD14,
CD11b, CD19, and CD16. Lineage-negative DCs were sorted into
CD1b/c+ (B-B5; BioSource International,
Camarillo, CA) Langerhans cell precursors (38) or
CD123+ (CD123, BD Bioscience) plasmacytoid DCs
(39). MDDCs were generated from
CD14+ monocytes positively selected using MACS
columns after labeling for CD14 and goat anti-mouse MACS beads
(Miltenyi Biotec, Bergisch Gladbach, Germany). Cells were selected on a
MACS column as recommended by the manufacturers.
CD14+ monocytes were cultured in IL-4 (20 ng/ml)
and GM-CSF (40 ng/ml) for 57 days as previously described
(40). Immature DCs were matured in the presence of TNF-
(10 ng/ml; R&D Systems, Minneapolis, MN) for 2 days.
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Results
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Distribution of PI-9 in peripheral blood leukocytes
To extend our previous observations that PI-9 is expressed in
lymphoid (T, B, and NK-like) cell lines, but not myeloid cell lines
(19), we examined PI-9 in PBLs by intracellular flow
cytometry using a specific mAb (22). PI-9 was evident in
the majority of PBLs in both mononuclear cells (R1) and granulocytes
(R2; Fig. 1A). Most
mononuclear cells were clearly positive (>90%). Dual-color analysis
showed that >95% of CD3+ cells are PI-9
positive, 100% of CD4+ and
CD8+ cells are PI-9 positive, and
75% of
CD19+ cells are PI-9 positive (data not shown).
Many granulocytes (>70%) were also positive, but appeared to have
lower amounts of PI-9, with only a slight positive shift in staining
apparent over the isotype control (Fig. 1A). Comparison of
the mean fluorescence intensities indicated that mononuclear cells
express at least 5-fold more PI-9 than granulocytes.

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FIGURE 1. Distribution of PI-9 in peripheral blood leukocytes.
A, Flow cytometric analysis of PI-9 in PBLs. PBLs were
stained with a PI-9-specific mAb, 7D8 (filled histogram), compared with
an IgG1 isotype control (open histogram). This figure is representative
of four different donors. B, Distribution and
subcellular localization of PI-9 in PBL subsets. Leukocyte subsets were
enriched and assessed as described in Materials and
Methods. Indirect immunofluorescence was performed with a mAb
specific to PI-9 (7D8) or PI-6 (3A) and was detected with
FITC-conjugated anti-mouse Ig (green). The nuclei were
counterstained with propidium iodide (red), and images were obtained
using laser scanning confocal microscopy. Relative levels of PI-9 can
be compared as all images were captured using the same settings. This
figure is representative of three separate experiments.
C, Proportion of PI-9- and PI-6-positive cells in
enriched leukocyte subsets. Subsets were assessed for marker expression
as described in Materials and Methods.
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To further identify the populations of mononuclear cells that produce
PI-9, B cells, CD4+ and
CD8+ T cells, NK cells, monocytes, and
granulocytes were enriched from PBLs using established immunodepletion
procedures. These were analyzed for PI-9 by indirect immunofluorescence
so that its intracellular distribution could be simultaneously assessed
(Fig. 1B). The efficiency of immunodepletion was monitored
by staining for CD3, CD4, CD8, CD14, CD19, or CD56 (Fig. 1C). PI-9 was evident in all populations, with the highest
levels in NK and T cells (CD4+ and
CD8+ T cells expressed equivalent levels). B
cells, monocytes, and granulocytes had much lower levels. In all cell
types PI-9 exhibited a nucleocytoplasmic localization, consistent with
previous reports (19, 20). The expression pattern of PI-9
differed from that of the closely related serpin, PI-6, which is a
cathepsin G inhibitor present in myeloid cells (41).
Intracellular localization of PI-9 in grB-expressing cells
The observation of high PI-9 expression in NK and CTLs suggests
that it protects grB-producing cells against endogenous grB. Using
indirect immunofluorescence and laser scanning confocal microscopy we
examined the intracellular localization of PI-9 in primary NK cells and
the NK-like cell line, YT. This showed that in addition to its
previously reported cytoplasmic and nuclear distribution (Fig. 2A) (20), PI-9 is
associated with vesicles in the CL cytoplasm that also contain grB
(Fig. 2, B and C). These vesicles were positive
for the lysosomal/granule marker lysosome-associated membrane
protein-1 and not with markers for the endoplasmic reticulum or
Golgi apparatus (data not shown), indicating that they are secretory
lysosomes (cytotoxic granules). To determine whether the association of
PI-9 with lysosomes is unique to CLs, the distribution of endogenous
PI-9 in the epithelial cell line BeWo was also examined (Fig. 2D). Here PI-9 was evident only in the cytoplasm and
nucleus, and no colocalization between PI-9 and lysosomal markers was
observed.

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FIGURE 2. Colocalization of PI-9 and grB in CLs. Activated CTLs
(A) were stained for PI-9 (green), and the nucleus was
counterstained with propidium iodide (PI; red). Activated NK cells on
targets (B) or YT cells (C) were stained
for PI-9 (green) and grB (red). Two-color images were obtained using
laser scanning confocal microscopy. A and
B, Single sections through the cell; C, a
projected view of multiple scans through the depth of the cell at
1-µm intervals to give a three-dimensional representation of the
entire cell; D, representative single sections of BeWo
cells (choriocarcinoma) stained for PI-9 (green) and the lysosomal
marker cathepsin A (red). No PI-9 association with lysosomes was
evident in any of the cells inspected (n = 15;
sampling all 0.3-µm sections generated through each cell).
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In a previous study we separated membrane and cytosolic fractions of
CLs and showed that PI-9 is present in the cytosol and does not
copurify with grB in the granule fractions (19). Given
that PI-9 is not present within granules, the results shown in Fig. 2
suggested that it is associated with the cytoplasmic surface of the
granule and is poised to rapidly inactivate grB entering the cytoplasm
from leaking granules. To test this idea we examined YT cells for
evidence of extragranular grB in complex with PI-9. We took advantage
of the fact that grB-PI-9 complexes are stable under SDS-PAGE and
immunoblotting conditions (19, 21), and that we have two
high affinity PI-9 Abs that detect PI-9 in complex with grB very
efficiently. As shown in Fig. 3A, these Abs (rabbit 12 and
15) detect the grB-PI-9 complex better than they detect free PI-9, and
they also detect the degradation products commonly observed following
serpin-proteinase complex formation. Degradation of the complex occurs
because distortion of the protease (in particular) renders it highly
susceptible to proteolysis (42, 43). The Abs do not bind
grB (Fig. 3A), and their corresponding preimmune sera do not
recognize PI-9, complex, or degradation products (data not shown). None
of the four grB Abs we have tested detected the complex or degradation
products with similar sensitivity to the PI-9 Abs. An immunoblot using
the most sensitive of these grB Abs (2C5) is shown in Fig. 3A.

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FIGURE 3. Detection of preformed complexes in CLs. A, Rabbit anti
PI-9 polyclonal antisera preferentially recognize complexes of PI-9 and
grB as well as complex degradation products. Lysates of COS cells
expressing PI-9 were incubated in the presence (+) or the absence (-)
of excess grB, and samples were detected by immunoblotting with rabbit
anti-PI-9 antisera R12 or R15, or the anti-grB mAb 2C5.
Note that the 2C5 blot was overexposed to demonstrate that the Ab
can detect grB in complex. B, Detection of preformed
complexes in cytolytic cells. YT cells were incubated in the presence
(+) or the absence (-) of a proteosome inhibitor (Prot. Inhib.), then
lysed in NP40 or SDS lysis buffer. Cell lysates were immunoblotted with
rabbit 15 antiserum, then stripped and reprobed with rabbit 12
antiserum. The position of uncomplexed PI-9 is arrowed, and the
positions of the complex and primary degradation products are
bracketed. Minor complex degradation products (*) are indicated on
the right.
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When YT cells are lysed in buffers containing NP-40, active grB
is released from granules and binds cytoplasmic PI-9 postlysis
(20, 21). By contrast, lysis of CTLs in buffers containing
SDS prevents postlysis interactions, presumably by rapidly denaturing
cellular proteins (37). Thus, lysis of YT cells in SDS
will denature free PI-9 and free grB, and a complex evident in
SDS-treated YT cell extracts will have formed before lysis. As shown in
Fig. 3B, lysis of YT cells in NP40 generated a postlysis
complex of
70 kDa as well as smaller products resulting from complex
degradation that were detected by both PI-9 antisera, but more
efficiently by rabbit 15. When cells were lysed in SDS buffer, small,
but reproducible, amounts of complex and degradation products were
detected by rabbit 15 (Fig. 3B). This suggests that there is
a pool of extragranular grB in the cytoplasm of YT cells that is bound
to PI-9 and undergoing proteolysis.
Because serpin/proteinase complexes are irreversible and involve
distortion of both serpin and proteinase (42, 43), we
predicted that cytoplasmic PI-9/grB complexes would be recognized and
degraded by the ubiquitin-proteosomal machinery. Cells cultured in the
presence of a proteosome inhibitor should therefore accumulate
complexes. Indeed, greater amounts of complexes were detected by both
PI-9 antisera when cells were incubated with the proteosomal inhibitor,
calpain inhibitor I, and lysed in SDS (Fig. 3B). This also
supports the idea that grB enters the cytoplasm of CLs during normal
cellular function and is rapidly inactivated by PI-9.
PI-9 enhances the potency of human CTLs
Since PI-9 potentially protects CLs from death induced by
misdirected grB, we wanted to determine the effect on CTL potency of
overexpressing PI-9 in activated PBLs. Normal donor PBLs were activated
with PHA and transduced with retroviral vectors containing the PI-9
gene in either the forward (coding) or the reverse (noncoding)
orientation. These vectors allow transcription of the inserted cDNA as
a bicistronic mRNA that also encodes GFP (28, 44).
Cultures transduced with either the coding or noncoding vectors were
enriched to equivalent amounts of GFP-expressing cells (
72%) by
FACS (data not shown). Those transduced with the PI-9 gene in the
coding orientation expressed 4-fold higher levels of PI-9 mRNA
(p < 0.02) compared with those in which the
PI-9 gene was in the noncoding orientation (Fig. 4A). Both cultures contained
an equal proportion of CD8 cells, which was 7580% of the total PBLs
(data not shown).

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FIGURE 4. PI-9 enhances the potency of human CTLs. PBLs were transduced with
bicistronic retroviral vectors containing a PI-9 cDNA in the forward
(coding) or reverse (noncoding) direction in a transcriptional unit
also encoding GFP. A, Relative levels of PI-9 mRNA in
GFP-positive PBLs. Results are expressed as the concentration of PI-9
mRNA/the concentration of GAPDH mRNA, and are the mean ± SEM of
four determinations from two separate experiments. Cells transduced
with PI-9-coding virus expressed more PI-9 mRNA than those transduced
with noncoding virus (**, p < 0.02).
B, Specific CTL lysis by PBLs after transduction with
retrovirus. These values represent the specific lysis of OKT3 targets
minus the lysis of JY targets (<6%) and thus reflect killing by
TCR-positive CTLs. Results are the mean ± SEM of four wells. CTLs
that overexpressed coding PI-9 mRNA gave greater percent specific lysis
than CTLs transduced with noncoding control virus (**,
p < 0.02; *, p < 0.05).
Similar results were found in two separate experiments.
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The ability of uncloned populations of transduced CTLs to lyse target
cells expressing an anti-CD3 mAb (OKT3) (31) was
evaluated. In parallel, we also determined the lysis of JY target
cells, which do not express anti-CD3 mAbs, so we were able to
account for NK cell activity in the cultures. In each experiment the
specific lysis of JY targets (NK cell killing) was subtracted from that
of OKT3 targets (total killing) to give the level of CTL activity. At
every E:T cell ratio tested we observed increased potency of CTLs that
expressed elevated levels of PI-9 (Fig. 4B). For example, at
an E:T cell ratio of 0.5:1 we observed a 3-fold increase in potency of
killing by CTLs that overexpressed PI-9 (p <
0.02). Since PI-9 can protect cells from apoptosis caused by grB, we
infer that overexpression of PI-9 increases CTL potency by improving
viability.
Regulation of PI-9 in grB-expressing cells
CL stimulation, which increases the level of grB, should also
result in a corresponding increase in PI-9. We therefore examined the
regulation of PI-9 in T and NK cells under conditions known to induce
grB synthesis and release. PBLs were stimulated with IL-2, which
expands and activates T cells, or a combination of Con A and PMA, which
results in T cell activation and granule exocytosis. As shown by
immunoblotting, both these stimuli induced grB expression, peaking on
days 6 and 3, respectively (Fig. 5, A and B). No significant increase in PI-9 was
observed in T cells stimulated with IL-2 alone (Fig. 5A).
However, stimulation of T cells with Con A/PMA resulted in a 3-fold
induction of PI-9 over endogenous levels (Fig. 5B). This
treatment also generated the higher Mr
form of grB (35 kDa) that is only observed following T cell
degranulation (45). Thus, in vitro, PI-9 up-regulation is
associated with the release of grB from CLs.

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FIGURE 5. Regulation of PI-9 expression in CLs. PBMCs were activated in the
presence of 100 U/ml IL-2 (A) or a combination of Con A
and PMA (10 µg/ml and 10 ng/ml, respectively; B), or
culture-generated quiescent NK cells (C) were activated
in the presence of irradiated MM-170 cells and 200 U/ml IL-2. On the
indicated days cells were harvested, and lysates were prepared. Cells
(0.5 x 106) loaded/lane) were resolved by reducing
SDS-PAGE and sequentially immunoblotted with mAbs to PI-9 (7D8,
hybridoma supernatant diluted 1/10), grB (2C5, diluted 1/2000), and an
antiserum to actin (diluted 1/1000). FACS analysis indicated that 40%
of IL-2-stimulated T cells and 64% of Con A/PMA-stimulated T cells
were CD8+. *, Presence of the 35-kDa form of grB.
Densitometric analysis was performed on immunoblots from four separate
stimulations, and the relative levels of PI-9 are plotted.
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The regulation of PI-9 was also investigated in NK cells.
Culture-generated quiescent NK cells were activated by incubation with
targets (irradiated MM-170 cells) in the presence of IL-2. These NK
cells constitutively express both PI-9 and grB, as evident on day 1 of
stimulation (Fig. 5C). While activated NK cells killed
MM-170 cells (data not shown) and up-regulated grB, which peaked on day
3, no significant increase in PI-9 was detected over time. Taken
together, these results suggest that the level of PI-9 in
proliferating, nondegranulating T cells and activated NK cells is
sufficient to protect against grB. However, the increase in PI-9
expression during T cell degranulation suggests that granule exocytosis
is associated with increased entry of grB into the effector cell
cytoplasm, and that degranulating cells consequently require higher
levels of PI-9.
Since PI-9 is up-regulated in response to T cell degranulation in
vitro, its expression was also investigated in activated T cells in
vivo by immunohistochemical analysis of normal and inflamed human
tissues. When normal spleen was examined using the specific PI-9 mAb,
7D8, in standard immunohistochemical procedures, no PI-9-positive
lymphocytes were detected (Fig. 6, b and c). However, when lymphocytes were
extracted from freshly isolated spleen and stained for PI-9 using the
more sensitive technique of indirect immunofluorescence, PI-9-positive
cells were apparent (Fig. 6a). This indicated that the level
of PI-9 expressed in quiescent lymphocytes is below the level of
immunohistochemical detection using this Ab. By contrast, when we
examined inflamed tissue samples by immunohistochemistry, PI-9-positive
cells were clearly evident within lymphocytic infiltrates. For example,
PI-9-positive lymphocytes were observed in sections of a ductal
carcinoma of the breast (Fig. 6d) that were also positive
for grB (Fig. 6e). Thus, PI-9 is up-regulated in
grB-expressing effector cells in vivo.

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FIGURE 6. Expression of PI-9 in activated lymphocytes and DCs. a,
Indirect immunofluorescence of PI-9 (green) in lymphocytes isolated
from normal spleen; b, PI-9 is undetectable by
immunohistochemistry in formalin-fixed, paraffin-embedded normal
spleen; c, isotype control of a serial section of the
same normal spleen; d, PI-9 in activated lymphocytes in
ductal breast carcinoma; e, coexpression of grB in
activated lymphocytes; f, isotype control;
g, localization of PI-9 to DCs within a tonsillar
germinal center; h, higher magnification illustrating
the dendritic morphology of the PI-9-positive cells; i,
isotype control; jl, PI-9-positive cells within the
thymus. PI-9-positive cells (green) are located within the medulla
identified by the presence of Hassall corpuscles (HC). PI-9 does not
colocalize with CD3+ thymocytes (j, red),
but slight colocalization is noted where cytosolic PI-9 overlaps with
membrane CD45 (k, red) and CD4 (l, red)
expressed on DCs.
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Expression of PI-9 in DC populations
In addition to protecting CLs from endogenous grB, PI-9 should
protect accessory and bystander cells from exogenous grB released
during the immune response. Supporting this idea, PI-9-positive DCs
were evident in tonsillar germinal centers using the
immunohistochemical procedures described above (Fig. 6, g
and h). PI-9-positive DCs were also detected by two-color
immunofluorescence in the thymus. These thymic PI-9-positive cells were
CD3- CD4+
CD45+ (Fig. 6, jl) and
CD8- (data not shown) with DC morphology and
were located in the keratin-negative medulla. The morphology and
phenotype of these PI-9-positive DCs are consistent with several
populations of human thymic DCs recently described (46).
It is important to note that no PI-9-positive lymphocytes were detected
in either tonsil or thymus, suggesting that DCs constitutively express
higher levels of PI-9 compared with resting or immature
lymphocytes.
Since immunohistochemistry is qualitative, highly purified DC
populations were isolated from whole blood to assess the relative
levels of PI-9. Consistent with the FACS data, low levels of PI-9 were
present in monocytes purified from PBLs. IL-4- and GM-CSF-induced
differentiation of these cells into immature MDDCs resulted in a
significant increase in PI-9 expression (Fig. 7A). Maturation of MDDCs by
exposure to TNF-
resulted in a further increase in the expression of
PI-9 (Fig. 7B). By densitometric analysis, this increase in
PI-9 in MDDCs was
4-fold over monocytes and increased a further
3.5-fold upon maturation with TNF-
.

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FIGURE 7. Expression of PI-9 in primary DCs and MDDCs. A, Fifty
micrograms of cell lysates were prepared from elutriated monocytes
(Mono), sorted monocytes (sMono), lineage-negative DCs
(lin- DC), monocyte-derived DCs (MDDC), and T cells;
B, sorted monocytes were further divided into
CD16+ and CD16- populations, lineage-negative
DCs were divided into CD1b/c+ (Langerhans cell precursors)
and CD123+ (plasmacytoid DCs), and MDDCs were cultured in
the presence (+) or the absence (-) of TNF- (10 ng/ml) for 2 days.
Samples were resolved by 12.5% reducing SDS-PAGE, transferred to
nitrocellulose, and immunoblotted for PI-9 with 7D8 hybridoma
supernatant diluted 1/10, detected with HRP conjugated anti-mouse
Ig, and ECL. Blots were stripped and reprobed for actin (diluted
1/1000). C, Simplified diagram illustrating the
differentiation of DCs from either a myeloid or a lymphoid precursor.
Boxed populations were assessed for PI-9 by immunoblotting and
immunohistochemistry (shades of gray represent relative levels of
PI-9). Checkered boxes indicate that while PI-9-positive DCs were
observed in the thymus, the phenotype of these DCs is not yet known.
Dashed arrows indicate ex vivo stimulation. Data in this figure are
modified from Ref. 94 with additional information from
Refs. 46 48 81 , and 95 .
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To identify specific DC types that express PI-9, subpopulations were
purified from whole blood and examined for PI-9 by immunoblotting. The
CD16+ monocytic precursors of tissue DCs
(47, 48) expressed higher levels of PI-9 than
CD16- monocytes (Fig. 7B).
Lineage-negative DCs purified from peripheral blood expressed PI-9 at
an intermediate level between monocytes and MDDCs (Fig. 7A). These lineage-negative DCs contain two major
populations: CD1b/c+ Langerhans cell precursors
(38) and CD123+ plasmacytoid DCs
(39). The plasmacytoid DCs expressed an intermediate level
of PI-9, while Langerhans cell precursors expressed virtually no PI-9
(Fig. 7B).
The differential expression of PI-9 in DC populations from both the
myeloid and lymphoid lineages is illustrated in Fig. 7C. The
distribution of PI-9 in DC subsets suggests that expression is not
limited by ancestry, and that differing requirements for protection
from grB during Ag presentation to naive CD8+ T
cells during induction of effector functions determines PI-9
expression.
 |
Discussion
|
|---|
Cells have evolved a number of mechanisms to control apoptosis.
For example, inhibitor of apoptosis proteins inhibit caspases
directly (49), cellular FLIP blocks Fas-mediated apoptosis
(50), and Bcl-2 family members regulate apoptosis at the
mitochondria (reviewed in Refs. 51 and 52).
We and others believe that PI-9 and other intracellular serpins are
part of the anti-apoptotic machinery of cells involved in or
exposed to the cellular immune response (23, 41, 53, 54).
In particular, we have proposed that PI-9 protects cells against
misdirected grB (19, 21, 22, 24).
Expression, regulation, and function of PI-9 in CLs
A role for PI-9 in protecting grB-expressing cells is supported by
its unusual intracellular distribution, described in the first part of
this study. In addition to its cytoplasmic and nuclear localization
(20), PI-9 in CLs is clearly associated with
grB-containing cytotoxic granules. Fractionation studies indicate that
PI-9 is not present within granules (19). Other studies
show that, like PI-6 (55), when PI-9 is provided with an
efficient signal peptide, it is retained in the endoplasmic reticulum
and cannot move through the secretory pathway (A. Gillard and P. Bird,
unpublished observations). Therefore, PI-9 must associate with
the external, cytoplasmic face of the granule through interaction with
a specific granule component. Our demonstration that PI-9 does not
associate with lysosomes in epithelial cells suggests that it interacts
with a protein or other component not found on nonsecretory lysosomes
or on other membrane-bound organelles. For example, it may bind a
specific lipid, as the lipid content of the granule membrane differs
from that of the plasma membrane and other organelles
(56).
GrB is stored in granules in an active form (57); thus,
leakage from granules or from the synapse would allow it to access
nucleocytoplasmic substrates and kill the CL. The positioning of PI-9
at the granule surface and of the PI-9/grB complexes evident within CLs
suggests that granules do leak and that PI-9 is present to rapidly
inactivate extragranular grB. Once granule exocytosis is triggered, the
granules are refilled with newly synthesized grB; however, some of the
newly synthesized grB is constitutively secreted as a 35-kDa form
(45). The 35-kDa form of grB is specifically associated
with degranulating cells, so the correlation we report with a 3-fold
increase in PI-9 strongly suggests that grB misdirection occurs during
T cell degranulation. While this in vitro system probably does not
fully recapitulate the situation in vivo, our demonstration of an
increase in CTL killing efficiency on 3- to 5-fold overexpression of
PI-9 suggests that the similar fold up-regulation seen in Con
A/PMA-treated cells is physiologically relevant. We therefore conclude
that CTL viability is enhanced by a PI-9-mediated reduction in suicide
or fratricide induced by misdirected grB.
What might cause granule leakage? Granules are secretory lysosomes
containing lysosomal hydrolases in addition to granzymes and perforin
(58, 59, 60). While there is no direct evidence that granules
leak, it is clear that lysosomal rupture can be induced by stressors
such as oxidation and UV irradiation, leading to apoptosis and necrosis
(61, 62). Increased levels of reactive oxygen species have
been observed in CLs, which may lead to apoptosis (63).
This suggests that granule leakage occurs during effector cell
activation and/or function.
Release of grB into the effector cell cytoplasm need not only occur
from leaking granules. It is possible that secreted grB is endocytosed
by effectors or bystanders. The uptake of grB into target cells is
thought to be mediated by the 300-kDa M6PR (2). The M6PR
is expressed in all nucleated cells, with up to 20% of the receptor
present at the cell surface (64, 65, 66, 67, 68). Interestingly, the
M6PR is up-regulated on activated T cells (69), which
might increase their susceptibility to secreted grB.
Role of PI-9 in accessory cells
The cellular immune response involves a complex interplay between
many cell types. APC or accessory cells (DCs, macrophages, and B cells)
induce differentiation of naive T cells into cytotoxic or Th
lymphocytes by secretion of cytokines and expression of costimulatory
molecules. These accessory cells are closely associated with CLs and
are likely to be exposed to collateral damage mediated by grB and
perforin during the immune response. The presence of PI-9 would provide
protection against inadvertent killing of these cells.
How likely is such inadvertent killing? DCs have established roles in
presenting Ag to CD4+ Th cells and eliciting Th1
(CTL) or Th2 (B cell) responses. However, distinct DC subpopulations
also directly interact with B cells or CD8+ CTLs.
For example, follicular DCs in the germinal center directly contribute
to B cell proliferation and differentiation (70), while
virally infected DCs and DCs purified from blood can directly present
to CD8+ T cells in the absence of
CD4+ Th cells (71, 72, 73, 74).
This close association of activated CTLs and DCs may result in
elimination of DCs by effector CTLs (33, 75). Elimination
of DCs in normal mice is unusual, presumably due to protective
mechanisms, but elimination of Ag-specific DCs by cognate CTLs has been
observed in transgenic mouse models (76, 77). Although
this demonstrates that DCs are potentially susceptible to CTLs, the
mechanism of CTL-dependent clearance of DCs is unclear. One study found
DC elimination to be independent of Fas and perforin (77),
while another reports that it is mediated partly by the perforin
pathway (78). Consistent with the latter results, we and
others have suggested that expression of PI-9 in DCs prevents
grB-mediated apoptosis during Ag presentation to CTLs (23, 53). This is further supported by the recent report that SPI6,
one of seven murine PI-9 homologues (79), protects murine
DCs from CTL-induced apoptosis (54).
Our results show that PI-9 is expressed in specific DC subsets. Thymic
medullary DCs comprise three different subsets: a major
CD11b- subset of lymphoid origin, a minor
CD11b+ subset of myeloid origin
(46), and a population of plasmacytoid DCs
(80). The CD11b+ thymic DCs resemble
tonsillar germinal center DCs (81) and are thought to be
phenotypically and morphologically related (46).
Considering this relationship, it is likely that the PI-9-positive DCs
observed in the thymus are related to the PI-9-positive DCs located in
the tonsil. Both these DC populations are probably derived from
CD16+ myeloid precursors (47, 48, 82). PI-9 is highly expressed in CD16+
monocytes, which is consistent with PI-9 expression in the
CD11b+ thymic DCs and tonsillar germinal
center DCs.
The differential expression of PI-9 in DCs suggests differing
requirements for protection from grB-mediated apoptosis in DC subsets.
Thymic medullary DCs are essential in the positive and negative
selection of thymocytes. GrB-positive cells are present in the thymic
medulla, with grB transcripts detected in double-positive
(CD4+ CD8+) thymocytes
(83) and in both CD4+ or
CD8+ single-positive thymocytes
(84). This suggests that thymocytes undergoing selection
express grB and have cytotoxic potential. Thus, the presence of PI-9 in
thymic medulla DCs is consistent with a role in protecting these DCs
from grB-mediated apoptosis.
Some subsets of germinal center DCs are involved in the presentation
and activation of T cells directly (81), while
plasmacytoid DCs are IFN-producing cells (85, 86, 87) that
initiate potent Th1 (CTL) responses (88). The expression
of PI-9 in these cells suggests that DC populations that present to and
activate CD8+ precursor T cells are at risk from
the effector functions of the T cells they activate. This is also
supported by the up-regulation of PI-9 in MDDCs upon TNF-
-induced
maturation, suggesting that mature APC require protection from
inadvertent apoptosis.
Role of PI-9 in other cells
It would be advantageous for other cell types to express PI-9 to
protect against misdirected grB during the immune response. For
example, PI-9 is expressed in endothelial and mesothelial cells likely
to be exposed to CLs and is up-regulated by inflammatory stimuli
(24, 89). The expression of grB and perforin has also been
demonstrated in human CD4+ CTLs (90, 91), suggesting that PI-9 has a cytoprotective role in some
CD4+ T cells. The level of PI-9 expressed in B
cells, monocytes, and granulocytes is lower than in CLs or DCs, and it
is unlikely that they would be protected from direct CTL attack. Hence,
these cells have sufficient PI-9 to cope with low levels of misdirected
grB, but could still be cleared by CTLs if they become infected or
tumorigenic.
Two recent papers have indicated a role for PI-9 in tumor evasion by
providing neoplastic cells with an advantage against grB-mediated
cytotoxicity (92, 93). However, both studies failed to
establish the baseline expression of PI-9 in tissues and cells or to
compare the level of PI-9 expression in normal and tumor samples. The
expression of PI-9 in epithelial cells has been reported
(24), and PI-9 is in the ductal tissue of the breast, the
columnar epithelia of the colon, and the ciliated columnar epithelia
lining the female reproductive tract (M. Buzza, unpublished
observations). The presence of PI-9 in carcinomas of breast, colon, and
cervix (92) is therefore not surprising.
Additionally, the work reported here shows that PI-9 is widely
distributed in normal leukocytes, which may account for the presence of
PI-9 in T, B, and Hodgkin lymphomas (93). Analysis of the
latter data indicates that only 28% of 224 biopsies were positive for
PI-9. Furthermore, the number of PI-9-positive cells within each biopsy
varied, with only 17% containing a majority of PI-9-positive tumor
cells. The lack of PI-9 in most of these lymphomas suggests it is
unlikely that PI-9 up-regulation is a common mechanism by which
lymphomas resist immune destruction.
 |
Acknowledgments
|
|---|
We thank J. Sun for recombinant grB, J. Trapani (Peter
MacCallum Cancer Institute, Melbourne, Australia) for grB Abs,
A. Pshezhetsky (University of Montreal, Montreal, Canada) for cathepsin
A Abs, P. Hosking (Department of Anatomical Pathology, Box Hill
Hospital, Melbourne, Australia) for archival tissues, and R. Boyd
and M. Malin (Department of Pathology and Immunology, Monash
University, Clayton, Melbourne, Australia) for thymus tissue.
 |
Footnotes
|
|---|
1 This work was supported by the National Health and Medical Research Council of Australia, and the National Institutes of Health (Grant AI45108). H.S.W. is funded by Senior Research Fellowship 148950. 
2 Address correspondence and reprint requests to Dr. Phillip Bird, Department of Biochemistry and Molecular Biology, Building 13B, Room G09, Monash University, Clayton 3800, Australia. E-mail address: phil.bird{at}med.monash.edu.au 
3 Abbreviations used in this paper: grB, granzyme B; CL, cytotoxic lymphocyte; DC, dendritic cell; GFP, green fluorescence protein; MDDC, monocyte-derived DC; M6PR, mannose-6-phosphate receptor; NP40, Nonidet P-40; PI-9, proteinase inhibitor 9. 
Received for publication April 19, 2002.
Accepted for publication November 5, 2002.
 |
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