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Department of Immunology, Weizmann Institute of Science, Rehovot, Israel
| Abstract |
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| Introduction |
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In patients with advanced hematological malignancies who cannot withstand myeloablative conditioning because of age and/or performance status, recent attempts were made to develop low toxicity conditioning protocols in conjunction with HLA-matched transplants. Potent post-transplant immunosuppression and the presence of large numbers of alloreactive T cells in the graft enabled a high rate of engraftment. However, graft-vs-host disease (GvHD),3 particularly chronic GvHD, remains a major obstacle (7). Although in high risk leukemia, such transplant-related mortality is acceptable, it would be totally intolerable if applied to patients with long life expectancy. Thus, the use of purified allogeneic stem cells, which do not pose any risk for GvHD and which can continuously present donor type Ags in the host thymus, thereby inducing durable tolerance to donor cells or tissues, represents one of the most desirable goals in transplantation biology. One approach to address this challenge is based on the use of donor veto cells depleted of host reactive T cells.
Veto activity was defined in 1980 by Miller as the capacity to specifically suppress cytotoxic T cell precursors directed against Ags of the veto cells themselves, but not against third-party Ags (8, 9, 10, 11). Interestingly, it has been shown that some of the most potent veto cells are of T cell origin; in particular, a very strong veto activity was documented for CD8+ CTL lines or clones (12, 13, 14, 15, 16, 17). The specificity of the veto effect mediated by CTL clones was shown by several studies to be unrelated to their TCR specificity (18, 19, 20). The suppression of effector CTL-precursor directed against the veto cells is both Ag-specific and MHC-restricted, resulting from the unidirectional recognition of the veto cell by the responding CTLs, but not vice versa (18). Furthermore, it has been shown that this suppression is mediated by apoptosis (18, 21).
Although CD8+ CTLs are endowed with very potent veto activity, their use in allogeneic stem cell transplantation is limited due to their marked graft-vs-host reactivity. To address this problem we developed a new approach for the generation of host-nonreactive CTLs based on stimulation of donor CD8+ T cells against third-party stimulators under IL-2 deprivation. This approach is based on the observation that only those CTLs activated are capable of surviving IL-2 starvation in the primary culture. Other studies used T cytotoxic 2 CTLs, which were shown to be associated with a reduced GVH reactivity (22), or NK cells (23), which are not associated with any risk for GVHD. One obstacle in the study of basic questions related to the mechanism of action of veto cells is presented by the assay for these cells. Due to the low frequency of the effector T cells against which the veto cell inhibitory activity is directed, the fate of the effector cells was traditionally followed indirectly by functional limiting dilution assays, which are cumbersome and depend on numerous parameters. However, the availability of new TCR transgenic (Tg) strains of mice, in which the transgene is directed against H-2 determinants, as well as the development of tetramer technology have made it possible to directly monitor in such MLR cultures the fate of the effector T cells by FACS analysis. Thus, the 2C Tg mouse model, the T cells of which bear a transgene directed against H-2d, was used to document the veto reactivity of activated bone marrow cells (21, 23, 24). In the present study we used this Tg mouse model to study the relative veto reactivities of various veto cells, including host nonreactive CD8+ CTLs, activated CD4+ T cells, B cells, and NK cells.
| Materials and Methods |
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The mice used were 6- to 12-wk-old females. BALB/c (H-2d), FVB (H-2q), SJL (H-2s), and C57BL/6 (H-2b) were obtained from the Weizmann Institute Animal Center (Rehovot, Israel). DBA/2 (H-2d) and C3H/HeJ (H-2k) mice were obtained from the Roscoe B. Jackson Memorial Laboratory (Bar Harbor, ME). A breeding pair of Tg H-2b mice expressing the TCR from the CTL clone 2C with specificity for H-2Ld was provided by J. Nikolic-Zugic (Sloan-Kettering Institute, New York, NY). Progeny of these Tg mice were bred at the Weizmann Institute Animal Breeding Center. All mice were kept in small cages (five animals in each cage) and were fed sterile food and acid water.
Preparation of host-nonreactive, donor anti-third-party CTLs
Anti-third-party CTLs were prepared as described by Bachar-Lustig et al. (25). Briefly, splenocytes of BALB/c or DBA/2 origin were cultured against irradiated (20 Gy) FVB, C3H/HeJ. or SJL (third-party stimulators) splenocytes. Responders (2 x 106/ml) and stimulators (2 x 106/ml) were cultured for 6 days in RPMI 1640 complete tissue culture medium at 37°C in a 5% CO2/air incubator. Six days after culture initiation, cells were fractionated on Ficoll, and the lymphoid fraction was subjected to positive selection of CD8+ cells using magnetically labeled anti-CD8 Abs and a MACS system (Miltenyi Biotec, Bergisch Gladbach, Germany). The isolated cells (2 x 106/ml) were restimulated with irradiated (20 Gy) splenocytes from the original third-party donors (FVB, C3H/HeJ, or SJL; 2 x 106/ml), and human rIL-2 (40 U/ml; Eurocetus, Milan, Italy) was added, beginning that day, every second day to the MLR culture (days 6, 8, and 10). On day 10, the MLR cultures were harvested, fractionated on Ficoll-Paque Plus (Amersham Biosciences, Uppsala, Sweden), analyzed by FACS for CD8 level, and tested for veto activity at different cell ratios, as described in Results.
Preparation of host-nonreactive, anti-third-party CD4+ cells
Splenocytes of BALB/c or FVB mice (nonspecific H-2 control) were harvested, and single cell suspensions were prepared. The cell suspensions were treated with Tris-buffered ammonium chloride to remove RBC, and the isolated mononuclear cells (2 x 106/ml) were stimulated with irradiated (20 Gy) C3H/HeJ or SJL (third-party stimulators) splenocytes (2 x 106/ml). Responders and stimulators were cultured for 10 days in a complete tissue culture medium at 37°C in a 5% CO2/air incubator. Six days after culture initiation, cells were fractionated on Ficoll, and the lymphoid fraction was then subjected to positive selection of CD4+ cells using magnetically labeled anti-CD4 Abs and a MACS system (Miltenyi Biotec). Human rIL-2 (40 U/ml; Eurocetus) was added every second day to the MLR culture. On day 10, the MLR cultures were harvested, fractionated on Ficoll-Paque Plus (Amersham Biosciences), analyzed by FACS for their CD4 level, and tested for their veto activity at different cell ratios, as described in Results.
Preparation of activated NK cells
Splenocytes of BALB/c mice or FVB mice were harvested, and single cell suspensions were prepared. The cell suspensions were treated with Tris-buffered ammonium chloride to remove RBC, and the isolated mononuclear cells (2 x 106/ml) were subjected to positive selection of NK cells using magnetically labeled anti-NK Abs (DEX-5) and a MACS system (Miltenyi Biotec). Human rIL-2 (1500 U/ml; Eurocetus) was added to the culture. On day 4, the cultures were harvested, fractionated on Ficoll-Paque Plus (Amersham Biosciences), analyzed by FACS for their Dex-5 Ag level, and tested for their veto activity at different cell ratios, as described in Results.
Preparation of activated B cells
Splenocytes of BALB/c mice or FVB mice were harvested, and single cell suspensions were prepared. The cell suspensions were treated with Tris-buffered ammonium chloride to remove RBC, and the isolated mononuclear cells (2 x 106/ml) were subjected to positive selection of B cells using magnetically labeled anti-B-220 Abs and a MACS system (Miltenyi Biotec). The purified cells were then cultured in the presence of LPS (20 µg/106 cells; Difco, Detroit, MI). On day 4, the cultures were harvested, fractionated on Ficoll-Paque Plus (Amersham Biosciences), and analyzed by FACS for their veto activity at different cell ratios, as described in Results.
Assay for veto activity in the 2C TCR Tg mouse model
Spleen cells of 2C Tg H-2b mice, expressing the TCR-
with specificity for H-2Ld mice (provided by J. Nikolic-Zugic, Sloan-Kettering Institute), were collected as described above. The cells (2 x 106/ml) were then stimulated with irradiated (20 Gy) BALB/c splenocytes (2 x 106/ml) in the presence or the absence of 20, 10, or 2% cells of specific (BALB/c origin) and nonspecific (FVB origin) veto CTLs. Cultures were incubated for 72 h in 24-well plates. The deletion of specific effector T cells was monitored by cytofluorometric analysis, measuring the level of 2C Tg cells, specifically stained by the 1B2 Ab, directed against the clonotypic anti-H-2Ld TCR.
Cytofluorometric analysis
FACS analysis was performed using a modified FACScan (BD Biosciences, Mountain View, CA). Fluorescence data were collected using 3-decade logarithmic amplification on 2550 x 103 viable cells, as determined by forward light scatter intensity. Cells were stained with anti-CD8
(Ly-2)-FITC, anti-CD8
(Ly-2)-CyChrome, anti-CD8
(Ly-2)-allophycocyanin, anti-CD3
-PE, anti-CD95 (Fas)-FITC (BD Pharmingen, San Diego, CA), and anti-CD4-Quantum Red (
). Biotinylated 1B2 Abs (provided by J. Nikolic-Zugic, Sloan-Kettering Institute) were stained with R-PE streptavidin (Jackson ImmunoResearch Laboratories, West Grove, PA).
Detection of apoptotic cells
Annexin V-Cy5 was used to detect apoptotic cells. Cells were incubated in annexin V binding buffer (26, 27, 28) and supplemented with 5 µl of annexin V-Cy5. The cells were incubated at room temperature for 5 min in the dark, then washed in binding buffer. Positive cells were monitored by flow cytometry.
| Results |
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Direct FACS analysis of veto activity. The TCR Tg anti-H-2d CD8+ T cells of the 2C mouse can be identified by immunostaining with a clonotypic Ab directed against the transgene TCR. Thus, it is possible to monitor by FACS the induction of apoptosis of the effector cells by specific veto cells.
To adapt this model for the study of veto cells, anti-third-party veto CTLs, which were previously characterized by functional inhibition of specific target killing (limiting dilution assay of the Cr release assay), were initially used. In these experiments, anti-third-party CTLs generated from the BALB/c (H-2d) or FVB/N (H-2q) background were added to MLR cultures of 2C effectors stimulated against irradiated BALB/c splenocytes.
As shown in Fig. 1 (a representative experiment of 17 different experiments), marked expansion of 2C cells was found when cells were stimulated in the absence of veto CTLs. This expansion of 2C effector cells, which were double-stained with anti-CD8 and the clonotypic Ab 1B2, was markedly inhibited upon the addition of anti-third-party CTLs from the BALB/c background. In contrast, the addition of anti-third-party veto CTLs generated from FVB/N splenocytes to the same culture at the same concentration only slightly inhibited the expansion of CD8+1B2+ responder cells. The specificity of the veto CTLs was further demonstrated by measuring the inhibition at different veto:effector cell ratios (Table I). Thus, although marked reactivity was exhibited at a very low ratio (43% inhibition at a 0.005 veto:effector ratio), only insignificant inhibition was displayed by CTL of C3H background (H-2k, not recognized by 2C effectors) even at a ratio of 0.05 (2% inhibition). A more pronounced nonspecific inhibition was first detected at a 0.1 veto:effector cell ratio. The specificity revealed by these results suggests that the host-nonreactive CTLs directed against third-party cells indeed exhibit veto activity and rules out potential elimination of effector cells by residual alloreactive clones, which might still be present in the veto CTL preparation. This conclusion is supported by veto experiments in which the anti-third-party CTLs were generated from F1 mice, which lack any alloreactivity against the recipients by virtue of their genetic background (progeny of breeding the veto cell strain with the effector cell strain). As shown in Table II, the veto effect of F1 CTLs was similar to that exhibited by the parent anti-third-party CTLs.
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Role of cell contact and veto cell irradiation
As previously suggested by other indirect assays, the veto activity of the CTLs is dependent on cell contact. Thus, upon separating veto CTLs from effector cells in Transwell plates, the veto activity was completely lost (Table II). Likewise, irradiation of the veto cells abrogated their reactivity (Table II).
Relative potencies of different veto cells
Several lymphocyte subpopulations and bone marrow cells were shown to exhibit veto activity (29, 30, 31, 32, 33, 34, 35, 36, 37, 38, 39, 40, 41). The establishment of a quick and effective direct assay using 2C TCR Tg murine cells enabled us to compare the relative potencies of different veto cells using the same scale. Thus, the veto activity of anti-third-party CTLs in the 2C model, reflected by expansion inhibition of CD8+1B2+ effector cells, was compared with that exhibited by the following lymphocyte subpopulations: 1) resting CD4+ T cells, 2) resting CD8+ T cells, 3) resting NK cells, 4) activated CD4+ T cells, 5) LPS-activated B cells, and 6) IL-2-activated NK cells. As shown in Table I, in which the veto activity of anti-third-party CTLs was evaluated at different veto:effector cell ratios, and in Table III, in which the inhibitory activity of the different activated cells is shown, anti-third-party CTLs exhibit the most potent veto activity. By this analysis we define the lowest veto:effector cell ratio at which significant veto activity is exhibited compared with the cell ratio at which inhibition is found with nonspecific test cells (from the H2 background not recognized by the 2C effectors). Thus, whereas a significant inhibition of 2C expansion was attained at a veto:effector cell ratio of 0.005 (p = 0.05; Table I), addition of anti-third-party CTLs of the H-2q background did not lead to any appreciable inhibition up to a veto:effector ratio of 0.2 (p = 0.005; Table III).
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Activated CD4 cells exhibit inhibition only at a veto:effector ratio of 0.2, suggesting reduction of veto activity compared with NK cells by 2- to 5-fold, whereas activated B cells are completely devoid of veto activity.
Finally, all cell types tested failed to exhibit veto activity if not activated before addition to the 2C culture (Fig. 2).
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| Discussion |
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A second major finding of the present study is the establishment of the relative hierarchy of veto activity, comparing anti-third-party CTLs, activated NK cells, and activated CD4+ T cells. The former veto cell preparation was shown to be more effective by a factor of 1020 compared with activated NK cells, which, in turn, are more effective by a factor of 2.050 compared with activated CD4+ T cells. Interestingly, activated B cells are completely devoid of veto activity.
The role of NK cells in this context could be complex, because it has been shown that alloreactive NK cells could potentially reduce host immune cells without GVHD, thereby enhancing engraftment of stem cell allografts (49, 50, 51). Such ablation of host-type immune cells is possibly also associated with undesirable infections. However, the donor-specific veto reactivity measured in the present study at different veto:effector ratios in the absence of alloreactivity (as evidenced by the control group in which NK cells of a genetic background not recognized by the 2C effector cells did not lead to deletion of the effector cells) strongly support previous studies (23) suggesting that nonalloreactive NK cells could induce tolerance with minimal ablation of host immunity.
It is well established that the level of immune debulking is inversely proportional to the number of veto cells required to overcome graft rejection. Thus, although megadose stem cell transplants could suffice to allow engraftment in heavily conditioned patients, large numbers of other veto cells might be required to establish stem cell engraftment in patients exposed to reduced intensity conditioning. Considering that new methodologies have been developed to expand ex vivo NK cells (52, 53, 54, 55) as well as host nonreactive CD4+ T cells (56, 57), it might be possible in the future to use all these different sources of veto cells to facilitate engraftment of hemopoietic allografts without the unwanted complications of GVHD-producing T cells.
| Footnotes |
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1 This work was supported in part by National Institutes of Health Grant CA49369, Therapy of CML; and grants from E. Drake; and the Gabriella Rich Center for Transplantation Biology Research. ![]()
2 Address correspondence and reprint requests to Dr. Yair Reisner, Department of Immunology, Weizmann Institute of Science, Rehovot 76100, Israel. E-mail address: yair.reisner{at}weizmann.ac.il ![]()
3 Abbreviations used in this paper: GvHD, graft-vs-host disease; Tg, transgenic. ![]()
Received for publication March 25, 2004. Accepted for publication September 23, 2004.
| References |
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3 domain of class I MHC. Science 252:1424.
+ dendritic cell is responsible for inducing peripheral self-tolerance to tissue-associated antigens. J. Exp. Med. 196:1099.This article has been cited by other articles:
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J. Mariotti, J. Foley, K. Ryan, N. Buxhoeveden, V. Kapoor, S. Amarnath, and D. H. Fowler Graft rejection as a Th1-type process amenable to regulation by donor Th2-type cells through an interleukin-4/STAT6 pathway Blood, December 1, 2008; 112(12): 4765 - 4775. [Abstract] [Full Text] [PDF] |
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S. Reich-Zeliger, E. Bachar-Lustig, A. Bar-Ilan, and Y. Reisner Tolerance Induction in Presensitized Bone Marrow Recipients by Veto CTLs: Effective Deletion of Host Anti-Donor Memory Effector Cells J. Immunol., November 15, 2007; 179(10): 6389 - 6394. [Abstract] [Full Text] [PDF] |
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