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* Department of Ophthalmology, Department of Pathology, and Department of Microbiology and Immunology, Emory University, Atlanta, GA 30322; and
Department of Ophthalmology, University of Alabama, Birmingham, Birmingham, AL 35294
| Abstract |
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| Introduction |
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It is now well documented that malignant uveal and cutaneous melanomas express common tumor-specific Ags, e.g., tyrosinase, GP-100, and MART, that are highly immunogenic (4). These Ags are presented on the melanoma cell surface as peptides associated with MHC class I molecules and target malignant cells for recognition by CD8+ CTL via the TCR. Patients with cutaneous melanomas that lose expression of MHC class I have a shorter life span, supporting the idea that CD8+ CTL control tumor growth (5). However, cutaneous melanoma patients vaccinated with melanoma-specific Ags in one study showed no evidence of tumor regression despite increased melanoma-specific CD8+ CTL precursors (6). Thus, melanoma-specific CD8+ T cells were not able to promote melanoma regression when they were induced in patients after tumors had been identified.
In contrast with cutaneous melanoma, uveal melanomas that express MHC class I molecules have been associated with a more aggressive phenotype, which correlates with a poorer prognosis in comparison to uveal melanomas that have lost or decreased MHC class I expression (7). The association of a poor prognosis with MHC class I expression in uveal melanoma is believed to result from the loss of antitumor NK cell activity whose effector function is inhibited by MHC class I molecules (8), but it may also involve inhibition of CD8+ CTLs, which recognize tumor Ags presented by MHC class I on uveal melanomas. Understanding the mechanisms of CTL inhibition to ocular tumors may lead to therapeutic approaches to overcome T cell inhibition and promote ocular tumor elimination.
Ocular immune privilege is exemplified by the observation that immunogenic tumors are eliminated by tumor-specific CD8+ CTL responses when injected in the skin but not in the anterior chamber (a.c.)3 of the eye (9). Several potential explanations have been put forth to explain the evasion of CD8+ CTL by tumors developing in the eye, including the following: 1) immune ignorance due to sequestration of ocular Ags; 2) systemic tolerance in tumor-specific CTLs; 3) inhibited migration of CTL into the eye; 4) inhibition of CTL activity within the eye; and 5) loss of Ag expression by the tumor. Immune ignorance due to sequestration of ocular Ags was postulated because of the blood-aqueous barrier and the absence of demonstrable afferent lymphatics draining the a.c. (10). However, many observations indicate that ocular Ags normally escape the eye. For example, a.c. administration of soluble OVA induces T cell expansion in the draining submandibular lymph nodes and spleen (11, 12, 13), leading to the induction of tolerance in CD4+ (12, 14) and CD8+ (13, 15) T cells. In addition, tumor-specific TCR transgenic CD8+ T cells proliferate in the submandibular lymph nodes when transferred into mice bearing tumors in the a.c. (16). Moreover, P815 tumor cells injected into the a.c. grow progressively but also induce tumor-specific CD8+ CTL responses (17, 18, 19) that eliminate a subsequent injection with P815 in the opposite eye, a phenomenon termed intracamerally induced, concomitant immunity (20). Thus, sequestration of tumor Ags in the a.c., induction of systemic tumor-specific CTL tolerance, or the failure of tumor-specific CTLs to migrate into the eye do not account for immune evasion by certain ocular tumors.
To determine why an immunogenic tumor grows unchecked in the a.c. of the eye in primary ocular tumor development, we used a model of immune evasion using E.G7-OVA, an EL-4 thymoma transduced to express OVA, as a surrogate tumor Ag (21). E.G7-OVA cells can be tracked, enumerated, and isolated in vivo by flow cytometric cell sorting in Thy 1.1 congenic B6.Pl mice because E.G7-OVA expresses the Thy 1.2 allotype. In addition, the E.G7-OVA/B6 model is very useful for understanding mechanisms of immune evasion by primary ocular tumors because OVA-specific T cell responses are induced, immunodominant OVA epitopes for both CD4 (22) and CD8 (21) T cells are very well characterized, and TCR transgenic mice specific for both class I (23) and class II (24) restricted OVA epitopes are available. Our results indicate that E.G7-OVA grow progressively in the a.c. of the eye despite the induction of tumor-specific CD8+ CTL responses. Infiltration of the eye by immunosuppressive CD11b+ myeloid cells may play a role in preventing immune elimination of E.G7-OVA by CD8+ CTL.
| Materials and Methods |
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Male and female C57BL/6/J (B6; H-2b, Thy1.2+) mice were purchased from the National Cancer Institute (Frederick Cancer Research and Development Center, Frederick, MD) and from The Jackson Laboratory. C57BL/6.PL (B6.PL; H-2b, Thy1.1+), B6;129P2-B2Mtm1Unc/J (B2M/; H-2b, Thy1.2+) (25), and B6.129S6-Cd4tm1Knw/J (CD4/; H-2b, Thy1.2+) (26) were purchased from The Jackson Laboratory, and C57BL/6J-TgN (TCR-1) (23), also referred to as OT-I, were a gift from Dr. M. Bevan (University of Washington, Seattle, WA). B6.PL, B2M/, CD4/, and OT-I mice were bred and maintained in the animal facilities at Emory University. B2M/ and CD4/ are on a B6 background, and OT-I mice have been backcrossed for >10 generations to B6 mice and are considered congenic with B6 mice. All of the procedures on animals were approved by the Institutional Animal Care and Use Committee at Emory University, conducted according to the principals in the guidelines of the Committee on Care and Use of Laboratory Animals (Institute of Laboratory Animal Resources, National Research Council, Washington, DC) and in adherence to the provisions of the Association for Research in Vision and Ophthalmology (ARVO) Statement for the use of Animals in Ophthalmic and Vision Research.
Tumor cell lines and Ag
EL-4 (H-2b, Thy 1.2+) and EL-4 transduced to express OVA (E.G7-OVA) (21), provided by Dr. M. Bevan (University of Washington, Seattle, WA), or human insulin (EL-4 insulin) (27) were grown in standard growth medium (SGM) (RPMI 1640 medium supplemented with 10% FBS, 2 mM L-glutamine, 1 mM sodium pyruvate, 50 µM 2-ME, gentamicin, penicillin, and streptomycin) at 37°C in a 5% CO2 atmosphere. All cell lines were maintained free of mycoplasma. E.G7-OVA were continuously cultured in 1.0 mg/ml neomycin to maintain the expression of the transfected OVA gene. OVA peptide 257264 (SIINFEKL) was a gift from Dr. B. Evavold (Emory University, Atlanta, GA) and was dissolved in PBS at a concentration of 3 mM.
Tumor cell and Ag administration
For all injections, mice were anesthetized with of a saline solution containing 12 mg of ketamine (Sigma-Aldrich) and 0.20.4 mg of xylazine (Bayer) delivered i.m. in the thigh or i.p. For intradermal (i.d.) injections, tumors (104106 cells) were injected into the skin of the back in 0.2 ml of PBS. For a.c. injections, the eye was anesthetized by topical drops of proparacaine HCl (Alcon Laboratories). The eye was then proptosed using forceps, and the cornea was punctured by insertion of a 30-gauge needle directly above the pupil and almost parallel to the iris. Released aqueous humor was removed with an ophthalmic sponge. A 33-gauge beveled needle fitted on a Hamilton 700 series microsyringe (Hamilton) was then inserted briefly into the incision site to wick the remaining aqueous humor from the a.c., and then the a.c. was filled by injection of 1.5 µl of air. Tumor cells (1022.0 x 104) contained in 2 µl of PBS were then injected into the a.c. by pressing a 33-gauge blunt needle fitted on a Hamilton 700 series microsyringe against the incision. The air bubble seals the corneal puncture and prevents leaking. In most experiments, only one eye was treated, and the experiment was terminated before tumor growth ruptured the globe. In experiments where both eyes were treated, one eye was enucleated (see below) before rupture of the globe.
Enucleation
Tumor-bearing eyes were removed to minimize stress from progressive growth of ocular tumors that, during the course of the experiment, would rupture the globe. Mice were anesthetized as described above for a.c. injections. The eye was proptosed using forceps, and then the conjunctiva, muscles, and optic nerve were cut with microscissors to remove the eye from the orbit. Bleeding, which was minimal, was stopped by applying direct pressure with a surgical sponge. Mice were monitored postoperatively for signs of pain and distress, such as wasting, hunched posture, or ruffled fur. In multiple experiments, no evidence of distress or infection was observed in any mice, indicating that the procedure was well-tolerated.
Collagenase digestion of eyes and flow cytometric enumeration of tumors and tumor-infiltrating leukocytes (TIL)
Mice were euthanized by cervical dislocation, and their eyes were removed, washed in 2 ml of PBS on ice, and then incubated for 12 h at 37°C in a 5% CO2 atmosphere in 2 ml of RPMI 1640 medium supplemented with 58.5 U/ml Collagenase IV (Sigma-Aldrich) and 1% FBS. Eyes were then pressed between frosted glass slides to generate single-cell suspensions. The cell suspension was filtered through a nylon mesh screen to remove debris, washed with PBS, and resuspended in 0.4 ml of FACS buffer (PBS + 1% FBS). Eye suspensions (0.2 ml) were added to individual wells of a 96-well plate for staining. Cells were washed with FACS buffer, and Fc receptors were blocked by incubation with purified CD16/32 Ab (BD Pharmingen) and then incubated with combinations of FITC-, PE-, or APC-labeled anti-CD8
, anti-Thy1.2, anti-Gr-1, anti-CD11b, or anti-CD45 Abs (BD Pharmingen). Following incubation, wells were washed and resuspended in 0.5 ml of FACS buffer supplemented with 20 µl of Viaprobe (BD Pharmingen) and run on a FACSCalibur flow cytometer (BD Biosciences). The forward light scatter channel was set at E-1 with high sample voltage to simultaneously visualize large E.G7-OVA tumor cells and smaller TIL. To enumerate E.G7-OVA and TIL in tumor-challenged eyes, a known sample volume was collected on the flow cytometer at a collection rate, which was determined experimentally to be constant over multiple runs. The number of CD45+ cells in the sample was determined by the following formula: ((Number of CD45 cells collected/collection time)/collection rate (µl/sec)) * 1000 µl.
The number of E.G7-OVA, defined as Thy 1.2+ events in B6.Pl mice, or CD8+, CD11b+, or CD11b+/Gr-1+ cells within the sample was calculated by multiplying the number of CD45+ cells in the sample by the percentage of CD45+ cells of the respective cell population. In some experiments, Thy 1.2+ E.G7-OVA tumors or CD11b+ cells were isolated from collagenase-digested B6.PL eyes by FACSsorting on a FACSVantage (BD Biosciences) or MoFlo flow cytometer (DakoCytomation). CD11b+ cells were enriched from collagenase-digested eye samples before sorting using EasySep magnetic selection (StemCell Technologies). E.G7-OVA tumors were sorted to >95% purity, and CD11b+ cells were sorted to >94% purity. Flow cytometric analysis was performed using FlowJo software (Tree Star).
Ab-mediated CD8+ T cell depletion
Mice were injected with 0.4 mg of anti-CD8 Ab (clone 2.43) (provided by Dr. A. Lukacher, Emory University) i.p. given in daily doses of 0.2 mg, 0.1 mg, and 0.1 mg in a 1 mg/ml solution in sterile PBS before tumor challenge. After tumor challenge, mice were given 0.1 mg of anti-CD8 Ab twice weekly. As a control for Ab administration, another group of mice were given rat IgG (Jackson ImmunoResearch Laboratories).
CTL assay
Splenocytes (3.0 x 107) were stimulated with irradiated (20,000 rad) E.G7-OVA (0.5 x 106 cells) in 10 ml of SGM contained in a 25-cm2 flask. Following incubation for 7 days at 37°C in a 5% CO2 atmosphere, the number of live cells was determined by trypan blue exclusion, and a standard 4-h 51Cr release assay was performed using Na2Cr51O4 (DuPont) labeled E.G7-OVA or EL-4 insulin targets at various E:T ratios. Percentage of lysis was determined by the following formula: (observed spontaneous release)/(maximal spontaneous release) x 100.
Histology
Paraffin-embedded 5-µm sections of untreated and tumor-bearing eyes were stained with H&E.
Assay of CTL suppression by myeloid suppressor cells (MSC)
Naive splenocytes from OT-I mice were diluted 1/10 with naive splenocytes from B6.Pl mice to decrease the high frequency of OVA-specific CD8+ T cells in OT-I spleens to a lower more physiological level. Diluted OT-I splenocytes (4.0 x 106) were then added to an individual well of a 24-well plate with or without the addition of isolated myeloid suppressors (0.51.0 x 106 cells) and with or without SIINFEKL peptide (0.1 µg/ml) in a total volume of 2 ml of SGM. Following incubation for 4 days at 37°C in a 5% CO2 atmosphere, the number of live cells was determined, and a CTL assay was performed with E.G7-OVA or EL-4 targets at various E:T ratios.
Statistical analysis
Differences in the number of mice developing tumors in the skin were compared by a Fisher exact test. Differences in indicated cell numbers in collagenase-digested eyes or percentage of control in CTL assays were compared by a Students t test with equal or unequal variance as determined by a F test, and p values <0.05 were considered statistically significant.
| Results |
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Previous studies have shown that E.G7-OVA forms tumors when 106 cells are injected in the skin (28) or 4.0 x 106 cells are injected in the peritoneal cavity (29) of syngeneic B6 mice. Consistent with these observations, B6 mice uniformly developed skin tumors in our hands when injected with
105 E.G7-OVA cells in the skin, which grew progressively over time, whereas only a rare mouse developed a tumor when 104 tumor cells were injected into the skin (Fig. 1 and Table I). The failure of E.G7-OVA to form tumors at low doses was largely the result of tumor elimination by the adaptive immune response because 44% of immune-deficient Rag/ mice developed skin tumors when injected with 104 E.G7-OVA cells, a difference that was statistically significant (p = 0.04) compared with similarly challenged B6 mice.
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The specificity of tumor immunity in B6 mice was determined in a CTL assay using E.G7-OVA and EL-4-insulin targets. E.G7-OVA was created by transfecting EL-4 with a vector in which OVA and neomycin phosphotransferase (neo) expression, a selectable marker, were expressed under control of ubiquitous promoters (21). A similar expression vector was used to express human insulin and neo genes in EL-4 insulin cells (27). Hence, EL-4 insulin target cells control for CTL activity directed against neo or shared tumor Ags expressed by E.G7-OVA and EL-4. In naive untreated mice, splenic CTL responses were at background levels (Fig. 2). Splenic CTL responses in mice injected in the skin with 106 E.G7-OVA cells preferentially lysed E.G7-OVA but not EL-4 insulin targets, suggesting that immunity was OVA-specific. Tumor-specific CTL responses were not detected in the spleens of mice that eliminated 104 E.G7-OVA cells injected into the skin (data not shown), which likely reflects a limited CTL expansion in the spleen and/or trafficking of the CTL to the tumor site. A larger tumor dose most likely induces sufficient expansion of tumor-specific CTL precursors to reach a detectable level.
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Previous studies have monitored ocular tumor development after the injection of tumor cells in the a.c. by determining the percentage of the a.c. that was filled by cells through slit lamp examination (30). A limitation of this approach is that tumor cells cannot be distinguished from infiltrating leukocytes. We have used an assay using immunofluorescent Abs and flow cytometry of collagenase-digested eyes to enumerate tumor cells and infiltrating leukocytes, simultaneously. Representative results of an experiment (Fig. 3), in which E.G7-OVA cells were added to untreated eye suspensions from B6.PL mice, validate this approach. E.G7-OVA can be easily distinguished from ocular cells because the majority of the E.G7-OVA (>90%) display cell surface expression of CD45 (data not shown), whereas only a minority of cells (<1%) in normal untreated eyes of B6.PL mice are CD45+ (Fig. 3A). The small percentage of CD45+ bone marrow-derived cells in untreated eyes are most likely contained within blood vessels and/or parenchymal tissues of the eye. Although these leukocytes are CD45+ they can be distinguished from tumors because E.G7-OVA expresses the Thy1.2 allotype, whereas no cells in Thy 1.1 congenic B6.Pl mice express Thy 1.2 (Fig. 3B). This experiment also demonstrates that E.G7-OVA do not express CD8, which further distinguishes tumors from infiltrating CTL.
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Using this flow cytometry assay, tumor cell numbers were determined at several time points following injection of various numbers of E.G7-OVA into the a.c. of B6.Pl or B6.Rag/ mice (Fig. 4A). E.G7-OVA grew progressively after injection with 104 tumor cells in all B6.PL mice and in immunodeficient B6.Rag/ mice. Tumor growth was confined to the anterior and posterior compartments of the a.c. (compare Fig. 4, B and C). Decreasing the number of cells injected into the eye by 10- to 100-fold delayed the kinetics of tumor cell growth and the length of time for tumors to completely fill the a.c., as has been previously reported (31). However, all of the mice injected with 102 E.G7-OVA developed ocular tumors. These data indicate that tumor-specific CD8+ CTL did not eliminate doses
102 tumor cells injected in the a.c. of B6 mice, whereas doses as high as 104 were rejected when injected into the skin.
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One potential explanation for the growth of E.G7-OVA in the eye but not the skin is that tumor Ags are sequestered in the eye, and hence the immune system is ignorant of ocular tumors. However, previous studies have shown that mice injected with P815 cells in the a.c. generated tumor-specific CTL responses (19) and were immune to a secondary tumor challenge with P815 cells in the skin or the opposite eye (20). To determine whether a.c. administration of E.G7-OVA induced tumor immunity, B6 mice were injected with E.G7-OVA (5.0 x 103 cells) in the a.c. of eye. Eleven days later, the tumor containing eyes were removed, mice were challenged with 5.0 x 105 E.G7-OVA or EL-4 cells in the skin, and tumor growth was monitored. All of the control mice, which were not exposed to E.G7-OVA in the a.c., developed tumors when challenged with E.G7-OVA or EL-4 in the skin (Table II). By contrast, >90% of the mice previously injected with E.G7-OVA in the a.c. rejected a subsequent challenge with E.G7-OVA. Rejection was OVA specific because E.G7-OVA regressed, but the parental EL-4 cells grew into tumors in most of the mice. E.G7-OVA and EL-4 grew with similar kinetics in the skin of control mice (Fig. 5). However, EL-4 tumors developing in the skin of mice previously primed with E.G7-OVA a.c. were slightly smaller than EL-4 tumors in control mice (Fig. 5). This difference was statistically significant at day 14 (p = 0.05) and day 20 (p = 0.03) and may indicate that a.c. administration of E.G7-OVA also induced weak immune responses to tumor Ags, other than OVA, that are shared by E.G7-OVA and EL-4. However, in another experiment, EL-4 tumors in E.G7-OVA-primed mice were not significantly different in size from EL-4 tumors in control mice (data not shown). Only one mouse that was given E.G7-OVA via the a.c. developed a tumor after challenge with E.G7-OVA in the skin, and this tumor was markedly smaller than E.G7-OVA tumors in control mice (Fig. 5). These data indicate that the administration of E.G7-OVA in the a.c. induced a systemic tumor-specific immune response, demonstrating that tumor Ags were not sequestered in the eye in this model.
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Another potential explanation for immune evasion of E.G7-OVA tumors developing in the a.c. is that tumor-specific CD8+ CTLs may fail to migrate into the eye. To address this possibility, CD45+ leukocytes infiltrating primary ocular tumors were analyzed for CD8, CD11b, and Gr-1 expression at multiple time points after a.c. administration of E.G7-OVA. Ten days after injection of 104 E.G7-OVA cells into the a.c., 62 ± 6% of live CD45+ cells were Thy1.2+ E.G7-OVA tumors, <1% were CD8+, and 38 ± 6% were Thy 1.2 negative and CD8 negative (Fig. 6A), suggesting that CD8+ T cells did not accumulate in the primary ocular tumor. Alternatively, CD8 T cells may have migrated into the eye, but the CD8 molecules down modulated on CTL that were activated in the eye. However, 38 ± 8% of CD45+ cells within the eye were CD11b+ (Fig. 6B), which accounts for both CD8-negative and Thy 1.2-negative populations. Roughly half of the CD45+ cells that expressed CD11b coexpressed Gr-1, a marker expressed by monocytes (32), neutrophils (32), and MSC (33). The number of CD8+ T cells in tumor-containing eyes on day 10 was increased 3-fold from untreated control eyes, but this difference was not statistically significant (p = 0.14), whereas CD11b+ cells were significantly increased at all time points tested and accumulated to almost equal numbers with tumor cells as the tumors grew progressively (Fig. 6C). By day 10, CD11b+ cells that did not express Gr-1 increased 9-fold, and CD11b+ cells that expressed Gr-1 increased 145-fold.
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The low frequency of CD8+ T cells in primary ocular tumors could result from the failure of large numbers of CD8+ CTL to migrate into the eye or the death of CD8+ CTL within the eye. To determine whether tumor-specific CTL could migrate into the eye, we tested whether tumor-specific immunity induced by administration of E.G7-OVA via the a.c. could cause rejection of a subsequent challenge with E.G7-OVA in the opposite eye. B6.PL mice were given PBS or injected with E.G7-OVA (2.0 x 104 cells) in the a.c. of the right eye. Seven days later, treated eyes were removed, and mice were challenged with E.G7-OVA in the a.c. of the left eye. E.G7-OVA tumors and CD8+ cells were enumerated in the left eyes 4 days after challenge, and representative flow cytometry plots are shown in Fig. 7. The percentage of Thy 1.2+ E.G7-OVA cells was significantly reduced in E.G7-OVA-primed mice compared with mice injected with PBS, indicating that tumor burden was significantly reduced in the opposite eye as the result of priming with E.G7-OVA via the a.c. In contrast, the percentage of CD8+ cells increased dramatically in eyes of mice previously injected with E.G7-OVA in the opposite eye compared with uninjected mice. Similar results were observed when the absolute number of cells in the eyes was determined in multiple mice (Table III). These data further substantiate the interpretation that a.c. administration of E.G7-OVA induced tumor-specific immune responses and demonstrate that tumor-specific CD8+ CTL can migrate into the eye, where they prevented the growth of the tumor presumably by lysing the E.G7-OVA.
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CD11b+ cells have been shown to inhibit tumor-specific CTL responses in other murine tumor models (33, 34, 35, 36, 37), raising the possibility that CD11b+ cells may be inhibiting tumor-specific CD8+ CTL responses. To test this hypothesis, CD11b+ cells were sorted from tumor-bearing eyes or normal spleen cells by flow cytometry and then added to cultures of spleen cells from naive OT-I mice that were stimulated with the cognate SIINFEKL peptide. CTL responses were measured 4 days later (Fig. 10A). CTL cultures that were stimulated with SIINFEKL developed CTL activity against OVA-expressing E.G7-OVA targets, but not against the parental cell line EL-4 (data not shown), in comparison to unstimulated cultures. In five independent experiments (Fig. 10B), CD11b+ cells isolated from ocular tumors significantly inhibited the lytic activity of peptide-stimulated cultures (37 ± 27% of control). Lytic activity was also significantly reduced after the addition of naive splenic CD11b+ cells (68 ± 29% of control), but their specific activity was slightly, albeit not significantly (p = 0.12), less than that of the CD11b+ cells from the eye of tumor-bearing mice. These data suggest that myeloid cells infiltrating primary ocular tumors may suppress CD8+ CTL responses, thereby contributing to primary ocular tumor growth.
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| Discussion |
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E.G7-OVA tumors grew progressively in the a.c. of B6.PL mice and with delayed kinetics in OT-I mice despite the infiltration of CD11b+ cells that accumulated at numbers almost equal to the tumor cells. These data suggest that CD11b+ cells within primary ocular tumors are not tumoricidal, although CD11b+ cells are known to have tumoricidal properties under other circumstances. In addition, the CD11b+ cells within primary ocular tumors were particularly efficient suppressors of CD8+ CTL responses in vitro. Therefore, these CD11b+ cells may be analogous to MSC, which have been shown to promote tumor progression by suppressing CD8+ CTL responses systemically and regionally within the tumor microenvironment (reviewed by Serafini et al. (42)).
MSC accumulate in peripheral blood of patients with malignancies (43, 44) and accumulate in the spleen (33, 34, 35, 36, 37), and within tumors (45) in several different murine tumor models. The mechanism by which tumor-derived CD11b+ T cells suppress CTL responses in our system is not currently understood. However, MSC might inhibit tumor-specific CD8+ CTL activity by altering L-arginine metabolism (reviewed by Bronte et al. (46)) via inducible NO synthase or arginase I, which promotes CTL apoptosis (45, 47) or interferes with CTL signal transduction (48) in other murine tumor models. The low frequency of CD8+ T cells within primary ocular tumors would be consistent with CD8+ T cell apoptosis within the eye mediated via NO production by CD11b+ cells. This interpretation is supported by the observation that inhibition of NO production, by administration of NG-nitro-L-arginine methyl ester in an experimental model of autoimmune uveoretinitis, decreased T cell apoptosis in the retina (49).
CD11b+ cells infiltrating primary ocular tumors in our experiments were both Gr-1+ and Gr-1 cells, which were also reported to accumulate in the eyes of mice injected in the a.c. with tumors that express membrane-bound Fas ligand, where they are associated with inflammatory responses that eliminated the tumor (50). In addition, Ab-mediated depletion of CD11b+ cells mitigated endotoxin-induced uveitis, suggesting that CD11b+ cells contribute to the pathology of this disease (51). These data indicate that not all Gr-1+, CD11b+, or CD11b/Gr-1 double-positive cells are MSC. In our experiments, CD11b+ cells from naive spleens also suppressed CTL responses, suggesting that a suppressor phenotype may be the default pathway of CD11b+ cells. Environmental signals associated with inflammation may promote differentiation of CD11b+Gr-1+ cells into mature neutrophils, which are tumoricidal. For example, Gr-1+ MSC lost suppressive activity when cultured with all trans-retinoic acid, a regulator of cell differentiation that induces promyelocytes to differentiate into mature neutrophils (52). Recently, Gregory et al. (53) have presented a novel treatment for ocular tumors involving the injection of membrane Fas ligand vesicles into the eye, which induced neutrophil infiltration and promoted ocular tumor elimination. This treatment might also promote the differentiation of MSC within ocular tumors into neutrophils that are tumoricidal.
In our experiments, a.c. administration of tumors induced tumor-specific immunity that eliminated tumors subsequently injected in the opposite eye, suggesting that these protective tumor-specific CD8+ CTL responses may be inhibited by MSC within primary ocular tumors. MSC cells accumulate after immunization (54) and in chronic infection (55). Therefore, the normal physiological function of these cells may be immune suppression to prevent immunopathology. Consistent with this hypothesis, a large number of CD45+ cells that were not tumors and not CD8+ CTL accumulated in the eyes of mice previously primed with E.G7-OVA via the a.c., which displayed reduced tumor burden after a subsequent injection of E.G7-OVA in the opposite eye in comparison to unprimed mice (Fig. 7 and Table III). In preliminary experiments, we have found that CD11b+/Gr-1+ cells accumulate in these eyes but have not determined whether they are MSC or tumoricidal neutrophils. Hence, the ratio of MSC:effector CD8+ CTL may be critical in determining whether CTL are effective at eliminating tumors. CD11b+ cells accumulated with early kinetics in primary ocular tumors (Fig. 6) at a time when CD8+ CTL precursors were most likely expanding and differentiating in secondary lymphoid organs. Therefore, when tumor-specific CD8+ CTL migrated into primary ocular tumors, they encountered a very high frequency of CD11b+ MSC. In contrast, CD8+ CTL may outnumber CD11b+ MSC after a secondary challenge with tumors in the opposite eye of primed mice because CD8+ CTL precursors have already expanded to the first tumor challenge. In support of this hypothesis, primary ocular tumors grew with delayed kinetics in OT-I mice, which was associated with increased numbers of CD8+ T cells within the eye in comparison to B6.Pl mice. Seven days after a.c. administration of E.G7-OVA to OT-I mice, the number of CD11b+/Gr-1+ cells and CD8+ T cells within eyes was equivalent, and tumor burden was low. However, on day 13, tumor burden increased and CD11b+/Gr-1+ cells outnumbered CD8+ T cells. The observation that CD11b+ cells isolated from tumor-containing eyes of B6.Pl mice inhibited CD8+ CTL responses in vitro suggests that CD11b+ cells may inhibit tumor-specific CD8+ T cell within the primary ocular tumor microenvironment in vivo.
Accumulation of MSC within human primary ocular tumors has not been reported. However, patients with uveal melanomas containing tumor-associated macrophages (TAM) were associated with larger tumors of the more aggressive epithelioid type and a poor prognosis in one study (56). These TAM may be immune suppressive because CD11b+ Gr-1+ MSC have been shown to differentiate into F4/80+ TAM after transfer into tumor-bearing mice, which suppress tumor-specific CD8+ CTL, and thereby promote tumor growth (45). Chemotherapeutic treatments that inhibit or delete MSC, such as Gemcitibine (35), may promote primary ocular tumor elimination by restoring tumor-specific CD8+ CTL activity within the eye.
| Acknowledgments |
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| Disclosures |
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| Footnotes |
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1 This work was supported by a research grant from the Georgia Knights Templar Educational Foundation, a gift from Malcolm and Musette Powell, a grant from the Foundation for Fighting Blindness, a National Eye Institute core grant (P30EYO06360), a grant from Research to Prevent Blindness, and research grants (EY13459 and EY014877) from National Institutes of Health. K.C.M. is the recipient of a National Research Service Award Grant F32 EY07079 from the National Eye Institute. J.A.K. is the recipient of the Senior Scientific Investigator award from Research to Prevent Blindness. ![]()
2 Address correspondence and reprint requests to Dr. Kyle C. McKenna, Department of Ophthalmology, Emory University, Clinic B, Room B2514, 1365 Clifton Road Northeast, Atlanta, GA 30322. E-mail address: kmckenn{at}emory.edu ![]()
3 Abbreviations used in this paper: a.c., anterior chamber; SGM, standard growth medium; i.d., intradermal; TIL, tumor-infiltrating leukocytes; MSC, myeloid suppressor cell; neo, neomycin phosphotransferase; TAM, tumor-associated macrophage. ![]()
Received for publication January 17, 2006. Accepted for publication May 4, 2006.
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D. S. Dace, P. W. Chen, and J. Y. Niederkorn CD8+ T Cells Circumvent Immune Privilege in the Eye and Mediate Intraocular Tumor Rejection by a TNF-{alpha}-Dependent Mechanism J. Immunol., May 15, 2007; 178(10): 6115 - 6122. [Abstract] [Full Text] [PDF] |
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