CTLA-4 control over Foxp3+ regulatory T cell function

Naturally occurring Foxp3+CD4+ regulatory T cells (Tregs) are essential for maintaining immunological self-tolerance and immune homeostasis. Here, we show that a specific deficiency of cytotoxic T lymphocyte antigen 4 (CTLA-4) in Tregs results in spontaneous development of systemic lymphoproliferation, fatal T cell-mediated autoimmune disease, and hyperproduction of immunoglobulin E in mice, and it also produces potent tumor immunity. Treg-specific CTLA-4 deficiency impairs in vivo and in vitro suppressive function of Tregs-in particular, Treg-mediated down-regulation of CD80 and CD86 expression on dendritic cells. Thus, natural Tregs may critically require CTLA-4 to suppress immune responses by affecting the potency of antigen-presenting cells to activate other T cells.

CTLA-4 Control over Foxp3 + Regulatory T Cell Function

Naturally occurring Foxp3 + CD4 + regulatory T cells (Tregs) are essential for maintaining immunological self-tolerance and immune homeostasis. Here, we show that a specific deficiency of cytotoxic T lymphocyte antigen 4 (CTLA-4) in Tregs results in spontaneous development of systemic lymphoproliferation, fatal T cell–mediated autoimmune disease, and hyperproduction of immunoglobulin E in mice, and it also produces potent tumor immunity. Treg-specific CTLA-4 deficiency impairs in vivo and in vitro suppressive function of Tregs—in particular, Treg-mediated down-regulation of CD80 and CD86 expression on dendritic cells. Thus, natural Tregs may critically require CTLA-4 to suppress immune responses by affecting the potency of antigen-presenting cells to activate other T cells.

CTLA-4 Control over Foxp3 + Regulatory T Cell Function

Naturally occurring Foxp3 + CD4 + regulatory T cells (Tregs) are essential for maintaining immunological self-tolerance and immune homeostasis. Here, we show that a specific deficiency of cytotoxic T lymphocyte antigen 4 (CTLA-4) in Tregs results in spontaneous development of systemic lymphoproliferation, fatal T cell–mediated autoimmune disease, and hyperproduction of immunoglobulin E in mice, and it also produces potent tumor immunity. Treg-specific CTLA-4 deficiency impairs in vivo and in vitro suppressive function of Tregs—in particular, Treg-mediated down-regulation of CD80 and CD86 expression on dendritic cells. Thus, natural Tregs may critically require CTLA-4 to suppress immune responses by affecting the potency of antigen-presenting cells to activate other T cells.

CTLA-4 Control over Foxp3 + Regulatory T Cell Function

Naturally occurring Foxp3 + CD4 + regulatory T cells (Tregs) are essential for maintaining immunological self-tolerance and immune homeostasis. Here, we show that a specific deficiency of cytotoxic T lymphocyte antigen 4 (CTLA-4) in Tregs results in spontaneous development of systemic lymphoproliferation, fatal T cell–mediated autoimmune disease, and hyperproduction of immunoglobulin E in mice, and it also produces potent tumor immunity. Treg-specific CTLA-4 deficiency impairs in vivo and in vitro suppressive function of Tregs—in particular, Treg-mediated down-regulation of CD80 and CD86 expression on dendritic cells. Thus, natural Tregs may critically require CTLA-4 to suppress immune responses by affecting the potency of antigen-presenting cells to activate other T cells.

CTLA-4 Control over Foxp3 + Regulatory T Cell Function

Naturally occurring Foxp3 + CD4 + regulatory T cells (Tregs) are essential for maintaining immunological self-tolerance and immune homeostasis. Here, we show that a specific deficiency of cytotoxic T lymphocyte antigen 4 (CTLA-4) in Tregs results in spontaneous development of systemic lymphoproliferation, fatal T cell–mediated autoimmune disease, and hyperproduction of immunoglobulin E in mice, and it also produces potent tumor immunity. Treg-specific CTLA-4 deficiency impairs in vivo and in vitro suppressive function of Tregs—in particular, Treg-mediated down-regulation of CD80 and CD86 expression on dendritic cells. Thus, natural Tregs may critically require CTLA-4 to suppress immune responses by affecting the potency of antigen-presenting cells to activate other T cells.

Regulatory T cells - a brief history and perspective

It is now widely accepted that the normal immune system harbors a regulatory T-cell population specialized for immune suppression. It was found initially that some CD4(+) T cells in normal animals were capable of suppressing autoimmunity. Characterization of this autoimmune-suppressive CD4(+) T cell population revealed that they constitutively expressed the CD25 molecule, which made it possible to distinguish them from other T cells, delineate their developmental pathways, in particular their thymic development, and characterize their potent in vivo and in vitro immunosuppressive activity. The marker also helped to identify human regulatory T cells with similar functional and phenotypic characteristics. Recent studies have shown that CD25(+)CD4(+) regulatory T cells specifically express the transcription factor Foxp3. Genetic anomaly of Foxp3 causes autoimmune and inflammatory disease in rodents and humans through affecting the development and function of CD25(+)CD4(+) regulatory T cells. These findings at the cellular and molecular levels altogether provide firm evidence for Foxp3(+)CD25(+)CD4(+) regulatory T cells as an indispensable cellular constituent of the normal immune system and for their crucial roles in establishing and maintaining immunologic self-tolerance and immune homeostasis. They can be exploited for clinical use to treat immunological diseases and control physiological and pathological immune responses.

Regulatory T cells as potential immunotherapy in allergy

PURPOSE OF REVIEW

CD4 regulatory T cells are fundamental for the induction and maintenance of immunological tolerance to self and foreign-antigens, including allergens. Here we discuss recent advances in the field of regulatory T cells and how this knowledge can be exploited to treat and prevent allergy.

RECENT FINDINGS

Current research suggest that naturally occurring CD4CD25 regulatory T cells together with inducible IL-10-producing CD4 regulatory T cells actively control allergic responses and that their function or numbers may contribute to the development or progression of allergy. Indeed, successful treatment of allergy by allergen-specific immunotherapy may depend on the induction of IL-10 secreting CD4 T cells. Work has begun to reveal the impact of various pharmaceutical treatments on naturally occurring CD25 regulatory T cells. In addition, recent findings point to an important role for toll-like receptors in the tuning of regulatory T cell function and homeostasis. This may link the hygiene hypothesis to regulatory T cells and open up new possibilities for early intervention in allergic disease.

SUMMARY

The identification of a role for regulatory T cells in allergic disease has provided a host of new therapeutic possibilities, with the potential prospect of safe and long-term alleviation of allergic diseases.

Emerging possibilities in the development and function of regulatory T cells

CD25+CD4+ Regulatory T cells (Treg) represent a unique population of lymphocytes capable of powerfully suppressing immune responses. A large body of experimental data have now confirmed the essential role played by these cells in a host of clinically relevant areas such as self-tolerance, transplantation, allergy and tumor/microbial immunity. Despite this mass of knowledge, significant gaps in our understanding of fundamental Treg biology remain, particularly regarding their development and mechanisms of suppression. In this review we attempt to highlight the current controversies and directions in which this exciting field is moving.

Phenotypic and functional characterization of human CD25+ B cells

We demonstrate that humans have a phenotypically and functionally distinct subset of B lymphocytes that express the interleukin (IL)-2 receptor (IL-2R) alpha-chain, cluster of differentiation (CD) 25. We found that one-third of the circulating CD20+ B cells expressed CD25 and, using fluorescence-activated cell sorter (FACS) analysis, that these cells were significantly larger and more granulated than B cells not expressing CD25. The simultaneous expression of the other two subunits (CD122 and CD132) and the proliferative responses of cells expressing CD25 to IL-2 suggested that, in addition to CD25, functional IL-2 receptors were expressed on this cell population. CD25 expression on B cells was selectively up-regulated by Toll-like receptor 2 (TLR2), TLR4, and TLR9 ligands but not by a TLR3 ligand or Epstein-Barr virus (EBV) stimulation. Blockade of the nuclear factor (NF)-kappaB pathway completely abolished CD25 up-regulation by these B cells. Interestingly, CD25+ B cells expressed significantly higher levels of surface immunoglobulins but lacked the ability to secrete immunoglobulin (Ig), as compared with CD25- B cells. Furthermore, CD25+ B cells performed significantly better as antigen-presenting cells in allogeneic mixed lymphocyte reactions (MLR), which may be a result of their expression of high levels of the costimulatory molecules CD27 and CD80. Finally, blocking of CD25 on B cells led to an almost total abrogation of MLR. Our results indicate that CD25+ B cells have distinct phenotypic and functional properties, including the ability to contribute to antigen presentation, which is linked to their expression of CD25. Finally, the differential regulation of CD25 expression via selective TLR ligands suggests a role for CD25+ B cells in bridging innate and acquired immune responses.

CD4+ CD25+ FOXP3+ regulatory T cells from human thymus and cord blood suppress antigen-specific T cell responses

Activation of self-reactive T cells in healthy adults is prevented by the presence of autoantigen-specific CD4+CD25+ regulatory T cells (CD25+ Treg). To explore the functional development of autoantigen-reactive CD25+ Treg in humans we investigated if thymic CD25+ Treg from children aged 2 months to 11 years and cord blood CD25+ Treg are able to suppress proliferation and cytokine production induced by specific antigens. While CD4+CD25- thymocytes proliferated in response to myelin oligodendrocyte glycoprotein (MOG), tetanus toxoid and beta-lactoglobulin, suppression of proliferation was not detected after the addition of thymic CD25+ Treg. However, CD25+ Treg inhibited interferon (IFN)-gamma production induced by MOG, which indicates that MOG-reactive CD25+ Treg are present in the thymus. In contrast, cord blood CD25+ Treg suppressed both proliferation and cytokine production induced by MOG. Both cord blood and thymic CD25+ Treg expressed FOXP3 mRNA. However, FOXP3 expression was lower in cord blood than in thymic CD25+ T cells. Further characterization of cord blood CD25+ T cells revealed that FOXP3 was highly expressed by CD25+CD45RA+ cells while CD25+CD45RA- cells contained twofold less FOXP3, which may explain the lower expression level of FOXP3 in cord blood CD25+ T cells compared to thymic CD25+ T cells. In conclusion, our data demonstrate that low numbers of MOG-reactive functional CD25+ Treg are present in normal thymus, but that the suppressive ability of the cells is broader in cord blood. This suggests that the CD25+ Treg may be further matured in the periphery after being exported from the thymus.

CD4+CD25+-regulatory T cells from mouse to man

Immunological tolerance is one of the fundamental concepts of the immune system. During the past decade, CD4+CD25+-regulatory T cells have emerged as key players in the development of tolerance to autoantigens as well as to foreign antigens. Still many questions remain illusive regarding the basic properties of CD4+CD25+-regulatory T cells. This review aims to recapitulate some of the current understandings about the phenotype, function and clinical relevance of murine and human CD4+CD25+-regulatory T cells.

Defective suppression of Th2 cytokines by CD4+CD25+ regulatory T cells in birch allergics during birch pollen season

BACKGROUND

CD4(+)CD25+ regulatory T cells suppress proliferation and cytokine production by human T cells both to self-antigens and exogenous antigens. Absence of these cells in human newborns leads to multiple autoimmune and inflammatory disorders together with elevated IgE levels. However, their role in human allergic disease is still unclear.

OBJECTIVE

This study aimed to evaluate the capacity of CD4(+)CD25+ regulatory T cells to suppress proliferation and cytokine production outside and during birch-pollen season in birch-allergic patients relative to non-allergic controls.

METHODS

CD4+ cells were obtained from blood of 13 birch-allergic patients and six non-allergic controls outside pollen season and from 10 birch-allergic patients and 10 non-allergic controls during birch-pollen season. CD25+ and CD25- fractions were purified with magnetic beads and cell fractions, alone or together in various ratios, were cultured with antigen-presenting cells and birch-pollen extract or anti-CD3 antibody. Proliferation and levels of IFN-gamma, IL-13, IL-5 and IL-10 were measured by thymidin incorporation and ELISA, respectively. Numbers of CD25+ cells were analysed by flow cytometry.

RESULTS

CD4(+)CD25+ regulatory T cells from both allergics and non-allergics potently suppressed T cell proliferation to birch allergen both outside and during birch-pollen season. However, during season CD4(+)CD25+ regulatory T cells from allergic patients but not from non-allergic controls were defective in down-regulating birch pollen induced IL-13 and IL-5 production, while their capacity to suppress IFN-gamma production was retained. In contrast, outside pollen season the regulatory cells of both allergics and non-allergic controls were able to inhibit T-helper 2 cytokine production.

CONCLUSION

This is the first study to show differential suppression of Th1 and Th2 cytokines, with CD4(+)CD25+ regulatory T cells from birch-pollen-allergic patients being unable to down-regulate Th2, but not Th1 responses during birch-pollen season.

Effect of neurofeedback on motor recovery of a patient with brain injury: a case study and its implications for stroke rehabilitation

This case study showed the effect of neurofeedback (NFB) training in a patient with a brain tumor and co-existing traumatic brain injury. The patient received 40 sessions of NFB intervention. Tests and videotaped recordings evaluated pre- and post-NFB intervention. This study demonstrated minimal to significant improvements in several functional tasks. The conclusion is that the use of NFB for a person with a head injury and brain tumor can be generalized to be used with stroke survivors.

CD4 T cell activation by myelin oligodendrocyte glycoprotein is suppressed by adult but not cord blood CD25+ T cells

Regulatory T cells expressing CD25 have been shown to protect rodents from organ-specific autoimmune diseases. Similar CD25+ cells with a memory phenotype exerting suppressive function after polyclonal or allogeneic stimulation are also present in adult human blood. We demonstrate that adult human CD25+ cells regulate the response to myelin oligodendrocyte glycoprotein (MOG), as depletion of CD25(+) cells increases responses of PBMC and the addition of purified CD25+ cells suppresses MOG-specific proliferation and IFN-gamma production of CD4(+)CD25(-) T cells. In contrast, cord blood CD25+ cells do not inhibit responses to self antigens, and only a small subpopulation of cord CD25+ cells expresses the typical phenotype of adult regulatory T cells (CD45RA(-) and GITR(+)) enabling suppression of polyclonal responses. We conclude that activation of self-reactive T cells in normal healthy individuals is prevented by the presence of self-antigen-specific CD25+ regulatory T cells and that the majority of these cells mature after birth.

Characterization of human CD25+ CD4+ T cells in thymus, cord and adult blood

CD4(+) CD25(+) regulatory T cells prevent organ-specific autoimmune diseases in various animal models. We analysed human lymphoid tissues to identify similar CD25(+) regulatory T cells. Adult peripheral blood contained two populations of CD4(+) T cells that expressed CD25 at different densities. The larger population (approximately 40%) expressed intermediate levels of CD25 (CD25(+)) and displayed a memory T-cell phenotype (CD45RA-/RO(+), CD45RB(low), CD95(+), CD62L(low), CD38(low)). The smaller population of cells (approximately 2%) expressed very high levels of CD25 (CD25(++)). In addition to the activation/memory T-cell antigens mentioned above they also expressed intracellular CD152 (CTLA-4) as well as enhanced levels of cell-surface CD122, similar to the murine CD4(+) CD25(+) regulatory counterpart. To exclude that the CD25(++) cells had not been recently primed by external antigen we analysed cord blood and thymus. CD25(++), CD152(+) and CD122(++) cells were present in paediatric thymus (10% of CD4(+) CD8(-) thymocytes) expressing signs of recent selection (CD69+) and in cord blood (5% of CD4(+) cells) where they showed a naive phenotype. In addition, cord blood contained a small population of CD25(+) cells (approximately 2% of CD4 T cells) that were CD152(-) and CD122(low) and displayed signs of activation. Together with published data that CD25(+) CD25(++) cells from the thymus and peripheral blood are regulatory, our results suggest that regulatory CD25(+) T cells leave the thymus in a naïve state and become activated in the periphery.

A recombinant trimeric surfactant protein D carbohydrate recognition domain inhibits respiratory syncytial virus infection in vitro and in vivo

The pulmonary collectin, lung surfactant protein D (SP-D), plays a role in host defense mediated by the interaction of surface carbohydrates of inhaled pathogens with the lectin domains of SP-D. Respiratory syncytial virus (RSV), the most important viral pathogen of neonates and infants, encodes a highly glycosylated attachment protein, G. Binding studies were performed with G protein from RSV (human, A2 strain) and both native and recombinant human SP-D. The effect of recombinant trimeric SP-D lectin domains (rSP-D) on the interaction between RSV and host cells was determined by two methods: an infectivity study with monolayers of Hep-2C cells and in vivo infections in BALB/c mice. These studies show that full-length and recombinant SP-D bind to RSV G protein in a concentration-dependent manner. Both EDTA and mannan inhibited binding of full-length SP-D. These results indicate that binding occurs via the carbohydrate recognition domain of the SP-D. The recombinant SP-D inhibited RSV infectivity in cell culture in a dose-dependent manner, giving 100% inhibition of replication. Intranasal administration of recombinant SP-D to RSV-infected mice inhibited replication of the virus in the lungs, reducing levels of lung virus by 80%. These results suggest that SP-D plays a major role in clearing RSV from the lungs.

A comparison of iron absorption from single meals and daily diets using radioFe (55Fe, 59Fe)

The purpose of the present study was to compare two measures of Fe absorption, one from single meals and the other from daily diets. Ten ileostomy subjects were given the same low-fibre composite diet for all three meals each day for five consecutive days. After 3 weeks the experiment was repeated with a high-fibre diet. The morning meal constituted one-seventh of the total daily diet intake, the mid-day meal two-sevenths and the evening meal four-sevenths of the total daily diet intake. On days 4 and 5 of each diet period the morning meal was labelled with 55Fe and all three meals were labelled with 59Fe. The activities retained in the subjects 19 d later showed the Fe absorption from the low-fibre diet measured from the morning meals to be almost 80% greater than the average Fe absorption measured from all meals during the same 2 d. With the high-fibre diet the absorption from the morning meals was less than 50% greater than the average for all meals but the difference was not significant. We suggest that all meals of the day should be labelled with radioFe in order to avoid inflating the measures of Fe absorption.

Effect of milk and fermented milk on iron absorption in ileostomy subjects

This study was undertaken to determine whether milk with its high calcium content adversely affects the absorption of nonheme iron from the diet as greatly as single-meal studies indicate. Nine ileostomy subjects ate a low-fiber, low-phytate diet for 8 consecutive weeks. During the first and eight weeks they drank a 250-mL soft drink with three main meals and an evening snack each day (0.16 g Ca/d). During the two intervening 3-wk periods, they drank the same amount of low-fat milk or fermented low-fat milk (Verum; Hälsofil, Norrmejerier, Umeä, Sweden) according to a formally randomized crossover design (1.4 g Ca/d). During the last 2 d in each of the four periods, apparent iron absorption (balance) from a test diet together with that period's beverage was measured and the plasma ferritin concentration was determined. There was no decrease in apparent iron absorption during the milk diet periods.

Sens-A-Ray. A new system for direct digital intraoral radiography

A new system for direct digital intraoral radiography, Sens-A-Ray, is presented. This system is based on a detector with a charge-coupled device that was designed especially for direct exposure to x-ray radiation. The system also includes interface electronics and an IBM AT-compatible personal computer with a digital I/O with frame memory, a super VGA graphics board, a high-resolution monitor, and software for the exposure, capture, storage, and enhancement of images. An external optical mass storage device is used for permanent storage of images in digital format. A video printer may be used to create hard copies. The system produces radiographic images at a significantly lower exposure than required for E-speed intraoral film. Applications of the system are exemplified, and its basic properties are discussed.

A comparative study in rats of measures of the availability of dietary zinc and iron

The purpose of this study was to compare three measures of the availability of dietary Zn and Fe in order to test their validity. Thirty-six 5-wk-old rats were fed deionized water and wheat crispbread made from endosperm flour, whole-grain flour, or endosperm flour supplemented with Zn and Fe to the whole-grain levels ad libitum for 14 d. The retention of 65Zn and 59Fe from test meals of the same breads after 1 wk and the sum of the excretion of endogenous Zn and Fe (injected 65Zn and 59Fe) with the Zn and Fe balances, respectively, were used as independent measures of Zn and Fe absorption. Measurements of Zn absorption, Zn balance, and serum Zn concentration gave quite different results with regard to the availability of Zn in the three breads, presumably because of the homeostatic regulation of the absorption and excretion of Zn when the Zn in the diet is in excess of the body's needs. Measurements of Fe absorption, Fe balance, and Fe concentrations in liver and serum were consistent in demonstrating overloading of Fe in the group given wheat-endosperm crispbread supplemented with Zn and Fe, but there was evidence that the isotope retention method overestimated iron absorption.

The relation of the accumulation of cadmium in human placenta to the intake of high-fibre grains and maternal iron status

Exposure to cadmium via the diet is known to depend to a large extent on the intake of cereal grains, particularly the high-fibre fractions of wheat. Subjects with low iron status absorb more cadmium than those with better iron status. The purpose of the present study was to determine to what extent cadmium accumulation in human placenta is affected by the intake of grain fibre and maternal iron status during pregnancy. Thirty-nine pregnant women participated in the study. In each trimester the women were requested to complete a dietary history and to allow blood samples to be taken for haemoglobin, serum ferritin and serum thiocyanate determinations, the latter as a marker for smoking. At delivery the whole placenta was taken for the determination of the cadmium concentration. The 32 women who had serum thiocyanate levels less than 70 mumol/l, who had completed at least one dietary history and from whom a blood sample was obtained in the third trimester, were included in the final statistical analyses. In the group of women who consumed less than the median intake of grain fibre and had more than 15 micrograms ferritin/l serum in the third trimester, the placenta cadmium concentration was nearly half that in the placentae of women who had consumed more grain fibre or had lower iron status in late pregnancy.

Factors affecting the long-term results of endodontic treatment

The influence of various factors that may affect the outcome of root canal therapy was evaluated in 356 patients 8 to 10 yr after the treatment. The results of treatment were directly dependent on the preoperative status of the pulp and periapical tissues. The rate of success for cases with vital or nonvital pulps but having no periapical radiolucency exceeded 96%, whereas only 86% of the cases with pulp necrosis and periapical radiolucency showed apical healing. The possibility of instrumenting the root canal to its full length and the level of root filling significantly affected the outcome of treatment. Of all of the periapical lesions present on previously root-filled teeth, only 62% healed after retreatment. The predictability from clinical and radiographic signs of the treatment-outcome in individual cases with preoperative periapical lesions cases was found to be low. Thus, factors which were not measured or identified may be critical to the outcome of endodontic treatment.

The extent of coprophagy in rats with differing iron status and its effect on iron absorption

The purpose of this study was to determine the prevalence of coprophagy in rats with differing iron status and its effect on the measurement of iron absorption from test meals with and without bran. Two experiments were performed using radioisotope-labelled microspheres added as a non-digestible marker for the ingested faeces and the diet and 59Fe added as a marker for the nonhaem iron in the test meal. In this study, coprophagy occurred at group mean rates of between 5 and 22% and was independent of the iron status of the rats or the presence or absence of bran in the diet. The relative absorption of iron, measured as the retention of 59Fe from a single meal, was affected to the same extent in groups with the same iron status, if it was affected at all. Thus comparisons of iron absorption from diets with and without bran should not be affected by coprophagy.

The importance of the body's need for zinc in determining Zn availability in food: a principle demonstrated in the rat

1. The hypothesis that the availability of zinc in a food is limited by factors in the food was tested against the hypothesis that Zn absorption is homeostatically regulated by the body according to its need for Zn. 2. The experimental model used was the short-term administration to rats of a parenteral nutrition solution with no added Zn in an attempt to increase their need for Zn in an anabolic phase. 3. The absorption and retention of 65Zn from a piece of endosperm-wheat crisp-bread in rats injected intraperitoneally with the parenteral nutrition solution was more than 40% higher than that in a control group injected with physiological saline (9 g sodium chloride/l). 4. The results indicate that the availability of Zn in the bread is not fixed but variable and dependent on the body's need for Zn.