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Journal of Virology, March 2003, p. 3799-3808, Vol. 77, No. 6
0022-538X/03/$08.00+0 DOI: 10.1128/JVI.77.6.3799-3808.2003
Copyright © 2003, American Society for Microbiology. All Rights Reserved.
Division of Virology, Department of Neuropharmacology (IMM-6), The Scripps Research Institute, La Jolla, California 92037,1 Institut de Pharmacologie et de Biologie Structurale-UMR 5089, CNRS, 31077 Toulouse, Cedex 4, France,2 Department of Neuropharmacology (CVN-9),3 Department of Pathology, University of CaliforniaSan Francisco, San Francisco, California 941434
Received 12 August 2002/ Accepted 26 November 2002
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-inducible protein 10, and RANTES. T cells were also found in the central nervous system (CNS) in five of six patients with Creutzfeldt-Jakob disease. T cells harvested from brains and spleens of scrapie-infected mice were analyzed using a newly identified mouse PrP (mPrP) peptide bearing the canonical binding motifs to major histocompatibility complex (MHC) class I H-2b or H-2d molecules, appropriate MHC class I tetramers made to include these peptides, and CD4 and CD8 T cells stimulated with 15-mer overlapping peptides covering the whole mPrP. Minimal to modest Kb tetramer binding of mPrP amino acids (aa) 2 to 9, aa 152 to 160, and aa 232 to 241 was observed, but such tetramer-binding lymphocytes as well as CD4 and CD8 lymphocytes incubated with the full repertoire of mPrP peptides failed to synthesize intracellular gamma interferon (IFN-
) or tumor necrosis factor alpha (TNF-
) cytokines and were unable to lyse PrP-/- embryo fibroblasts or macrophages coated with 51Cr-labeled mPrP peptide. These results suggest that the expression of PrPsc in the CNS is associated with release of chemokines and, as shown previously, cytokines that attract and retain PrP-activated T cells and, quite likely, bystander activated T cells that have migrated from the periphery into the CNS. However, these CD4 and CD8 T cells are defective in such an effector function(s) as IFN-
and TNF-
expression or release or lytic activity. |
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Within the brain, TSE disease generates an accumulation of protease-resistant proteins, PrPsc or PrPres, derived by a posttranslational event from a normal host-encoded protease-sensitive isoform, designated PrPc or PrPsen (10, 34). PrPc is attached by a glycolipid anchor to the cell surface. In the CNS, PrPc converts to PrPsc in both neurons and astrocytes (10, 13). In genetic experiments with PrP knockout (PrP-/-) mice, hamster PrPc was expressed only in neurons after using a neuron-specific enolase promoter (35) or in astrocytes upon using an astrocyte-specific glial fibrillary astrocyte protein (GFAP) promoter (37). In both instances, challenge with hamster scrapie resulted in TSE, thereby incriminating both neurons and astrocytes in the replication of PrPsc and in the disease process. Still unclear are how PrPc converts to PrPsc in these cells and how PrPsc accumulation gives rise to the profound neurodegeneration characteristic of scrapie.
Associated with ongoing TSE disease is the expression of tumor necrosis factor-alpha (TNF-
), interleukin-1 alpha (IL-1
), IL-1ß, GFAP, and murine acute-phase response gene mRNA in the brain but not in peripheral tissues like spleen, kidneys, or liver (9). Absent or not altered in the TSE brains are IL-4, IL-5, gamma interferon (IFN-
), IL-2, IL-6, and IL-3 mRNA (9). In addition to these cytokines, chemokines are present within and outside the CNS, where they function as soluble mediators possessing a spectrum of actions and chemotactic activities (3, 39, 46). Localized production of chemokines is possible from astrocytes and neurons, the two CNS cell types involved in conversion of PrPc to PrPsc. Yet expression of chemokines in the CNS during scrapie infection is unknown.
In this work, we evaluated the expression of chemokines as well as the presence of a cellular T-cell immune response in TSE. For that purpose, we studied scrapie-infected mice for the expression of multiple chemokine genes, infiltration of T lymphocytes, and presence of major histocompatibility complex (MHC) molecules throughout the progression of TSE. We found that IFN-
-inducible protein 10 (IP-10), macrophage inflammatory protein 1
(MIP-1
), RANTES, and to a lesser extent MIP-1ß mRNA were enhanced but not those of other chemokine molecules. We also noted T-cell infiltration into the parenchyma of the brains from scrapie-infected mice and in five of six patients with clinical, neuropathologic, and biochemically defined Creutzfeldt-Jakob disease (CJD). Tetramer analysis of T cells from scrapie-infected mice suggests that such T cells may be specific to MHC-restricted prion peptides but incapable of lytic responses or PrP peptide-stimulated IFN-
and TNF-
production.
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The Armstrong (ARM) strain of lymphocytic choriomeningitis virus (LCMV), clone 53b, was also used (33, 40). LCMV was plaque purified three times on Vero cells, and stocks were prepared by a single passage on BHK-21 cells. Eight- to twelve-week-old mice were infected with a single i.p. dose of 105 PFU. For secondary challenge, mice were inoculated with 106 PFU of LCMV i.p.
Brain material and clinical and neuropathologic synopsis of CJD patients and immunochemical studies. The brains from six patients with sporadic CJD (sCJD) were examined and immunohistochemically stained for T- and B-cell markers (CD3 and CD20, respectively) in the Neuropathology Prion Disease Laboratory at the University of California in San Francisco. The patients' ages ranged from 55 to 73 years. All had the characteristic neurohistopathological feature of CJD, vacuolar (spongiform) degeneration of the gray matter. In addition, PrPsc was identified in each of the cases by the hydrolytic autoclaving method applied to formalin-fixed, paraffin-embedded brain sections (30) and by the more sensitive and specific histoblot technique applied to unfixed, cryostat sections blotted to nitrocellulose paper (42).
Cell lines. Mouse embryo fibroblasts (MEF) were made from both PrP-/- lines. Murine H-2b mutant RMA-S cells and human T2 cells transfected with H-2Db or transfected with H-2Ld molecules were grown as described previously (23). The murine H-2b cell line (MC57) and H-2d line (BALB Cl-7) were utilized as reported previously (40, 45). Cells were grown in either RPMI 1640 (RMA-S, MC-57, BALB Cl-7, and MEF) or Iscove's modified Dulbecco's medium (T2-Db and T2-Ld) containing 8% bovine serum, L-glutamine (2 mM), and antibodies (penicillin [10 U/ml] and streptomycin [10 µg/ml]). Geneticin (400 µg/ml) was added to Iscove's modified Dulbecco's medium to maintain selection of T2-Db and T2-Ld cells.
Peptides. Selected peptides representing motifs for H-2b or H-2d MHC alleles were synthesized on an automated peptide synthesizer (model 430A; Applied Biosystems) by the solid-phase method using 9-fluorenylmethoxy carbonyl chemistry, purified by high-pressure liquid chromatography on an RP3000-C8 reverse-phase column, and identified by electrospray mass spectrometry (23). In addition, overlapping 15-mer peptides (see Table 3) that covered the mouse PrP (mPrP) sequence were purchased from Multiple Peptide Systems, San Diego, Calif.
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TABLE 3. Peptides of mPrP used in CD8 and CD4 T-cell assaysa
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Cytotoxic T-cell assay. mPrP peptides at a concentration of 20 µg/ml were incubated with PrP-/- MEF labeled with 51chromium (15, 40, 45). Lymphocytes harvested from the brain (15) and spleen (40, 45) were added at effector-to-target cell ratios of 100:1, 50:1, and 25:1 for a 5-h assay as described elsewhere (15, 40, 45). As a positive control, PrP-/- MEF were infected with LCMV (multiplicity of infection, 1.0) for 48 h and added to lymphocytes harvested from scrapie-infected mice or from LCMV-infected mice as described elsewhere (15, 40, 45).
MHC class I tetramers. Kb-restricted mPrP amino acids (aa) 2 to 9, aa 152 to 160, and aa 232 to 241; Db-restricted LCMV GP aa 33 to 41; Db-restricted LCMV NP aa 396 to 404; and Kb-restricted LCMV GP aa 34 to 43 were used as allophycocyanin or phycoerythrin conjugates. Either these were obtained from the Tetramer Core Facility, Emory University, Atlanta, Ga. (1), or in some instances, biotinylated MHC-peptide monomers were made as tetramers in our laboratory (21) immediately before use. Staining with MHC class I tetramers was performed at a 1:50 to 1:100 dilution in the presence of various surface antibodies for 30 min at 4°C, and propidium iodide was added at a final concentration of 5 µg/ml to allow analytical exclusion of dead cells (21).
Flow cytometry and cytokine ELISPOT. Single-cell suspensions of lymphocytes were restimulated for 5 h with MHC class I- or class II-restricted peptides (1 or 2 µg/ml, respectively) in the presence of recombinant human IL-2 (10 to 50 U/ml; PharMingen, La Jolla, Calif.) and brefeldin A (1 µg/ml; Sigma, St. Louis, Mo.). Staining for cell surface antigen and intracellular antigens was performed as described previously (21). Negative controls were peptide-stimulated cells obtained from uninfected mice, cells restimulated for 5 h in the absence of viral peptides, and cells stained with conjugated cytokine-specific antibodies preincubated for 30 min at 4°C with an excess of recombinant cytokine. Cells were acquired with FACSort or FACSCalibur flow cytometers (Becton Dickinson) using Cell Quest software (Becton Dickinson). For five- and six-color analyses, a FACSVantage SE flow cytometer (Becton Dickinson) was used. FITC-, phycoerythrin-, CyChrome-, peridinin chlorophyll-a protein-, or allophycocyanin-conjugated, biotinylated, and/or purified antibodies (PharMingen) were used to evaluate CD4 (RM4-5) and CD8a (53-6.7) cells and evaluated as described elsewhere (21, 40, 45).
Immunohistochemical staining of CNS tissues. Brains removed from test mice were covered with Tissue-Tec OCT (Miles Diagnostics Division, Elkhart, Ind.), snap-frozen at -80°C in isopentane, and then stored at -20°C. Immunohistochemistry was performed on 6- to 10-µm-thick cryostat sections that were fixed in 100% ethanol for 15 min at 4°C and blocked with avidin and biotin (Vector Laboratories, Burlingame, Calif.). Staining was done with the following primary antibodies: anti-CD8 (anti-Ly-2 and Ly-3; PharMingen), anti-CD4 (anti-L3T4; PharMingen), anti-H-2 monotypic antigen (MHC class I), anti-Ia antigen (MHC class II), anti-B220 (Boehringer Mannheim, Indianapolis, Ind.), and anti-F4/80 (Serotec, Oxford, England). The second antibody was either a biotinylated anti-mouse IgG used in conjunction with the Vectastain Elite ABC (peroxidase) kit (Vector Laboratories) or anti-Ig-FITC. In the former case, staining was detected using diaminobenzidine as a chromogen. Sections were counterstained in Mayer's hematoxylin (Sigma) and mounted in Aqua-Mount (Lerner Laboratories, Pittsburgh, Pa.).
For light microscopy study, brain tissue was fixed in Bouin's fixative or 10% formaldehyde, prepared in paraffin, sectioned, and stained with hematoxylin and eosin.
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FIG. 1. (A and B) CD8+ T-cell infiltration in the parenchyma of a C57BL/6 (A) and BALB/WEHI (B) mouse 18 weeks after i.c. inoculation with scrapie. (C and D) Micrographs of sections of autopsied CNS from two distinct patients with CJD stained with antibody to human T cells. In these human tissues, T cells most often lay near blood vessels but occasionally appeared in the brain parenchyma.
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TABLE 1. Immunohistologic study of the CNS during scrapie infection
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FIG. 2. RPA analysis of brains harvested from scrapie-infected mice at 6 and 18 weeks post-i.c. inoculation. Individual mice were infected with scrapie (+) (pool of four). -, uninfected age- and sex-matched controls.
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Mapping mPrP peptide sequences that bound to H-2b (C57BL/6) or H-2d (BALB) MHC class I alleles. We then analyzed mPrP for peptide sequence motifs that were candidates for binding to Kb, Db, Kd, or Ld MHC class I alleles (23, 38, 41). Figures 3 and 4 display the prion sequences bearing murine MHC binding motifs: two for Db, nine for Kb, two for Kd, and four for Ld. These 17 peptides were then synthesized and tested for binding to their corresponding MHC class I alleles. For a MHC stabilization assay, RMAS cells (Db, Kb) transfected with Kd molecules and P815 (H-2d) were used to measure Db, Kb, Kd, or Ld stabilization in the presence of increasing peptide concentrations. Empty, unstable MHC molecules reaching the cell surface can be stabilized by peptides added exogenously. The affinity of a peptide for an MHC allele is tightly correlated to its ability to stabilize it. On this basis, MHC stabilization assays have been developed and are now commonly used to estimate the MHC binding properties of a given peptide. In our study, the positive control peptides exhibited affinity values (SC50) of 0.01 µM (Db binding [Fig. 3]), 0.1 µM (Kb binding [Fig. 3]), 1 µM (Ld binding [Fig. 3]), and 0.3 µM (Kd binding, not shown), respectively. The mPrP peptides were considered to be potent MHC binders when displaying affinity values (SC50) of 50 µM or less. In summary, we found that none of the peptides bearing the Db- or Kd-binding motif bound to their respective MHC alleles (SC50 > 1,000 µM), whereas one of the four Ld peptides (mPrP aa 100 to 108: KPSKPKTNL) bound to Ld (SC50 = 20 µM) and three of the nine Kb peptides (mPrP aa 2 to 9: ANLGYWLL; aa 152 to 160: NMYRYPNQV; and aa232 to 241: STVLFSSPPV) bound to Kb with SC50s of 20, 30, and 3 µM, respectively.
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FIG. 3. Motif of mPrP Db and Kb peptides that are appropriate for MHC class I binding (upper panels) and the data to show that only three of these mPrP peptides bind at heightened affinity to the corresponding MHC molecules. The lower panel displays data from three independent H-2b (C57BL/6) mice showing that their splenic lymphocytes bound to Kb tetramers containing mPrP aa 2 to 9, aa 152 to 160, and aa 232 to 241. Background binding for C57BL/6 control mice and C57BL/6 PrP-/- mice is shown. The positive control for Kb binding was Moloney murine leukemia virus peptide SSWDFITV (41), and that for Db binding was LCMV ARM NP peptide FQPQNGQFI (21). For binding, the horizontal axis of the graph shows the reciprocal log peptide dilution, while the vertical axis reflects the mean fluorescence intensity. Abbreviations: ko, knockout; Uninf Cont, uninfected control.
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FIG. 4. Motif of mPrP Kd and Ld peptides that are appropriate for MHC class I binding and data to show that only one of these peptides, mPrP 100 to 108, binds to Ld MHC molecules. The positive control for Ld binding is the P29 peptide YPNVNIHNF (11), and the negative control is the PB1 peptide VSDGGPNLY (12). For binding, the horizontal axis of the graph shows the reciprocal log peptide dilution, while the vertical axis reflects the mean fluorescence intensity.
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Effector function(s) of lymphocytes obtained from scrapie-inoculated PrP+/+ mice. Next we examined whether CD4 or CD8 T cells infiltrating the CNS and the enhanced MHC expression contributed to the pathogenesis of scrapie. For these studies we employed several groups of mice made genetically deficient to CD4, CD8, MHC class I, or MHC class II molecules. However, deletion of CD4 or CD8 T cells did not significantly decrease the kinetics or incidence of developing scrapie, as shown in Table 2 and in agreement with a report by Klein et al. (24). Mice null for CD4 and CD8 T cells died or showed severe morbidity at 156 ± 8 or 154 ± 8 days (mean ± 1 standard error), respectively, compared to 148 ± 8 days for CD4 and CD8 T-cell-competent mice. Similarly, MHC class I and class II knockout mice developed severe disease at days 165 ± 5 or 158 ± 7, respectively, incubation periods similar to those of genetically normal mice. However, mice lacking both CD4 and CD8 T cells took 193 ± 5 days to show signs of clinical scrapie infection, a significantly longer period (P < 0.01) than that observed for wild-type mice or those lacking only one component, i.e., CD4-/-, CD8-/-, MHC class I-/-, or MHC class II-/- alone. These data were confirmed in a repeat experiment. In the limited number of MHC class I and MHC class II double-knockout mice available (total of four receiving i.c. and three receiving i.p. inoculations of scrapie) also showed prolonged incubation periods for developing clinical disease, taking longer than single-knockout MHC I or MHC II mice. All mice inoculated i.c. took at least 204 days to become moribund, and mice inoculated i.p. became clinically ill at or after 254 days. Within 8 days of becoming ill, all these MHC double-knockout mice died or were sacrificed because of severe morbidity, and neuropathologic and biochemical evidence of scrapie infection was found.
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TABLE 2. Enhanced survival of mice genetically deficient for both CD4 and CD8 T lymphocytes to scrapie infection
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or TNF-
(data not shown) (8, 21, 29), although again expression of those cytokines was easily induced in mice at days 7, 50, or 120 after LCMV infection when their splenic lymphocytes were similarly incubated with relevant LCMV Kb, Db, or Ld peptides (21, 40). In addition, neither IL-2, IL-6, nor IL-10 expression was induced in lymphocytes harvested from PrP+/+ mice at similar times after scrapie infection and incubation with mPrP aa 2 to 9, aa 152 to 160, or aa 232 to 241, although IL-4, IL-6, and IL-10 were expressed in lymphocytes after LCMV infection (21, 40, 44).
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FIG. 5. (A) Lymphocytes obtained from the spleens of mice either primed once or three times with scrapie fail to lyse syngeneic PrP-/- target cells coated with 20 µg of those peptides which when separately placed in Kb tetramers bound such T cells (see Fig. 3). In contrast, T cells harvested from littermates primed seven days (Po) earlier with LCMV ARM 105 PFU i.p. or 60 days after initial priming receiving a second injection of LCMV ARM (So) lyse these PrP-/- target cells when they were infected with LCMV ARM 2 days earlier or coated with 20 µg of the LCMV GP peptide aa 33 to 41. See Materials and Methods and reference 21 for details of 51Cr-release assay and immunizations. Abbreviations: ko, knockout; CTL, cytotoxic T lymphocyte; E:T, effector-to-target cell; INF, infected; ND, not determined; spl, spleen; 3 x inoc, inoculated three times. (B) T cells obtained after multiple (three) inoculations with scrapie fail to generate intracytoplasmic IFN- when stimulated with the various pools of peptides that cover the mPrP sequence (see Table 3). Data are from a single mouse and representative of four additional mice. The positive control shows IFN- cytoplasmic staining for CD8 and CD4 T cells obtained 7 days after an inoculation with 105 PFU of LCMV ARM. Spleen lymphocytes were incubated with CD8 T-cell peptide LCMV GP aa 33 to 41 or CD4 T-cell peptide LCMV GP aa 61 to 80. See Materials and Methods and reference 21 for details.
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and TNF-
as well as molecules bound to CD4 or CD8 T cells. Although the accompanying control splenocytes from LCMV-immunized mice concurrently tested but with appropriate LCMV peptides gave positive results, we were unable to detect any convincing intracellular expression of IFN-
(Fig. 5B) or TNF-
(data not shown) in either CD8 or CD4 T cells from scrapie-inoculated mice. Notably, similar inoculation of murine scrapie into PrP-/- mice, due to a deletion of mPrP, also failed to reveal IFN-
or TNF-
cytoplasmic expression in CD8 or CD4 T lymphocytes. Further, such lymphocytes from scrapie-infected PrP+/+ or PrP-/- mice failed to lyse syngeneic PrP-/- 51Cr-labeled MEF coated with the peptide cocktails (Fig. 5). |
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Since only activated T cells are believed to cross the blood-brain barrier to enter the CNS, presumably scrapie infection was responsible for the initial T-cell activation. The cause could be generation of antigen-specific scrapie T cells or, alternatively or concomitantly, chemokine and cytokine chemoattractants induced during scrapie infection in the brain. We (20) and others (reviewed in references 3, 39, and 46) have incited cytokine and chemokine expression focally in selected tissues using transgenic approaches with cell-specific promoters and reported the resulting infiltration of lymphocytes into the target area. Our studies here are unable to discriminate between these two possibilities at present. The detection here of suspected PrP+/+ antigen-specific T cells by tetramers, but at low levels, was not associated with intracellular cytokine expression when such lymphocytes were incubated with the appropriate prion peptide(s). This finding is in accord with those of Zajac et al. (47), who reported an example of disassociation between tetramer-positive staining and intracellular cytokine staining in a viral model, while Field and Shenton (16) previously reported peripheral lymphocyte sensitization with TSE infection.
After entering the brain, activated T cells remain for approximately 10 to 14 days and then circulate out unless the recognition T-cell antigen appears expressed in the CNS milieu or appropriate chemokines are continuously present (15, 18). Although the presence of CD8+ and CD4+ T cells and scrapie infection in the CNS bear a direct association, the lack of marked inflammatory cell recruitment to that site, coupled with the failure of T cells obtained from the periphery and the CNS to display detectable effector functions in vitro as cytotoxicity or expression or release of Th1 cytokines, suggests that these cells are minimally or not at all significant to the disease process. In agreement are earlier studies in which several immunosuppressive strategies or separate deletion of either CD4 or CD8 T cells did not alter the kinetics or outcome of scrapie infection (reviewed in references 4, 5, and 24). Further, the Th1 cytokine IFN-
was not found in brains of mice succumbing to scrapie infection (9). However, as shown here, deletion of both CD4 and CD8 T cells significantly delayed the onset of disease, although once disease occurred, it was uniformly fatal. Hence, the delayed progression of disease and expression of TNF-
in brains of scrapie-infected mice (9) raise the possibility that the T-cell response may modestly influence the infection.
Why is it difficult to detect prion-specific T-cell response with scrapie infection? Arguments (reviewed in references 4 and 5) to explain such a phenomenon range from proposing a state of tolerance due to identical amino acid sequences between PrPc and PrPsc that is not broken either by scrapie infection or immunization with scrapie prions injected in adjuvant and the unusual protease resistance of PrPsc, which might prevent its degradation and processing in antigen-presenting cells. Yet, immune responses are reproducibly generated against other "self antigens" when the self protein or one of its peptide fragments is inoculated with adjuvants or during infections. For example, immune responses to CNS proteins like myelin basic protein, proteolipid protein of myelin, and myelin-associated oligodendrocyte basic protein, etc., are easily generated and often associated with corresponding autoimmune diseases (17, 19, 28, 48). Further, specific antiviral immune responses can be detected against endogenous murine retroviruses (31) that have existed in their hosts over thousands of years, most often infecting thymi and peripheral lymph nodes. Heterologous PrP in adjuvant can elicit immune (antibody) responses, suggesting that antigen processing of the PrP molecule can occur (25).
CD8 and CD4 T cells generated during scrapie infection, under the experimental conditions used here, were unable to mount effector functions. Of interest, this inability to act as lytic agents or cytokine producers also occurred when scrapie was inoculated into PrP-/- mice with a deletion of the PrP gene as well as PrP-/- mice that were unable to transcribe PrP because of an engineered mutation. However, it may be possible using other immunizing strategies or vehicles to express prions (i.e., DNA vaccination) that at least scrapie-specific CD4 T-cell responses can be generated, since antibodies to prions can be made. As for scrapie-specific CD8+ T cells, we mapped potential peptide motifs for MHC class I H-2b and H-2d molecules. Found were three CD8 T-cell motifs that bound well to Kb (SC50, 3, 20, and 30 µM) and one that bound to Ld (SC50, 20 µM) molecules. Kb tetramers made with these three mPrP peptidesaa 2 to 9, aa 152 to 160, and aa 232 to 241-bound, albeit to a modest extent, to splenic lymphocytes at days 7, 50, and 71 after scrapie inoculation. However, these lymphocytes from PrP+/+ mice were unable to synthesize the intracellular cytokines IFN-
or TNF-
when stimulated with appropriate peptides and were unable to lyse 51chromium-labeled PrP-/- MEF coated with mPrP peptides. These findings are reminiscent of those from recent studies of CD4-/- mice infected with LCMV (47) and from a report characterizing circulating T cells for tumor-specific antigens (27). Lastly, the accumulation of T cells in the brains of scrapie-infected mice likely mirrors other models in which T cells accumulated and resided in the CNS following antigen-specific stimulation, when the recognized antigen was continuously expressed in the brain (15, 18) and/or when attracted by chemokines expressed in the CNS (3, 39, 46). Further analysis of these T cells and their induced genetic profiles should be of interest.
We thank Denis Hudrisier, INSERM, Toulouse University, France, for kind assistance in peptide prediction and MHC binding studies; John Altman, Vaccine Center Yerkes, Emory University Medical School, and the NIH Tetramer Core, for advice and assistance in making and providing prion tetramer reagents; Rick Race, NIH Rocky Mountain Laboratories, Laboratory of Persistent Viral Diseases, for assistance with the PrPsc analyses; and John Alcantara for technical assistance.
This is publication number 13546-NP from the Department of Neuropharmacology, The Scripps Research Institute, La Jolla, Calif. ![]()
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