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Journal of Virology, November 2004, p. 11641-11647, Vol. 78, No. 21
0022-538X/04/$08.00+0 DOI: 10.1128/JVI.78.21.11641-11647.2004
Copyright © 2004, American Society for Microbiology. All Rights Reserved.
Ronald J. Messer,1
Shimon Sakaguchi,2
Guojun Yang,1,
Shelly J. Robertson,1 and
Kim J. Hasenkrug1*
Laboratory of Persistent Viral Diseases, Rocky Mountain Laboratories, National Institute of Allergy and Infectious Diseases, National Institutes of Health, Hamilton, Montana,1 Department of Experimental Pathology, Institute for Frontier Medical Sciences, Kyoto University, Kyoto, Japan2
Received 3 March 2004/ Accepted 21 June 2004
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In the Friend virus (FV) model of retrovirus infection (15, 19), our investigators previously found that virus persistence was associated with an immunosuppressive population of CD4+ T cells (17). Those studies were done with a strain of mice that is somewhat analogous to people infected with human immunodeficiency virus in the respect that the mice are able to reduce infection and recover from acute disease but develop long-term persistent infections. The persistently infected mice have weakened mixed lymphocyte responses compared to naïve mice and, interestingly, fail to reject transplants of FBL-3 tumors. FBL-3 is an FV-induced tumor which is rapidly rejected by naïve mice (17). The failure to reject FBL-3 tumors was unexpected, because the tumor expresses immunogenic FV antigens and can be used to immunize mice against infection with FV. Thus, it was expected that the FV-exposed mice would have stronger rather than weaker anti-FBL-3 responses. Normal naïve mice reject FBL-3 through a CD8+ T-cell-mediated mechanism (50), but they become unable to reject the tumors after receiving an adoptive transfer of CD4+ T cells from persistently infected mice (17). CD4+ T cells from persistently infected mice also suppress cytotoxic T-lymphocyte responses in mixed lymphocyte cultures, indicating a generalized nonspecific immunosuppression (17). These results are consistent with those for CD4+ regulatory T cells, which can also suppress in a nonspecific manner once they become activated (47).
In the present studies we sought to determine if virus spread, pathology, and immunosuppression could be prevented by modulating the T-cell response during the acute phase of FV infection. Several groups have reported that CD4+ regulatory T cells can be depleted by in vivo administration of antibodies to CD25. However, since CD25, the alpha-chain of the interleukin-2 (IL-2) receptor, is also up-regulated on activated effector T cells, in vivo administration of anti-CD25 antibody during acute FV infection could deplete activated effector T cells as well as regulatory T cells. CD4+ regulatory T cells also constitutively express the glucocorticoid-induced tumor necrosis factor receptor family-related gene (GITR) at high levels (27), and it has been shown that a monoclonal antibody (DTA-1) against GITR delivers an agonistic signal that eliminates suppression by regulatory T cells without causing depletion in vivo (43). Furthermore, anti-GITR delivers costimulatory signals to antigen-activated effector cells, thereby enhancing specific effector responses directly as well as indirectly (20, 21, 33, 34, 49). Thus, in vivo DTA-1 antibody administration could potentially attenuate suppression while simultaneously intensifying the anti-FV effector T-cell response. Indeed, we found that administration of anti-GITR during the first 10 days of FV infection increased Th1 cytokine production by both CD4+ and CD8+ T cells, significantly reduced acute infection levels, prevented FV-induced splenomegaly, and restored long-term antitumor immune responses.
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Virus and virus infection. The FV stock used in these experiments was uncloned FV complex containing B-tropic Friend murine leukemia helper virus and polycythemia-inducing spleen focus-forming virus (24). The complex was prepared as a 10% spleen cell homogenate from BALB/c mice infected 14 days previously with 3,000 spleen focus-forming units of uncloned virus stock. For virus challenge experiments, mice were injected intravenously with 0.5 ml of phosphate-buffered balanced salt solution containing 2% fetal bovine serum and 1,500 spleen focus-forming units of FV complex. Chronically infected mice were mice that had been infected at least 8 weeks previously and had recovered from FV-induced splenomegaly. Virus levels are usually stable at approximately 104 infectious centers per spleen by 6 to 8 weeks postinfection.
Treatment of mice with antibodies. The rat-derived anti-GITR-producing hybridoma (DTA-1) (43) was grown in RPMI medium containing 10% fetal calf serum. Supernatant was harvested, spun at 500 x g for 10 min to remove cells and debris, and frozen at 20°C. Supernatants were pooled, quantified, and stored at 20°C. For in vivo treatments, 0.5 ml of the supernatant containing 70 µg of antibody was injected intraperitoneally every other day from the day of infection until day 10 postinfection. Control mice were treated with an equal amount of rat immunoglobulin (Ig).
Palpation for splenomegaly. FV disease progression was followed by spleen palpation of anesthetized mice, a standard procedure used to follow progression of FV infection as previously described (14). Palpations were done in a blinded manner, and splenomegaly was rated on a scale from 1 to 4, with 1 being normal, 2 being moderately splenomegalic (three to five times enlarged), and 3 and 4 being severely splenomegalic (large enough to protrude to or past the ventral midline and weighing 10 to 20 times a normal spleen).
Tumor inoculation and measurement of tumor size. Mice were injected intradermally on the dorsal region with 107 FBL-3 cells in 0.1 ml of RPMI 1640. FBL-3 is an FV-induced tumor line derived from a C57BL/6 (B6) mouse, and the subline used in these experiments expresses FV antigens but does not produce infectious virus. Following tumor transplantation, the tumor diameters were measured in two directions using a pressure-sensitive micrometer, and means from the two measurements were plotted.
Infectious center assays. Titrated numbers of spleen cells from infected mice were plated onto susceptible Mus dunni cells, cocultivated for 5 days, fixed with ethanol, stained with Friend murine leukemia helper virus envelope-specific MAb720, and developed with peroxidase-conjugated goat anti-mouse IgG and substrate to detect foci of infected cells (9).
Intracellular cytokine staining and flow cytometry.
Cell surface and intracellular cytokine staining were performed using Becton Dickinson/PharMingen reagents (except where noted) and the Cytofix/Cytoperm intracellular cytokine staining kit. T-cell antibodies were fluorescein isothiocyanate-anti-CD43 (1B11), phycoerythrin (PE)-anti-CD25 (PC61), PE-anti-CD44 (IM7), allophycocyanin (APC)-anti-CD4(RM4-5), and APC-anti-CD8(53-6.7). Dead cells (propidium iodidehigh) were excluded from all cell surface analyses. For intracellular cytokine staining, erythrocyte-depleted spleen cells were incubated with plate-bound anti-CD3 and soluble anti-CD28 (23) for 5 h at 37°C in the presence of monensin (2 µg/ml). Anti-CD3 and anti-CD28 were used to obtain a broad perspective of the full range of T-cell activity in the infected mice (44). Cells were washed twice, incubated with anti-Fc
2/3 receptor (2.4G2) to block Fc receptors, and stained with APC-labeled anti-CD4 or anti-CD8 and fluorescein isothiocyanate-labeled anti-CD43 in round-bottom 96-well plates. The cells were then washed, permeabilized, and reacted with PE-conjugated monoclonal antibodies specific for IL-2 (CalTag, Burlingame, Calif.), IL-4, IL-10, gamma interferon (IFN-
), or tumor necrosis factor alpha (TNF-
). Data were acquired on a FACSCalibur flow cytometer (Becton Dickinson) from 100,000 CD4- or CD8-gated events acquired per sample and were analyzed using BD Cellquest Pro software (version 4.0.1; Becton Dickinson). Surface markers were analyzed on cells directly ex vivo. Tetramers were obtained from Beckman Coulter (San Diego, Calif.).
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FIG. 1. Effects of anti-GITR therapy on acute FV infection. (A) Mean severity of splenomegaly data for the rat Ig control group (squares) and the anti-GITR group (circles) are plotted over time in days. The beginning and end of anti-GITR therapy are indicated by arrows. Each dot represents the mean on a scale from 1 (normal) to 4 (severely splenomegalic) (14). Mann-Whitney tests showed the differences to be significant between 6 and 14 days (P < 0.05; n = 6 mice/group). (B) Infectious center assays at 2 weeks postinfection showed significantly fewer virus-producing cells in the spleens of mice treated with anti-GITR than in control mice (P = 0.026 by Mann-Whitney test using log10 values). (C) Splenomegaly was plotted over time in weeks, with the beginning and end of anti-GITR therapy indicated by arrows. Error bars indicate standard deviations and the differences between the groups were significant for all time points from 1 to 6 weeks postinfection (P < 0.05 by Mann-Whitney test; n = 6 mice/group).
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was of special interest, because it has previously been associated with recovery from FV infection (31). At 1 week postinfection the level of activated CD8+ T cells (CD43+) increased in both groups due to FV infection (Fig. 2A). However, the response was significantly higher in the anti-GITR group than in the control group. There was also a significantly greater expansion of CD8+ T cells specific for the FV gagL epitope (5, 39), as measured by tetramer staining (Fig. 2A). In addition, the anti-GITR group also had significantly more CD8+ T cells producing IFN-
(Fig. 2B). Thus, anti-GITR therapy produced a faster expansion of activated CD8+ T cells, including those producing IFN-
.
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FIG. 2. Surface markers and cytokine production by CD8+ T cells at 1 week postinfection. CD8-gated T cells were analyzed for CD43 and Db GagL tetramer (39) expression at 1 week postinfection. The mean percentage of CD43-positive cells was 13.5% for the infected/rat Ig control group and 18.6% for the anti-GITR group (P = 0.0022 by Mann-Whitney test; n = 6 mice/group). Tetramer-positive CD8+ T cells averaged 0.2% in the infected/rat Ig control mice and 0.6% in anti-GITR mice (P = 0.0152; n = 6 mice/group). The mean percentage of CD8+ T cells producing IFN- was significantly greater in the anti-GITR group (2.2%) than in the infected/rat Ig control group (1.2%; P = 0.0022; n = 6 mice/group).
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-producing cells. The in vitro activation required for intracellular cytokine staining consistently gave a moderate background of TNF-
-producing cells from naïve mice (Fig. 3A). TNF-
production by naive cells following in vitro stimulation with anti-CD3 and anti-CD28 for intracellular cytokine staining is not uncommon (M. Slifka, personal communication). Interestingly, TNF-
-producing CD8+ T cells were significantly diminished in FV-infected mice, indicating immunosuppression relative to naïve mice (Fig. 3A). Anti-GITR therapy significantly reversed this suppression.
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FIG. 3. Surface markers and cytokine production by CD8+ T cells at 2 and 8 weeks postinfection. Stars indicate statistically different values (P < 0.05) between the control-treated and anti-GITR-treated groups as determined by Mann-Whitney tests. n = 6 for both the control-treated groups and the anti-GITR groups at both 2 weeks postinfection (A) and 8 weeks postinfection (B). Error bars indicate standard deviations.
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- and TNF-
-producing CD8+ T cells than the control group at this late time point (Fig. 3B).
CD4+ T cells were analyzed in a similar manner. At 1 week postinfection the mean percentage of activated CD4+ T cells in the anti-GITR group was almost double that in the control group, and there were five times as many CD4+ T cells producing IFN-
(Fig. 4). By 2 weeks postinfection the percentages of CD4+ T cells producing the Th1 cytokines IL-2 and IFN-
were significantly higher in the anti-GITR group than in the control group (Fig. 5A). No IL-4- or IL-10-producing CD4+ T cells were detected in either group at either 1 or 2 weeks postinfection (data not shown). As previously shown (43), in vivo administration of anti-GITR was nondepleting and did not significantly alter the percentage of CD4+ T cells expressing CD25. By 8 weeks postinfection there were only slightly higher levels of CD4+ T cells with an effector phenotype in the anti-GITR group, but the level of memory cells averaged over 10% higher (Fig. 5B). No significant differences in cytokine production between the groups were observed at the 8-week time point (data not shown). Results indicated that anti-GITR treatment significantly affected the differentiation of both CD8+ and CD4+ T cells into memory cells following FV infection.
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FIG. 4. Surface markers and cytokine production by CD4+ T cells at 1 week postinfection. (A) CD4-gated T cells were analyzed for CD43 and CD44 expression at 1 week postinfection. The mean percentage of CD43/44 double-positive cells was 2.6% in the naïve group, 9.6% in the rat Ig control group, and 16.7% in the anti-GITR group (P = 0.0022 by Mann-Whitney test; n = 6 mice/group). (B) Lymphocyte-gated spleen cells were analyzed by intracellular cytokine staining for cytokine production by CD4+ T cells. The mean percentage of CD4+ T cells producing IFN- was significantly greater in the anti-GITR group (1.0%) than in the rat Ig control group (0.2%; P = 0.0022; n = 6 mice/group). None of the groups made detectable levels of IL-4 or IL-10 (data not shown).
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FIG. 5. Surface markers and cytokine production by CD4+ T cells at 2 and 8 weeks postinfection. Stars indicate statistically different values (P < 0.05) between the control-treated and anti-GITR-treated groups as determined by Mann-Whitney tests. n = 6 for both the control-treated groups and the anti-GITR groups at both 2 weeks postinfection (A) and 8 weeks postinfection (B). Error bars indicate standard deviations from the mean.
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FIG. 6. Improved antitumor responses following anti-GITR therapy. Tumor growth is plotted over time in the various groups. Each line represents tumor growth in a single mouse. The mice were transplanted with 107 FBL-3 tumor cells by intradermal injection at 8 weeks postinfection with FV. In accordance with animal care and use rules at Rocky Mountain Labs to prevent pain and suffering, all animals were euthanized if their tumors grew to a mean diameter greater than 20 mm.
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Treatment with anti-GITR during the first 10 days of FV infection resulted not only in significantly reduced acute infection and pathology, but also in a long-lasting reduction in FV-induced suppression of antitumor responses. The finding of an anamnestic response in two of the transplant mice (Fig. 6) was consistent with the finding of increased numbers of T cells with a memory phenotype in the anti-GITR group (Fig. 3 and 5). The variability in the tumor rejection times suggested that it might be possible to improve the anti-GITR dosage or treatment schedule to induce a more consistent effect. Alternatively, GITR-negative regulatory T cells may also be suppressing CD8+ T-cell responses (18), or anti-GITR may have only a partial effect. It was recently shown that agonistic signals through the 4-1BB molecule were more potent than anti-GITR signaling in preactivated regulatory T cells (7). Thus, anti-4-1BB antibody might produce a stronger effect than anti-GITR antibody.
Our finding that early anti-GITR treatment produced a significant effect on antitumor responses 50 days after cessation of therapy indicated that the treatment produced a relatively stable alteration in the immunological status of the mice. A stable alteration was also indicated by sustained Th1 responses in the anti-GITR group, as evidenced by increased percentages of IFN-
- and TNF-
-producing CD8+ T cells at 8 weeks postinfection (Fig. 3B).
It was recently shown that chronic infections of mice with lymphocytic choriomeningitis virus resulted in a gradual impairment of the function of virus-specific CD8+ T cells (52). Impairment of CD8+ T-cell function due to chronic stimulation could partially account for the inability of mice persistently infected with FV to reject FBL-3 tumors, since FBL-3 rejection is mediated by CD8+ T cells (50) specific for an FV gag antigen (5, 28). However, the CD8+ T cells in the anti-GITR-treated mice were also subjected to chronic stimulation, yet those mice were able to reject FBL-3 tumors. Furthermore, the immunosuppression in mice persistently infected with FV is not limited to FV-induced tumors but has also been observed as a suppressed response in which no chronic stimulation could have occurred, e.g., suppressed mixed lymphocyte reactions and suppressed rejection of tumors not of FV origin (17). Finally, our group previously showed that the suppression of FBL-3 tumor responses could be passed from persistently infected mice to naïve mice by adoptive transfer of CD4+ T cells, but not of CD8+ T cells (17). Taken as a whole, the data indicate that the impairment of CD8+ T cells in mice persistently infected with FV is not solely due to chronic stimulation, but it is strongly influenced by a subset of CD4+ T cells with immunosuppressive activity and that activity could be reversed by GITR ligation. The long-term inhibition of immunosuppression following only 10 days of anti-GITR therapy during acute infection indicates that the activity of these cells during the early phase of infection is of critical importance in establishing the immunosuppressive state. This conclusion is supported by the finding that anti-GITR therapy did not improve responsiveness when given at the time of tumor transplantation but had to be given early. These results suggest that anti-GITR prevented induction of regulatory T cells but did not reverse suppression in already-induced cells.
We did not observe increases in CD4+/CD25+ T cells after FV infection, as has been observed in Leishmania infections associated with suppression by regulatory T cells (3). It has been proposed that in addition to the "natural" CD4+/CD25+ regulatory T cells that normally control autoimmune responses through a cell-to-cell contact mechanism (37, 41), there are also "adaptive" regulatory T cells that develop as a consequence of suboptimal stimulation or costimulation during an infection (4, 26, 45). To date, there is no pattern of cell surface markers that unambiguously distinguishes regulatory T cells from other T cells, and subsets of regulatory T cells, such as Th3 cells that secrete transforming growth factor ß (6) and Tr1 cells that secrete IL-10 (13), have been described, as well as CD4+/CD25 regulatory T cells (26, 51). Thus, regulatory T cells represent a complex subset of cells that still requires further definition. Our investigators recently found that immunosuppressive CD4+ T cells that arise in response to FV infection and inhibit CD8+ T-cell function are contained in both the CD25-positive and -negative subsets (10).
The present results suggest the possibility of using anti-GITR therapy in modulating regulatory T cells and controlling immunosuppression. For example, human immunodeficiency virus-infected and human T-cell leukemia type 1-infected patients are at high risk of developing malignancies because of their immunosuppressed state (38), and there is evidence that an aspect of the immunosuppression in these patients may be due to regulatory T cells (1, 11, 29). Anti-GITR modulation of suppressor cells might be a safer approach than more radical therapies, such as general depletion of regulatory T cells by anti-CD25 antibodies, because of less chance of inducing autoimmune disease. However, adult mice with a C57BL genetic background such as those used in our studies are relatively resistant to the development of autoimmune disease (36, 42), and anti-GITR has the potential to induce autoimmune disease in more susceptible mouse strains (21, 43). Thus, our experiments demonstrate the potential benefits of modulation by anti-GITR, but further improvement must be made to more specifically down-regulate suppression of antiviral responses while maintaining suppression of autoimmune responses.
Present address: Laboratory of Immunological Monitoring, Robert W. Franz Cancer Research Center, Providence Portland Medical Center, Portland, OR 97213-2967. ![]()
Present address: Laboratory of Cancer Immunobiology, Robert W. Franz Cancer Research Center, Providence Portland Medical Center, Portland, OR 97213-2967. ![]()
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