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Journal of Virology, April 2006, p. 3506-3514, Vol. 80, No. 7
0022-538X/06/$08.00+0 doi:10.1128/JVI.80.7.3506-3514.2006
Copyright © 2006, American Society for Microbiology. All Rights Reserved.
Center for Vaccinology, Department of Clinical Biology, Microbiology and Immunology, Ghent University and Hospital, Ghent, Belgium
Received 30 September 2005/ Accepted 10 January 2006
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10 IU/liter), these antibodies convey protection against infection with hepatitis B virus (HBV) (22). More than 20 years of experience with hepatitis B vaccines and experimental immunization with HBsAg of inbred mouse strains (25) have shown that the immune responses of humans and mice to HBsAg are highly variable. In mice, high-, intermediate-, and nonresponder strains have been defined, and these response patterns are governed by genes located in the major histocompatibility complex (H-2) (23). Evidence is accumulating that the human immune response to HBsAg is also dictated by genes located in the major histocompatibility complex. Poor responses are frequently observed for subjects with HLA haplotypes DR3, DR7, DQ2, and/or DP11 and are seen less frequently for subjects expressing DR1, DR5, DP4, DQ3, and/or DQ5 (7, 10, 17, 21, 24).
HBsAg is a complex macromolecular particle composed of proteins, carbohydrates, and lipids. The envelope proteins and carbohydrates, integral parts of glycoproteins, are of viral origin, whereas the lipid moiety, representing approximately 25 to 30% of the particle mass, is of host origin (26, 33). The complete removal of lipids from HBsAg destabilizes the particle and precipitates the hydrophobic protein moiety. Partial delipidation preserves the particle structure and keeps it in solution but induces minor structural changes that have only been examined at the B-cell level. Some investigators found that lipid extraction did not alter (16) or markedly increased (8, 12, 30) B-cell immunogenicity, whereas others demonstrated that detergent treatment of HBsAg clearly reduced its B-cell antigenicity (9, 11). The effects of partial delipidation on the T-cell antigenicity of HBsAg have never been examined. We have studied this issue because we estimated that changing the interaction of proteins and lipids in HBsAg particles might alter their uptake and processing by antigen-presenting cells (APC) and consequently modify their presentation to and recognition by T lymphocytes. The experiments performed to address this issue are discussed here.
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PBMC were also obtained from three patients suffering from chronic HBV infection (CC1, CC2, and CC3). Table 1 shows important demographic, histological, and serological data for these subjects. For patients CC1 and CC2, PBMC were obtained during interferon treatment. The study protocol was approved by the Ethical Review Board of the University Hospital of Ghent. All participants gave written informed consent.
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TABLE 1. Demographic and clinical data for three chronic hepatitis B patients
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Antigens. The antigens used in the in vitro lymphoproliferation tests were (i) recombinant HBsAg (subtype adw) produced in Saccharomyces cerevisiae (lot DVP23; GlaxoSmithKline, Rixensart, Belgium) (27), (ii) recombinant glycoprotein D2 from herpes simplex virus (gD2, expressed in mammalian cells; GlaxoSmithKline), and (iii) tetanus toxoid (TT; obtained from Statens Seruminstitut, WHO, Copenhagen, Denmark).
Removal of lipids. Partial delipidation of HBsAg was performed as described by Gavilanes et al. (9). In brief, HBsAg particles suspended in 10 mM Tris-HCl-50 mM NaCl, pH 7.0, were incubated with the nonionic, nondenaturing detergent ß-D-octyl glucoside (OG [C14H28O6]; used at 2% [wt/vol]) (Sigma Aldrich) for 2 h at room temperature. HBsAg incubated with OG (or a control sample not treated with detergent) was layered onto a linear cesium chloride gradient (CsCl density, 1.15 to 1.32 g/ml) and centrifuged for 18 h at 145,000 x g (15°C) in a Beckman SW27 rotor. Fractions of 0.5 ml were collected, beginning at the top of the gradient, and the HBsAg content, measured with an AUSRIA II-125 kit, was determined for each fraction (Fig. 1). HBsAg-positive fractions were pooled and dialyzed against phosphate-buffered saline. After dialysis, the delipidated Ag preparation was concentrated at 4°C using an ultrafiltration device (Centricon 100; Amicon) and called 2% OG. The nominal molecular mass cutoff value of the membrane was 100 kDa. A control preparation, called 0% OG, consisted of sham-delipidated particles and was prepared by running HBsAg through all the steps described above except for delipidation with OG. The 2% OG- and 0% OG-treated preparations were analyzed by sodium dodecyl sulfate-polyacrylamide gel electrophoresis (Fig. 2), using a PhastSystem setup (Pharmacia LKB Biotechnology, Sweden) with a PhastGel high-density gel (20% homogenous polyacrylamide gel). Gels were stained using the silver nitrate staining method described by Heukeshoven and Dernick (13). In these gels, no fractions with molecular weights lower than that of complete HBsAg were found, indicating that lipid removal did not induce degradation of HBsAg.
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FIG. 1. Centrifugation of native ( ) and 2% OG-treated () HBsAg in a linear CsCl gradient (1.15 to 1.32 g/ml). The x axis represents the different fractions, and the y axis represents the Ag content measured with the AUSRIA II test. The figure shows that delipidation (2% OG treatment) increases the density of the HBsAg particles. OG-treated HBsAg retains sufficient antigenicity to be recognized by the antibodies used in the AUSRIA II kit from Abbott Laboratories.
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FIG. 2. Electrophoretic mobility (by sodium dodecyl sulfate-polyacrylamide gel electrophoresis) of 2% OG-treated HBsAg. Native and sham-delipidated (0% OG-treated) HBsAg preparations are shown for comparison. Samples were electrophoresed in a PhastGel high-density gel, and visualization was done by silver staining. Lanes: 1, 0% OG-treated HBsAg; 2, 2% OG-treated HBsAg; 3, native HBsAg; 4, molecular size markers (6.2 to 94 kDa).
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Lymphoproliferation assays. The in vitro cellular immune responses of the vaccinees and chronic HBV patients were measured using an HBsAg-specific lymphoproliferation assay (20). In brief, nonfractionated PBMC were suspended in RPMI 1640 medium supplemented with 25 mM HEPES, 50 U/ml penicillin, 50 µg/ml streptomycin, 2 mM L-glutamine (all from Invitrogen Corporation, Carlsbad, California), 5 x 105 M 2-mercaptoethanol (Sigma Chemical Co., St. Louis, MO), and 10% heat-inactivated human AB+ serum (complete medium). PBMC (4 x 105/well) from vaccine recipients or chronic HBV patients were cultured for 6 days (37°C in 5% CO2) in 96-well round-bottomed microtiter plates containing HBsAg or delipidated particles. TT and/or gD2 was used as a positive control antigen. Nonstimulated control cultures (blanks) consisted of PBMC that were kept in culture medium without Ag.
For proliferation assays with T-cell lines, 2 x 104 T cells/well were incubated with complete medium in flat-bottomed plates for 4 days with 1 x 105 autologous, irradiated (2,500 rad; 60Co source) PBMC as APC, in the presence or absence of HBsAg.
All proliferation assays were performed in triplicate, and [3H]thymidine (0.5 µCi/well; Amersham International, Buckinghamshire, United Kingdom) was added 18 h before harvesting. The cultures were harvested using an automated harvesting device and assayed for [3H]thymidine incorporation by liquid scintillation counting in an LKB-Wallac 8100 counter (LKB, Bromma, Sweden). Data are expressed as means of triplicate cultures ± SD,
cpm (mean cpm of Ag-stimulated cultures mean cpm of control cultures), or stimulation indexes (SIs), which were calculated by the following formula: SI = mean experimental cpm (with antigen)/mean control cpm (without antigen). SIs were considered positive when they were
2. The SD of triplicates seldom exceeded 15%.
HBsAg dose and APC dose titration experiments. To examine the antigenic (stimulating) qualities of the different HBsAg preparations, increasing quantities of Ag (from 0.0001 to 9 µg/ml) were added to 105 PBMC. To facilitate comparison of the antigenic quality of native HBsAg with that of 2% OG-treated HBsAg, the concentration required to reach 50% of the maximum proliferation was calculated for each Ag for each subject tested. As an alternative approach, increasing numbers of PBMC as APC (from 2.5 x 104 to 10 x 104) were added to 2 x 104 T cells and 3 µg/ml HBsAg. The number of PBMC required to reach 50% of the maximum proliferation was calculated for each Ag for each subject tested.
Mouse experiments. C57BL/6 and SJL mice, purchased from Charles River (Sulzfeld, Germany), and BALB/c mice, obtained from GlaxoSmithKline, were used for immunization experiments. The experimental groups consisted of female mice (six per group) that were between 5 and 6 weeks of age at the initiation of the experiment. The antigens were suspended in complete Freund's adjuvant or adsorbed to Al(OH)3 and injected intramuscularly (50 µl, in the thigh) on day 0. On day 28, a second dose of Ag (booster) was administered. Animals were bled from the orbital plexus on weeks 0, 2, 4, 6, and 8. Anti-HBs in mouse plasma was measured with the AUSAB RIA test as described for anti-HBs measurements in human serum.
Statistics. The Mann-Whitney U test was used to compare the geometric mean titers (GMTs) in the mouse experiments.
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FIG. 3. T-cell antigenicity of delipidated HBsAg. Increasing doses of native ( ), 0% OG-treated (x), and 2% OG-treated () HBsAg were added to 2 x 104 HBsAg-specific T cells (cell lines HBL-2-TW, HBL-19-TW, HBL-1-VA, and HBL-14-DO) in the presence of 105 autologous, irradiated PBMC (from the patients from which the cell lines were generated). Lymphoproliferation, expressed as the SI, was measured on day 4. An example of a calculation of the HBsAg concentration required to reach 50% of the maximal proliferation is shown for the cell line HBL-2-TW. Lines marking the 50% level of the maximal response on the y axis show the dose of HBsAg on the x axis that is required to reach this 50% proliferative response.
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TABLE 2. Antigenicity of delipidated HBsAg for HBsAg-restricted T-cell lines
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Treatment of HBsAg with ß-D-octyl glucoside enhances immune recognition by nonfractionated PBMC from HR and NR hepatitis B vaccinees. The increased T-cell antigenicity of delipidated HBsAg was not only demonstrable with T-cell lines but was even more prominent when nonfractionated PBMC from HRs or NRs to the HBsAg vaccine were examined. When increasing doses of native or 2% OG-treated HBsAg were added to nonfractionated PBMC from HRs, substantially smaller amounts of delipidated HBsAg were required to induce a vigorous response (Fig. 4, left panel). Delipidated HBsAg induced marked proliferative responses in PBMC from an NR (Fig. 4, right panel), whereas native HBsAg was unable to induce any proliferative response in the NR, even at an Ag concentration of 12 µg/ml. Table 3 summarizes the results of experiments performed with PBMC from two HRs and six NRs to the HBsAg vaccine. In HRs, the T-cell antigenicity of delipidated HBsAg was 100 to 200 times higher than that of untreated HBsAg. In NRs, delipidated HBsAg was able to induce a proliferative response, whereas native HBsAg was unable to do so. The amount of delipidated HBsAg required to induce a proliferative response in NRs was much higher than that needed to evoke a comparable or even superior response in HRs. For three individuals (GR1, GR2, and NR5), the experiment was performed twice, and comparable results were obtained.
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FIG. 4. HBsAg dose titration. Increasing doses of native ( ) and 2% OG-treated () HBsAg were added to 4 x 105 nonfractionated PBMC. Lymphoproliferation was measured after 6 days of culture. Data show the proliferative responses (SIs) of PBMC from a good responder (left panel) and a non/poor responder (right panel) to the hepatitis B vaccine.
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TABLE 3. Antigenicity of delipidated HBsAg assayed using PBMC from responders (R) and non/poor responders (NR) to hepatitis B vaccine compared to those of native and sham-treated HBsAg
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TABLE 4. Antigenicity of delipidated HBsAg assayed using PBMC from chronic hepatitis B virus carriers compared to that of native HBsAg
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TABLE 5. Delipidation of HBsAg does not alter proliferative responses of TT-specific T-cell lines
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TABLE 6. Recognition of delipidated HBsAg by two HBsAg-specific T-cell lines requires the presence of autologous PBMC as APC
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TABLE 7. Ag specificities of T-cell lines generated by stimulating PBMC with delipidated HBsAg
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FIG. 5. Kinetic analysis of anti-HBs responses of BALB/c (A), C57BL/6 (B), and SJL (C) mice to different HBsAg preparations. Groups of six mice were immunized (day 0) and boosted (day 28) intramuscularly with either 2 µg native ( ), 1 µg native ( ), 0.5 µg native ( ), 2 µg 2% OG-treated (), 1 µg native plus 1 µg 2% OG-treated (x), or 0.5 µg native plus 0.5 µg 2% OG-treated (+) HBsAg. Ag preparations were adsorbed to Al(OH)3 (A) or dissolved in complete Freund's adjuvant (B and C). Anti-HBs titers were measured with a radioimmunoassay. Titers are expressed as GMT values.
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Since the HBsAg polypeptide contains four hydrophobic regions with helical organization that possibly span the lipid bilayer, and since these sequences are endowed with T-cell immunogenicity (3, 5), it is conceivable that partial delipidation facilitates the processing and presentation of these important domains. From this perspective, the expression and biological function of lipase activity in antigen-presenting cells deserve further attention. Since HBsAg-specific T-cell lines can be triggered with 10 to 20 times less delipidated HBsAg than untreated antigen, we assume that delipidated HBsAg is more efficiently (or rapidly) processed and/or that more peptide-class II complexes are exported and exposed at the cell surface of the APC. Most clones recognize peptides in the areas that are considered to be located in hydrophobic
-helical transmembrane regions of HBsAg (according to a topological model proposed by Stirk et al. and Howard et al. [15, 34]). Since, after treatment with OG, the content of
-helical regions decreased from 52 to 35%, and since most changes occur in the hydrophobic parts of the Ag (9), it is conceivable that some T-cell epitopes become more accessible. It is obvious that the protein moieties of the HBsAg particles and their associated T-cell epitopes could be liberated more efficiently after reducing the lipid content of the particles. We conclude that the increased antigenicity of the delipidated particles in the first series of experiments can be explained by the fact that T-cell epitopes became available at a more rapid pace and possibly at a higher density. We invoke the same mechanism to explain the highly increased antigenicity of delipidated HBsAg towards nonfractionated PBMC from HR vaccinees. However, improved processing and presentation can most probably not explain why PBMC from NR vaccinees and CC patients are stimulated by delipidated HBsAg, whereas they do not react upon exposure to standard or elevated concentrations of untreated HBsAg.
We have previously demonstrated that APC from NR vaccinees are able to take up, process, and adequately present HBsAg to T-cell lines derived from HRs (4, 6). We assume that NRs lack most T cells recognizing the dominant epitopes because their T cells equipped with the appropriate T-cell receptor are systematically eliminated or silenced during thymic maturation or by a postthymic event. Following intense stimulation of the immune system by repetitive vaccination (four or many more doses) with HBsAg, T cells recognizing subdominant epitopes and a minority of T cells recognizing dominant epitopes start to expand and, if present in sufficient numbers, support a humoral anti-HBs response. Subdominant-epitope-restricted T cells can only be detected in vitro when delipidated HBsAg is employed in the assay system. We invoke a similar mechanism to explain the behavior of T cells from CC patients. It has been known for years that CC patients have very weak humoral and cellular immune responses towards HBsAg. The use of delipidated HBsAg in lymphoproliferative assays reveals the presence of very low-affinity HBsAg-specific Th cells in CC patients. Their existence was not unsuspected, since T-cell tolerance or a T-cell nonresponse is clonal and heterogeneous and seldom would be expected to be total. T-cell responses to even delipidated HBsAg are approximately 1,000-fold less efficient in CC patients and vaccine NRs than in vaccine responders. Functionally, there is probably little difference between a zero response and a 1,000-fold-lower Th-cell response in terms of clearing a chronic infection or mediating a vaccine response. This is consistent with the absence of viral clearance and lack of anti-HBs production in CC patients and NRs, respectively. Further studies of the phenotypic and functional characteristics of these T cells, as well as of their immunopathological significance, are needed.
Different control experiments ensured that the observed phenomena are not nonspecific adjuvant effects induced by the delipidation procedure but that the intrinsic antigenicity of HBsAg is increased by lipid extraction.
As demonstrated by others, delipidated HBsAg alone has significantly reduced B-cell antigenicity compared to native HBsAg (9). It was described previously that partial removal of lipids induced conformational changes and a reduction of immune recognition by polyclonal antibodies. However, after delipidation of HBsAg with OG, the particle can still be recognized as an HBsAg in an Abbott AUSRIA assay. This suggests that at least a part of the major "a" determinant remains intact after treatment with the detergent. To bypass the reduced B-cell immunogenicity of the delipidated particles, we mixed delipidated and native HBsAg so that the former contributed to the improved T-cell antigenicity and the latter contributed to the B-cell antigenicity of the vaccine. When vaccination experiments were performed with mixtures of native and delipidated particles, similar (BALB/c mice [high responders to HBsAg; H-2d]) or slightly superior (C57BL/6 mice [intermediate responders to HBsAg; H-2b] and SJL mice [low responders to HBsAg; H-2s]) anti-HBs titers were reached compared to vaccinations with native HBsAg alone.
Further analysis of the T-cell response induced in vitro with delipidated HBsAg can shed new light on the immunopathogenesis of chronic hepatitis B virus infections and on the etiology of vaccine nonresponsiveness. Our studies may be helpful in the search for a more immunogenic or even therapeutic hepatitis B vaccine.
We are grateful to R. Rossau (Innogenetics N.V., Ghent, Belgium) and to B. Vandekerckhove (Blood Transfusion Center of Oost-Vlaanderen, Ghent, Belgium) for performing initial HLA typing. The help of J. Vandekerckhove and L. Van Troys (Department of Biochemistry, University of Ghent) with protein concentration measurements is highly appreciated. We also thank A. Elewaut and his staff (Department of Internal Medicine, Gastroenterology, University Hospital, Ghent, Belgium) for collecting blood from patients chronically infected with hepatitis B virus. We thank GlaxoSmithKline for supplying HBsAg, gD2, and the adjuvant mixtures and Eurocetus (The Netherlands) for their kind gift of recombinant IL-2.
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