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Journal of Virology, January 2003, p. 980-988, Vol. 77, No. 2
0022-538X/03/$08.00+0 DOI: 10.1128/JVI.77.2.980-988.2003
Copyright © 2003, American Society for Microbiology. All Rights Reserved.
Laboratory for Vaccine Research, National Institute for Public Health and the Environment, Bilthoven,1 Department of Immunology, Faculty of Veterinary Medicine, University of Utrecht, Utrecht,2 Department of Hematology, University Medical Center, Utrecht, The Netherlands3
Received 26 July 2002/ Accepted 8 October 2002
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Primary infection with RSV can cause lower respiratory tract disease in young infants, manifesting as pneumonia or bronchiolitis (43). The disease is associated with an inflammatory response to infection, likely involving the production of cytokines and chemokines by lung epithelial cells and the recruitment of immune cells into the lungs. The T-cell response is an essential component of the immune response needed for viral clearance from the lungs (1, 18, 24). Antibodies against the fusion protein (F) and the attachment protein (G) are generated during RSV infection, but even in the presence of high levels of virus-neutralizing antibodies, reinfections occur (27), and antibodies are not needed for viral clearance (25). Also, vaccination with the formalin-inactivated RSV vaccine induced high titers of RSV-specific antibodies in vaccinees, yet caused more severe clinical disease upon natural infection (12, 36, 29).
While T-cell responses are required in RSV infections for clearance of RSV from the lung, it has been shown in murine studies that CD4 as well as CD8 T cells can be responsible for enhanced lung pathology (4, 9). Severe pneumonia with extensive influx of eosinophils into the lungs can be elicited in mice by type 2 helper T (Th2) cells specific for RSV G, which are primed during vaccination with formalin-inactivated RSV before intranasal challenge with live RSV (13, 49). This strong eosinophilic inflammation is also observed after RSV challenge of mice vaccinated with a vaccinia virus recombinant expressing solely the G protein of RSV (39).
A peptide corresponding to residues 183 to 195 in the G protein of RSV is recognized by Th2 cells in BALB/c mice (46). CD8 T-cell responses against epitopes derived from the G protein have not been observed in either BALB/c mice or humans (2, 6, 11, 38). CD4 T cells in mice that are vaccinated with a vaccinia virus recombinant expressing the F protein of RSV that are subsequently challenged with live virus produce less interleukin-4 and interleukin-5 than G-primed mice, and there is no eosinophil influx into the lungs (45).
CD8 T-cell responses against F are common in mice of different major histocompatibility complex (MHC) types (10; G. van Bleek, unpublished results). In the BALB/c model, a CD8 T-cell response has been shown to regulate the outcome of CD4 T-cell responses preventing enhanced disease (44). Whether these insights obtained from the murine model are relevant for the human situation has to be evaluated.
In peripheral blood mononuclear cells (PBMC) from healthy adults as well as from diseased infants, CD8 T-cell responses and CD4 T-cell responses can be detected. Although some data on the molecular targets of the human antiviral CD4 and CD8 T-cell responses have been published, epitopes have only been described for a limited number of MHC molecules and not in much molecular detail (8, 23, 34).
In the present study, we describe the characterization of the immunodominant epitopes derived from the RSV F protein that are recognized by human CD4 T cells in the context of those HLA class II molecules that are expressed most frequently within the Caucasian population. Antigenic peptides are found along the entire length of the F protein. In most donors, CD4 T cells recognize more than one peptide within the F protein. Several peptides are productively presented in the context of more than one HLA class II molecule, while at the level of detection of the direct gamma interferon (IFN-
) enzyme-linked immunospot (Elispot) assays performed, there are also peptides that are haplotype specific. Most peptides are presented by HLA-DR molecules. In general, donors that share HLA class II molecules recognize the same pattern of peptides. In all donors, the CD4 T-cell response against the F peptides constituted a considerable part of the total response against RSV. Thus, RSV F is a major target structure for human memory CD4 T cells.
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Virus and peptides. Human RSV strain A2 was propagated in HEp-2 cells, and the viral titer was determined by plaque assay. The virus was routinely used for infection of PBMC at a multiplicity of infection of 1. A series of 94 peptide amides, 18 amino acid residues long, were synthesized by standard solid-phase Fmoc chemistry. The peptides synthesized were based on the sequence of fusion protein F of RSV strain A2. They overlapped by 12 amino acid residues. The purity of the peptides varied between 50 and 90%, as determined by analytical reverse-phase high-performance liquid chromatography. Peptides 11, 12, and 85 were missing from the set.
Elispot assay.
Filtration plates (96-well; MAIPS4510; Millipore) were coated overnight with anti-IFN-
coating antibody 1-D1K (100 µl, 15 µg/ml; Mabtech) in 0.1 M carbonate-bicarbonate buffer pH 9.6, at 4oC. Before adding the cells, the plates were washed thoroughly with phosphate-buffered saline and blocked for 1 h at 37°C with RPMI 1640 containing 10% fetal bovine serum. Cells and either virus or peptide at the indicated amount were added to the well in a final volume of 200 µl of RPMI 1640 and 10% fetal bovine serum and penicillin and streptomycin. Cells were incubated at 37°C for 24 h in a humidified incubator. Then cells were removed by thoroughly washing in phosphate-buffered saline, and 100 µl of detecting monoclonal antibody 7-B6-1-biotin (Mabtech), diluted to 1 µg/ml in phosphate-buffered saline-0.5% fetal bovine serum, was added to the wells.
After incubation for 2 h at room temperature and washing (phosphate-buffered saline), 100 µl (diluted 1:1,000 in phosphate-buffered saline-0.5% fetal bovine serum), ExtraAvidine alkaline phosphatase conjugate (Sigma) was added and incubated for 1 to 2 h at room temperature. Then the plates were washed in phosphate-buffered saline, and 5-bromo-4-chloro-3-indolylphosphate-nitroblue tetrazolium substrate was added at 100 µl/well (Sigma; one tablet dissolved in 10 ml of H2O). Spots were counted by two investigators. Data are represented as the number of spots per 106 PBMC minus background of unstimulated samples. In Table 1, the uncorrected number of spots is shown. In the monoclonal antibody blocking experiments, the cells and monoclonal antibody were incubated for 30 min at 37°C, after which the peptides were added to the cultures. The monoclonal antibodies used are culture supernatants of hybridomas B8.11.2, producing anti HLA-DR, and SPVL3, producing anti-HLA-DQ.
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TABLE 1. Characterization of immunodominant domains within the RSV-A2 fusion proteina
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Preparation of responder T-cell and antigen presenting cell fractions. T-cell depletions of antigen-presenting cell populations and antigen-presenting cells plus CD8 depletions from responder T-cell populations were performed by negative selections on midiMACS columns (Miltenyi Biotec, Bergisch-Gladbach, Germany) according to the manufacturer's instructions. In brief, cells were incubated with phycoerythrin-labeled anti-CD8 and anti-HLA-DR (T-cell responder population) or anti-CD3 (antigen-presenting cell population) antibodies for 20 min on ice in phosphate-buffered saline supplemented with 2% fetal calf serum, washed once in 50 ml of the same buffer, and then incubated for 15 min at 4 to 7°C with antiphycoerythrin microbeads. The magnetically labeled fraction was retained on a midiMACS column, and the unbound cell fractions were further used in experiments. After depletions, less than 2% of the cell fraction that had been depleted remained.
Proliferation assay. T-cell lines at day 24 of culture (2 x 104) were stimulated with 105 irradiated PBMC in the presence of 5 µM peptide in AIM-V medium supplemented with 1% human AB serum and penicillin-streptomycin. After 72 h, cultures were pulsed with [3H]thymidine for 20 h.
IFN-
production.
T-cell lines at day 14 after a single in vitro stimulation with peptide (0.4 x 105/well) or at day 24 after two peptide stimulations (105/well) were used as responders to test reactivity (IFN-
production) against heterozygous and homozygous antigen-presenting cell populations (PBMC depleted of CD3+ cells, 3 x 105/well) pulsed with the peptides (at 5 µM) that were used to make the lines. Cells were cultured in 96-well round-bottomed plates in 200 µl of AIM-V medium plus 1% human AB serum. After 72 h, supernatants were harvested and the IFN-
concentration determined by standard enzyme-linked immunosorbent assay. As a control, responder cells alone and antigen-presenting cells alone did not produce IFN-
. In some wells, antigen presentation was blocked with 1:10 diluted culture supernatant of B8.11.2, a hybridoma producing an anti-DR blocking antibody. This concentration of antibody was not toxic and specific for the antigen presentation of peptides in the context of HLA-DR. The antibody was incubated for 30 min at 37°C before peptides and responder cells were added to the cultures.
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production in PBMC from healthy donors. To obtain an estimate of the total antiviral response, we also stimulated T cells with the entire spectrum of viral antigens, by infecting PBMC with RSV at a multiplicity of infection of 1. In Table 1, the data are summarized for a group of donors in which the most frequently occurring HLA class II molecules within the Caucasian population are represented.
We were able to detect IFN-
production in response to stimulation of PBMC with the peptide pools as well as with live RSV at a multiplicity of infection of 1. The magnitude of the response varied from donor to donor, but was generally on the order of 100 to 500 spots per 106 PBMC (Table 1 and data not shown). Most donors responded to more than one peptide pool. Next, we mapped the individual peptides from the positive pools for five individual donors (Fig. 1). For most pools, a clear response identified one or two positive peptides. In several cases, two adjacent peptides were found positive, possibly containing an overlapping epitope.
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FIG. 1. Determination of antigenic peptides within positive peptide pools. Direct IFN- Elispot assays were performed with single 18-mer F peptides at 20 µM. Only peptides of pools that were positive in previous assays were tested. The values are number of spots per 106 PBMC minus the number of spots in unstimulated PBMC. Donor VB-5, HLA-A2, B35,62, C4, DRB1*0401, DRB1*0403, DQB1*03; donor CE-3, HLA-A2, B40, DRB1*03,*0401, DQB1*02,03; donor VB-2, HLA-A1,29, B44,57, DRB1*0701, DRB1*1101, DQB1*03; donor CH-1, HLA-A2, B27,60, C2,3, DRB1*15,*16, DQB1*0502, DQB1*0602; and donor CE-4, HLA-A3,28, B7,35, DRB1*01, DQB1*05.
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To determine the T-cell subset responding to the peptides, we performed IFN-
Elispot assays with PBMC depleted for either CD8 T cells or CD4 T cells. For all the positive peptides that we found, the responses were completely abrogated after CD4 depletion (data not shown). The involvement of CD4 T cells in the peptide-specific responses was further confirmed by peptide stimulations of PBMC in the presence of HLA-DR blocking antibody B8.11.2 or HLA-DQ blocking antibody SPVL3 (Fig. 2). For most peptides, IFN-
production was completely abrogated when the peptide concentration was titrated in the presence of HLA-DR blockade (Fig. 2A, C, D, and F). However, in two donors with HLA-DRB1*1302,-DRB1*15,-DQB1*06 and HLA-DRB1*1301,-DQB1*06, the response against peptides 50 and 51 was HLA-DQ restricted (Fig. 2B). These peptides were also recognized in a HLA-DQ-restricted fashion by a donor expressing HLA alleles DRB1*01 and DQB1*05 (Fig. 2D). A third donor (HLA-DRB1*15,*09, -DQB1*03,*06) recognized two adjacent peptides (peptide numbers 45 and 46) also in the context of HLA-DQ (Fig. 2E).
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FIG. 2. MHC restriction of F peptide-specific CD4 T-cell responses. Inhibition of IFN- production by MHC class II-specific monoclonal antibodies B8.11.2 (anti-HLA-DR) and SPVL3 (anti-HLA-DQ). (A, C, and F) IFN- Elispot assay with PBMC from donors VB-5(A), VB-2 (C), and VB-7 (F). F peptide 18-mers (peptide numbers are given in the figure) were titrated, and B8.11.2 culture supernatant was used diluted 1:100 (white bars) and 1:4 (grey bars). The number of IFN- spots in unblocked cultures is shown (black bars). As a control for the specificity of MHC class II blocking, MHC class I-mediated stimulation by the influenza virus (Flu) matrix peptide M57-65 was also performed in the presence of B8.11.2. (B, D, and E) IFN- Elispots of donors VP-1 (B, left panel) and MP-4 (B, right panel), donor CE-7 (D), and donor JB-1 (E). Blocking performed with culture supernatant of B8.11.2 diluted 1:50 (white bars) and culture supernatant of SPVL3 diluted 1:100 (grey bar). Unblocked cultures are shown as black bars.
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Elispot assay without preexpansion of T cells indicates that during a natural infection, the total array of peptides that we have characterized can be functionally presented to the immune system. Assigning restriction elements to RSV F CD4 T-cell epitopes: HLA-DR and -DQ restriction. We then set out to assign specific restriction elements to the epitopes that we found. The set of 30 antigenic peptides that were characterized in Fig. 1 were used to test a larger panel of donors with HLA-DR types most frequently occurring within the Caucasian population (32) (Table 2). Most donors sharing a certain HLA class II allele recognized the same set of peptides. Thus, the HLA allele that is involved in the presentation of a certain peptide can be predicted from this shared response.
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TABLE 2. Summary of F-derived peptides that are involved in CD4 memory T-cell responses in PBMC from healthy donorsa
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Figure 3A shows that peptide 57 was presented by HLA-DRB1*1101 and peptide 69 by HLA-DRB1*1501/B4*01 to the T cells of donor VB-7. In Fig. 3B and 3C, results are shown from T-cell stimulation assays with short-term T-cell lines from donors CH-1 (DRB1*1501, -*16) and VB-2 (DRB1*0701, -*1101) as responder cells and homozygous antigen-presenting cell populations as stimulator cells. From these experiments, we concluded that peptides 69 and 79 are presented by HLA-DRB1*1501 (Fig. 3B). Peptides 6 and 10 are both restricted by HLA-DRB1*0701 (Fig. 3C).
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FIG. 3. HLA allele-specific presentation of peptides. (A) IFN- Elispot assay with PBMC of donor VB-7 (DRB1*1101,*1501) depleted of CD8- and HLA class II-positive cells. As antigen-presenting cells, we used PBMC from homozygous donors (VB-10, DRB1*1101, and VB-12, DRB1*1501) that were depleted of CD3-positive cells. Black bars, VB-7 PBMC not depleted; white bars, DRB1*1101 antigen-presenting cells; hatched bars, DRB1*1501 antigen-presenting cells. From the number of spots depicted, the background in the absence of peptide has been subtracted. (B) IFN- production of short-term T-cell lines. The responder populations were incubated for 3 days with heterozygous (CH-1, DRB1*1501, -*16) antigen-presenting cells or homozygous (VB-12, DRB1*1501) antigen-presenting cells. Both antigen-presenting cell populations were CD3 depleted. Black bars, no peptide; white bars, 20 µM peptide 69 (left side) or 20 µM peptide 79 (right side). B8.11.2, anti-HLA-DR antibody. (C) Proliferation assay with short-term T-cell lines of donor VB-2 (DRB1*0701, *1101). Antigen-presenting cells were from VB-8 (DRB1*0701) or VB-10 (DRB1*1101). Black bars, no peptide; white bars, 20 µM peptide 6 (left side) or 20 µM peptide 10 (right side).
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TABLE 3. Sequences of dominant F peptides that are presented by HLA class II moleculesa
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In the present study, we took a first step to mapping the targets of the antiviral CD4 T-cell response. We quantitated the responses directly ex vivo with IFN-
Elispot assays. Therefore, our results shed new light not only on the specificity of the response, but also on the magnitude of the memory T-cell response. We show for a panel of healthy blood donors that CD4 T-cell memory responses against RSV can be directly detected without preexpansion of T cells. The frequency of CD4 memory T-cell responses varied between donors but was generally on the order of 0.05 to 0.3% of CD4 T cells (Table 1 and data not shown). These values are in the range of the memory T-cell responses reported for mumps, but are approximately 10-fold lower than the responses found for cytomegalovirus (48). We did not find a correlation between the higher-responding donors and the time of year that their blood was sampled, i.e., the RSV season. Moreover, in those isolated cases in which the same donor was sampled twice, the level of anti-RSV CD4 T-cell memory was similar.
We tested a panel of donors that together covered the most frequently occurring HLA class II haplotypes within the Caucasian population for their T-cell responsiveness against peptides derived from RSV F. A broad repertoire of CD4 memory T cells are primed in vivo, because most of the donors tested responded against multiple epitopes within the F protein of RSV. The F protein appears to be one of the dominant antigenic proteins within RSV, because in most donors the numbers of T cells responding to F peptides constituted a considerable fraction of the T cells that responded to the entire virus.
In one earlier study by Levely et al., a dominant CD4 T-cell epitope was characterized, encompassing amino acid residues 338 to 355 of RSV strain A2-F (34). The response against this peptide was HLA-DR restricted, but the presenting HLA molecule was not further identified. The peptide was recognized by different donors that did not share a single HLA class II molecule. Our data indicate that peptide 57, corresponding to residues 337 to 354 of the F protein, was most strongly recognized in the context of HLA-DRB1*1101 and -DRB1*1301 and further in the context of HLA-DRB1*03 and -DRB1*0403. These data are in good agreement with the Levely study, in which responding donors carried HLA-DR4, -DR5, or -DR6.
Levely and coworkers also identified other regions that induced weak proliferative responses which were not further characterized. However, we noticed that some of these regions overlap the peptides that we characterized in our Elispot assays. For instance, responses against sequences 31 to 45, 81 to 95, and 111 to 125 were found by Levely and coworkers in a donor carrying HLA-DR4 and -DR5. These peptides correspond to our peptides 6 (amino acid residues 31 to 48), 14 (amino acid residues 79 to 96) and 19 (amino acid residues 109 to 126), which we identified as being presented by HLA-DRB1*04. Furthermore, a weak proliferative response found by Levely et al. against peptide 231 to 251, corresponding to our peptide 39 (residues 229 to 246), may have been a response in the context of HLA-DR5 expressed by the responding donor, because we found a response to peptide 39 in the context of HLA-DRB1*1101. The very consistent finding of T-cell responses against the same peptides in our experiments and those performed 10 years ago by Levely et al. with a different functional readout (proliferation) underscores the usefulness of these peptides to monitor F-specific memory CD4 T-cell responses.
Bovine RSV F protein is 81% homologous to the human F protein (33). In cattle, the CD4 T-cell responses against F were predominantly mapped in the F1 part of the protein. In contrast, epitopes in our human volunteers were distributed along the entire length of the F protein. Only a single stretch of 46 amino acid residues (residues 121 to 168) was not recognized. This part of the protein overlaps the 27-residue peptide (110 to 136) that is removed from the fusion protein after furin cleavage in the Golgi compartment (22, 50) and extended into the hydrophobic N-terminal region of F1. However, antigenic peptides 19 and 20 also overlap the region between F1 and F2, implying that furin cleavage in the Golgi does not interfere with MHC class II presentation. Interestingly, a peptide corresponding to bovine F residues 301 to 316, differing at only one position from human RSV (305Ile
Leu), is recognized by human CD4 T cells as well as bovine T cells (19). Moreover, this peptide is presented by DQ class II molecules in both humans and cattle.
Many immunodominant regions that were identified in the present study are highly conserved between different A strain viruses (Table 3). Peptides 30 and 69 are completely conserved in A and B strains, and peptides 39, 40, 45/46, 50/51, 66, 77, 79, and 87 are conserved in all A strains. For other peptides, single substitutions were found in a single A strain (peptides 5, 6, 8, 33, 57,72, 84, and 91). Some amino acid stretches are more variable, such as the amino-terminal part of F2 (peptides 2 and 3) and the region overlapping peptides 19 and 20. It is possible that the substitutions in different virus strains affect the ability of peptides to bind to the HLA class II binding groove or influence contact with the T-cell receptor. Moreover, variations outside the epitopes may also affect antigen processing and presentation.
In vaccination studies performed in animal models, it has been shown that an exuberant T-cell response against components of RSV can cause enhanced disease characterized by inflammatory infiltrates in the lung. The nature of these infiltrates is determined by the cytokine and chemokine patterns produced by the activated T-cell population (3, 13, 24). In BALB/c mice vaccinated with formalin-inactivated RSV, a Th2 response is responsible for disease enhancement resulting from an inflammatory response in the lung that is associated with a strong eosinophilia (42).
Studies in the BALB/c mouse model have mostly focused on the Th2 type T-cell response. However, in BALB/c mice it is also possible to establish lung disease that is caused by a more Th1-dominated response that correlates with a predominant influx of neutrophils into the lung. This type 1 response can be induced by either a strong CD4 or an excessive CD8 T-cell response (9, 42). In the autopsy reports of formalin-inactivated RSV-vaccinated children that died of severe lower respiratory tract disease, eosinophils were found in the lungs (30). Also, enhanced eosinophil counts in the peripheral blood were reported for infants vaccinated with formalin-inactivated RSV who survived a subsequent infection with the natural virus (12). In contrast, eosinophils have not been observed in lung tissue of children with fatal primary RSV infection (37). Moreover, blood eosinophil counts are not generally enhanced in bronchiolitis patients (20). It is unclear whether Th1 or Th2 cells are involved in severe disease in primary RSV infections in infants.
The nature of a T-cell response can be influenced by the specific antigenic complex of MHC and peptide (7, 40). In fact, in the BALB/c model of vaccinia virus G vaccination, a Vß14 T-cell subset recognizing a single MHC-peptide combination dominates the CD4 T-cell response and is responsible for the Th2 shift of the RSV-specific CD4 T cells. It is this Th2-biased CD4 T-cell response that triggers the cascade of events leading to severe lower respiratory tract disease (47). Therefore, knowledge of antigenic peptides recognized by human RSV-specific CD4 T cells, in combination with the MHC molecules that present them to the T cells, is an essential first step towards our understanding of the role of T cells in human immune pathology.
This project was supported by the Breedtestrategie, a research initiative from Utrecht University, in conjunction with the RIVM and ID-Lelystad.
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chain complementary determining region 2 changes the differentiation of naive CD4 T cells in response to antigen from T helper cell type 1 (Th1) to Th2. J. Exp. Med. 191:2065-2074.
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