Responsiveness of Thymus Cells to Syngeneic and Allogeneic Lymphoid Cells

THE thymus is necessary for the normal development of cell-mediated immunity in mice as shown by the immunological defects after neonatal thymectomy¹. Thymus cells themselves can be stimulated by allogeneic lymphoid cells in mixed leucocyte reaction (MLR)² and become killer cells or cytotoxic lymphocytes after stimulation with allogeneic spleen cells in vitro (H. Wagner and M. Feldmann, unpublished work) and in vivo^3,4. This suggests that the thymus as well as peripheral lymphoid tissues contain T cells which can be stimulated by foreign histocompatibility antigen to divide and differentiate into the cytotoxic lymphocytes which mediate cellular immunity. There have been suggestions that thymus cells might be stimulated to divide by “self” antigen, as well as foreign cells: incorporation of ³H-thymidine above background levels has been found in cultures with syngeneic spleen and thymus cells of adult rats⁵, although the experiments do not determine whether thymus or spleen cells have been stimulated. In contrast to these experiments, Howe et al. reported that only thymus cells of neonatal CBA mice reacted to allogeneic and syngeneic spleen cells of adult animals in “one way” MLR cultures^6,7. Whether the reaction of neonatal thymus cells to syngeneic adult spleen cells is recognition of “self” antigens is uncertain, since spleens of adult mice could carry antigens which do not occur in neonatal animals and are therefore “unknown” for neonatal thymus cells. We demonstrate here that neonatal thymus cells do not react to 4-day-old CBA spleen cells, but adult thymus cells do react against both allogeneic and syngeneic adult spleen cells.     

Chimaerism in the Immune System of Tetraparental Mice

TETRAPARENTAL mice, formed by combining two eight-cell embryos derived from different inbred strains^1,2, have been used for a variety of immunological studies^3,6. These animals have immune cells capable of destroying both parental cell lines and specific blocking factors in the serum capable of preventing such destruction^3,4. In view of this surprising result, it is desirable to clarify the nature of the chimaerism in the immune organs of these mice. One important point is whether a tetraparental mouse could have a mixed spleen, but a thymus derived from only one parent. This would also have implications for the development of these organs. As a first step in this direction we have fused pairs of embryos differing by a cyto-logically distinct chromosome marker, the T6 chromosome⁷. By examining cells in mitosis in the resultant adult thymus, spleen and bone marrow, we have found that within each animal the ratio of the two cell types is remarkably constant from organ to organ although it varies extensively from one animal to another.     

Ly-6.2: A new lymphocyte specificity of peripheral T-cells

A new cell-membrane alloantigen determining locus, Ly-6, has recently been described, and the single specificity Ly-6.2 has been defined by the serum (BALB/c× A)F₁ anti-CXBD. Using both fluorescence and cytotoxicity, we found this specificity predominantly on peripheral (extrathymic) T cells, as tissues react thus: thymus, 0–5 percent; spleen, 25 percent; lymph nodes, 69 percent; bone marrow, 15 percent. These reactions agree with the proportion of (Thy⁺, Ig^–) cells present in these tissues. Cortisone-resistant thymus cells were positive. Absorption studies with thymus cells demonstrated the sparse or absent representation of Ly-6.2 on intrathymic T cells. Examination of spleen and lymph node cells from T cell-depleted C57BL/6 mice (after in vitro treatment with anti-Thy-1 serum or examination of tissues of C57BL/6-nu/nu mice) also showed a depletion of Ly-6.2⁺ cells. Conversely, removal of Ig⁺ B cells, which caused a relative increase in the number of T cells in the residual population, also increased the number of Ly-6.2⁺ cells. Additive effects of anti-Thy-1.2 and anti-Ly-6.2 could not be demonstrated, which suggests that the same population was Thy-1.2⁺, Ly-6.2⁺. However, additive effects could be shown with an anti-Ia serum and anti-Ly-6.2. The Ly-6.2 specificity is not found on red cells, liver, brain, or antibody-forming cells, but has been identified on a T-cell (but not B-cell) tumor and on kidney. Ly-6.2 can therefore be considered to be a marker for peripheral T cells, and it differs from the Thy-1 and the Ly-1,2,3, and 5 specificities in its relative absence from the thymus.     

Development of T lymphocytes in Xenopus laevis: appearance of the antigen recognized by an anti-thymocyte mouse monoclonal antibody

Development of T lymphocytes in Xenopus laevis was studied using a mouse monoclonal antibody (mAb), XT-1, that was produced against surface determinants on thymocytes of J strain frog. Ontogenic studies, employing immunofluorescence, showed that cells positive for the determinant recognized by XT-1 mAb (XT-1⁺ cells) were first detected in the thymus of J strain Xenopus by Nieuwkoop and Faber stage 48 (7 days postfertilization) and then in the spleen, liver and kidney by stage 52 (20 days postfertilization). Percentages of XT-1⁺ cells in the thymus increased rapidly by stage 49 (10 days postfertilization) and reached adult levels by stage 52, and those in the spleen, liver, and kidney reached adult levels by stage 56 (40 days postfertilization). Electron microscopic immunohistochemistry revealed that most XT-1⁺ cells in thymuses from stage 56 larvae were typical small lymphocytes (4–7 μm in diameter). In contrast, many XT-1⁺ cells in larval thymuses at stage 49 are large (8–10 μm in diameter) lymphoblastoid cells. Thymectomy at stage 46 (5 days postfertilization) depleted XT-1⁺ cells in larval and adult lymphoid organs to background levels. These results suggest that the XT-1⁺ cells are differentiated from the lymphoid precursor cells in the thymus before the appearance of small lymphocytes and migrate into peripheral lymphoid organs. The cell surface determinant recognized by the XT-1 mAb may provide an important marker for the differentiation of T lymphocytes in Xenopus.     

Evidence for Subpopulation of Mature Lymphocytes within Mouse Thymus

THERE is increasing evidence that thymus cells migrate from the thymus to the peripheral lymphoid tissues where they make up most, if not all, of the thymus-dependent population of lymphocytes^1–3. The term “thymus-derived” is thus appropriately applied to this population. Yet most thymocytes are different from peripheral lymphocytes, both in immunological competence and in surface antigenic characteristics. For example, thymocytes have more theta (θ)⁴ and less H2 antigen⁵ than do peripheral lymphocytes and in TL-positive strains of mice only thymocytes normally express the TL antigen⁶. Recently, Lance et al.⁷ found that injected thymocytes which had migrated to lymph nodes and spleen were progressively less susceptible to anti-TL and more susceptible to anti-H2 serum over the first 24 h. I report here experiments in which thymus cells injected intravenously into irradiated syngeneic mice and harvested as early as 3 h later from the peripheral lymphoid tissues can be shown to have the surface antigenic properties of peripheral thymus-derived lymphocytes rather than thymocytes. A second experiment demonstrates that at least part of the differentiation from thymocyte to thymus-derived lymphocyte seems to occur within the thymus.     

Infection of Adult Thymus with Murine Retrovirus Induces Virus-Specific Central Tolerance That Prevents Functional Memory CD8+ T Cell Differentiation

In chronic viral infections, persistent antigen presentation causes progressive exhaustion of virus-specific CD8⁺ T cells. It has become clear, however, that virus-specific naïve CD8⁺ T cells newly generated from the thymus can be primed with persisting antigens. In the setting of low antigen density and resolved inflammation, newly primed CD8⁺ T cells are preferentially recruited into the functional memory pool. Thus, continual recruitment of naïve CD8⁺ T cells from the thymus is important for preserving the population of functional memory CD8⁺ T cells in chronically infected animals. Friend virus (FV) is the pathogenic murine retrovirus that establishes chronic infection in adult mice, which is bolstered by the profound exhaustion of virus-specific CD8⁺ T cells induced during the early phase of infection. Here we show an additional evasion strategy in which FV disseminates efficiently into the thymus, ultimately leading to clonal deletion of thymocytes that are reactive to FV antigens. Owing to the resultant lack of virus-specific recent thymic emigrants, along with the above exhaustion of antigen-experienced peripheral CD8⁺ T cells, mice chronically infected with FV fail to establish a functional virus-specific CD8⁺ T cell pool, and are highly susceptible to challenge with tumor cells expressing FV-encoded antigen. However, FV-specific naïve CD8⁺ T cells generated in uninfected mice can be primed and differentiate into functional memory CD8⁺ T cells upon their transfer into chronically infected animals. These findings indicate that virus-induced central tolerance that develops during the chronic phase of infection accelerates the accumulation of dysfunctional memory CD8⁺ T cells.     

Depression of Humoral Antibody Formation in the Chicken by Thymectomy and Antilymphocyte Serum

STUDIES on the chicken¹ established that transplantation immunity and humoral antibody formation were two independent systems of immune reactivity which were under the developmental control of two distinct primary lymphoid organs—the thymus and the bursa of Fabricius. Although a clear distinction of the two primary lymphoid organs has not been made in mammals, a division between thymus-dependent (T cells) and thymus independent (B cells) lymphocyte functions is now well documented^2,3. In the mouse, T cells are involved in cell mediated immune responses and are also necessary for the full expression of the humoral antibody response to many antigens.     

Protein complexes associated with β-catenin differentially influence the differentiation profile of neonatal and adult CD8+ T cells

The canonical Wnt signaling pathway is a master cell regulator involved in CD8⁺ T cell proliferation and differentiation. In human CD8⁺ T cells, this pathway induces differentiation into memory cells or a “stem cell memory like” population, which is preferentially present in cord blood. To better understand the role of canonical Wnt signals in neonatal or adult blood, we compared the proteins associated with β-catenin, in nonstimulated and Wnt3a-stimulated human neonatal and adult naive CD8⁺ T cells. Differentially recruited proteins established different complexes in adult and neonatal cells. In the former, β-catenin-associated proteins were linked to cell signaling and immunological functions, whereas those of neonates were linked to proliferation and metabolism. Wnt3a stimulation led to the recruitment and overexpression of Wnt11 in adult cells and Wnt5a in neonatal cells, suggesting a differential connexion with planar polarity and Wnt/Ca²⁺ noncanonical pathways, respectively. The chromatin immunoprecipitation polymerase chain reaction β-catenin was recruited to a higher level on the promoters of cell renewal genes in neonatal cells and of differentiation genes in those of adults. We found a preferential association of β-catenin with CBP in neonatal cells and with p300 in the adult samples, which could be involved in a higher self-renewal capacity of the neonatal cells and memory commitment in those of adults. Altogether, our results show that different proteins associated with β-catenin during Wnt3a activation mediate a differential response of neonatal and adult human CD8⁺ T cells.     

Ontogeny of cellular immunity: size and turnover of rat thymocytes responsive to in vitro stimulation

Velocity sedimentation of thymus cell suspensions prepared from Wistar rats of different ages has been used to separate cells mainly on the basis of size. Large cells, many in division, sediment faster than the major population of small thymocytes and can be separated from them on this basis. In vitro responsiveness to mitogens has been found to be associated with the minor populations of larger cells, particularly the medium-large cells (230–270 μm³). The mitogen-responsive populations also contain cells which show a high autonomous DNA synthesis.The size distribution of thymus cells in neonatal animals is more varied than in adults and there is frequently a higher proportion of large cells. The mitogen-responsive cells were again found among the fast sedimenting large cells and the highest responses were seen with the very largest cells (approximately 450 μm³).The cells in both adult and neonatal animals which have the capacity to respond to mitogens in vitro are probably larger in size than the normal peripheral recirculating thoracic duct cells. The major population of normal small thymocytes showed a much lower spontaneous uptake of ³H-thymidine and did not respond to mitogens.     

Normal thymic cortical epithelial cells developmentally regulate the expression of a B-lineage transformation-associated antigen

Nonlymphoid, stromal cells in the mouse thymus are believed to be important in T cell maturation and have been proposed to play a central role in the acquisition of major histocompatibility complex (MHC) restriction and self-tolerance by maturing thymocytes. Both cortical and medullary epithelial cells in the thymus express high levels of class II (A) major histocompatibility antigens (MHC Ags). We show here that a specific subset of these A^– epithelial cells express a transformation-associated antigen (6C3Ag) found previously on the surfaces of Abelson murine leukemia virus-transformed pre-B cells and on those bone marrow-derived stromal cell clones which support normal and preneoplastic pre-B cell proliferation. Among solid lymphoid organs, only the thymus contains 6C3Ag¹ cells and within the thymus, this antigen is found exclusively on A^– epithelial cells in cortical regions. It is striking that the expression of the 6C3Ag on thymic epithelium is developmentally regulated, suggesting a role for this lymphostromal antigen in the maturation of the thymic microenvironment.     

Further studies on Th-B, a cell surface antigenic determinant present on mouse B cells, plasma cells and immature thymocytes.

A goat antiserum (Goat anti-M104E) has been produced which contains antibodies selectively cytotoxic for mouse B cells and a subpopulation of thymus cells. It reacts with the Th-B antigenic determinant which has been shown by us (1–3) to be present on B cells and on plasma cells and on some cells in the thymus. It also is very cytotoxic for mouse B cells while a previously developed rabbit antiserum was not. The antiserum was obtained by immunization with cells of the BALB/c mouse myeloma MOPC-104E. When the antiserum was purified by in vivo absorption in mice, antibodies remained which were cytotoxic for cells of all of several myelomas at a titer between 1:128 and 1:1024 as determined by an in vitro complement dependent cytotoxicity test. The in vivo purified antibodies were also cytotoxic for about 70% of thymus cells, for about 70% of spleen cells, for about 50% of lymph node cells and for about 20% of bone marrow cells. They were very cytotoxic for splenic or lymph node B cells separated from T cells by a nylon wool column and only slightly cytotoxic for splenic or lymph node T cells. The antibodies were only weakly cytotoxic for one out of five T cell tumors tested and not cytotoxic for the remaining four. Irrespective of target cells used, the cytotoxicity of purified Goat anti-M104E was easily removed by absorption with cell suspensions from tissues which contain B cells, plasma cells or thymus cells. In order to confirm that the same anti-Th-B antibodies recognize the determinant present on spleen cells and on some thymocytes, the purified Goat anti-M104E serum was absorbed with either spleen cells or thymus cells. The absorbed sera were tested for ability to label thymocytes or spleen cells using the fluorescence activated cell sorter (FACS). Either absorption removed essentially all the antibody capable of binding to either cell population. In addition it was shown, using the FACS, that only B cells and not T cells of the spleen contain the Th-B determinant. The anti-Th-B antibodies have now been used for the rapid elimination of B cells from a mixed population of lymphocytes without affecting the function of mature T cells. Thus in vitro treatment of spleen cells from SRBC-immunized donors with purified Goat anti-M104E plus complement results in the killing of a high proportion of the B memory cells as shown by the reduction of PFC produced when the treated cells are transferred to irradiated recipients. The T cell helper function of the transferred cells is not affected by Goat anti-M104E treatment as shown by appropriate cell transfer experiments in which effective B cells are provided by an AKR anti-Thy-1.2-treated spleen cell population and effective T cells are provided by the Goat anti-M104E-treated spleen cell population. Antibodies detecting Th-B may serve as an approach to understanding the ontogeny of lymphocytes. Our results suggest that Th-B is a cell surface marker appearing early in the development of lymphoid cells, on the common precursor of B and T cells and that it is lost from T cells as they mature in the thymus.     

Distinct roles of Cdc42 in thymopoiesis and effector and memory T cell differentiation

Cdc42 of the Rho GTPase family has been implicated in cell actin organization, proliferation, survival, and migration but its physiological role is likely cell-type specific. By a T cell-specific deletion of Cdc42 in mouse, we have recently shown that Cdc42 maintains naïve T cell homeostasis through promoting cell survival and suppressing T cell activation. Here we have further investigated the involvement of Cdc42 in multiple stages of T cell differentiation. We found that in Cdc42^−/− thymus, positive selection of CD4⁺CD8⁺ double-positive thymocytes was defective, CD4⁺ and CD8⁺ single-positive thymocytes were impaired in migration and showed an increase in cell apoptosis triggered by anti-CD3/-CD28 antibodies, and thymocytes were hyporesponsive to anti-CD3/-CD28-induced cell proliferation and hyperresponsive to anti-CD3/-CD28-stimulated MAP kinase activation. At the periphery, Cdc42-deficient naive T cells displayed an impaired actin polymerization and TCR clustering during the formation of mature immunological synapse, and showed an enhanced differentiation to Th1 and CD8⁺ effector and memory cells in vitro and in vivo. Finally, Cdc42^−/− mice exhibited exacerbated liver damage in an induced autoimmune disease model. Collectively, these data establish that Cdc42 is critically involved in thymopoiesis and plays a restrictive role in effector and memory T cell differentiation and autoimmunity.     

Anti-theta Antisera may Contain Anti-allotype Contamination

THETA (θ) is a tissue-specific mouse allo-antigen present in the highest concentrations in thymus and brain^1–3. Anti-θ allo-antisera are produced after multiple injections of thymus cell suspensions into hosts differing at the θ locus, but not at the principal histocompatibility locus (H-2). Anti-θ antisera have been used by many investigators^3–9 to differentiate thymus derived lymphocytes from non-thymus derived lymphocytes and to describe the relative role of each class of cells in various immunological functions. Because it is possible that some thymocytes bear immunoglobulins bound to the cell surface, we tested the hypothesis that anti-θ allo-antisera contain antibodies directed against immunoglobulin allotype specificities of the donor, as well as antibodies to the donor θ allo-antigens.     

Changes in heat shock protein synthesis and heat sensitivity during mouse thymocyte development

Heat shock protein synthesis was examined in mouse thymocytes at three stages of development: early embryonic thymocytes, which are CD4^?CD8^?, adult thymocytes, which are primarily CD4⁺CD8⁺, and mature spleen T cells, which are CD4⁺CD8^? or CD4^?CD8⁺. After either a 41°C or 42°C heat shock, the synthesis of the maior heat-inducible protein (hsp68) was elevated during the first hour of recovery but then decreased abruptly in thymocytes from adult mice. In contrast, the synthesis of hsp68 continued for up to 4 h after heating embryonic mouse thymocytes or mature spleen T cells. The more rapid termination ofthe heat shock response in the adult thymocytes was not the result of eitherless heat damage or more rapid repair since the recovery of general protein synthesis was more severely delayed in these cells. As well, the double positive CD4⁺CD8⁺ cells were more sensitive to hyperthermia than either the double negative CD4^?CD8^? or single positive CD4⁺CD8^? or CD4^?CD8⁺ cells. Exposure of fetal thymus organ cultures to elevated temperature revealed that the double negative thymocytes were able to survive and differentiate normally following a heat shock treatment that was lethal for the double positive thymocytes. Exposure of thymocytes from adult mice to elevated temperatures induced apoptotic cell death. This was evident by the cleavage of DNA into oligonucleosome-sized fragments. Quantitation of the extent of DNA fragmentation and the number of apoptotic cells by flow cytometry demonstrated that the extent of apoptotic cell death was related to the severity of the heat stress. Double positive (CD4+CD8+) thymocytes are selected on the basis of their T-cell antigen receptor (TCR). Most of these cells are negatively selected and die within the thymus by an active process of cell deletion known as apoptosis. Restricting hsp synthesis in response to stress might be essential during developmental processes in which cell maturation is likely to result in death rather than functional differentiation. © 1993Wiley-Liss, Inc.     

Immunohistochemical and ultrastructural evidence for myelopoiesis in the scid/scid mouse thymus

The ultrastructure of scid mouse thymus (a small encapsulated epithelial mass within the precardial fat pad) is described. The epithelium did not form cortex or medulla and hence remained relatively undifferentiated. Small unmyelinated nerves innervated the capsule, the major blood vessels and were distributed between the epithelial cells. Fenestrated blood vessels were common. Thymocytes were not identified but numeous granulocytes, mast cells and some fibroblasts, macrophages and interdigitating cells were present. All stages of granulopoiesis were observed in scid thymus. A very small number of immunoreactive ER-MP58 cells indicated bone marrow derived myeloid precursor cells, and low numbers of ER-MP12⁺ and ER-MP20⁺ mononuclear cells indicated stages of myeloid cells committed to the granulocyte/macrophage lineage. Cells containing proliferating nuclear cell antigen (cells in G1, S and G2-M stage) were present throughout the thymic mass. BALB/c thymuses contained cortical foci of p53⁺ cells whereas in scid mice, p53 positive cells were scattered singly throughout the thymus. This study indicates that the presence of moderately extensive myelopoiesis within the scid mouse thymus has potential for the study of extramedullary hematopoiesis, and also is important to bear this function in mind when using the scid mouse as an immunological model for thymus reconstitution and for creating organoid cultures.     

Loss of Pten Disrupts the Thymic Epithelium and Alters Thymic Function

The thymus is the site of T cell development and selection. In addition to lymphocytes, the thymus is composed of several types of stromal cells that are exquisitely organized to create the appropriate environment and microenvironment to support the development and selection of maturing T cells. Thymic epithelial cells (TECs) are one of the more important cell types in the thymic stroma, and they play a critical role in selecting functional T cell clones and supporting their development. In this study, we used a mouse genetics approach to investigate the consequences of deleting the Pten tumor suppressor gene in the TEC compartment of the developing thymus. We found that PTEN deficiency in TECs results in a smaller thymus with significantly disordered architecture and histology. Accordingly, loss of PTEN function also results in decreased T cells with a shift in the distribution of T cell subtypes towards CD8⁺ T cells. These experiments demonstrate that PTEN is critically required for the development of a functional thymic epithelium in mice. This work may help better understand the effects that certain medical conditions or clinical interventions have upon the thymus and immune function.     

Enhanced natural killer (NK) cell activity and NK-sensitive thymic cells in murine muscular dystrophy

Studies have shown that there is an abnormality in the thymus of dystrophic mice with respect to age-dependent thymus weight changes and altered morphology (T. DeKretser and B. Livett, Nature (London), 263, 682, 1976). Recently, others have shown that natural killer (NK) cells can lyse cells of a large, immature, rapidly dividing cell subpopulation within the thymus of normal young (3 weeks of age) mice (M. Hansson, K. Karre, R. Kiessling, J. Roder, B. Anderson, and P. Hayry, J. Immunol., 123, 765, 1979). The NK susceptibility of dystrophic mouse thymocytes as targets was therefore studied. Spleen cells from normal (+/+) and dystrophic ($\text{dy}{}^{\mathrm{2J}}\text{dy}{}^{\mathrm{2J}}$) male C57BL/6J mice 8–10 weeks old were passed over nylon wool and the nonadherent cells were incubated with ⁵¹Cr-labeled YAC-1 lymphoma target cells or thymocytes in a ⁵¹Cr-release assay. Spleen cells from dystrophic mice killed twofold more YAC-1 target cells than did spleen cells from normal mice. Thymocytes from 3- to 4-week-old dystrophic mice were three to four times more susceptible to NK lysis by dystrophic mouse spleen cells as compared with normal mouse spleen cells. Spleen cells from dystrophic mice had the same NK activity against dystrophic and normal mouse thymocytes as targets. Normal mouse spleen cells killed three- to fourfold more dystrophic mouse thymocytes than that of normal mouse thymocytes as targets. Target cellbinding studies revealed that conjugate-forming cells from nylon nonadherent dystrophic mouse spleen cells were found to be two- to fourfold greater than for normal mouse spleen cells using YAC-1 tumor cells as targets. The number of lymphocytes bound per YAC-1 target cell ranged from 2 to 5 for dystrophic mouse spleen cells as compared with 1 to 2 for the normal control group. Using both normal and dystrophic mouse thymocytes as targets, the conjugate-forming cells from dystrophic mouse spleen cells were also found to be twofold greater than in the normal control group. Cold target inhibition studies revealed that the natural killing of dystrophic mouse thymocytes was due to a YAC-1-reactive NK cell. Effector cell depletion studies using monoclonal anti-Thy-1.2 plus complement treatment and plastic petri dish adherence also revealed that the natural killing of dystrophic mouse thymocytes was not due to either T lymphocytes or macrophages. Taken together, these results show an increase in NK-sensitive thymocyte targets in dystrophic mice, in combination with an increase in splenic NK activity.     

Suppressor activity in the spleen of neonatal mice.

Helper cells of T-cell origin are required for the in vitro proliferation of low numbers of adult mouse thymus cells in response to allogeneic spleen cells. These helper cells are present in the adult mouse spleen. We have demonstrated that neonatal mouse spleen cells lack the helper activity present in adult spleen cells. We have also shown that this lack of helper activity is the result of active suppression. The suppression is due to a suppressor cell which is present in high quantities in the neonatal spleen and can be eliminated by treatment with anti-θ serum and complement.     

Human Breast Milk and Antiretrovirals Dramatically Reduce Oral HIV-1 Transmission in BLT Humanized Mice

Currently, over 15% of new HIV infections occur in children. Breastfeeding is a major contributor to HIV infections in infants. This represents a major paradox in the field because in vitro, breast milk has been shown to have a strong inhibitory effect on HIV infectivity. However, this inhibitory effect has never been demonstrated in vivo. Here, we address this important paradox using the first humanized mouse model of oral HIV transmission. We established that reconstitution of the oral cavity and upper gastrointestinal (GI) tract of humanized bone marrow/liver/thymus (BLT) mice with human leukocytes, including the human cell types important for mucosal HIV transmission (i.e. dendritic cells, macrophages and CD4⁺ T cells), renders them susceptible to oral transmission of cell-free and cell-associated HIV. Oral transmission of HIV resulted in systemic infection of lymphoid and non-lymphoid tissues that is characterized by the presence of HIV RNA in plasma and a gradual decline of CD4⁺ T cells in peripheral blood. Consistent with infection of the oral cavity, we observed virus shedding into saliva. We then evaluated the role of human breast milk on oral HIV transmission. Our in vivo results demonstrate that breast milk has a strong inhibitory effect on oral transmission of both cell-free and cell-associated HIV. Finally, we evaluated the effect of antiretrovirals on oral transmission of HIV. Our results show that systemic antiretrovirals administered prior to exposure can efficiently prevent oral HIV transmission in BLT mice.