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Mastoridis S, Patel V, Christakoudi S, Lozano JJ, Salehi S, Kurt A, Grossart C, Kodela E, Martinez-Llordella M, Sanchez-Fueyo A. Impact of liver failure on the circulating extracellular vesicle miRNA repertoire. Hepatol Res 2023; 53:771-785. [PMID: 37060575 DOI: 10.1111/hepr.13909] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/15/2022] [Revised: 03/19/2023] [Accepted: 04/05/2023] [Indexed: 04/16/2023]
Abstract
BACKGROUND & AIMS Cell-derived small extracellular vesicles (sEVs) participate in cell-cell communication via the transfer of molecular cargo including selectively enriched microRNAs (miRNAs). Utilizing advances in sEV isolation and characterization, this study investigates the impact of liver injury and dysfunction on the circulating EV-miRNA profile. METHODS High-throughput screening of 799 sEV-miRNAs isolated from plasma was performed in patients across a spectrum of liver disorders including compensated and decompensated chronic liver disease, acute-on-chronic liver failure (ACLF), and acute liver failure, in addition to healthy controls and those with severe sepsis. miRNA levels were compared with clinical and biochemical parameters, composite scores of liver disease, and patient outcomes. RESULTS miRNA screening revealed the degree of hepatic dysfunction to be the main determinant of changes in circulating sEV-miRNA profile, with liver-specific miRNA-122 being among the most highly dysregulated in severe injury. Principal components analyses of the 215 differentially expressed miRNAs showed differing profiles, particularly among those with acute liver injury and ACLF. A distinct profile of dysregulated miRNA, but not circulating cytokines, was shown to characterize ACLF, with four consensus miRNAs identified-miR-320e, miR-374-5p, miR-202-3p, and miR-1910-5p. High miR-320e was associated with poorer 90-day survival (p = 0.014) and regulated the functional gene targets IK, RPS5, MANBAL, and PEBP1. CONCLUSIONS This first comprehensive analysis to the best of our knowledge of patients with varying degrees and stages of liver failure demonstrates miRNA profiles specifically within the sEV compartment to be significantly altered in progressive liver disease and highlights the diagnostic and prognostic potential of sEV-miRNA in ACLF while also establishing downstream gene targets.
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Affiliation(s)
- Sotiris Mastoridis
- Institute of Liver Studies, School of Immunology and Microbial Sciences, Faculty of Life Sciences and Medicine, King's College London, London, UK
- Nuffield Department of Surgical Sciences, University of Oxford, Oxford, UK
| | - Vishal Patel
- Institute of Liver Studies, School of Immunology and Microbial Sciences, Faculty of Life Sciences and Medicine, King's College London, London, UK
- Institute of Liver Studies, King's College Hospital NHS Foundation Trust, London, UK
- The Roger Williams Institute of Hepatology (Foundation for Liver Research), London, UK
| | - Sofia Christakoudi
- Department of Epidemiology and Biostatistics, Imperial College London, London, UK
- Department of Inflammation Biology, School of Immunology and Microbial Sciences, Faculty of Life Sciences and Medicine, King's College London, London, UK
| | - Juan Jose Lozano
- Bioinformatic Platform, Biomedical Research Centre in Hepatic and Digestive Diseases, Instituto de Salud Carlos III, Madrid, Spain
| | - Siamak Salehi
- Institute of Liver Studies, School of Immunology and Microbial Sciences, Faculty of Life Sciences and Medicine, King's College London, London, UK
| | - Ada Kurt
- Institute of Liver Studies, School of Immunology and Microbial Sciences, Faculty of Life Sciences and Medicine, King's College London, London, UK
| | - Cathleen Grossart
- Institute of Liver Studies, School of Immunology and Microbial Sciences, Faculty of Life Sciences and Medicine, King's College London, London, UK
| | - Elisavet Kodela
- Institute of Liver Studies, School of Immunology and Microbial Sciences, Faculty of Life Sciences and Medicine, King's College London, London, UK
- Institute of Liver Studies, King's College Hospital NHS Foundation Trust, London, UK
| | - Marc Martinez-Llordella
- Institute of Liver Studies, School of Immunology and Microbial Sciences, Faculty of Life Sciences and Medicine, King's College London, London, UK
| | - Alberto Sanchez-Fueyo
- Institute of Liver Studies, School of Immunology and Microbial Sciences, Faculty of Life Sciences and Medicine, King's College London, London, UK
- Institute of Liver Studies, King's College Hospital NHS Foundation Trust, London, UK
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Lim TY, Perpiñán E, Londoño MC, Miquel R, Ruiz P, Kurt AS, Kodela E, Cross AR, Berlin C, Hester J, Issa F, Douiri A, Volmer FH, Taubert R, Williams E, Demetris AJ, Lesniak A, Bensimon G, Lozano JJ, Martinez-Llordella M, Tree T, Sánchez-Fueyo A. Low dose interleukin-2 selectively expands circulating regulatory T cells but fails to promote liver allograft tolerance in humans. J Hepatol 2023; 78:153-164. [PMID: 36087863 DOI: 10.1016/j.jhep.2022.08.035] [Citation(s) in RCA: 15] [Impact Index Per Article: 15.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/22/2022] [Revised: 08/11/2022] [Accepted: 08/17/2022] [Indexed: 02/01/2023]
Abstract
BACKGROUND & AIMS CD4+CD25+Foxp3+ regulatory T cells (Tregs) are essential to maintain immunological tolerance and have been shown to promote liver allograft tolerance in both rodents and humans. Low-dose IL-2 (LDIL-2) can expand human endogenous circulating Tregs in vivo, but its role in suppressing antigen-specific responses and promoting Treg trafficking to the sites of inflammation is unknown. Likewise, whether LDIL-2 facilitates the induction of allograft tolerance has not been investigated in humans. METHODS We conducted a clinical trial in stable liver transplant recipients 2-6 years post-transplant to determine the capacity of LDIL-2 to suppress allospecific immune responses and allow for the complete discontinuation of maintenance immunosuppression (ClinicalTrials.gov NCT02949492). One month after LDIL-2 was initiated, those exhibiting at least a 2-fold increase in circulating Tregs gradually discontinued immunosuppression over a 4-month period while continuing LDIL-2 for a total treatment duration of 6 months. RESULTS All participants achieved a marked and sustained increase in circulating Tregs. However, this was not associated with the preferential expansion of donor-reactive Tregs and did not promote the accumulation of intrahepatic Tregs. Furthermore, LDIL-2 induced a marked IFNγ-orchestrated transcriptional response in the liver even before immunosuppression weaning was initiated. The trial was terminated after the first 6 participants failed to reach the primary endpoint owing to rejection requiring reinstitution of immunosuppression. CONCLUSIONS The expansion of circulating Tregs in response to LDIL-2 is not sufficient to control alloimmunity and to promote liver allograft tolerance, due, at least in part, to off-target effects that increase liver immunogenicity. Our trial provides unique insight into the mechanisms of action of immunomodulatory therapies such as LDIL-2 and their limitations in promoting alloantigen-specific effects and immunological tolerance. CLINICAL TRIALS REGISTRATION The study is registered at ClinicalTrials.gov (NCT02949492). IMPACT AND IMPLICATIONS The administration of low-dose IL-2 is an effective way of increasing the number of circulating regulatory T cells (Tregs), an immunosuppressive lymphocyte subset that is key for the establishment of immunological tolerance, but its use to promote allograft tolerance in the setting of clinical liver transplantation had not been explored before. In liver transplant recipients on tacrolimus monotherapy, low-dose IL-2 effectively expanded circulating Tregs but did not increase the number of Tregs with donor specificity, nor did it promote their trafficking to the transplanted liver. Low-dose IL-2 did not facilitate the discontinuation of tacrolimus and elicited, as an off-target effect, an IFNγ-orchestrated inflammatory response in the liver that resembled T cell-mediated rejection. These results, supporting an unexpected role for IL-2 in regulating the immunogenicity of the liver, highlight the need to carefully evaluate systemic immunoregulatory strategies with investigations that are not restricted to the blood compartment and involve target tissues such as the liver.
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Affiliation(s)
- Tiong Y Lim
- Institute of Liver Studies, King's College Hospital, Medical Research Council (MRC) Centre for Transplantation, School of Immunology & Microbial Sciences, Faculty of Life Sciences and Medicine, King's College London, London, UK
| | - Elena Perpiñán
- Institute of Liver Studies, King's College Hospital, Medical Research Council (MRC) Centre for Transplantation, School of Immunology & Microbial Sciences, Faculty of Life Sciences and Medicine, King's College London, London, UK
| | - Maria-Carlota Londoño
- Institute of Liver Studies, King's College Hospital, Medical Research Council (MRC) Centre for Transplantation, School of Immunology & Microbial Sciences, Faculty of Life Sciences and Medicine, King's College London, London, UK; Liver Unit, Hospital Clínic Barcelona, IDIBAPS, CIBERehd, Barcelona, Spain
| | - Rosa Miquel
- Institute of Liver Studies, King's College Hospital, Medical Research Council (MRC) Centre for Transplantation, School of Immunology & Microbial Sciences, Faculty of Life Sciences and Medicine, King's College London, London, UK; Liver Histopathology Laboratory, King's College Hospital, London, UK
| | - Paula Ruiz
- Institute of Liver Studies, King's College Hospital, Medical Research Council (MRC) Centre for Transplantation, School of Immunology & Microbial Sciences, Faculty of Life Sciences and Medicine, King's College London, London, UK
| | - Ada S Kurt
- Institute of Liver Studies, King's College Hospital, Medical Research Council (MRC) Centre for Transplantation, School of Immunology & Microbial Sciences, Faculty of Life Sciences and Medicine, King's College London, London, UK
| | - Elisavet Kodela
- Institute of Liver Studies, King's College Hospital, Medical Research Council (MRC) Centre for Transplantation, School of Immunology & Microbial Sciences, Faculty of Life Sciences and Medicine, King's College London, London, UK
| | - Amy R Cross
- Transplantation Research Immunology Group, Nuffield Department of Surgical Sciences, University of Oxford, John Radcliffe Hospital, Oxford, UK
| | - Claudia Berlin
- Transplantation Research Immunology Group, Nuffield Department of Surgical Sciences, University of Oxford, John Radcliffe Hospital, Oxford, UK
| | - Joanna Hester
- Transplantation Research Immunology Group, Nuffield Department of Surgical Sciences, University of Oxford, John Radcliffe Hospital, Oxford, UK
| | - Fadi Issa
- Transplantation Research Immunology Group, Nuffield Department of Surgical Sciences, University of Oxford, John Radcliffe Hospital, Oxford, UK
| | - Abdel Douiri
- School of Population Health and Environmental Sciences, King's College London, London, UK
| | - Felix H Volmer
- Department of Gastroenterology, Hepatology and Endocrinology, Hannover Medical School, Hannover, Germany
| | - Richard Taubert
- Department of Gastroenterology, Hepatology and Endocrinology, Hannover Medical School, Hannover, Germany
| | - Evangelia Williams
- Department of Immunobiology, School of Immunology & Microbial Sciences (SIMS), King's College London, London, UK
| | | | - Andrew Lesniak
- Department of Pathology, University of Pittsburgh, Pittsburgh, PA, USA
| | - Gilbert Bensimon
- Département de Pharmacologie Clinique, Hôpital de la Pitié-Salpêtrière et UPMC Pharmacologie, Paris-Sorbonne Université, Paris, France; Laboratoire de Biostatistique, Epidémiologie Clinique, Santé Publique Innovation et Méthodologie (BESPIM), CHU-Nîmes, Nîmes, France
| | - Juan José Lozano
- Bioinformatic Platform, Biomedical Research Center in Hepatic and Digestive Diseases (CIBEREHD), Carlos III Health Institute, Barcelona, Spain
| | - Marc Martinez-Llordella
- Institute of Liver Studies, King's College Hospital, Medical Research Council (MRC) Centre for Transplantation, School of Immunology & Microbial Sciences, Faculty of Life Sciences and Medicine, King's College London, London, UK
| | - Tim Tree
- Department of Immunobiology, School of Immunology & Microbial Sciences (SIMS), King's College London, London, UK
| | - Alberto Sánchez-Fueyo
- Institute of Liver Studies, King's College Hospital, Medical Research Council (MRC) Centre for Transplantation, School of Immunology & Microbial Sciences, Faculty of Life Sciences and Medicine, King's College London, London, UK.
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Kurt AS, Strobl K, Ruiz P, Osborn G, Chester T, Dawson L, Warwas KM, Grey EH, Mastoridis S, Kodela E, Safinia N, Sanchez-Fueyo A, Martinez-Llordella M. IL-2 availability regulates the tissue specific phenotype of murine intra-hepatic Tregs. Front Immunol 2022; 13:1040031. [PMID: 36389734 PMCID: PMC9661520 DOI: 10.3389/fimmu.2022.1040031] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/08/2022] [Accepted: 10/14/2022] [Indexed: 11/21/2022] Open
Abstract
CD4+CD25+Foxp3+ Tregs are known to acquire tissue-specific features and exert cytoprotective and regenerative functions. The extent to which this applies to liver-resident Tregs is unknown. In this study, we aimed to explore the phenotypic and functional characteristics of adult murine liver resident Tregs during homeostasis. Additionally, we investigated their role in ameliorating liver inflammation and tissue damage. Quantification of Foxp3+CD4+CD25+ cells comparing different tissues showed that the liver contained significantly fewer resident Tregs. A combination of flow cytometry phenotyping and microarray analysis of intra-hepatic and splenic Tregs under homeostatic conditions revealed that, although intra-hepatic Tregs exhibited the core transcriptional Treg signature, they expressed a distinct transcriptional profile. This was characterized by reduced CD25 expression and increased levels of pro-inflammatory Th1 transcripts Il1b and Ifng. In vivo ablation of Tregs in the Foxp3-DTR mouse model showed that Tregs had a role in reducing the magnitude of systemic and intra-hepatic inflammatory responses following acute carbon tetrachloride (CCl₄) injury, but their absence did not impact the development of hepatocyte necrosis. Conversely, the specific expansion of Tregs by administration of IL-2 complexes increased the number of intra-hepatic Tregs and significantly ameliorated tissue damage following CCl₄ administration in C57BL/6 mice. The cytoprotective effect observed in response to IL-2c was associated with the increased expression of markers known to regulate Treg suppressive function. Our results offer insight into the transcriptome and complex immune network of intra-hepatic Tregs and suggest that strategies capable of selectively increasing the pool of intra-hepatic Tregs could constitute effective therapies in inflammatory liver diseases.
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Affiliation(s)
- Ada S. Kurt
- Institute of Liver Studies, Division of Transplantation Immunology & Mucosal Biology, King’s College London, London, United Kingdom
| | - Karoline Strobl
- Institute of Liver Studies, Division of Transplantation Immunology & Mucosal Biology, King’s College London, London, United Kingdom
- Institute of Cancer Research, Medical University of Vienna, Vienna, Austria
| | - Paula Ruiz
- Institute of Liver Studies, Division of Transplantation Immunology & Mucosal Biology, King’s College London, London, United Kingdom
| | - Gabriel Osborn
- Institute of Liver Studies, Division of Transplantation Immunology & Mucosal Biology, King’s College London, London, United Kingdom
| | - Tonika Chester
- Institute of Liver Studies, Division of Transplantation Immunology & Mucosal Biology, King’s College London, London, United Kingdom
| | - Lauren Dawson
- Institute of Liver Studies, Division of Transplantation Immunology & Mucosal Biology, King’s College London, London, United Kingdom
| | - Karsten M. Warwas
- Institute of Liver Studies, Division of Transplantation Immunology & Mucosal Biology, King’s College London, London, United Kingdom
- Applied Tumour Immunity, German Cancer Research Centre (DKFZ), Ruprecht-Karls-Universitat, Heidelberg, Germany
| | - Elizabeth H. Grey
- Institute of Liver Studies, Division of Transplantation Immunology & Mucosal Biology, King’s College London, London, United Kingdom
| | - Sotiris Mastoridis
- Institute of Liver Studies, Division of Transplantation Immunology & Mucosal Biology, King’s College London, London, United Kingdom
- Nuffield Department of Surgical Sciences, University of Oxford, Oxford, United Kingdom
| | - Elisavet Kodela
- Institute of Liver Studies, Division of Transplantation Immunology & Mucosal Biology, King’s College London, London, United Kingdom
| | - Niloufar Safinia
- Institute of Liver Studies, Division of Transplantation Immunology & Mucosal Biology, King’s College London, London, United Kingdom
| | - Alberto Sanchez-Fueyo
- Institute of Liver Studies, Division of Transplantation Immunology & Mucosal Biology, King’s College London, London, United Kingdom
- *Correspondence: Alberto Sanchez-Fueyo,
| | - Marc Martinez-Llordella
- Institute of Liver Studies, Division of Transplantation Immunology & Mucosal Biology, King’s College London, London, United Kingdom
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4
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Vionnet J, Miquel R, Abraldes JG, Wall J, Kodela E, Lozano JJ, Ruiz P, Navasa M, Marshall A, Nevens F, Gelson W, Leithead J, Masson S, Jaeckel E, Taubert R, Tachtatzis P, Eurich D, Simpson KJ, Bonaccorsi-Riani E, Feng S, Bucuvalas J, Ferguson J, Quaglia A, Sidorova J, Elstad M, Douiri A, Sánchez-Fueyo A. Non-invasive alloimmune risk stratification of long-term liver transplant recipients. J Hepatol 2021; 75:1409-1419. [PMID: 34437910 DOI: 10.1016/j.jhep.2021.08.007] [Citation(s) in RCA: 21] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/09/2021] [Revised: 07/26/2021] [Accepted: 08/03/2021] [Indexed: 02/08/2023]
Abstract
BACKGROUND & AIMS Management of long-term immunosuppression following liver transplantation (LT) remains empirical. Surveillance liver biopsies in combination with transcriptional profiling could overcome this challenge by identifying recipients with active alloimmune-mediated liver damage despite normal liver tests, but this approach lacks applicability. Our aim was to investigate the utility of non-invasive tools for the stratification of stable long-term survivors of LT, according to their immunological risk and need for immunosuppression. METHODS We conducted a cross-sectional multicentre study of 190 adult LT recipients assessed to determine their eligibility to participate in an immunosuppression withdrawal trial. Patients had stable liver allograft function and had been transplanted for non-autoimmune non-replicative viral liver disease >3 years before inclusion. We performed histological, immunogenetic and serological studies and measured the intrahepatic transcript levels of an 11-gene classifier highly specific for T cell-mediated rejection (TCMR). RESULTS In this cohort, 35.8% of patients harboured clinically silent fibro-inflammatory liver lesions (13.7% had mild damage and 22.1% had moderate-to-severe damage). The severity of liver allograft damage was positively associated with TCMR-related transcripts, class II donor-specific antibodies (DSAs), ALT, AST, and liver stiffness measurement (LSM), and negatively correlated with serum creatinine and tacrolimus trough levels. Liver biopsies were stratified according to their TCMR transcript levels using a cut-off derived from biopsies with clinically significant TCMR. Two multivariable prediction models, integrating ALT+LSM or ALT+class II DSAs, had a high discriminative capacity for classifying patients with or without alloimmune damage. The latter model performed well in an independent cohort of 156 liver biopsies obtained from paediatric liver recipients with similar inclusion/exclusion criteria. CONCLUSION ALT, class II DSAs and LSM are valuable tools to non-invasively identify stable LT recipients without significant underlying alloimmunity who could benefit from minimisation of immunosuppression. LAY SUMMARY A large proportion of liver transplant patients with normal liver tests have inflammatory liver lesions, which in 17% of cases are molecularly indistinguishable from those seen at the time of rejection. ALT, class II donor-specific antibodies and liver stiffness are useful in identifying patients with this form of subclinical rejection. We propose these markers as a useful tool to help clinicians determine if the immunosuppression administered is adequate.
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Affiliation(s)
- Julien Vionnet
- Institute of Liver Studies, King's College London University and King's College Hospital, London, United Kingdom; Transplantation Center and Service of Gastroenterology and Hepatology, University Hospital of Lausanne, Lausanne, Switzerland
| | - Rosa Miquel
- Institute of Liver Studies, King's College London University and King's College Hospital, London, United Kingdom; Liver Histopathology Laboratory, King's College Hospital, London, United Kingdom
| | - Juan G Abraldes
- Liver Unit, Division of Gastroenterology, Centre of Excellence for Gastrointestinal Inflammation and Immunity Research, University of Alberta, Edmonton, Canada
| | - Jurate Wall
- Institute of Liver Studies, King's College London University and King's College Hospital, London, United Kingdom
| | - Elisavet Kodela
- Institute of Liver Studies, King's College London University and King's College Hospital, London, United Kingdom
| | - Juan-Jose Lozano
- Bioinformatic Platform, Biomedical Research Center in Hepatic and Digestive Diseases (CIBEREHD), Instituto de Salud Carlos III, Spain
| | | | | | | | | | - Will Gelson
- Addenbrooke's Hospital, Cambridge, United Kingdom
| | | | - Steven Masson
- Newcastle Upon Tyne Hospitals NHS Foundation Trust, Newcastle Upon Tyne, United Kingdom
| | | | | | | | | | | | | | - Sandy Feng
- Division of Transplantation, Department of Surgery, University of California San Francisco, San Francisco, CA, USA
| | - John Bucuvalas
- Mount Sinai Kravis Children's Hospital and Recanati/Miller Transplantation Institute, Mount Sinai Health System, New York, NY, USA
| | | | | | - Julia Sidorova
- Instituto de Tecnología del Conocimiento (ITC), Campus Somosaguas, Universidad Complutense, Madrid, Spain
| | - Maria Elstad
- School of Population Health and Environmental Sciences, King's College London, London, United Kingdom
| | - Abdel Douiri
- School of Population Health and Environmental Sciences, King's College London, London, United Kingdom
| | - Alberto Sánchez-Fueyo
- Institute of Liver Studies, King's College London University and King's College Hospital, London, United Kingdom.
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Mastoridis S, Londoño MC, Kurt A, Kodela E, Crespo E, Mason J, Bestard O, Martínez-Llordella M, Sánchez-Fueyo A. Impact of donor extracellular vesicle release on recipient cell "cross-dressing" following clinical liver and kidney transplantation. Am J Transplant 2021; 21:2387-2398. [PMID: 32515541 DOI: 10.1111/ajt.16123] [Citation(s) in RCA: 22] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/12/2020] [Revised: 05/26/2020] [Accepted: 05/30/2020] [Indexed: 01/25/2023]
Abstract
In several murine models of transplantation, the "cross-dressing" of recipient antigen presenting cells (APCs) with intact donor major histocompatibility complex (MHC) derived from allograft-released small extracellular vesicles (sEVs) has been recently described as a key mechanism in eliciting and sustaining alloimmune responses. Investigation of these processes in clinical organ transplantation has, however, been hampered by the lack of sensitivity of conventional instruments and assays. We have employed advanced imaging flow cytometry (iFCM) to explore the kinetics of allograft sEV release and the extent to which donor sEVs might induce cross-dressing following liver and kidney transplantation. We report for the first time that recipient APC cross-dressing can be transiently detected in the circulation shortly after liver, but not kidney, transplantation in association with the release of HLA-bearing allograft-derived sEVs. In liver transplant recipients the majority of circulating cells exhibiting donor HLA are indeed cross-dressed cells and not passenger leukocytes. In keeping with experimental animal data, the downstream functional consequences of the transfer of circulating sEVs harvested from human transplant recipients varies depending on the type of transplant and time posttransplant. sEVs released shortly after liver, but not kidney, transplantation exhibit immunoinhibitory effects that could influence liver allograft immunogenicity.
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Affiliation(s)
- Sotiris Mastoridis
- Medical Research Council (MRC) Centre for Transplantation, Institute of Liver Studies, King's College London, London, United Kingdom
| | - María-Carlota Londoño
- Medical Research Council (MRC) Centre for Transplantation, Institute of Liver Studies, King's College London, London, United Kingdom.,Liver Unit, Hospital Clinic Barcelona, IDIBAPS, CIBEREHD, Barcelona, Spain
| | - Ada Kurt
- Medical Research Council (MRC) Centre for Transplantation, Institute of Liver Studies, King's College London, London, United Kingdom
| | - Elisavet Kodela
- Medical Research Council (MRC) Centre for Transplantation, Institute of Liver Studies, King's College London, London, United Kingdom
| | - Elena Crespo
- Kidney Transplant Unit, Bellvitge University Hospital, Barcelona, Spain
| | - John Mason
- Department of Physiology, Anatomy & Genetics, University of Oxford, United Kingdom
| | - Oriol Bestard
- Kidney Transplant Unit, Bellvitge University Hospital, Barcelona, Spain
| | - Marc Martínez-Llordella
- Medical Research Council (MRC) Centre for Transplantation, Institute of Liver Studies, King's College London, London, United Kingdom
| | - Alberto Sánchez-Fueyo
- Medical Research Council (MRC) Centre for Transplantation, Institute of Liver Studies, King's College London, London, United Kingdom
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6
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Merritt E, Londoño MC, Childs K, Whitehouse G, Kodela E, Sánchez-Fueyo A, Martínez-Llordella M. On the impact of hepatitis C virus and heterologous immunity on alloimmune responses following liver transplantation. Am J Transplant 2021; 21:247-257. [PMID: 32524678 DOI: 10.1111/ajt.16134] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/18/2020] [Revised: 06/03/2020] [Accepted: 06/03/2020] [Indexed: 01/25/2023]
Abstract
Virus-induced heterologous immunity is considered a barrier to transplantation tolerance. Yet, hepatitis C (HCV)-infected liver transplant (LT) patients occasionally achieve operational tolerance. We investigated the mechanisms through which HCV infection modulates donor-specific T cell responses following LT and the influence of HCV eradication. We generated T cell lines from HCV-infected LT and non-LT patients before and after HCV eradication and quantified alloreactive responses using cell lines expressing single-HLA class-I antigens in the presence/absence of PD-1/CTLA-4 blockade. HCV-specific CD8+ T cells cross-reacted with allogeneic class-I HLA molecules. HCV-positive LT recipients exhibited a higher proportion of CD8+ T cells coexpressing inhibitory receptors (PD-1/CTLA4) than HCV-negative LT, and their expression correlated with CXCL10 plasma levels. This resulted in decreased antidonor and third-party proliferative responses, which were significantly reversed by HCV eradication. PD-1/CTLA-4 blockade increased the proportion of HCV-specific CD8+ T cells reacting against donor only before viral clearance. In conclusion, HCV infection results in the generation of HCV-specific CD8+ T cells capable of reacting against allogeneic HLA molecules. Following LT, this results in a PD-1/CTLA4-dependent decrease in alloimmune responses. Our findings challenge the notion that heterologous immunity is necessarily detrimental in LT and provide an explanation for the association between HCV eradication and immune-mediated allograft damage.
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Affiliation(s)
- Elliot Merritt
- MRC Centre for Transplantation, Department of Inflammation Biology, Faculty e Sciences & Medicine, Institute of Liver Studies, King's College London, London, UK
| | - Maria-Carlota Londoño
- MRC Centre for Transplantation, Department of Inflammation Biology, Faculty e Sciences & Medicine, Institute of Liver Studies, King's College London, London, UK
- Liver Unit, Hospital Clínic Barcelona, IDIBAPS, CIBEREHD, Barcelona, Spain
| | - Kate Childs
- MRC Centre for Transplantation, Department of Inflammation Biology, Faculty e Sciences & Medicine, Institute of Liver Studies, King's College London, London, UK
| | - Gavin Whitehouse
- MRC Centre for Transplantation, Department of Inflammation Biology, Faculty e Sciences & Medicine, Institute of Liver Studies, King's College London, London, UK
| | - Elisavet Kodela
- MRC Centre for Transplantation, Department of Inflammation Biology, Faculty e Sciences & Medicine, Institute of Liver Studies, King's College London, London, UK
| | - Alberto Sánchez-Fueyo
- MRC Centre for Transplantation, Department of Inflammation Biology, Faculty e Sciences & Medicine, Institute of Liver Studies, King's College London, London, UK
| | - Marc Martínez-Llordella
- MRC Centre for Transplantation, Department of Inflammation Biology, Faculty e Sciences & Medicine, Institute of Liver Studies, King's College London, London, UK
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7
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Sánchez‐Fueyo A, Whitehouse G, Grageda N, Cramp ME, Lim TY, Romano M, Thirkell S, Lowe K, Fry L, Heward J, Kerr A, Ali J, Fisher C, Lewis G, Hope A, Kodela E, Lyne M, Farzaneh F, Kordasti S, Rebollo‐Mesa I, Jose Lozano J, Safinia N, Heaton N, Lechler R, Martínez‐Llordella M, Lombardi G. Applicability, safety, and biological activity of regulatory T cell therapy in liver transplantation. Am J Transplant 2020; 20:1125-1136. [PMID: 31715056 PMCID: PMC7154724 DOI: 10.1111/ajt.15700] [Citation(s) in RCA: 123] [Impact Index Per Article: 30.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/03/2019] [Revised: 10/29/2019] [Accepted: 11/04/2019] [Indexed: 01/25/2023]
Abstract
Regulatory T cells (Tregs) are a lymphocyte subset with intrinsic immunosuppressive properties that can be expanded in large numbers ex vivo and have been shown to prevent allograft rejection and promote tolerance in animal models. To investigate the safety, applicability, and biological activity of autologous Treg adoptive transfer in humans, we conducted an open-label, dose-escalation, Phase I clinical trial in liver transplantation. Patients were enrolled while awaiting liver transplantation or 6-12 months posttransplant. Circulating Tregs were isolated from blood or leukapheresis, expanded under good manufacturing practices (GMP) conditions, and administered intravenously at either 0.5-1 million Tregs/kg or 3-4.5 million Tregs/kg. The primary endpoint was the rate of dose- limiting toxicities occurring within 4 weeks of infusion. The applicability of the clinical protocol was poor unless patient recruitment was deferred until 6-12 months posttransplant. Thus, only 3 of the 17 patients who consented while awaiting liver transplantation were dosed. In contrast, all six patients who consented 6-12 months posttransplant received the cell infusion. Treg transfer was safe, transiently increased the pool of circulating Tregs and reduced anti-donor T cell responses. Our study opens the door to employing Treg immunotherapy to facilitate the reduction or complete discontinuation of immunosuppression following liver transplantation.
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Affiliation(s)
- Alberto Sánchez‐Fueyo
- Institute of Liver StudiesMRC Centre for TransplantationDepartment of Inflammation BiologyFaculty of Life Sciences & MedicineKing's College LondonLondonUK
| | - Gavin Whitehouse
- Institute of Liver StudiesMRC Centre for TransplantationDepartment of Inflammation BiologyFaculty of Life Sciences & MedicineKing's College LondonLondonUK
| | - Nathali Grageda
- MRC Centre for TransplantationPeter Gorer Department of ImmunobiologyFaculty of Life Sciences & MedicineKing's College LondonLondonUK
| | - Matthew E. Cramp
- Hepatology Research GroupPlymouth University Peninsula Schools of Medicine and DentistrySouthwest Liver UnitDerriford HospitalPlymouth Hospitals NHS TrustPlymouthUK
| | - Tiong Y. Lim
- Institute of Liver StudiesMRC Centre for TransplantationDepartment of Inflammation BiologyFaculty of Life Sciences & MedicineKing's College LondonLondonUK
| | - Marco Romano
- MRC Centre for TransplantationPeter Gorer Department of ImmunobiologyFaculty of Life Sciences & MedicineKing's College LondonLondonUK
| | - Sarah Thirkell
- NIHR Biomedical Research CentreGuy's and St Thomas' NHS Foundation Trust and King's College LondonLondonUK
| | - Katie Lowe
- NIHR Biomedical Research CentreGuy's and St Thomas' NHS Foundation Trust and King's College LondonLondonUK
| | - Laura Fry
- NIHR Biomedical Research CentreGuy's and St Thomas' NHS Foundation Trust and King's College LondonLondonUK
| | - Julie Heward
- NIHR Biomedical Research CentreGuy's and St Thomas' NHS Foundation Trust and King's College LondonLondonUK
| | - Alex Kerr
- NIHR Biomedical Research CentreGuy's and St Thomas' NHS Foundation Trust and King's College LondonLondonUK
| | - Jakia Ali
- NIHR Biomedical Research CentreGuy's and St Thomas' NHS Foundation Trust and King's College LondonLondonUK
| | - Chris Fisher
- NIHR Biomedical Research CentreGuy's and St Thomas' NHS Foundation Trust and King's College LondonLondonUK
| | - Gillian Lewis
- NIHR Biomedical Research CentreGuy's and St Thomas' NHS Foundation Trust and King's College LondonLondonUK
| | - Andrew Hope
- NIHR Biomedical Research CentreGuy's and St Thomas' NHS Foundation Trust and King's College LondonLondonUK
| | - Elisavet Kodela
- Institute of Liver StudiesMRC Centre for TransplantationDepartment of Inflammation BiologyFaculty of Life Sciences & MedicineKing's College LondonLondonUK
| | - Mike Lyne
- NIHR Biomedical Research CentreGuy's and St Thomas' NHS Foundation Trust and King's College LondonLondonUK
| | - Farzin Farzaneh
- School of Cancer and Pharmaceutical SciencesKing's College LondonLondonUK
| | - Shahram Kordasti
- Systems Cancer Immunology LabComprehensive Cancer CentreKing’s College London, & Haematology Department Guy’s HospitalLondonUK
| | - Irene Rebollo‐Mesa
- BiostatisticsInstitute of Psychiatry, Psychology and NeuroscienceKing's College LondonLondonUK
| | - Juan Jose Lozano
- Bioinformatic PlatformBiomedical Research Center in Hepatic and Digestive Diseases (CIBEREHD)Instituto de Salud Carlos IIISpain
| | - Niloufar Safinia
- MRC Centre for TransplantationPeter Gorer Department of ImmunobiologyFaculty of Life Sciences & MedicineKing's College LondonLondonUK
| | - Nigel Heaton
- Institute of Liver StudiesMRC Centre for TransplantationDepartment of Inflammation BiologyFaculty of Life Sciences & MedicineKing's College LondonLondonUK
| | - Robert Lechler
- NIHR Biomedical Research CentreGuy's and St Thomas' NHS Foundation Trust and King's College LondonLondonUK
| | - Marc Martínez‐Llordella
- Institute of Liver StudiesMRC Centre for TransplantationDepartment of Inflammation BiologyFaculty of Life Sciences & MedicineKing's College LondonLondonUK
| | - Giovanna Lombardi
- MRC Centre for TransplantationPeter Gorer Department of ImmunobiologyFaculty of Life Sciences & MedicineKing's College LondonLondonUK
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8
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Lim TY, Martinez-Llordella M, Kodela E, Gray E, Heneghan MA, Sanchez-Fueyo A. Low-Dose Interleukin-2 for Refractory Autoimmune Hepatitis. Hepatology 2018; 68:1649-1652. [PMID: 29698571 DOI: 10.1002/hep.30059] [Citation(s) in RCA: 47] [Impact Index Per Article: 7.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/07/2017] [Revised: 03/25/2018] [Accepted: 04/18/2018] [Indexed: 01/09/2023]
Affiliation(s)
- Tiong Y Lim
- Institute of Liver Studies, King's College Hospital, Medical Research Council Centre for Transplantation, School of Immunology & Microbial Sciences, Faculty of Life Sciences and Medicine, King's College London, London, UK
| | - Marc Martinez-Llordella
- Institute of Liver Studies, King's College Hospital, Medical Research Council Centre for Transplantation, School of Immunology & Microbial Sciences, Faculty of Life Sciences and Medicine, King's College London, London, UK
| | - Elisavet Kodela
- Institute of Liver Studies, King's College Hospital, Medical Research Council Centre for Transplantation, School of Immunology & Microbial Sciences, Faculty of Life Sciences and Medicine, King's College London, London, UK
| | - Elisabeth Gray
- Institute of Liver Studies, King's College Hospital, Medical Research Council Centre for Transplantation, School of Immunology & Microbial Sciences, Faculty of Life Sciences and Medicine, King's College London, London, UK
| | - Michael A Heneghan
- Institute of Liver Studies, King's College Hospital, Medical Research Council Centre for Transplantation, School of Immunology & Microbial Sciences, Faculty of Life Sciences and Medicine, King's College London, London, UK
| | - Alberto Sanchez-Fueyo
- Institute of Liver Studies, King's College Hospital, Medical Research Council Centre for Transplantation, School of Immunology & Microbial Sciences, Faculty of Life Sciences and Medicine, King's College London, London, UK
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9
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Moysidou M, Karaliota S, Kodela E, Salagianni M, Koutmani Y, Katsouda A, Kodella K, Tsakanikas P, Ourailidou S, Andreakos E, Kostomitsopoulos N, Skokos D, Chatzigeorgiou A, Chung KJ, Bornstein S, Sleeman MW, Chavakis T, Karalis KP. CD8+ T cells in beige adipogenesis and energy homeostasis. JCI Insight 2018. [PMID: 29515042 DOI: 10.1172/jci.insight.95456] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/19/2022] Open
Abstract
Although accumulation of lymphocytes in the white adipose tissue (WAT) in obesity is linked to insulin resistance, it remains unclear whether lymphocytes also participate in the regulation of energy homeostasis in the WAT. Here, we demonstrate enhanced energy dissipation in Rag1-/- mice, increased catecholaminergic input to subcutaneous WAT, and significant beige adipogenesis. Adoptive transfer experiments demonstrated that CD8+ T cell deficiency accounts for the enhanced beige adipogenesis in Rag1-/- mice. Consistently, we identified that CD8-/- mice also presented with enhanced beige adipogenesis. The inhibitory effect of CD8+ T cells on beige adipogenesis was reversed by blockade of IFN-γ. All together, our findings identify an effect of CD8+ T cells in regulating energy dissipation in lean WAT, mediated by IFN-γ modulation of the abundance of resident immune cells and of local catecholaminergic activity. Our results provide a plausible explanation for the clinical signs of metabolic dysfunction in diseases characterized by altered CD8+ T cell abundance and suggest targeting of CD8+ T cells as a promising therapeutic approach for obesity and other diseases with altered energy homeostasis.
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Affiliation(s)
- Maria Moysidou
- Clinical, Experimental Surgery & Translational Research, Biomedical Research Foundation Academy of Athens, Athens, Greece.,University of Crete, School of Medicine, Heraklion, Crete, Greece
| | - Sevasti Karaliota
- Clinical, Experimental Surgery & Translational Research, Biomedical Research Foundation Academy of Athens, Athens, Greece
| | - Elisavet Kodela
- Clinical, Experimental Surgery & Translational Research, Biomedical Research Foundation Academy of Athens, Athens, Greece.,University of Crete, School of Medicine, Heraklion, Crete, Greece
| | - Maria Salagianni
- Clinical, Experimental Surgery & Translational Research, Biomedical Research Foundation Academy of Athens, Athens, Greece
| | - Yassemi Koutmani
- Clinical, Experimental Surgery & Translational Research, Biomedical Research Foundation Academy of Athens, Athens, Greece
| | - Antonia Katsouda
- Clinical, Experimental Surgery & Translational Research, Biomedical Research Foundation Academy of Athens, Athens, Greece
| | - Konstantia Kodella
- Clinical, Experimental Surgery & Translational Research, Biomedical Research Foundation Academy of Athens, Athens, Greece
| | - Panagiotis Tsakanikas
- Clinical, Experimental Surgery & Translational Research, Biomedical Research Foundation Academy of Athens, Athens, Greece
| | - Styliani Ourailidou
- Clinical, Experimental Surgery & Translational Research, Biomedical Research Foundation Academy of Athens, Athens, Greece
| | - Evangelos Andreakos
- Clinical, Experimental Surgery & Translational Research, Biomedical Research Foundation Academy of Athens, Athens, Greece
| | - Nikolaos Kostomitsopoulos
- Clinical, Experimental Surgery & Translational Research, Biomedical Research Foundation Academy of Athens, Athens, Greece
| | | | | | - Kyoung-Jin Chung
- Technische Universität Dresden, School of Medicine, Dresden, Germany
| | - Stefan Bornstein
- Technische Universität Dresden, School of Medicine, Dresden, Germany
| | - Mark W Sleeman
- Department of Physiology, Monash University, Clayton, Victoria, Australia
| | | | - Katia P Karalis
- Clinical, Experimental Surgery & Translational Research, Biomedical Research Foundation Academy of Athens, Athens, Greece.,Technische Universität Dresden, School of Medicine, Dresden, Germany.,Endocrine Division, Boston Children's Hospital, Boston, Massachusetts, USA
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10
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Kodela E, Moysidou M, Karaliota S, Koutmani Y, Tsakanikas P, Kodella K, Karavia EA, Kypreos KE, Kostomitsopoulos N, Karalis KP. Strain-specific Differences in the Effects of Lymphocytes on the Development of Insulin Resistance and Obesity in Mice. Comp Med 2018; 68:15-24. [PMID: 29460717 PMCID: PMC5824135] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/04/2017] [Revised: 06/06/2017] [Accepted: 08/02/2017] [Indexed: 06/08/2023]
Abstract
Obesity is characterized as a chronic, low-grade inflammatory disease owing to the infiltration of the adipose tissue by macrophages. Although the role of macrophages in this process is well established, the role of lymphocytes in the development of obesity and metabolism remains less well defined. In the current study, we fed WT and Rag1-/- male mice, of C57BL/6J and BALB/c backgrounds, high-fat diet (HFD) or normal diet for 15 wk. Compared with WT mice, Rag1-/- mice of either of the examined strains were found less prone to insulin resistance after HFD, had higher metabolic rates, and used lipids more efficiently, as shown by the increased expression of genes related to fatty acid oxidation in epidydimal white adipose tissue. Furthermore, Rag1-/- mice had increased Ucp1 protein expression and associated phenotypic characteristics indicative of beige adipose tissue in subcutaneous white adipose tissue and increased Ucp1 expression in brown adipose tissue. As with inflammatory and other physiologic responses previously reported, the responses of mice to HFD show strain-specific differences, with increased susceptibility of C57BL/6J as compared with BALB/c strain. Our findings unmask a crucial role for lymphocytes in the development of obesity and insulin resistance, in that lymphocytes inhibit efficient dissipation of energy by adipose tissue. These strain-associated differences highlight important metabolic factors that should be accommodated in disease modeling and drug testing.
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Affiliation(s)
- Elisavet Kodela
- Biomedical Research Foundation of the Academy of Athens, Clinical Experimental Surgery & Translational Research, Athens, University of Crete, School of Medicine, Heraklion, Crete, Greece
| | - Maria Moysidou
- Biomedical Research Foundation of the Academy of Athens, Clinical Experimental Surgery & Translational Research, Athens, University of Crete, School of Medicine, Heraklion, Crete, Greece
| | - Sevasti Karaliota
- Biomedical Research Foundation of the Academy of Athens, Clinical Experimental Surgery & Translational Research, Athens, Greece
| | - Yassemi Koutmani
- Biomedical Research Foundation of the Academy of Athens, Clinical Experimental Surgery & Translational Research, Athens, Greece
| | - Panagiotis Tsakanikas
- Biomedical Research Foundation of the Academy of Athens, Clinical Experimental Surgery & Translational Research, Athens, Greece
| | - Konstantia Kodella
- Biomedical Research Foundation of the Academy of Athens, Clinical Experimental Surgery & Translational Research, Athens, Greece
| | - Eleni A Karavia
- Department of Pharmacology, University of Patras Medical School, Patras, Greece
| | - Kyriakos E Kypreos
- Department of Pharmacology, University of Patras Medical School, Patras, Greece
| | - Nikolaos Kostomitsopoulos
- Biomedical Research Foundation of the Academy of Athens, Clinical Experimental Surgery & Translational Research, Athens, Greece;,
| | - Katia P Karalis
- Biomedical Research Foundation of the Academy of Athens, Clinical Experimental Surgery & Translational Research, Athens, Greece, Endocrine Division, Boston Children's Hospital, Boston, Massachuttes
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11
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Whitehouse G, Gray E, Mastoridis S, Merritt E, Kodela E, Yang JHM, Danger R, Mairal M, Christakoudi S, Lozano JJ, Macdougall IC, Tree TIM, Sanchez-Fueyo A, Martinez-Llordella M. IL-2 therapy restores regulatory T-cell dysfunction induced by calcineurin inhibitors. Proc Natl Acad Sci U S A 2017; 114:7083-7088. [PMID: 28584086 PMCID: PMC5502598 DOI: 10.1073/pnas.1620835114] [Citation(s) in RCA: 72] [Impact Index Per Article: 10.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/16/2022] Open
Abstract
CD4+CD25+FOXP3+ Tregs constitute a heterogeneous lymphocyte subpopulation essential for curtailing effector T cells and establishing peripheral tolerance. Calcineurin inhibitors (CNIs) are among the most effective agents in controlling effector T-cell responses in humans. However, CNIs also reduce the size of the Treg pool. The functional consequences of this negative effect and the mechanisms responsible remain to be elucidated. We report here that CNIs compromise the overall Treg immunoregulatory capacity to a greater extent than would be predicted by the reduction in the size of the Treg compartment, given that they selectively promote the apoptosis of the resting and activated Treg subsets that are known to display the most powerful suppressive function. These effects are caused by reduced access to IL-2, because Tregs remain capable of translocating NFAT even in the presence of high CNI levels. Exogenous IL-2 restores the phenotypic changes and overall gene-expression effects exerted by CNIs and can even promote Treg expansion by enhancing antiapoptotic Bcl-2 expression. In a skin transplant model, the addition of IL-2 synergizes with CNIs treatment, promoting intragraft accumulation of Tregs and prolonged allograft survival. Hence, the combination of IL-2 and CNIs constitutes an optimal immunomodulatory regimen that enhances the pool of suppressive Treg subsets while effectively controlling cytopathic T cells.
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Affiliation(s)
- Gavin Whitehouse
- Division of Transplantation Immunology and Mucosal Biology, Medical Research Council Centre for Transplantation, Faculty of Life Sciences and Medicine, King's College London, London SE5 9RS, United Kingdom
- Institute of Liver Studies, King's College Hospital, London SE5 9RS, United Kingdom
| | - Elizabeth Gray
- Division of Transplantation Immunology and Mucosal Biology, Medical Research Council Centre for Transplantation, Faculty of Life Sciences and Medicine, King's College London, London SE5 9RS, United Kingdom
- Institute of Liver Studies, King's College Hospital, London SE5 9RS, United Kingdom
| | - Sotiris Mastoridis
- Division of Transplantation Immunology and Mucosal Biology, Medical Research Council Centre for Transplantation, Faculty of Life Sciences and Medicine, King's College London, London SE5 9RS, United Kingdom
- Institute of Liver Studies, King's College Hospital, London SE5 9RS, United Kingdom
| | - Elliot Merritt
- Division of Transplantation Immunology and Mucosal Biology, Medical Research Council Centre for Transplantation, Faculty of Life Sciences and Medicine, King's College London, London SE5 9RS, United Kingdom
- Institute of Liver Studies, King's College Hospital, London SE5 9RS, United Kingdom
| | - Elisavet Kodela
- Division of Transplantation Immunology and Mucosal Biology, Medical Research Council Centre for Transplantation, Faculty of Life Sciences and Medicine, King's College London, London SE5 9RS, United Kingdom
- Institute of Liver Studies, King's College Hospital, London SE5 9RS, United Kingdom
| | - Jennie H M Yang
- Department of Immunobiology, Faculty of Life Sciences and Medicine, King's College London, London SE1 9RT, United Kingdom
| | - Richard Danger
- Division of Transplantation Immunology and Mucosal Biology, Medical Research Council Centre for Transplantation, Faculty of Life Sciences and Medicine, King's College London, London SE5 9RS, United Kingdom
- Institute of Liver Studies, King's College Hospital, London SE5 9RS, United Kingdom
| | - Marta Mairal
- Division of Transplantation Immunology and Mucosal Biology, Medical Research Council Centre for Transplantation, Faculty of Life Sciences and Medicine, King's College London, London SE5 9RS, United Kingdom
- Institute of Liver Studies, King's College Hospital, London SE5 9RS, United Kingdom
| | - Sofia Christakoudi
- Division of Transplantation Immunology and Mucosal Biology, Medical Research Council Centre for Transplantation, Faculty of Life Sciences and Medicine, King's College London, London SE5 9RS, United Kingdom
- Biostatistics and Health Informatics, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London SE5 8AF, United Kingdom
| | - Juan J Lozano
- Bioinformatics Platform, Biomedical Research Networking Center in Hepatic and Digestive Diseases, Barcelona 08036, Spain
| | - Iain C Macdougall
- Department of Renal Medicine, King's College Hospital, London SE5 9RS, United Kingdom
| | - Timothy I M Tree
- Department of Immunobiology, Faculty of Life Sciences and Medicine, King's College London, London SE1 9RT, United Kingdom
| | - Alberto Sanchez-Fueyo
- Division of Transplantation Immunology and Mucosal Biology, Medical Research Council Centre for Transplantation, Faculty of Life Sciences and Medicine, King's College London, London SE5 9RS, United Kingdom
- Institute of Liver Studies, King's College Hospital, London SE5 9RS, United Kingdom
| | - Marc Martinez-Llordella
- Division of Transplantation Immunology and Mucosal Biology, Medical Research Council Centre for Transplantation, Faculty of Life Sciences and Medicine, King's College London, London SE5 9RS, United Kingdom;
- Institute of Liver Studies, King's College Hospital, London SE5 9RS, United Kingdom
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12
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Bonaccorsi-Riani E, Danger R, Lozano JJ, Martinez-Picola M, Kodela E, Mas-Malavila R, Bruguera M, Collins HL, Hider RC, Martinez-Llordella M, Sanchez-Fueyo A. Iron Deficiency Impairs Intra-Hepatic Lymphocyte Mediated Immune Response. PLoS One 2015; 10:e0136106. [PMID: 26287688 PMCID: PMC4542211 DOI: 10.1371/journal.pone.0136106] [Citation(s) in RCA: 32] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/29/2015] [Accepted: 07/29/2015] [Indexed: 12/15/2022] Open
Abstract
Hepatic expression of iron homeostasis genes and serum iron parameters predict the success of immunosuppression withdrawal following clinical liver transplantation, a phenomenon known as spontaneous operational tolerance. In experimental animal models, spontaneous liver allograft tolerance is established through a process that requires intra-hepatic lymphocyte activation and deletion. Our aim was to determine if changes in systemic iron status regulate intra-hepatic lymphocyte responses. We used a murine model of lymphocyte-mediated acute liver inflammation induced by Concanavalin A (ConA) injection employing mice fed with an iron-deficient (IrDef) or an iron-balanced diet (IrRepl). While the mild iron deficiency induced by the IrDef diet did not significantly modify the steady state immune cell repertoire and systemic cytokine levels, it significantly dampened inflammatory liver damage after ConA challenge. These findings were associated with a marked decrease in T cell and NKT cell activation following ConA injection in IrDef mice. The decreased liver injury observed in IrDef mice was independent from changes in the gut microflora, and was replicated employing an iron specific chelator that did not modify intra-hepatic hepcidin secretion. Furthermore, low-dose iron chelation markedly impaired the activation of isolated T cells in vitro. All together, these results suggest that small changes in iron homeostasis can have a major effect in the regulation of intra-hepatic lymphocyte mediated responses.
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Affiliation(s)
- Eliano Bonaccorsi-Riani
- Department of Liver Studies, Division of Transplantation Immunology & Mucosal Biology, Medical Research Council (MRC) Centre for Transplantation, Faculty of Life Sciences & Medicine, King's College London University, King's College Hospital, Denmark Hill, London, United Kingdom
| | - Richard Danger
- Department of Liver Studies, Division of Transplantation Immunology & Mucosal Biology, Medical Research Council (MRC) Centre for Transplantation, Faculty of Life Sciences & Medicine, King's College London University, King's College Hospital, Denmark Hill, London, United Kingdom
| | - Juan José Lozano
- Liver Unit and Bioinformatic platform, CIBEREHD, Hospital Clinic Barcelona, Villaroel 170, Barcelona, Spain
| | - Marta Martinez-Picola
- Liver Unit and Bioinformatic platform, CIBEREHD, Hospital Clinic Barcelona, Villaroel 170, Barcelona, Spain
| | - Elisavet Kodela
- Department of Liver Studies, Division of Transplantation Immunology & Mucosal Biology, Medical Research Council (MRC) Centre for Transplantation, Faculty of Life Sciences & Medicine, King's College London University, King's College Hospital, Denmark Hill, London, United Kingdom
| | - Roser Mas-Malavila
- Department of Liver Studies, Division of Transplantation Immunology & Mucosal Biology, Medical Research Council (MRC) Centre for Transplantation, Faculty of Life Sciences & Medicine, King's College London University, King's College Hospital, Denmark Hill, London, United Kingdom
| | - Miquel Bruguera
- Liver Unit and Bioinformatic platform, CIBEREHD, Hospital Clinic Barcelona, Villaroel 170, Barcelona, Spain
| | - Helen L. Collins
- Department of Immunobiology, Division of Immunology, Infection & Inflammatory Disease, Faculty of Life Sciences & Medicine, King's College London, Franklin-Wilkins Building, Stamford Street, London, United Kingdom
| | - Robert C. Hider
- Institute of Pharmaceutical Science, Faculty of Life Sciences & Medicine, King's College London, Franklin-Wilkins Building, Stamford Street, London, United Kingdom
| | - Marc Martinez-Llordella
- Department of Liver Studies, Division of Transplantation Immunology & Mucosal Biology, Medical Research Council (MRC) Centre for Transplantation, Faculty of Life Sciences & Medicine, King's College London University, King's College Hospital, Denmark Hill, London, United Kingdom
| | - Alberto Sanchez-Fueyo
- Department of Liver Studies, Division of Transplantation Immunology & Mucosal Biology, Medical Research Council (MRC) Centre for Transplantation, Faculty of Life Sciences & Medicine, King's College London University, King's College Hospital, Denmark Hill, London, United Kingdom
- * E-mail:
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13
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Masouri S, Stefanaki I, Kypreou K, Kodela E, Bethimoutis G, Ntritsos G, Evangelou E, Stratigos A, Antoniou C. Replication of risk variants for psoriasis in a Southern European case–control study: correlation with clinical subphenotypes. Br J Dermatol 2015; 173:552-4. [DOI: 10.1111/bjd.13625] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/03/2023]
Affiliation(s)
- S. Masouri
- Department of Dermatology Andreas Syggros Hospital University of Athens Ionos Dragoumi 5 16121 Athens Greece
| | - I. Stefanaki
- Department of Dermatology Andreas Syggros Hospital University of Athens Ionos Dragoumi 5 16121 Athens Greece
| | - K.P. Kypreou
- Department of Dermatology Andreas Syggros Hospital University of Athens Ionos Dragoumi 5 16121 Athens Greece
| | - E. Kodela
- Department of Dermatology Andreas Syggros Hospital University of Athens Ionos Dragoumi 5 16121 Athens Greece
| | - G. Bethimoutis
- Department of Dermatology Andreas Syggros Hospital University of Athens Ionos Dragoumi 5 16121 Athens Greece
| | - G. Ntritsos
- Department of Hygiene and Epidemiology University of Ioannina Medical School Ioannina Greece
| | - E. Evangelou
- Department of Hygiene and Epidemiology University of Ioannina Medical School Ioannina Greece
- Department of Epidemiology and Biostatistics School of Public Health Imperial College London London U.K
| | - A.J. Stratigos
- Department of Dermatology Andreas Syggros Hospital University of Athens Ionos Dragoumi 5 16121 Athens Greece
| | - C. Antoniou
- Department of Dermatology Andreas Syggros Hospital University of Athens Ionos Dragoumi 5 16121 Athens Greece
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14
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Dessinioti C, Sypsa V, Kypreou K, Dimisianos G, Kodela E, Nikolaou V, Antoniou C, Stratigos AJ. A case-control study ofMC1Rvariants in Greek patients with basal cell carcinoma: increased risk independently of pigmentary characteristics. Exp Dermatol 2015; 24:476-8. [DOI: 10.1111/exd.12703] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/17/2015] [Indexed: 11/26/2022]
Affiliation(s)
- Clio Dessinioti
- Dermato-Oncology Unit; 1st Department of Dermatology; University of Athens; Andreas Sygros Hospital; Athens Greece
| | - Vana Sypsa
- Department of Hygiene, Epidemiology and Medical Statistics; Athens University Medical School; Athens Greece
| | - Katerina Kypreou
- Dermato-Oncology Unit; 1st Department of Dermatology; University of Athens; Andreas Sygros Hospital; Athens Greece
| | - Gerasimos Dimisianos
- Department of Medical Genetics; University of Athens Medical School; Agia Sophia Children's Hospital; Athens Greece
| | - Elisavet Kodela
- Dermato-Oncology Unit; 1st Department of Dermatology; University of Athens; Andreas Sygros Hospital; Athens Greece
| | - Vasiliki Nikolaou
- Dermato-Oncology Unit; 1st Department of Dermatology; University of Athens; Andreas Sygros Hospital; Athens Greece
| | - Christina Antoniou
- Dermato-Oncology Unit; 1st Department of Dermatology; University of Athens; Andreas Sygros Hospital; Athens Greece
| | - Alexander J. Stratigos
- Dermato-Oncology Unit; 1st Department of Dermatology; University of Athens; Andreas Sygros Hospital; Athens Greece
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15
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Stefanaki I, Panagiotou OA, Kodela E, Gogas H, Kypreou KP, Chatzinasiou F, Nikolaou V, Plaka M, Kalfa I, Antoniou C, Ioannidis JPA, Evangelou E, Stratigos AJ. Replication and predictive value of SNPs associated with melanoma and pigmentation traits in a Southern European case-control study. PLoS One 2013; 8:e55712. [PMID: 23393597 PMCID: PMC3564929 DOI: 10.1371/journal.pone.0055712] [Citation(s) in RCA: 32] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/23/2012] [Accepted: 12/29/2012] [Indexed: 11/18/2022] Open
Abstract
Background Genetic association studies have revealed numerous polymorphisms conferring susceptibility to melanoma. We aimed to replicate previously discovered melanoma-associated single-nucleotide polymorphisms (SNPs) in a Greek case-control population, and examine their predictive value. Methods Based on a field synopsis of genetic variants of melanoma (MelGene), we genotyped 284 patients and 284 controls at 34 melanoma-associated SNPs of which 19 derived from GWAS. We tested each one of the 33 SNPs passing quality control for association with melanoma both with and without accounting for the presence of well-established phenotypic risk factors. We compared the risk allele frequencies between the Greek population and the HapMap CEU sample. Finally, we evaluated the predictive ability of the replicated SNPs. Results Risk allele frequencies were significantly lower compared to the HapMap CEU for eight SNPs (rs16891982 – SLC45A2, rs12203592 – IRF4, rs258322 – CDK10, rs1805007 – MC1R, rs1805008 - MC1R, rs910873 - PIGU, rs17305573- PIGU, and rs1885120 - MTAP) and higher for one SNP (rs6001027 – PLA2G6) indicating a different profile of genetic susceptibility in the studied population. Previously identified effect estimates modestly correlated with those found in our population (r = 0.72, P<0.0001). The strongest associations were observed for rs401681-T in CLPTM1L (odds ratio [OR] 1.60, 95% CI 1.22–2.10; P = 0.001), rs16891982-C in SCL45A2 (OR 0.51, 95% CI 0.34–0.76; P = 0.001), and rs1805007-T in MC1R (OR 4.38, 95% CI 2.03–9.43; P = 2×10−5). Nominally statistically significant associations were seen also for another 5 variants (rs258322-T in CDK10, rs1805005-T in MC1R, rs1885120-C in MYH7B, rs2218220-T in MTAP and rs4911442-G in the ASIP region). The addition of all SNPs with nominal significance to a clinical non-genetic model did not substantially improve melanoma risk prediction (AUC for clinical model 83.3% versus 83.9%, p = 0.66). Conclusion Overall, our study has validated genetic variants that are likely to contribute to melanoma susceptibility in the Greek population.
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Affiliation(s)
- Irene Stefanaki
- Department of Dermatology, University of Athens Medical School, Andreas Sygros Hospital, Athens, Greece
| | - Orestis A. Panagiotou
- Department of Hygiene and Epidemiology, University of Ioannina School of Medicine, Ioannina, Greece
| | - Elisavet Kodela
- Department of Dermatology, University of Athens Medical School, Andreas Sygros Hospital, Athens, Greece
| | - Helen Gogas
- Department of Internal Medicine, University of Athens, Laikon Hospital, Athens, Greece
| | - Katerina P. Kypreou
- Department of Dermatology, University of Athens Medical School, Andreas Sygros Hospital, Athens, Greece
| | - Foteini Chatzinasiou
- Department of Dermatology, University of Athens Medical School, Andreas Sygros Hospital, Athens, Greece
| | - Vasiliki Nikolaou
- Department of Dermatology, University of Athens Medical School, Andreas Sygros Hospital, Athens, Greece
| | - Michaela Plaka
- Department of Dermatology, University of Athens Medical School, Andreas Sygros Hospital, Athens, Greece
| | - Iro Kalfa
- Blood Donation Unit, Laikon Hospital, Athens, Greece
| | - Christina Antoniou
- Department of Dermatology, University of Athens Medical School, Andreas Sygros Hospital, Athens, Greece
| | - John P. A. Ioannidis
- Department of Hygiene and Epidemiology, University of Ioannina School of Medicine, Ioannina, Greece
- Stanford Prevention Research Center, Department of Medicine and Department of Health Research and Policy, Stanford University School of Medicine, and Department of Statistics, Stanford University School of Humanities and Sciences, Stanford, California, United States of America
| | - Evangelos Evangelou
- Department of Hygiene and Epidemiology, University of Ioannina School of Medicine, Ioannina, Greece
- Department of Twin Research and Genetic Epidemiology, King's College London, London, United Kingdom
| | - Alexander J. Stratigos
- Department of Dermatology, University of Athens Medical School, Andreas Sygros Hospital, Athens, Greece
- * E-mail:
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Karalis KP, Giannogonas P, Kodela E, Koutmani Y, Zoumakis M, Teli T. Mechanisms of obesity and related pathology: linking immune responses to metabolic stress. FEBS J 2009; 276:5747-54. [PMID: 19754872 DOI: 10.1111/j.1742-4658.2009.07304.x] [Citation(s) in RCA: 106] [Impact Index Per Article: 7.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/04/2023]
Abstract
There is a tightly regulated interaction, which is well-conserved in evolution, between the metabolic and immune systems that is deranged in states of over- or under-nutrition. Obesity, an energy-rich condition, is characterized by the activation of an inflammatory process in metabolically active sites such as adipose tissue, liver and immune cells. The consequence of this response is a sharp increase in circulating levels of proinflammatory cytokines, adipokines and other inflammatory markers. Activation of the immune response in obesity is mediated by specific signaling pathways, with Jun N-terminal kinase and IkappaB kinase beta/nuclear factor kappa-light-chain-enhancer of activated B cells being the most well studied. It is known that the above events modify insulin signaling and result in the development of insulin resistance. The nutrient overload characterizing obesity is a metabolic stressor associated with intracellular organelle (e.g. the endoplasmic reticulum) stress. The exact characterization of the series of events and the mechanisms that integrate the inflammatory response with metabolic homeostasis at the cellular and systemic level is a very active research field. In this minireview, we discuss the signaling pathways and molecules associated with the development of obesity-induced inflammation, as well as the evidence that supports a critical role for the stress response in this process.
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Affiliation(s)
- Katia P Karalis
- Biomedical Research Foundation of the Academy of Athens (BRFAA), Greece.
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