Characterization of in vivo-activated allospecific T lymphocytes propagated from human renal allograft biopsies undergoing rejection

To evaluate in situ lymphocyte responses in cell-mediated immune tissue injury, we have developed an approach for propagation of human allospecific T lymphocytes directly from tissue biopsies. We have utilized renal allograft tissue obtained from eight patients undergoing cellular rejection. Needle biopsy tissue was cultured in medium containing interleukin 2 (IL 2), including recombinant-DNA-produced IL 2. In each case, lymphoblasts migrated out of the tissue and increased in numbers, especially adjacent to the tissue. In two cases in which there was no cellular infiltrate present in the biopsy, no lymphocytes proliferated in vitro. Instead, fibroblasts eventually filled the wells from these allograft biopsies. The continued presence of the allograft tissue enhanced the viability and growth of the lymphoblasts in cultures from rejecting allografts. The isolated lymphoblasts had surface markers of mature OKT3+ lymphocytes of either OKT4+ or OKT8+ subsets. OKT8+ cells predominated. There was variability (41 to 97%) in the percentage of T lymphoblasts that bore surface HLA-DR antigens. In assays of lymphoblasts obtained from eight separate renal allografts, there was donor-specific cytotoxicity, and in all but two of the cases there was donor-induced proliferation. The specificity of the cytotoxic reaction was tested by using 51Cr-labeled, PHA-stimulated target cells prepared from a panel of HLA-typed donors. Proliferation was tested after 48 hr in the presence of mitomycin C-treated peripheral blood mononuclear cells as stimulator cells by using only 10(4) responder T lymphoblasts. Of particular note was that the cytotoxicity of the isolated lymphoblasts showed specificity against both "private" HLA class I alloantigens (of the allograft donor) as well as "public" cross-reacting epitopes. This method permits the propagation and functional characterization of in vivo-activated T lymphoblasts that are obtained from the actual sites of immune-mediated injury. Preliminary studies of other tissues with diverse inflammatory processes indicate the possible widespread applicability of obtaining in vivo-activated lymphocytes.     

T cell receptor beta-chain selection in human allograft rejection

We have analyzed a series of T cell lines established from renal needle biopsies taken from renal allograft recipients with clinical signs of rejection. These T cells show strong cytotoxicity directed against donor HLA and their proliferative capacity in vitro is highly correlated with irreversible graft rejection. A total of 10 of 12 lines examined by Southern blot analysis using a J beta C beta DNA probe show predominant beta-chain rearrangements. In one instance DNA was isolated from cell lines generated from sequential biopsies taken from the same patient at different times of rejection. These lines show the same predominant beta-chain rearrangements. To determine whether these predominant rearrangements are due to expansion of a single clone or different T cell clones rearranging similar beta-chains, the same blots were analyzed with a J gamma probe. Cell line MH3 shows two predominant beta-chain rearrangements and at least seven of eight possible rearranged gamma-chain bands, implying that multiple clones share similar beta-chains. In contrast, the cell line King shows a single beta-chain and a single gamma-chain rearrangement. Many of the other cell lines fall between these two extremes, indicating that both beta-chain selection and clonal dominance are operating during graft rejection, resulting in the appearance of predominant beta-chain rearrangements.     

B lymphocytes differentially influence acute and chronic allograft rejection in mice

The relative contributions of B lymphocytes and plasma cells during allograft rejection remain unclear. Therefore, the effects of B cell depletion on acute cardiac rejection, chronic renal rejection, and skin graft rejection were compared using CD20 or CD19 mAbs. Both CD20 and CD19 mAbs effectively depleted mature B cells, and CD19 mAb treatment depleted plasmablasts and some plasma cells. B cell depletion did not affect acute cardiac allograft rejection, although CD19 mAb treatment prevented allograft-specific IgG production. Strikingly, CD19 mAb treatment significantly reduced renal allograft rejection and abrogated allograft-specific IgG development, whereas CD20 mAb treatment did not. By contrast, B cell depletion exacerbated skin allograft rejection and augmented the proliferation of adoptively transferred alloantigen-specific CD4(+) T cells, demonstrating that B cells can also negatively regulate allograft rejection. Thereby, B cells can either positively or negatively regulate allograft rejection depending on the nature of the allograft and the intensity of the rejection response. Moreover, CD19 mAb may represent a new approach for depleting both B cells and plasma cells to concomitantly impair T cell activation, inhibit the generation of new allograft-specific Abs, or reduce preexisting allograft-specific Ab levels in transplant patients.     

Recruitment of helper T cells for induction of tumour rejection by cytolytic T lymphocytes

Immunotherapy of cancer could be possible in cases in which competent effector T cells can be induced. Such an approach depends on expression of tumour-specific antigens by the tumour cells and on the availability of sufficient costimulatory support for activation of cytotoxic T lymphocytes. Here, a strategy for helper T cell recruitment for induction of tumour-specific cytotoxic immune responses is presented. Allogenic MHC class II molecules were introduced into tumour cells by cell fusion. These hybrid cells, when injected into mice, induced rejection of an established tumour. The contribution of CD4-expressing helper T cells in the induction phase and of CD8-expressing T cells in the effector phase of the immune response was demonstrated. The approach described could be applicable to cases in which a suitable tumour antigen is present but not identified; it employs regulatory interactions that govern physiological immune responses and is designed to be minimally invasive.     

Quantitative ultrastructure of cytolytic lymphocytes mediating allograft rejection in the mouse. I. Cellular alterations in T lymphocytes during specific target cell lysis

A quantitative ultrastructural analysis of cytolytic T lymphocytes (CTL) is presented which allows both the distinction of these cells from normal T lymphocytes and permits the demonstration of ultrastructural alterations of putative CTL following interaction with target cells (TC). Alloreactive CTL were generated in C57BL/10 mice receiving intraperitoneal fibroblastic allografts and target-binding splenic lymphocytes (TBSL) were concentrated by specific immunoadsorption on fibroblast monolayers. TBSL were subjected to ultrastructural quantification either at the onset of TC interaction or following 30 or 60 min incubation at 37 degrees C. By means of simple stereological relationships it was shown that, in comparison with normal, non-cytolytic splenic T lymphocytes, TBSL were slightly larger cells, displaying around 60% more cytoplasm, a similarly-sized nucleus and approximately triple the volume of Golgi apparatus. During the first 30 min of interaction with TC, the target binding surface of the TBSL plasma membrane decreased in area. This change was accompanied by a polarization of the TBSL towards the target. Incubation of lymphocytes with TC for a further 30 min resulted in a general polarization of lymphocytic cellular constituents away from the TC. These results were only attainable by objective quantitative analysis and are discussed in relation to possible mechanisms of CTL-mediated lysis.     

Role of the L3T4+ T cell in allograft rejection

Pancreatic islet and fetal pancreas allotransplantation has been used to examine the role of the L3T4+ T cell in allograft rejection. Tissues were grafted into recipient animals depleted of peripheral L3T4+ T cells by in vivo administration of GK1.5 (anti-L3T4) monoclonal antibody to ask the question: is there a requirement for the L3T4+ T cell in graft rejection? Data show that the requirement for the L3T4+ T cell depends on either the type of tissue transplanted or type of the antigenic disparity between donor and recipient. Data also indicate that islet allograft acceptance achieved after GK1.5 treatment of the recipient is not due to tolerance induction. We therefore conclude that the cellular requirements for allograft rejection are determined by the type of tissue transplanted and the genetic disparity between donor and recipient.     

Prevention of acute and chronic allograft rejection with CD4+CD25+Foxp3+ regulatory T lymphocytes

A major challenge in transplantation medicine is controlling the very strong immune responses to foreign antigens that are responsible for graft rejection. Although immunosuppressive drugs efficiently inhibit acute graft rejection, a substantial proportion of patients suffer chronic rejection that ultimately leads to functional loss of the graft. Induction of immunological tolerance to transplants would avoid rejection and the need for lifelong treatment with immunosuppressive drugs. Tolerance to self-antigens is ensured naturally by several mechanisms; one major mechanism depends on the activity of regulatory T lymphocytes. Here we show that in mice treated with clinically acceptable levels of irradiation, regulatory CD4+CD25+Foxp3+ T cells stimulated in vitro with alloantigens induced long-term tolerance to bone marrow and subsequent skin and cardiac allografts. Regulatory T cells specific for directly presented donor antigens prevented only acute rejection, despite hematopoietic chimerism. By contrast, regulatory T cells specific for both directly and indirectly presented alloantigens prevented both acute and chronic rejection. Our findings demonstrate the potential of appropriately stimulated regulatory T cells for future cell-based therapeutic approaches to induce lifelong immunological tolerance to allogeneic transplants.     

Mechanisms of in vivo generation of cytotoxic activity against allograft: 1. Local differentiation of mature cytotoxic T lymphocytes in rejection of allogeneic lymphocytes

Although cytotoxic activity was not detected within the spleen and regional lymph nodes from mice immunized sc with allogeneic lymphocytes, such activity was detected consistently in glass-nonadherent and anti-θ-sensitive peritoneal exudate cells (PE cells) from Day 5 after immunization and reached a maximum by Day 7. Immunized spleen cells developed cytotoxic T lymphocytes (CTLs) earlier and more effectively than normal spleen cells when transferred ip into X-irradiated syngeneic normal mice together with immunizing antigen, while they did not become cytotoxic when transferred without antigen. These results suggest that spleen and lymph node cells which may have differentiated into some transitional state by in vivo immunization may differentiate into mature CTLs, following direct contact with antigen at the site of graft. CTLs generated there appear to be responsible for the rejection of allogeneic lymphocytes. Cytotoxicity of PE cells was also generated in X-irradiated mice and augmented cytotoxicity was generated by treatment with cyclophosphamide.     

Homeostatic proliferation of lymphocytes results in augmented memory-like function and accelerated allograft rejection

Homeostatic proliferation is a normal physiological process triggered by lymphopenia to maintain a constant level of T cells. It becomes the predominant source of new T cells in adulthood after thymus regression. T cells that have undergone homeostatic proliferation acquire the memory phenotype, cause autoimmune disease, and are resistant to tolerance induction protocols. Transplantation is a rare example in which lymphopenia is deliberately induced for its immunosuppressive effect. However, it is not known whether the homeostatic proliferation that follows will have the opposite effect and accelerate rejection. We show that T cells that have undergone homeostatic proliferation acquire a memory phenotype, spontaneously skews toward the Th1 phenotype, even in the absence of antigenic stimulus. Interestingly, in contrast, the percentage of Foxp3(+) regulatory T cells increased by 28-fold following homeostatic proliferation. Using a mouse life-sustaining kidney transplant model, we showed that T cells that have gone through homeostatic proliferation in lymphopenic hosts transformed chronic rejection to acute rejection of a single MHC class II-mismatched kidney allograft. T cells that have undergone homeostatic proliferation consistently cause reliable rejection even when bona fide memory T cells cannot. These functional changes are long-lasting and not restricted to the acute phase of homeostatic proliferation. Our findings have important implications for tolerance induction or graft-prolonging protocols involving leukocyte depletion such as irradiation bone marrow chimera, T cell-depleting Abs, and lymphopenia induced by infections such as CMV and HIV.     

Inhibition of NF-kappaB-dependent T cell activation abrogates acute allograft rejection.

Using a heterotopic model of transplantation, we investigated the role of T cell activation in vivo during allograft rejection in I-kappaB(DeltaN)-transgenic mice that express a transdominant inhibitor of NF-kappaB in T cells. Our results show indefinite prolongation of graft survival in the I-kappaB(DeltaN)-transgenic recipients. Interestingly, at the time of rejection of grafts in wild-type recipients, histology of grafts in the I-kappaB(DeltaN)-transgenic recipients showed moderate rejection; nevertheless, grafts in the I-kappaB(DeltaN) recipients survived >100 days. Analysis of acute phase cytokines, chemokine, chemokine receptors, and immune responses shows that the blockade of NF-kappaB activation in T cells inhibits up-regulation of many of these parameters. Interestingly, our data also suggest that the T cell component of the immune response exerted positive feedback regulation on the expression of multiple chemokines that are produced predominantly by non-T cells. In conclusion, our studies indicate NF-kappaB activation in T cells is necessary for acute allograft rejection.     

A critical role for protein kinase C-theta-mediated T cell survival in cardiac allograft rejection

Protein kinase C (PKC)-theta mediates the critical TCR signals required for T cell activation. Previously, we have shown that in response to TCR stimulation, PKC-theta-/- T cells undergo apoptosis due to greatly reduced levels of the anti-apoptotic molecule, Bcl-xL. In this study, we demonstrate that PKC-theta-regulated expression of Bcl-xL is essential for T cell-mediated cardiac allograft rejection. Rag1-/- mice reconstituted with wild-type T cells readily rejected fully mismatched cardiac allografts, whereas Rag1-/- mice reconstituted with PKC-theta-/- T cells failed to promote rejection. Transgenic expression of Bcl-xL in PKC-theta-/- T cells was sufficient to restore cardiac allograft rejection, suggesting that PKC-theta-regulated survival is required for T cell-mediated cardiac allograft rejection in this adoptive transfer model. In contrast to adoptive transfer experiments, intact PKC-theta-/- mice displayed delayed, but successful cardiac allograft rejection, suggesting the potential compensation for PKC-theta function. Finally, a subtherapeutic dose of anti-CD154 Ab or CTLA4-Ig, which was not sufficient to prevent cardiac allograft rejection in the wild-type mice, prevented heart rejection in the PKC-theta-/- mice. Thus, in combination with other treatments, inhibition of PKC-theta may facilitate achieving long-term survival of allografts.     

Donor deficiency of decay-accelerating factor accelerates murine T cell-mediated cardiac allograft rejection

Decay-accelerating factor (DAF) is a cell surface regulator that accelerates the dissociation of C3/C5 convertases and thereby prevents the amplification of complement activation on self cells. In the context of transplantation, DAF has been thought to primarily regulate antibody-mediated allograft injury, which is in part serum complement-dependent. Based on our previously delineated link between DAF and CD4 T cell responses, we evaluated the effects of donor Daf1 (the murine homolog of human DAF) deficiency on CD8 T cell-mediated cardiac allograft rejection. MHC-disparate Daf1(-/-) allografts were rejected with accelerated kinetics compared with wild-type grafts. The accelerated rejection predominantly tracked with DAF's absence on bone marrow-derived cells in the graft and required allograft production of C3. Transplantation of Daf1(-/-) hearts into wild-type allogeneic hosts augmented the strength of the anti-donor (direct pathway) T cell response, in part through complement-dependent proliferative and pro-survival effects on alloreactive CD8 T cells. The accelerated allograft rejection of Daf1(-/-) hearts occurred in recipients lacking anti-donor Abs. The results reveal that donor DAF expression, by controlling local complement activation on interacting T cell APC partners, regulates the strength of the direct alloreactive CD8(+) T cell response. The findings provide new insights into links between innate and adaptive immunity that could be exploited to limit T cell-mediated injury to an allograft following transplantation.     

CD8 T cells are sufficient to mediate allorecognition and allograft rejection

Different T cell subsets may play different roles in allorecognition and allograft rejection. It has been suggested that CD8 T cells can only initiate rejection with help from CD4 T cells. Since CD8 T cells may have different requirements for allorecognition and for costimulation, it is important to clarify the role of CD8 cells in rejection. We examined the role of CD8 cells in allorecognition using a TCR transgenic mouse transplantation model. In our study, CD8 cells were able to recognize alloantigens and reject allografts in the absence of help from CD4 T cells. Furthermore our study provides a model to study the mechanisms of CD8-mediated allograft rejection. It may be important in the future, to consider that CD8 T cells may need to be targeted independently of CD4 T cells in strategies used to prevent rejection and induce tolerance.     

The Lyt phenotype of the T cells responsible for in vivo tumor rejection in syngeneic mice

Summary Spleen cells of BALB/c mice hyperimmunized with a transplantable methylcholanthrene-induced sarcoma Meth A (Meth A-Im-SPL) inhibited the growth of Meth A tumor in vivo in a tumor neutralizing test. Meth A-Im-SPL did not neutralize another antienically distinct sarcoma, Meth 1, indicating that the antitumor activity is tumor specific. Lyt-1⁺2^– cells of Meth A-Im-SPL (Im-Lyt-1⁺2^–) were the effectors since in vitro treatment of Meth A-Im-SPL with anti-Thy 1.2 or anti-Lyt 1.2 antibody plus complement completely abrogated their neutralizing activity, whereas treatment with anti-Lyt 2.2 plus complement did not. To further confirm the effector activity of Im-Lyt-1⁺2^– cells, T cell subpopulations were separated from Meth A-Im-SPL by the panning method. The purified Im-Lyt-1⁺2^–, but not Im-Lyt-1⁺2⁺ cells neutralized the tumor in athymic nu/nu mice as efficiently as in +/+ mice, suggesting that the donor Im-Lyt-1⁺2^– cells but not recipient T cells were primarily responsible for neutralizing the tumor. The present study, however, did not exclude the possible contribution of recipient T cells to the tumor neutralization and this is open to further investigation.Abbreviations Meth A-Im-SPL Meth A-immune mouse spleen cells - Meth 1-Im-SPL Meth 1-immune mouse spleen cells - sIg⁺ cells surface immunoglobulin positive cells - moAb monoclonal antibody     

Acute rejection in the absence of cognate recognition of allograft by T cells

We studied the effects of the indirect pathway of allograft recognition using T cells from TCR transgenic Marilyn mice, which recognize the male Ag H-Y in an I-A(b)-restricted fashion. The T cells are not alloreactive to the H-2(k) haplotype, because they are not activated when adoptively transferred into recombinase-activating gene-2(-/-) common gamma-chain(-/-) double-mutant H-2(k) male or female mice. However, skin from H-2(k) males, but not from H-2(k) females, is acutely rejected by recombinase-activating gene-2(-/-) transgenic female recipients. In vitro, Marylin spleen cells primed by H-2(k) skin grafting proliferated and secreted both IL-4 and IFN-gamma in response to H-2(k) male stimulators. However, the removal of H-2(b) APC from the responding population abolished the response. Taken together, these results show that the indirect recognition that triggers rejection in this model is due to the recognition of H-Y Ag shed from H-2(k) male allograft and presented by the recipient's own I-A(b) APC to transgenic T cells. This study demonstrates unequivocally the capacity of naive CD4(+) T cells to promote the rejection of allografts through mechanisms that involve indirect destruction of grafted tissues.     

Donor IFN-gamma receptors are critical for acute CD4(+) T cell-mediated cardiac allograft rejection.

Recent studies using mouse models demonstrate that CD4(+) T cells are sufficient to mediate acute cardiac allograft rejection in the absence of CD8(+) T cells and B cells. However, the mechanistic basis of CD4-mediated rejection is unclear. One potential mechanism of CD4-mediated rejection is via elaboration of proinflammatory cytokines such as IFN-gamma. To determine whether IFN-gamma is a critical cytokine in CD4-mediated acute cardiac allograft rejection, we studied whether the expression of IFN-gamma receptors on the donor heart was required for CD4-mediated rejection. To investigate this possibility, purified CD4(+) T cells were transferred into immune-deficient mice bearing heterotopic cardiac allografts from IFN-gamma receptor-deficient (GRKO) donors. While CD4(+) T cells triggered acute rejection of wild-type heart allografts, they failed to trigger rejection of GRKO heart allografts. The impairment in CD4-mediated rejection of GRKO hearts appeared to primarily involve the efferent phase of the immune response. This conclusion was based on the findings that GRKO stimulator cells provoked normal CD4 proliferation in vitro and that intentional in vivo challenge of CD4 cells with wild-type donor APC or the adoptive transfer of in vitro primed CD4 T cells failed to provoke acute rejection of GRKO allografts. In contrast, unseparated lymph node cells acutely rejected both GRKO and wild-type hearts with similar time courses, illustrating the existence of both IFN-gamma-dependent and IFN-gamma-independent mechanisms of acute allograft rejection.     

Idiotype-specific T lymphocytes responsible for the selection of somatic variants of a B cell hybrid

A B cell hybrid (2C3E1), which when cultivated in vitro stably expresses a serologically defined private idiotype on the cell surface, undergoes a somatic variation which culminates in the generation of idiotype-negative variants when propagated as a tumor in syngeneic BALB/c mice. Lyt-1+ and Lyt-2- BALB/c T cells derived from appropriately primed spleen cells when co-cultured with 2C3E1 tumor cells in vitro are responsible for the generation or selection of the idiotype-negative tumor variants. The idiotype-specific effector T cells responsible for the variant production in vitro and in vivo are triggered either by viable or irradiated 2C3E1 tumor cells, but not by soluble idiotype-positive monoclonal antibody secreted by the tumor. The idiotype-positive antibody did stimulate the production of the effector T cells when the soluble protein was covalently linked to the plasma membrane of BALB/c spleen cells, but not when the idiotype-positive protein was presented on allogeneic C57BL/6 spleen cells. A single exposure of spleen cells to 2C3E1 cells in vivo was sufficient to prime the idiotype-specific T cells, but the frequency and reproducibility of variant selection increased when the in vivo primed effector T cells were restimulated by irradiated 2C3E1 cells in vitro prior to co-cultivation with the wild-type 2C3E1 cells. The initial variant B cell lines could be segregated into several different phenotypes. However, after extensive cultivation either in vitro or after repeated transfer in vivo, all of the variant cell lines acquired a single stable phenotype that was characterized by the loss of both the surface and secreted idiotype marker and antigen-binding activity associated with the wild-type 2C3E1 cells.