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* Transplantation Immunology Group, Department of Hematology, University College London, London, U.K.;
Center for Immunology and Inflammatory Disease and
Transplantation Biology Research Center, Bone Marrow Transplantation Section, Massachusetts General Hospital/Harvard Medical School, Boston, MA 02129
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Abstract |
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, impaired cytotoxicity, and higher rates of sustained apoptosis. Furthermore, in contrast to the spleen, we observed a significant delay in donor CD8 cell recruitment to the bone marrow, a key location for hematopoietic tumors. Increasing the numbers of T cells transferred to MC led to the enhancement of CTL activity and detectable increases in absolute numbers of IFN-+ cells without inducing graft-vs-host disease (GVHD). TLR-induced systemic inflammation accelerated differentiation of functional CTL in MC but was associated with severe GVHD. In the absence of inflammation, both recipient T and non-T cell populations impeded the full development of GVHD-inducing effector function. We conclude that per-cell deficits in the function of donor CD8 cells activated in MC may be overcome by transferring larger numbers of T cells without inducing GVHD. |
Introduction |
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TopAbstractIntroductionMaterials and MethodsResultsDiscussionDisclosuresReferences |
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Although high numbers of donor T cells activated in MC do not cause GVHD, they do so readily upon transfer to secondary, irradiated allogeneic recipients (8). Moreover, the application of a local or systemic TLR stimulus allows such donor T cells to cause local or systemic GVHD, respectively (8). These studies indicate that donor leukocyte infusion (DLI)-derived GVH-reactive T cell populations activated in MC have no absolute, intrinsic functional defect. Rather, these and other data (9, 10, 11, 12, 13, 14) argue that extrinsic factors such as inflammation within the host environment are critical for the recruitment of activated T cells to the epithelial target tissues and hence the development of GVHD. It is still not known, however, whether anti-host CTL arising in established MC or freshly irradiated allogeneic (TBI-allo) recipients are fully equivalent in terms of functional activity and their capacity to induce GVL. Potentially important differences between the two host environments include the duration of direct Ag presentation by professional APC, the levels of lymphopenia-induced proliferation, the extent of suppression mediated by regulatory cell populations, and the degree of inflammation present at the time of T cell transfer. These and other factors have the potential to influence the precise cellular mechanisms of GVL operating in the two contexts. In support of this notion, CD4 cell help is not required for CD8 cell-mediated GVL following immediate transfer of donor T cells but is an absolute requirement following delayed transfer to MC (5). Better definition of the properties of GVH-reactive CD8 cells emerging following delayed T cell transfer to MC will be important in the development of strategies that seek to use DLI to induce GVL in the clinical setting.
The reduction in GVHD observed following delayed as compared with immediate DLI to full chimeras has been well documented (3, 4, 15). However, in this study we wished to examine the functional properties of GVH-reactive CD8 cells following delayed transfer to MC (where priming host APCs are present in large numbers) and compare them to those observed following immediate transfer to TBI-allo recipients. Using a tumor protection model that measures a donor CD8 cell-dependent GVL effect, we demonstrate herein that CD8 effectors arising following immediate transfer induce more GVL than do those arising following delayed transfer. Effector CD8 cells arising following delayed transfer are recruited with slower kinetics, show a reduced capacity to generate IFN-, and, for CD8 cells bearing a high-affinity TCR, impaired viability. Both the lack of inflammation and extrinsic regulation by host cell populations contribute to the reduced competence of effector CTL arising in MC.
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Materials and Methods |
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TopAbstractIntroductionMaterials and MethodsResultsDiscussionDisclosuresReferences |
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Animals were used under protocols approved by local institutional research committees and in accordance with National Institutes of Health or U.K. Home Office guidelines. Female BALB/cJ (H-2d), B10.A (H-2a), C57BL/6 (H-2b), B6 x DBA/2 (BDF1, H-2b/d), and B6.SJL (CD45.1) mice were purchased from the Frederick Cancer Research Facility (Frederick, MD). 2C TCR transgenic mice (H-2b on C57BL/6 background) (16) were kindly provided by Dr. Dennis Loh and bred at our facility. Donor mice were aged 6–13 wk and recipient mice were aged 11–12 wk at the time of transplantation.
Bone marrow transplantation
Mixed or fully allogeneic hematopoietic chimeras were established as previously described (5, 17) by lethal irradiation followed by reconstitution with a mixture of T cell-depleted (TCD) donor (15 x 106) and recipient-type (5 x 106) bone marrow (BM) cells or TCD donor BM alone. Recipient mice were lethally irradiated (BDF1 at 11 Gy, B6 at 10.25 Gy, BALB/c at 8 Gy, 137Cs source, 0.8 Gy/min or x-ray irradiation, 0.55 Gy/min using same total dose but split in to two fractions, separated by 48 h) and TCD BM cells injected i.v. 4 h later.
Donor leukocyte infusion and T cell purification
Splenocyte (SC) suspensions were prepared as described (18), (19). Where required, naive donor 2C CD8 cells were isolated (purity >93%) by immunomagnetic selection using anti-CD8 microbeads (Miltenyi Biotec). In PCR experiments, transgenic CD8+1B2+ cells were isolated post-transfer by immunomagnetic negative selection of untouched T cells and positive selection using IgG1 1B2 clonotypic Ab and anti-mouse IgG1 microbeads (>95% purity). In experiments that involved transfer of T or non-T cell populations derived from established MC to secondary recipients, primary DLI recipients were sacrificed on day 12 and splenocytes harvested. T cells were purified by negative immunomagnetic selection to remove non-T cells (purity >93%, pan T isolation kit, Miltenyi Biotec) and the positive fraction used as a non-T cell population (90% purity). To select DLI-derived or host T cells, untouched CD3 cells were then incubated with biotinylated anti-CD45.1 Ab followed by positive selection with anti-biotin-conjugated microbeads (Miltenyi Biotec). CD45.1+CD3+ T cells constituted >97% of the final population. The negative fraction was used as the CD45.1–CD3+ population.
Flow cytometry
The following mAbs were used: anti-CD4-PE (RM4-5), anti-CD8β-PE or -allophycocyanin (H35-17.2), anti-CD25-FITC (7D4), CD44-FITC (IM7), anti-CD45.2-FITC (104), anti-CD45.1-FITC or -biotin (A20), anti-IFN--PE or -allophycocyanin (XMG1.2), anti-H2-Dd-FITC (34-2-12), anti-CD62L-FITC or -PE (MEL-14), anti-B220-PE (RA3-6B2), and the appropriate isotype controls (BD Pharmingen). Intracellular Foxp3 staining was performed using anti-Foxp3 (FJK-16s, eBioscience). Annexin VFITC (BD Pharmingen) was used to detect early apoptosis in propidium iodide-negative (live) cells. CD8 cells bearing the 2C TCR were identified via the clonotype-specific mAb 1B2 (20) and anti-mouse IgG1-allophycocyanin (X56, BD Pharmingen). Intracellular staining of cytokines was performed after overnight ex vivo stimulation with irradiated host or donor SC mixed at a 1:1 ratio in 96-well plates or following brief ex vivo stimulation with PMA/ionomycin. Flow cytometry was performed using a FACSCalibur flow cytometer (BD Biosciences).
Quantitative real-time PCR
Primers/conditions for quantitative RT-PCR and the analysis have been described previously (21) or are described in supplemental Table S1.6
Serum cytokines
Serum IFN- levels were measured in sera using a cytometric bead array kit (BD Biosciences) according to the kit instructions.
In vivo cytotoxity
B cells were isolated from SC by immunomagnetic separation. Target cells were then differentially labeled with either low-dose (0.5 µM) or high-dose (5 µM) CFSE, mixed at a 1:1 ratio, and injected i.v. at a total of 10 x 106 cells/recipient. One to 16 h later cells recovered from the spleen were analyzed by flow cytometry for the presence of the two populations of CFSE-labeled cells and specific cytotoxicity was calculated as previously described (22).
EL4 cell culture and administration
EL4 cells were obtained from American Type Culture Collection and cultured as previously described (23).
Statistical analysis
Survival data were analyzed using the log rank test. Otherwise, statistical analyses were performed using Student’s t test (two-tailed).
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Results |
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TopAbstractIntroductionMaterials and MethodsResultsDiscussionDisclosuresReferences |
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To determine how the host environment might influence GVL, we first compared the degree of tumor protection following transfer of delayed DLI to MC vs early DLI to TBI-allo recipients. In these experiments, established B10.A + B6 
B6 MC received the same SC dose as a cohort of TBI-allo B6 mice also receiving a mixture of B6 and B10.A TCD BM. This assay measures a CD8 cell-mediated GVL effect against EL4, a class II-negative T cell lymphoma of host origin (5). Since early SC transfer to TBI-allo mice is associated with lethal GVHD, we performed preliminary titration experiments to determine the dose of donor B10.A SC that did not lead to prohibitive rates of GVHD in this setting (3 x 106 SC, not depicted). Having identified this limiting number of SC, we next transferred 3 x 106 B10.A SC on day 0 to groups of TBI-allo mice and to established MC followed by EL4 challenge via i.v. injection 1 wk later. Importantly, the 3 x 106 SC dose used in this experiment was 1 log lower than the SC dose (3 x 107 SC) required to induce GVL in MC (Ref. 5, 6, 7 and unpublished data). TBI-allo mice receiving EL4 and TCD BM alone on day 0 showed rapid mortality (Fig. 1, A and C median survival time (MST) 30 days), but mice receiving low-dose DLI and EL4 showed prolonged survival, even though two of nine mice died of GVHD as defined by lack of signs of tumor at autopsy (5) (MST of >90 days, p < 0.05). In contrast to TBI-allo mice, established MC (Fig. 1B) receiving low-dose DLI with EL4 showed no significant improvement in survival over recipients of EL4 alone (MST of 28 days in both groups, Fig. 1, B and C). There were no differences in either the kinetics of EL4 tumor growth (see EL4/no DLI groups in Fig. 1, A–C, p = NS) or its distribution (predominantly spleen, BM, liver) in MC or TBI-allo mice (not depicted). Thus, when using limiting numbers of SC, the GVL effect is greater upon transfer to TBI-allo mice compared with MC.
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To identify potential mechanisms underlying this marked difference between GVL activity in established MC and freshly irradiated recipients, we employed a model system that allowed us to track the fate of adoptively transferred T cells. Thus, 1 x 106 anti-host 2C CD8 cells bearing a transgenic TCR (with high affinity for host Ld Ag, identified using the clonotypic marker 1B2) were co-transferred together with 10 x 106 B6 CD45.1 SC to BALB/c TBI-allo recipients or established B6 + BALB/c BALB/c MC. TBI-allo recipients were also given TCD B6 CD45.2 BM to prevent death from aplasia. Again, we employed numbers of T cells lower than previously used in MC to induce GVL (5, 6, 7) (in this case, 3-fold lower) to enable a comparison with TBI-allo recipients. This number of cells is sufficient to partially eradicate host hematopoietic elements in MC without inducing GVHD (5, 8).
As we have previously reported, 2C CD8 cells underwent rapid proliferation in both contexts, but with delayed accumulation within the spleen of MC and slower acquisition of a CD44highCD62Llow phenotype (8). To examine the levels of initial activation, we examined expression of the early activation marker, CD25 (Fig. 2A). We observed almost no up-regulation of CD25 upon 2C CD8 cells following delayed DLI to MC at any time during the immune response, whereas >50% of cells expressed this receptor at day 3 following transfer to TBI-allo recipients (Fig. 2, A and B), indicating that the host environment influences early events in donor CD8 activation.
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is required for maximal GVL activity against EL4 tumor and for the eradication of host hematopoietic cells (24), we next measured the serum levels of this cytokine at timed intervals following T cell transfer. As shown in Fig. 2C, IFN- levels were markedly elevated at days 3 and 6 in TBI-allo mice, but they were undetectable or very low in MC. Thereafter, we observed significant increases in IFN- levels in MC but at levels >5-fold lower than the peak observed in TBI-allo recipients. In parallel, we purified 2C transgenic T cells at various intervals from the spleens of recipient mice following their adoptive transfer, extracted RNA, and performed quantitative RT-PCR for a number of effector molecules whose expression was compared with that in naive 2C CD8 cells (Fig. 2D and supplemental Table S2). In these experiments, cells were taken from mouse spleens on days 6 and 12 following adoptive transfer. The profiles generated revealed significant differences in the transcription of IFN- (Fig. 2D). In two independent experiments, IFN- mRNA was up-regulated in 2C CD8 cells populations derived from both sets of mice, but there was a trend to lower peak expression in CTL derived from MC, and levels thereafter were not sustained to the same extent as in TBI-allo recipients (Fig. 2D). In parallel, we examined the capacity of donor CD8 cells to generate IFN- following stimulation via their TCR with irradiated host BALB/c SC. Since such stimulation led to down-regulation of the 2C TCR making identification of such cells difficult, we instead examined IFN- synthesis by polyclonal DLI-derived CD8 cells. This population underwent similar blast formation and proliferation as CD8 cells bearing the transgenic TCR (not depicted). By day 6 there was a dramatic difference in the frequencies of transferred CD8 cells that expressed IFN-, with markedly increased IFN- production in cells derived from TBI-allo recipients (Fig. 2E). This difference was not evident, however, when SC derived from MC and TBI-allo recipients were stimulated ex vivo with PMA and ionomycin (supplemental Fig. S1), suggesting that it was TCR proximal signaling events that distinguished the two populations at this time point.
Although we observed marked and sustained up-regulation of granzyme B mRNA in 2C cells in both cohorts of mice, the degree of up-regulation was clearly greater in the TBI-allo mice (Fig. 2D). In contrast, no consistent differences were observed in the transcription of other cytokines, including IL-2, TNF-
, IL-4, or IL-10 mRNA (supplemental Table S2). FasL was not up-regulated in this system, and peak perforin mRNA expression was similar in both groups (supplemental Table S2). These differences were not the result of lymphopenia-induced proliferation, since the transcription of these molecules in 2C CD8 cells transferred to freshly irradiated syngeneic (TBI-syn) mice was similar to that of naive cells (not depicted).
We also examined the cytotoxic functions of donor T cells in vivo by evaluating the clearance of injected CFSEhigh host B cell targets (compared with co-injected CFSElow donor B cells). Host B cell eradication occurred rapidly (within 3 h, not depicted) and was virtually complete in TBI-allo mice on day 6, whereas it was absent at this early time point in MC even when analysis was delayed for 16 h (Fig. 2F). Note, however, that host hematopoietic elements are partially eradicated in BALB/c MC given this intermediate dose of SC, although the kinetics of the response are over 14–28 days (8).
Taken together, these data show defects in the initial activation, effector differentiation, and cytotoxicity of anti-host CD8 T cells upon transfer to MC compared with freshly irradiated mice.
2C CD8 cells demonstrate reduced viability in MC compared with TBI-allo recipients
Since full GVL activity might also depend upon the survival of anti-host CD8 cells, we next examined the viability of 2C CD8 cells at timed intervals following their adoptive transfer and measured the degree of early apoptosis by annexin V (AV) staining (Fig. 3). No significant early apoptosis of 2C CD8 cells was observed in TBI-syn control mice. As previously reported (25), the contraction phase of the 2C CD8+ T cell response in TBI-allo recipients is associated with significant, early apoptosis (Fig. 3). By day 10, however, the proportion of cells undergoing apoptosis in this group had fallen to baseline. In sharp contrast, high rates of early apoptosis were observed at the initiation of the response and then were sustained until at least day 18 in MCs (Fig. 3), well beyond the peak of expansion at days 10–12 (Fig. 4). We observed similar findings following transfer of 2C cells and B6 SC to B6 + BDF1 BDF1 chimeras (not depicted). These differences in viability were not observed for polyclonal CD8 T cells, however (not depicted).
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Eradication of tumors also requires that CTL access sites of tumor development and metastasis. In this context, the pattern of recruitment of CTL to the secondary lymphoid organs and BM is likely to be crucial in eradication of many hematopoietic tumors. Using the same model system described in Fig. 2, we therefore examined the kinetics of accumulation of 2C and polyclonal donor CD8 T cells within these sites following transfer of DLI to MC or TBI-allo mice (Fig. 4; similar data relating to 2C CD8 cells for spleen and lymph node have been published previously (8) and are shown for comparison). In the spleen, the numbers of polyclonal donor CD8 cells or Ag-specific 2C CD8 cells were similar to or exceeded those in TBI-allo recipients. In contrast, within the BM there was a substantial delay in donor CD8 cell accumulation such that at day 6 polyclonal and 2C CD8+ T cell numbers were nearly 2 logs lower than those in TBI-allo recipients. Peak absolute 2C CD8+ numbers in MC BM were 
5-fold lower than those in TBI-allo mice. These differences could not be accounted for by lymphopenia-induced proliferation at the different sites since similarly low levels of accumulation of donor T cells were observed in the BM of TBI-syn mice as in MC (not depicted). Findings in the lymph nodes were intermediate between those in the spleen and BM.
Taken together, the data in Figs. 2–4 indicate that the host environment is critical to the initial activation, effector differentiation, viability, and distribution of GVH-reactive CD8 cells.
Increasing the numbers of T cells transferred to MC can overcome per-cell deficits in the effector function of donor CD8 cells
The above findings were indicative of per-cell deficiencies in the functions of GVH-reactive CD8 cells activated in MC compared with TBI-allo recipients, at least at early time points. However, more detailed comparisons of donor CD8 effector functions over the whole primary response were difficult in the B6 BALB/c strain combination since TBI-allo BALB/c recipients had a very high initial GVHD-related mortality (>50% at day 6). We therefore evaluated IFN- generation and cytotoxic functions of polyclonal CD8 cells following transfer of 1 x 107 B6 CD45.1 SC to TBI-allo BDF1 recipients or established B6 + BDF1 BDF1 MC, in which GVHD lethality is observed at >14 days in the TBI-allo group (supplemental Fig. S2). In this strain combination, we also observed lower frequencies and absolute numbers of IFN-+ CD8 cells in MC compared with TBI-allo recipients even at later time points (supplemental Fig. S2). In contrast to the B6 BALB/c strain combination, cytotoxicity against host targets cells was consistently detectable in B6 + BDF1 BDF1 MC at day 6, albeit at reduced levels compared with TBI-allo recipients (supplemental Fig. S2). At day 14, in vivo cytotoxicity against host target cells was lower in B6 + BDF1 BDF1 MC than in TBI-allo recipients. Despite these relative functional deficits, the 1 x 107 SC dose was sufficient to eradicate substantial numbers of host hematopoietic elements in MC but with kinetics over 14–28 days (not depicted).
Robust GVL responses in MC require transfer of very large numbers of SC (3 x 107 SC) (Refs. 5, 7 and our unpublished data). Increases in GVL in this context might simply reflect a linear dose-response effect. However, increasing the alloreactive precursor frequency could also potentially increase the per-cell effector functions of donor CD8 cells, perhaps through bystander effects. We therefore sought to determine how increasing the numbers of T cells infused would influence the functional properties of donor CD8 cells. Thus, we evaluated both IFN- generation by DLI-derived CD8 cells and the degree of in vivo cytotoxicity following transfer of 3 x 107 B6 CD45.1 SC to B6 + BDF1 BDF1 MC (Fig. 5). Transfer of this dose of SC was associated with a marked accumulation of donor CD8 T cells in recipient spleen (Fig. 5A), and by day 28, host hematopoietic elements had been eradicated almost completely despite the absence of GVHD (Fig. 5B and not depicted). Increasing the number of T cells transferred was associated with no increase in the frequency of IFN-+ cells within the CD45.1+CD8+ population, but there was a detectable increase in their absolute numbers (Fig. 5, C and D). While cytotoxicity against host B cell targets at day 7 remained detectable but low, we now observed consistently high levels of cytotoxicity at days 14 and 30 (Fig. 5, E and F).
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+ cells did not, however, lead to GVHD.
TLR agonist-induced inflammation in MC enhances generation of CTL but has no effect upon IFN- generation
We have previously demonstrated that induction of inflammation via TLR ligation at the time of T cell transfer to established B6 + BDF1 BDF1 MC generates conditions permissive for the induction of GVHD (8). To model the effects of TLR triggering upon CD8 effector functions, B6 + BDF1 BDF1 MC were treated with PBS or a CpG oligodeoxynucleotide (ODN 1826) on day –1 before and days 3 and 6 following transfer of 3 x 107 B6 CD45.1 SC. As expected (8), CpG-treated mice developed clinical signs of GVHD (not depicted). The phenotype of CD45.1+ CD8 cells was evaluated within recipient spleens on day 7. CpG treatment was associated with similar accumulation of donor CD8 cells in both groups (Fig. 6A), with no increase in the donor CD8 cell generation of IFN- on a per-cell basis or in absolute numbers (Fig. 6B and not depicted). However, in vivo cytotoxicity against host B cell targets on day 7 was enhanced dramatically by CpG treatment (Fig. 6C) and this was associated with accelerated differentiation of dual CD44highCD62Llow CD8 cells (Fig. 6D). Collectively, these data indicate that inflammation induced by a single TLR agonist is sufficient to accelerate the development of competent effector CTL in MC, although such cells continue to lack the full capacity to generate IFN-.
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In the absence of inflammation, one potentially important T cell extrinsic factor that may affect the development of CD8 effector function in MC is the presence of regulatory cell populations within the host. Previous work has shown that the GVH response following delayed transfer of T cells to BMT recipients can be ameliorated by both T (26, 27, 28, 29, 30) and non-T (31) regulatory cells. While we observed lower numbers of host and DLI-derived CD4+Foxp3+ cells following irradiation or CpG-induced inflammation compared with MC (supplemental Fig. S4), we were unable to detect significant suppression in MC following DLI using in vitro proliferation assays where non-T cell or T cell (CD45.1+ or CD45.2–) fractions derived from the spleen were coincubated with normal syngeneic CD3+ cells stimulated with BDF1 SC (not depicted). We therefore employed the alternative strategy of adoptively cotransferring various cellular fractions to secondary, irradiated allogeneic recipients and testing function using the development of GVHD as a readout. We have previously demonstrated that transfer of selected DLI-derived T cells from MC to secondary allogeneic recipients leads to GVHD, indicating that there is no absolute intrinsic failure of effector differentiation in this population (8). In a first experiment, we transferred 2.5 x 107 B6 CD45.1 SC to established B6 + BDF1 BDF1 MC. On day 12, recipient mice were sacrificed and splenocytes harvested. On the basis of one recipient spleen to one secondary recipient, 2.7 x 107 nylon wool-passaged SC were transferred to secondary freshly irradiated BDF1 recipients together with TCD B6 BM. In parallel, CD45.1+ SC derived from the DLI were sorted and transferred on the basis of one recipient to one secondary recipient (7 x 106 lymphocytes) to a second cohort of lethally irradiated recipients. In both cohorts of recipients we confirmed similar frequencies of transferred CD45.1+ CD8 cells in peripheral blood 16 days following transfer (not depicted). After a lag period of 20 days, secondary recipients of nonfractionated cells lost >10% weight and developed clinical signs of mild GVHD, but then showed almost complete recovery by day 60 post-BMT (Fig. 7A). In sharp contrast, after a similar lag period, secondary recipients of CD45.1+-selected lymphocytes developed severe lethal GVHD (MST for CD45.1+ cells of 55 days vs >100 days for nonfractionated cells, p < 0.001). In a second series of experiments, recipient MC were sacrificed 12 days following DLI, and CD45.1+ T cells, CD45.1– T cells, and non-T cell fractions were isolated. TCD B6 BM together with 4 x 106 CD45.1+ purified T cells alone or in combination with recipient-derived 4 x 106 CD45.1– T cells or 12 x 106 non-T cells (reflecting their approximate ratios in recipient spleens) were then transferred to secondary lethally irradiated recipients (Fig. 7B). Cotransfer of recipient CD45.1– T cells and, to a lesser extent, non-T cells reduced the incidence of lethal GVHD (Fig. 7B). However, surviving mice receiving these accessory T or non-T cell fractions all demonstrated signs of histological GVHD (not depicted).
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Discussion |
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In full allogeneic chimeras, increasing the interval between initial conditioning and the transfer of donor T cells leads to a decline in detectable GVH reactivity and eventual extinction of GVL (3, 4, 5). An important distinction in our study is that, by considering established mixed rather than full allogeneic chimeras, we have examined how delayed T cell transfer influences GVL under conditions in which the continued presence of host APCs enables priming and marked clonal expansion of anti-host CTL (5, 8). Our previous findings that anti-host T cells developing in MC can induce marked GVHD upon adoptive transfer to secondary allogeneic recipients or following induction of systemic inflammation indicate that such T cells do not have a complete, intrinsic deficit in function or survival (8). However, when limiting numbers of T cells were used in DLI (one tenth of the dose previously administered to MC to induce GVL) (5, 6, 7), we observed striking differences between MC and TBI-allo recipients in the magnitude of GVL. Although the host environment is also likely to influence the functions of both donor CD4 and CD8 cells, we have shown previously that GVL activity is CD4-independent in TBI-allo recipients (5). Thus, the present study suggests that differences in the effector differentiation of CD8 cells activated in MC and freshly irradiated hosts are at least partially responsible for the disparities observed in the magnitude of GVL.
Injury to intestinal and other epithelial barriers by TBI may allow entry of microbial products into the systemic circulation, triggering APC and T cell activation (11). Enhanced systemic levels of proinflammatory cytokines such as TNF-, IL-1, and IL-6 (32) or costimulatory and cytokine expression by priming host dendritic cells (33) may accelerate the differentiation of CD8 effector cells in vivo (34). Massive egress of cells to inflamed, nonlymphoid tissues in TBI-allo hosts may further boost their lytic functions (35). Consistent with this possibility, artificial induction of inflammation with a TLR agonist was associated with accelerated CTL differentiation and greater killing of host target cells. Of note, however, was a failure to observe any significant increase in IFN- generation by donor CD8 cells activated in the presence of CpG, despite evidence of enhanced cytotoxicity. This contrasts with our finding that even very low doses of irradiation (2 Gy), which are expected to result in only very limited epithelial injury, are nevertheless sufficient to induce IFN-high CTL (supplemental Fig. S4), suggesting that the effects of irradiation on CTL differentiation are pleiotropic and not dependent on the presence of inflammation alone.
Depletion or inhibition of regulatory cell populations (36, 37) by irradiation or inflammation could also be relevant to enhanced recruitment of polyfunctional CTL in TBI-allo recipients. Following delayed T cell transfer to allogeneic chimeras, both T cell (26, 27, 28, 29, 30) and non-T myeloid suppressor populations (31) are reported to restrict the development of GVHD. Although we were unable to detect regulatory activity using in vitro assays where individual cell populations were employed at ratios present in the spleens of MC, we did observe a failure of nylon wool-passaged SC preparations from DLI recipients to induce severe GVHD in secondary, irradiated allogeneic recipients and demonstrated that T cells present within MC before DLI were predominantly responsible for this effect. Although we have not defined the specific T cell subset(s) responsible for suppression in this model, these data are consistent with the finding that postthymic, donor-derived CD25+ T cells developing within allogeneic chimeras are important for restricting the development of GVHD (28, 29). Nevertheless, it is important to note that even in the face of this regulatory impedance, sufficient activation, proliferation, and effector CTL differentiation occur to permit significant lymphohematopoietic GVH reactivity and antitumor responses in MC.
The survival of functional anti-host CTL for a period of time sufficient to eradicate tumor is an essential prerequisite for a successful GVL response. In this study, anti-host CD8 cells bearing a high-affinity TCR (although not polyclonal CD8 cells) underwent sustained and high apoptotic frequencies in MC that were maintained well beyond the initiation of the contraction phase. Rapid loss of anti-host CD8 cells bearing high-affinity TCR in MC could be important in depleting the repertoire of T cells that can mediate effective GVL, although such cells are not completely deleted in this (our unpublished data) or similar models (6). The markedly reduced expression of CD25 (IL-2R) by anti-host CD8 cells in MC compared with TBI-allo recipients suggests the possibility that activated CD8 cells arising in the two contexts might have different capacities to respond to IL-2, a factor that may be of greater importance where there is intense competition for cytokines, as is likely to be the case in MC. The considerable expansion of 2C cells in MC despite their relative lack of expression of IL-2R is somewhat surprising since it has previously been shown that parental IL-2–/– SC fail to support expansion of 2C cells in a parent F1 model (38). Our data would suggest therefore that IL-2 signaling (perhaps via the intermediate affinity receptor) is sufficient to promote primary expansion of 2C cells activated in MC. Priming in the absence of IL-2R expression might nevertheless lead to long-term dysfunction of such cells (39), a point that may be relevant to the failure to observe a GVL response to a secondary tumor challenge in MC given DLI (6).
The host environment regulates the initial distribution of donor CD8 cells within individual compartments of the lymphohematopoietic system. Thus, donor T cells show delayed kinetics of recruitment to the BM of MC compared with TBI-allo recipients. Such differences could be important in the tumor protection assay employed here, where initial tumor cell engraftment within the BM might escape surveillance by the early phase of alloreactive T cell response. Such findings might also help to explain the failure of DLI to induce responses in the acute leukemias (40), where rapid recruitment of CTL to the BM is likely to be important. During the early phase of the immune response in TBI-allo recipients, GVH-reactive CD8 cells recovered from the BM displayed a uniform CD44highCD62Llow phenotype, ruling out early site-specific selection for cells with a central memory like phenotype (41, 42) (not depicted). Although irradiation may induce "space" within the BM, it seems unlikely that this is the sole contributor to the different recruitment in the two contexts, since a saturable "niche" for recruitment of activated T cells to the BM was not demonstrated in a previous study (41). Indeed, escalation of the dose of donor SC transferred to MC leads to a proportionate increase in the numbers of donor CTL accumulating in the BM (not depicted). Although selectin, integrin, and chemokine requirements for central memory T cell trafficking to BM have begun to be identified (41), the determinants of recirculation of effector T cells to this site are not known in detail. We did not observe significant differences in the expression of CD44, VLA-4, or CXCR4 upon GVH-reactive CD8 cells in the MC or TBI-allo recipients (not depicted). An alternative explanation is that an inflammatory environment might induce changes within the BM vasculature that modulates access of activated T cells to, survival at, or egress from this site. For example, irradiation-induced injury to BM vasculature endothelium leads to SDF-1 up-regulation (43, 44) that could potentially promote T cell trafficking.
In summary, we have shown that the GVL response following delayed DLI to MC is associated with reduced functional competence and viability of effector CD8 cells. The feasibility of transferring larger numbers of T cells without inducing GVHD in this context may compensate for some of these per-cell deficiencies in effector function. These findings may therefore be relevant to protocols in human patients using delayed DLI following nonmyeloablative allogeneic hematopoietic stem cell transplantation, where the GVL effects may be suboptimal despite conversion to full donor chimerism (45). We have previously demonstrated that IFN- generation by donor CD8 cells is required for maximal GVL activity in freshly irradiated hosts and that this cytokine protects against the development of GVHD (24). Our data suggest that strategies to enhance GVL responses following delayed DLI to MC should center upon improving the capacity of donor CD8 cells to generate IFN-.
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Acknowledgments |
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Disclosures |
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TopAbstractIntroductionMaterials and MethodsResultsDiscussionDisclosuresReferences |
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Footnotes |
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1 This work was supported by the Leukemia Research, U.K., and by National Institutes of Health Grants PO1 CA111519 and RO1 CA79989, and by a Senior Research Award from the Multiple Myeloma Foundation. 
2 R.C. and B.F. contributed equally to this work.
3 Current address: Hematology-Oncology Clinic, National Cancer Center, Goyang, Korea.
4 Address correspondence and reprint requests to Dr. Megan Sykes, Transplantation Biology Research Center, Massachusetts General Hospital/Harvard Medical School, MGH-East, Building 149-5102, 13th Street, Boston, MA 02129. E-mail address: Megan.Sykes{at}tbrc.mgh.harvard.edu
5 Abbreviations used in this paper: BMT, bone marrow transplantation; AV, annexin V; BM, bone marrow; DLI, donor leukocyte infusion; GVH, graft-vs-host; GVHD, graft-vs-host disease; GVL, graft-vs-leukemia; MC, mixed chimera; MST, median survival time; SC, splenocyte; TBI-allo, freshly irradiated allogeneic recipients; TBI-syn, freshly irradiated syngeneic recipients; TCD, T cell-depleted.
6 The online version of this article contains supplemental material.
Received for publication August 4, 2008. Accepted for publication September 12, 2008.
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during graft-versus-host disease. J. Exp. Med. 175: 405-413. This article has been cited by other articles:
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  M. N. Rivas, K. Weatherly, M. Hazzan, B. Vokaer, S. Dremier, F. Gaudray, M. Goldman, I. Salmon, and M. Y. Braun Reviving Function in CD4+ T Cells Adapted to Persistent Systemic Antigen J. Immunol., October 1, 2009; 183(7): 4284 - 4291. [Abstract] [Full Text] [PDF]
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, n = 4), DLI (
, n = 7), EL4 (•, n = 5), or both (
, n = 9). Compared with tumor controls, mice receiving DLI + EL4 showed an improved survival rate (p < 0.05). B, Established MC: EL4 (
, n = 3) or DLI + EL4 (
, n = 8). C, Tumor-free survival in TBI-allo mice vs established MC (p < 0.05). Group symbols as for A and B.
, n = 5), or 4 x 106 CD45.1+ and 12 x 106 non-T cells + TCD B6 BM (
, n = 5) to freshly irradiated secondary recipients (survival comparison CD45.1+ T cells vs CD45.1+/CD45.1– T cells, p = 0.002; CD45.1+ T cells vs CD45.1+/non-T cells, p < 0.05).