Potential role of gamma delta T cells in autoimmune diseases

The Norton Lecture: a review of the oligodendrocyte in the multiple sclerosis lesion

The mechanisms involved in the elimination of oligodendrocytes and myelin from the demyelinated plaque of multiple sclerosis (MS) are inextricably intertwined and yet most investigations tend to consider them separately. This short review revisits the problem of oligodendrocyte pathology in MS and attempts to put the topic into perspective by examining the numerous immunologically-active molecules associated with the oligodendrocyte, some, but not all, cross-reactive with myelin. The consensus of opinion is that myelin is the primary target in MS but that oligodendrocytes are eventually lost from the lesion. Reappraisal of recent and past works brings into focus a possible key role for soluble mediators, in particular antibody and the pro-inflammatory cytokine, TNF alpha, in oligodendrocyte loss and myelin in MS. Despite extensive neuropathologic investigation by a number of laboratories, no evidence has yet been found to support the concept that apoptosis might account for oligodendrocyte depletion in MS, even though molecules belonging to the apoptotic cascade can be expressed by oligodendrocytes in and around lesions. Indeed, abundant evidence has been presented to show that oligodendrocytes initially respond to the demyelinating insult in MS by proliferating and elaborating new myelin but, no doubt due to the relentless progression of inflammatory events, the cells are eventually lost, probably via a cytolytic pathway. Strategies to block the progression of CNS inflammation in EAE and MS appear to promote the survival of oligodendrocytes and to enhance remyelination. Such strategies appear to hold much promise for the MS patient.

Triplet repeat polymorphism in the transmembrane region of the MICA gene: a strong association of six GCT repetitions with Behçet disease

A member of a novel family of the human major histocompatibility complex (MHC) class I genes termed MIC (MHC class I chain-related genes), MICA, has been recently identified near the HLA-B gene on the short arm of human chromosome 6. The predicted amino acid sequence of the MICA chain suggests that it folds similarly to typical class I chains and may have the capacity to bind peptides or other short ligands. Therefore, MICA is predicted to have a specialized function in antigen presentation or T cell recognition. During nucleotide sequence analyses of the MICA genomic clone, we found a triplet repeat microsatellite polymorphism of (GCT/AGC)n in the transmembrane (TM) region of the MICA gene. In 68 HLA homozygous B cell lines, 5 distinct alleles of this microsatellite sequence were detected. One of them contained an additional one base insertion that created a frameshift mutation resulting in a premature termination codon in the TM region. This particular allele may encode a soluble, secreted form of the MICA molecule. In addition, we have investigated this microsatellite polymorphism in 77 Japanese patients with Behcet disease, which is known to be associated with HLA-B51. The microsatellite allele consisting of 6 repetitions of GCT/AGC was present at significantly higher frequency in the patient group (Pc = 0.00055) than in a control population. Furthermore, the (GCT/AGC)6 allele was present in all B51 positive patients and in an additional 13 B51 negative patients. These results suggest the possibility of a primary association of Behcet disease with MICA rather than HLA-B.

Prospects of immunotherapy for rheumatoid arthritis

The main challenge in the development of new modalities for the treatment of rheumatoid arthritis is to enhance the specificity while reducing the adverse side-effects of therapeutics. Biotechnology provides a variety of reagents, such as monoclonal antibodies, recombinant cytokines, cytokine antagonists, and small peptides, with the potential to interfere with selected stages of the disease process in a highly specific manner. In addition, several new therapeutic approaches have emerged as a result of extensive research with animal models of disease, including T-cell vaccination and bone marrow transplantation. This article discusses current insights into the pathogenesis of rheumatic diseases, focusing on rheumatoid arthritis. A number of new therapeutic modalities for rheumatoid arthritis, in particular those acting on the immune system, are discussed. Because it is not possible to provide a complete overview of all the developments in the field in limited space, a selection of strategies and modalities which are representative of the broad variety of immunotherapeutic approaches currently used are highlighted.

An immunohistochemical study of immunological phenomena in minor salivary glands in patients with Sjögren's syndrome

Using different monoclonal antibodies, we performed an immunofluorescent technique on labial salivary glands in order to investigate the immunological phenomena involved in Sjögren's syndrome (SS). An aberrant expression of HLA-DR molecules was detected on cytoplasm of epithelial labial salivary cells in 9 out of 19 (47%) patients, with SS. No such expression was found in 8 patients without SS or in 3 normal controls. HLA-DQ molecules were demonstrated also in two out of ten SS patients without HLA-DR. A lymphocytic infiltration was not correlated with the expression of class II molecules. T cells bearing gamma delta receptors were not detected. The intracellular adhesion molecules (ICAM-1) and lymphocyte function associated antigen-1 (LFA-1) were not found on epithelial glandular salivary cells of patients and controls. In conclusion, these data suggested that the absence of ICAM-1 and LFA-1 in salivary cells and the absence of infiltrating T cells bearing gamma delta receptors exclude their immunopathogenetic role in SS; moreover, these data demonstrated that the aberrant expression of HLA class II molecules on epithelial salivary cells of patients with SS is not a phenomenon correlated with the lymphocytic infiltration.

Cytokine induction of heat shock protein expression in human oligodendrocytes: an interleukin-1-mediated mechanism

In this study, we examined the role of cytokines, known to be in elevated levels in multiple sclerosis (MS) plaques, in regulating oligodendrocyte (ODC) expression of heat shock protein (hsp) in human brain-derived glial cell cultures. Using dual-stain immunohistochemistry, we initially compared the ability of a mixture of cytokines (IL-1 alpha, IL-1 beta, IL-2, IL-6, IL-8, TNF-alpha, TNF-beta, IFN-beta and IFN-gamma) with that of physical stimuli such as heat shock and peroxide, to increase cellular expression of the mainly inducible hsp72 species in mixed glial cell cultures (containing ODC, astrocytes and microglia). Similar to heat shock and peroxide, the cytokine mixture induced hsp72 expression only in ODC (70 +/- 5% vs. a baseline of 3 +/- 1% positive cells). When used individually, however, only IL-1 alpha (79 +/- 3%), IFN-gamma (70 +/- 2%) and TNF-alpha (65 +/- 5%) induced ODC hsp72 expression in mixed glial cell cultures. In purified ODC preparations, only IL-1 alpha induced hsp72 expression (84 +/- 4%). An IL-1 receptor antagonist (IL-1ra), abrogated hsp72 induction by IL-1 alpha (16 +/- 3%) as well as that due to IFN-gamma (14 +/- 1%) and TNF-alpha (13 +/- 2%) in mixed glial cell cultures. Furthermore, ODC express IL-1 receptors, detected by confocal laser scanning microscopy. Our data indicate that cytokines mediate hsp induction in ODC possibly via a final common pathway involving IL-1 binding to its receptor on ODC. Such interaction could enhance any putative ODC-immune interactions which are dependent on hsp molecule recognition.

Differential expression of heat shock proteins by human glial cells

Heat shock proteins (HSP) have been implicated in the interactions between the gamma delta T lymphocyte population and target tissues. gamma delta T cells are found in increased numbers in multiple sclerosis (MS) plaques compared to their proportion in peripheral blood, co-localizing with oligodendrocytes (OGC) expressing HSP. We have demonstrated that such gamma delta T cells can induce in vitro lysis of human adult-derived OGC. Using immunohistochemical and flow cytometry techniques, we examined the constitutive and/or inducible expression of HSP in or on adult human-derived glial cell cultures in vitro. HSP70 was expressed in OGC maintained at basal temperature, but the expression of the inducible HSP70 protein was upregulated by a prior 43 degrees C heat exposure. HSP70 could not be detected within astrocytes (GFAP+ cells), whether heat stress was applied or not. Constitutive expression of HSP60 could be discerned on the surface of all OGC under non-stressed culture conditions. Only some astrocytes demonstrated minor punctate surface HSP60 staining, whereas the remainder did not express HSP60 constitutively. These observations raise the possibility that OGC, by virtue of their differential expression of HSP compared to other glial cells, may be particularly prone to interaction with HSP-reactive gamma delta T cells. Such findings may further implicate gamma delta T cells in the pathogenesis of MS, a putative autoimmune disease in which immune-mediated injury is directed specifically against the oligodendrocyte-myelin unit within the central nervous system.

Dual antigenic recognition by cloned human gamma delta T cells

The function of gamma delta T cells is still elusive. The nature of the antigens that they recognize and the mode of presentation of these antigens are largely unknown. The majority of human peripheral gamma delta T cells bear a V gamma 9/V delta 2 T cell receptor, and display nonclonal reactivity to mycobacteria, without restriction by MHC. It is unknown whether these cells have clonal antigenic specificity as well. Here we describe rheumatoid arthritis-derived V gamma 9/V delta 2 T cell clones, displaying dual antigenic recognition: a nonclonal, MHC-unrestricted recognition of mycobacteria, and a clonal recognition of a short tetanus toxin peptide presented by HLA-DRw53, a nonpolymorphic class II MHC molecule associated with susceptibility to rheumatoid arthritis. This is the first evidence that V gamma 9/V delta 2 T cells can recognize nominal antigenic peptides presented by class II MHC molecules. These results suggest that much like alpha beta T cells, V gamma 9/V delta 2 cells may contribute to the immune response against foreign antigens in an antigen-specific and MHC-restricted manner. The reactivity of these gamma delta T cells to mycobacteria may represent a superantigen-like phenomenon.