The passenger leukocyte—A fresh look

Animal models of high-risk corneal transplantation: A comprehensive review

Over the past century, corneal transplantation has become the most commonly performed allogeneic solid tissue transplantation. Although more than 80% of the corneal transplantations have favorable outcomes, immune-mediated rejection continues to be the major cause of failure in well over 50% of graft recipients that have inflamed and vascularized host beds. Over the past two decades, the progress in our understanding of the immunological pathways that mediate graft rejection has aided in the development of novel therapeutic strategies. In order to successfully test the efficacy of these interventions, it is essential to model the immunological processes occurring as a consequence of corneal transplantation. Herein, we have comprehensively reviewed the established animal models used for replicating the immunopathological processes causing graft rejection in high-risk corneal transplantation settings. We have also discussed the practical and technical differences, as well as biological and immunological variations in different animal models.

Immunophenotypic analysis of the aortic wall in Takayasu's arteritis: involvement of lymphocytes, dendritic cells and granulocytes in immuno-inflammatory reactions

The present study was undertaken to examine the cellular composition of the aortic wall in Takayasu's arteritis and to investigate the association of different cell types in the immuno-inflammatory reactions of this disease. Specimens of aortic wall affected by Takayasu's arteritis were obtained from 10 patients (five male, five female), aged 32 to 68 years (mean 49.5 years) at elective operation. The mean duration of disease was 6.5 years (range 2 months to 13 years). Specimens were embedded in paraffin and the sections stained with antibodies to CD3 (to identify T cells), CD20 (B cells), S-100 (dendritic cells), CD15 (granulocytes), CD68 (macrophages), alpha-SMA (smooth muscle cells) and von Willebrand factor (endothelial cells). Immunohistochemical examination demonstrated that all specimens showed histological alteration with the replacement of the muscular and elastic layers of the media and adventitia by dense fibrous tissue, and were characterized by varying degrees of inflammatory cell infiltration. In five cases, inflammatory nodules consisting of numerous T cells and B cells were observed in the adventitia. Within the inflammatory nodules, as well as around areas of neovascularization in the deep portion of the intima, lymphocytes were co-localized with dendritic cells. In addition, in the adventitia, the accumulation of a large number of granulocytes was observed. The present study demonstrates that immune inflammation is a typical feature of Takayasu's disease, and that the interactions between dendritic cells and lymphocytes may be important in the control of the immune reactions in this vascular pathology.

Interferon-gamma is necessary for initiating the acute rejection of major histocompatibility complex class II-disparate skin allografts

BACKGROUND

Although interferon (IFN)gamma has immunostimulatory functions, it is not essential for the acute rejection of fully allogeneic grafts in mice. It is not known whether IFNgamma plays a critical role in the acute rejection of MHC class I- or MHC class II-disparate allografts.

METHODS

We studied the survival of skin allografts transplanted from fully allogeneic (BALB/c), MHC class I-disparate (bml), or MHC class II-disparate (bm12) donors to C57BL/6 wild-type (IFNgamma+/+) and IFNgamma gene-knockout (IFNgamma-/-) recipients. We also investigated the in vitro responses of IFNgamma+/+ and IFNgamma-/- T cells to MHC class II-disparate splenocytes.

RESULTS

We found that IFNgamma-/- recipients reject BALB/c and bml skin grafts at the same rate as IFNgamma+/+ mice but are not capable of rejecting bm12 skin. Despite the inability of IFNgamma-/- mice to reject bm12 skin grafts, IFNgamma-/- T cells displayed vigorous proliferation and cytotoxic responses when stimulated with bm12 splenocytes in vitro. Furthermore, priming IFNgamma-/- recipients with bm12 splenocytes enabled these mice to reject bm12 skin grafts at a normal rate and to mount a cutaneous delayed-type hypersensitivity response to the bm12 antigen.

CONCLUSION

The data demonstrate that IFNgamma is not necessary for generating effector mechanisms associated with acute transplant rejection but that it is required for initiating alloimmune responses to MHC class II-disparate skin grafts.

Immune cholangitis: liver allograft rejection and graft-versus-host disease

A pronounced similarity exists between liver allograft rejection and graft-versus-host disease (GVHD) in the damage and eventual destruction of small intrahepatic bile ducts. Although an immunologic reaction has an important role, precisely identifying the target antigens or reason for persistence of the immune response has been difficult. An important difference between GVHD and liver rejection is the development of obliterative arteriopathy only in rejection. The three main histopathologic features of acute rejection are a predominantly mononuclear but mixed portal inflammation, subendothelial inflammation of portal or terminal hepatic veins (or both), and bile duct inflammation and damage. In acute rejection, a controversial issue is determining when therapeutic intervention is needed. The recommended approach is to base treatment on a combination of histopathologic changes and liver injury or dysfunction. Chronic rejection, which usually does not occur before 2 months after transplantation, is characterized by two main histopathologic features: (1) damage and loss of small bile ducts and (2) obliterative arteriopathy. Acute GVHD begins within the first month after transplantation and most commonly involves the skin, gastrointestinal tract, and liver, whereas chronic GVHD usually develops more than 80 to 100 days after liver transplantation and affects 30 to 50% of long-term survivors. Recognition of the early, cellular stages of chronic GVHD is important in preventing irreversible damage.

Major histocompatibility complex class I presentation of exogenously acquired minor alloantigens initiates skin allograft rejection

Major histocompatibility complex (MHC) class I molecules present peptides from endogenous proteins. However, in some cases class I-restricted peptides can also derive from exogenous antigens. This MHC class I exogenous presentation could be involved in minor histocompatibility antigen (mHAg)-disparate allograft rejection when donor alloantigens are not expressed in graft antigen-presenting cells (APC) that initiate the rejection mechanism. Here we addressed this question by using a skin graft experimental model where donors (H-2b or H-2d Tg beta-gal mice) expressed the mHAg like beta-galactosidase (beta-gal) in keratinocytes but not in Langerhans' cells (LC) which have an APC function. Rejection of Tg beta-gal skin by a beta-gal-specific CD8 cytotoxic T lymphocyte (CTL) effector mechanism should require presentation by donor and/or recipient LC of MHC class I-restricted peptides of exogenous beta-gal shed by keratinocytes. Indeed, our results showed that 1) H-2b Tg beta-gal skin was rejected by H-2bxs and H-2bxd recipients; 2) rejection was mediated by beta-gal-specific CD8+ CTL effectors; and 3) H-2bxd mice having rejected H-2b Tg beta-gal skin generated beta-gal-specific CTL restricted by H-2b and H-2d class I molecules and rejected subsequently grafted H-2d Tg beta-gal skin in an accelerated fashion, demonstrating that recipient LC have presented exogenous beta-gal-derived MHC class I epitopes. These results lead to the conclusion that MHC class I exogenous presentation of donor mHAg can initiate allograft rejection.

Rejection of spontaneously accepted rat liver allografts with recipientinterleukin-2 treatment or donor irradiation

While MHC incompatible DA (RTl(a)) to Lewis (RT1(1), LEW) rat liver allografts are acutely rejected, the reciprocal LEW to DA liver grafts are spontaneously accepted. The mechanism of this acceptance remains unclear. We evaluated the effect of donor treatment with total body irradiation (TBI) or gadolinium chloride (GdCl3), and recipient treatment with exogenous IL-2 after transplantation on the survival of the spontaneously accepted liver grafts. Male LEW and DA rats were used as donors and recipients for orthotopic liver allo- or iso-graft transplants. The LEW liver donor was treated by TBI (10 gray) 7 days before transplantation, or LEW donor Kupffer cell phagocytosis was blocked with GdCl3 (7 mg/kg) on days -2 and -1 pretransplant. In an attempt to reverse LEW liver graft acceptance, 180,000 units human IL-2 (hIL-2) were administered daily IP to the DA liver recipients from days 1 to 7 after liver grafting. While untreated LEW recipients rejected DA liver grafts within 13 days, DA recipients accepted LEW livers indefinitely (>302 days). In contrast, irradiation of the LEW liver donor prevented the spontaneous acceptance by DA recipients, and resulted in acute rejection of the liver grafts in 9-20 days. However, spontaneous graft tolerance was restored by parking the irradiated LEW donor liver in naive LEW rats for 48 hr before retransplantation to DA recipients (>50 days). When LEW donors were treated with GdCl3, which is known to block Kupffer cell phagocytosis and antigen processing, the spontaneous acceptance of the LEW liver grafts by DA recipients was unaffected. However, when exogenous rhIL-2 was given daily, LEW liver allografts were rejected by the DA recipients. The resulting liver failure correlated with a progressive increase in serum bilirubin and the development of a predominantly lymphocytic portal tract infiltration, bile duct epithelial damage, and portal vein endothelitis, which is consistent with acute allograft rejection. LEW and DA recipients of liver isografts developed no toxicity and survived indefinitely (>100 days) when treated with the same dose of IL-2. These results indicate that spontaneous rat liver allograft acceptance is associated with the presence of radiosensitive cells in the donor liver that may interact with recipient T cells to inhibit (Th1) production of IL-2.

Dominance of tissue-restricted cytotoxic T lymphocytes in the response to allogeneic renal epithelial cell lines

Our current knowledge of cytotoxic T lymphocytes (CTL) is largely derived from studies of effector populations generated in allogeneic mixed leukocyte cultures (MLC) and assayed for lytic activity to lymphoid cell (LC) targets. We herein report that the CTL response to allogeneic renal epithelial cell lines (REC) is dominated by effectors that efficiently lyse REC targets but show little cross-reactivity with LC targets. In contrast, CTL generated against allogeneic spleen cell stimulators (ie., in MLC) lysed REC and LC targets at comparable levels. Lytic activity in both types of cultures was mediated by CD8+TCRalpha/beta+ cells directed to classical H2 class I alloantigens. Anti-REC effectors cross-reacted with fibroblast and macrophage targets but not with targets commonly used to detect alloreactive CTL, such as lipopolysaccharide- or Con A-stimulated lymphoblasts or lymphoid tumor lines, whereas MLC-elicited effectors efficiently lysed all targets. CTL clones propagated from anti-REC cultures exhibited the same allospecificity and tissue specificity as bulk anti-REC effectors. Individual CTL clones were highly heterogeneous in their capacity to recognize the same class I alloantigen expressed on cells derived from different tissues. These data demonstrate that the cellular environment in which CD8 precursors encounter class I alloantigens can have a profound effect on the cell-type specificity of CTL populations. An important implication of these data is that conventional assays of CTL lytic activity may fail to reveal a significant component of the host response to allogeneic tissues.

Reduction in peripheral nerve allograft antigenicity with warm and cold temperature preservation

Lymphocyte migration into fresh and preserved peripheral nerve allografts was assessed to determine the effects of preservation time, preservation temperature, and graft harvest technique on the immunologic response to the peripheral nerve allograft. Peroneal nerve was harvested from either live or cadaveric (tissue) donors and stored as 1.5-cm segments at 5 degrees C or 37 degrees C for 1, 3, 5, or 7 days. Each of nine outbred ewes then received multiple segments of peroneal autograft, fresh allograft, and preserved nerve allograft implants. Lymphocyte migration was studied 7 days after implantation by intravenous injection of autologous 111In-labeled lymphocytes and quantified by gamma counter. Lymphocyte migration into fresh allografts (7212 +/- 1575) increased an average of 4.1 times over fresh autograft tissue (1758 +/- 421; p < 0.05). Short-term preservation (24 hours) at both temperatures enhanced lymphocyte migration into pretreated allograft tissue (12684 +/- 2575 at 5 degrees C, 8751 +/- 1577 at 37 degrees C) as compared with fresh allograft (7212 +/- 1575). Conversely, 7 days of pretreatment at both 5 degrees C (3586 +/- 1421) and 37 degrees C (1570 +/- 414) resulted in migration values not significantly different from autograft. No statistically significant difference was seen between grafts harvested from live (5710 +/- 1651) versus cadaveric (tissue) donors (4013 +/- 832) after 5 days of cold preservation.

Effect of cytokine-induced migration of Langerhans cells on corneal allograft survival

The unique paucity of Ia+ Langerhans cells (LCs) in the central cornea contributes to the immunological privilege of corneal allografts. A variety of stimuli can induce the centripetal migration of peripheral LCs. At least one of these stimuli (i.e. latex bead instillation) induces interleukin-1 (IL-1) secretion by corneal cells which acts as a potent chemoattractant for LCs. Within 30 minutes of intracorneal injection of IL-1, centripetal migration of LCs can be detected. The presence of donor-derived LCs in corneal allografts doubles the incidence of rejection of fully allogeneic corneal allografts as well as MHC matched, multiple minor H mismatched corneal allografts. Although the presence of donor-specific LCs greatly jeopardises corneal allograft survival, migration of host-derived LCs into corneal allografts does not appear to increase the risk of rejection.

Cell migration and chimerism after whole-organ transplantation: the basis of graft acceptance

Improvements in the prevention or control of rejection of the kidney and liver have been largely interchangeable (1, 2) and then applicable, with very little modification, to thoracic and other organs. However, the mechanism by which anti rejection treatment permits any of these grafts to be “accepted” has been an immunological enigma (3, 4). We have proposed recently that the exchange of migratory leukocytes between the transplant and the recipient with consequent long-term cellular chimerism in both is the basis for acceptance of all whole-organ allografts and xenografts (5). Although such chimerism was demonstrated only a few months ago, the observations have increased our insight into transplantation immunology and have encouraged the development of alternative therapeutic strategies (6).

Isolation of dendritic leukocytes from non-lymphoid organs

These observation suggest that dendritic leukocytes from several different non-lymphoid organs in situ are functionally immature and that in this respect they more closely resemble epidermal LC than mature lymphoid DC. The exception appears to be the interstitial dendritic leukocytes from small and large intestinal lamina propria and Peyer's patches, where functional maturation could be attributed to constitutively secreted GM-CSF by lamina propria cell in situ, or alternatively to the isolation procedure which might lead to functional maturation of gut DC. After overnight culture, and possibly following organ transplantation, interstitial dendritic leukocytes may mature into potent activators of antigen-specific T-cell proliferation (immunostimulation). Further studies are needed to characterize dendritic leukocytes in solid non-lymphoid organs, and these may lead to new strategies for overcoming graft rejection by inhibiting the maturation of dendritic leukocytes after transplantation.

Effect of donor Langerhans cells on corneal graft rejection

Unlike other cutaneous surfaces, the central portion of the corneal epithelium is typically devoid of Langerhans cells. The absence of Ia+ Langerhans cells in the central cornea is of more than casual interest and may explain the immunologic privilege that is characteristic of corneal allografts. The present communication summarizes previous studies that examined the role of corneal Langerhans cells in eliciting alloimmune responses and corneal graft rejection in rodents. Under normal circumstances, corneal allografts are poorly immunogenic when residing in the avascular ocular graft bed even though the graft displays large quantities of alloantigens. The afferent blockade of the immune response can be circumvented by donor-derived Langerhans cells that serve as potent immunogens for all categories of corneal allografts except grafts involving allodisparity only at class I major histocompatibility complex loci. Thus, the presence of donor-derived Langerhans cells exerts profound effects on the fate of corneal allografts.

Expression of ICAM-1 (CD54) on normal and leukaemic B cells: implication for the mixed lymphocyte reaction

Peripheral blood normal B lymphocytes were found to be poor stimulators in the mixed lymphocyte reaction (MLR), in contrast to normal activated B cells which were strong stimulators. This increased capacity to stimulate a strong MLR correlated with an increased expression of the ICAM-1 (CD54) molecule on the surface of these cells. Similarly, the capacity of leukaemic B cells to induce an allogenic stimulation in the MLR was limited to the ICAM-1 (CD54) positive leukaemic cells. The ability of normal activated or leukaemic B cells to induce an MLR was blocked by antibodies directed against ICAM-1.

Tubular and interstitial factors in the progression of glomerulonephritis

All recent studies of the outcome of different forms of progressive glomerulonephritis concur that a major factor, apparently determining outcome, is the presence and severity of tubulointerstitial changes, and not the degree of glomerular alteration. Moreover, at the time of biopsy, tubulointerstitial changes correlate much better with the glomerular filtration rate. These at first surprising findings are not only useful clinically, but should make us think about our models of how progression takes place in so-called glomerular nephritides. In fact, a major tubulointerstitial infiltrate of immune-competent cells is present in all forms of progressive glomerulonephritis, and again correlates with outcome. In addition, it is now clear the tubular epithelium is capable of synthesising and secreting a number of factors important in fibrogenesis, and of displaying major histocompatibility complex class II antigens and leucocyte-adhesion molecules. Tubular cells could thus present peptides to T helper cells and amplify, or maybe even initiate, immune reactions. Finally, fibrogenesis within the kidney is at last being studied, long after studies have been performed on liver and lung. In the past, too much attention has been paid to reversible inflammation and not enough to irreversible cirrhosis of the kidney.

The cryobiology of rat and human dendritic cells: preservation and destruction of membrane integrity by freezing

Dendritic cells (DCs) are now regarded as specialized leucocytes with distinctive morphological and functional characteristics as accessory or stimulator cells for many lymphocyte responses. While knowledge of the response of other leucocytes (e.g., lymphocytes, macrophages, and granulocytes) to freezing and thawing has been established for some years, an understanding of the cryobiological properties of DCs has not, hitherto, been determined specifically. Such information is important both for establishing procedures for the long-term storage of these cells for use in immunological procedures and for defining freezing conditions that might selectively kill DCs in attempts to modulate the immunogenicity of transplantable tissues during cryopreservation. Preparations of rat and human spleen cells enriched for DCs were frozen to -60 degrees C at one of six cooling rates (0.3, 1.5, 10, 20, 70, or 150 degrees C/min) using a procedure that was established for pancreatic islets with 2 M dimethyl sulfoxide (Me2SO) as the cryoprotectant. Following storage at -196 degrees C the survival of thawed cells was assessed by evaluating both the numbers of cells recovered after the complete process and the membrane integrity of the recovered cells using a supravital fluorescent probe assay. Survival profiles for DCs showed a dependence upon cooling rate similar to other lymphoid cells but DCs were more sensitive to freezing injury than either lymphocytes or macrophages: Optimum survival (75% recovery of numbers and 57% membrane integrity) of rat DCs was achieved by slow cooling (0.3 degrees C/min). Optimal recovery of human DCs was significantly higher (83% recovery of numbers and 72% membrane integrity) after cooling at either 0.3 or 1.5 degrees C/min. The viable yield of DCs from both species declined abruptly as cooling rate was increased, with less than 10% survival after cooling at 20 degrees C/min and negligible survival after cooling at 70 degrees C/min or greater. Analysis of variance of the survival data showed that the response of DCs to freezing and thawing was significantly different (P less than 0.005) from that of either lymphocytes or macrophages, thus providing additional evidence that DCs are distinct from other leucocytes, especially macrophages. This study defines conditions that either will provide effective cryopreservation of DCs for immunological purposes or are most likely to bring about their inactivation in cryobiological approaches to modulating tissue immunogenicity.

Dendritic cells: clinical aspects

Clinical aspects of dendritic cells have yet to be studied intensively. One obstacle, that of isolating and identifying dendritic cells from human blood and other tissues like skin and tonsil, is being overcome, although the field would be facilitated by dendritic-cell-specific monoclonals or other probes. Many of the specializations that dendritic cells exhibit as antigen-presenting cells in other mammals are being verified in man. New properties, particularly their capacity to induce clonal expansion of T cells and to be infected with retroviruses, have become evident. Four areas where it may be productive to give more attention to dendritic cells are transplantation, protective T-cell immunity, autoimmunity and HIV-1 infection.