Research Article
Open Access
Comparative Analysis of Induced CD4+ Tregs (Itreg) In
Response to CD8+ CTL Induction From PBL By MHC-I
Bound Mart-1 Peptide Pulsed DC or Autologous Tumor
Cells with Freshly Isolated TIL from Human Melanoma.
Sidharth S Jha1, Upendra P Hegde1, 2 and Nitya G Chakraborty1, 2*
1Department of Medicine, University of Connecticut Health Center, Farmington, CT 06030-1628, USA
2Carole and Ray Neag Comprehensive Cancer Center, University of Connecticut Health Center, Farmington, CT 06030-1628, USA
*Corresponding author: Nitya G Chakraborty, University of Connecticut Health Center, Farmington CT, 06030-1628. NGC - Tel: 860-679-1446; Fax:
860-679-1159; E-mail:
@
Received: April 27, 2016; Accepted: May 10, 2016; Published: June 06, 2016
Citation: Jha SS, Hegde UP, Chakraborty NG (2016) Comparative Analysis of Induced CD4+ Tregs (Itreg) In Response to CD8+ CTL
Induction From PBL By MHC-I Bound Mart-1 Peptide Pulsed DC or Autologous Tumor Cells with Freshly Isolated TIL from Human
Melanoma. Clin Res Dermatol Open Access 3(4): 1-11. DOI:
http://dx.doi.org/10.15226/2378-1726/3/4/00133
Abstract
CD4+CD25+thymus derived Tregs (tTregs) and peripherally
induced Tregs (pTreg) are known to control auto-destruction that
needs stimulation through major histocompatibility complex-II
(MHC-II). For cellular immunotherapy of cancer, tumor associated
antigen (TAA, these are also self-antigens) specific in vivo induced
CD8+ Cytotoxic T Lymphocytes (CTL) are rapidly eliminated. Under
ex vivo condition TAA specific CTL generated with purified CD8+ cells
continued to grow and remain active for months. Ex vivo induced
CD8+ CTL with un-fractionated Peripheral Blood Lymphocytes
(PBL) stimulated with Mart-127-35 A2 peptide pulsed autologous
dendritic cells (DC), died within three weeks. Whereas Influenza
(Flu58-66) peptide antigen specific CTL induced identically, continued
to expand and remain functional beyond four weeks. No significant
difference between binding affinity of Mart-127-35 peptide and Flu58-66
peptide to HLA A2 was observed. Upon activation CD8+ cells from the
cultures expressed MHC-II molecules along with other activation and
homing receptors. Expanding CD4+ cells were isolated from In vitro
Co-cultures (IVC) with PBL for Mart-1 peptide and Flu peptide. CD4+
cells isolated from Mart-I IVC secreted significantly higher amount of
IL-10 and IL-4 upon re-stimulation with autologous DC and/or anti-
CD3 antibody, than CD4+ cells isolated from Flu PBL IVC. In a similar
fashion, CD4+ cells isolated from PBL IVC with autologous Tumor or
from freshly obtained tumor tissues were found to secrete significant
amount of IL-10, subsequently CD8+ CTLs in such cultures did not
survive for long. This finding suggests that CD4+CD25+ iTreg (or pTreg
for in vivo) cells induced in vivo / in vitro, negatively regulate effect or
immune response via CD8+ CTL against tumor by elaborating IL-10.
In this process activated CD8+ CTL against different antigens might
provide differential additional signals via newly expressed MHC-II
molecules to the CD4+ cells as needed for different antigens.
Keywords: tTreg; pTreg; iTreg; Immune regulation; Tumor
immunotherapy
Introduction
Thymus is not full proof eliminator of self- antigen reactive
T cells hence spontaneously arising TAA specific CTLs could be
detected in vivo as well as could be activated for CTL mediated tumor immunotherapy. Unfortunately most of the time such
CTLs are short lived. Sakaguchi [1,2] showed that a set of T cells
emerging from the thymus naturally as CD4+CD25+ regulatory
T cells (nTreg; now termed as tTreg) has a critical role in the
control of autoimmune pathology. Tregs cells are also generated
in the periphery and are referred to as peripherally inducible
Treg (pTreg) cells. Both tTreg and pTregs show regulatory
roles in the periphery [2, 3]. It is not possible to differentiate
between tTreg and pTreg when CD4+CD25+ T cells are isolated
from peripheral blood3. For the sake of argument it could be said
that unless there is a need to stop newly induced self-reactive
T cells (or CTL) in vivo, there is no need for pTreg. These CD4+
pTreg might recognize some ligand (epitope) associated with
MHC-II molecules for their activation and expansion. In humans
also pTregs are induced from CD4+CD25- cells in response
to activation of self reactive cells4. Unfortunately the ligand
associated with locally available MHC-II molecules are either
not known or too difficult to identify such specific ligand in vivo
[3]. Previously in ex vivo experiments we have demonstrated
iTreg mediated down regulation of CTL response in a relevant
human tumor system [5]. We compared freshly isolated Treg
cells as natural tTregs with in vitro induced (CD4+CD25+FoxP3+)
iTreg cells. Using Mart-127-35 epitope as a prototypic self-butmelanoma-
associated epitope, we tested the effect of these two
types of Treg cells on the activation and expansion of the epitope
specific CD8+ CTL in cultures. We found that tTreg cells were not
suppressive towards generating Mart-127-35 epitope specific CTL
when the CTL precursors are stimulated by the relevant peptideloaded
fully activated DC. On the other hand iTregs emerging
from CD4+CD25- precursors, in the cultures were found to be
significantly suppressive [5]. We further found that while the
CTL responses in the Mart-1 model are exquisitely sensitive to
suppression by the iTreg, CTL responses against a foreign and
dangerous antigen such as influenza Flu58-66 are not. These results
indicated that when CTL precursors, with specificity for a self but
tumor-associated epitope, are optimally stimulated, tTreg are not much of an impediment but iTregs are [5]. Growing body
of evidence suggests that Treg cells consist of a heterogeneous
group of CD4+ T cells [6]. Evidence for the negative role of Treg
cells on anti-tumor immune response underscores the need for
blocking Tregs in tumor immunotherapeutic schema. It is also
necessary to find out the possible reason for the induction of
pTreg and the epitope (if any) they react to for their expansion
to suppress tumor antigen specific CTL. Keeping in mind the
difficulties to understand in vivo induction of tumor antigen
specific pTreg, in this present work we wanted to induce CD8+
CTL response against tumor associated but self-antigen
Mart-127-35 and Flu derived antigen Flu58-65 as foreign antigen
using un-fractionated PBL in order to explore the functional
characteristics of the CD4+CD25+ Treg cells induced in identical
culture conditions with the two different antigens. We also
worked with CD4+CD25+ cells isolated from PBL + autologous
Tumor IVC or from number of freshly obtained tumor tissues. In
all these three conditions we found remarkable similarity of IL-
10 production by induced CD4+CD25+, a common mechanism of
stopping self –antigen or tumor reactive CTL expansion.
Materials And Methods
Study Subjects
Healthy individuals or melanoma patients were included in the
study with appropriate approval from the institute's regulatory
board. Blood samples from HLA A2 positive donors were taken for
the study with informed consent. The study population consisted
of subjects diagnosed with primary cutaneous melanoma with
or without systemic metastasis. Informed consent was obtained
from each participant who volunteered to donate 50 milliliters
peripheral blood, when possible surgically removed tumor tissue.
The details of the collection of samples and cell preparation have
been described [5, 7].
Tissue culture
Tissue cultures were performed in IMDM medium (HyClone
Laboratories Inc., USA) supplemented with 10% Fetal Bovine
Serum (FBS) (GIBCO Inc., USA), henceforth described as complete
medium.
T cell purification
CD4+ and CD8+T cells were purified using Dynal magnetic
beads (Invitrogen, USA), as described earlier [5]. Purity of the
isolated cells was verified and > 98% pure cells were used for
the study.
DC culture
The method of the generation of myeloid DC from Peripheral
Blood Mononuclear Cells (PBMC), used in this study has been
described previously [5, 8]. Briefly, monocytes/macrophages
were isolated as adherent cells from Ficoll-Hypaque gradient
derived PBMC. The adherent cells were cultured in complete
medium containing 1000 U/ml of GM-CSF (R & D Systems,
Minneapolis, MN) 1000 U/ml of IL-4 (R & D Systems, Minneapolis,
MN) for 7 days. The non-adherent and loosely adherent dendritic
cells were harvested by vigorous washing.
Expansion of epitope specific T cells in In vitro co
culture (IVC)
CD8+ T (purity > 98%) cells were co cultured with peptide
pulsed DC as described earlier [5, 8]. Briefly, human peripheral
blood derived CD8+ T cells were co-cultured with autologous DCs
pulsed with 100μg/ml of either Mart-127-35 or Flu MP58-66 peptide
(T cells: DC=10:1). These cultures were maintained in complete
medium supplemented with 100U/ml IL-2. Expansion of antigen
specific CTL was quantified 7-10 days post co-culture by staining
with respective epitope specific tetramers (1st Stimulation).
These CTL were further re-stimulated under similar conditions
for 3 more times at 7-10 days interval and the expansion of
antigen specific CTL were quantified by tetramer staining before
each re-stimulation.
PBL IVC
10 x 106 PBMC after Ficoll-Hypaque gradient cut were kept
separately in the complete medium without any cytokines
or frozen at liquid N2 for later use. Once DC maturation was
done, these PBL were co-cultured with autologous DCs pulsed
with 100μg/ml of either Mart-127-35 or MP58-66 peptide (T cells:
DC=10:1). These cultures were maintained in complete medium
supplemented with 100 U/ml IL-2. Expansion of antigen specific
CTL in PBL IVC was quantified 7-10 days post co-culture
by staining with respective epitope specific tetramers (1st
Stimulation). These PBL IVC were further re-stimulated under
similar conditions for 3 more times at 7-10 days interval and the
expansion of antigen specific CTL were quantified by tetramer
staining before each re-stimulation.
Phenotypic Analysis by flow cytometry
The immune fluorescence procedure for phenotypic and
functional analysis by flow cytometry has been described
previously [5, 9]. For FACS staining, anti-hIFNγ, anti-hIL-4, antihIL-
10, anti-hTNFα, anti-hFoxp3, anti-hCD25, anti-hCD62L,
anti-h4-1BB, anti-hOX40 and anti-hHLA-DR, DP, DQ antibodies
were purchased from BD Biosciences; anti-hIL-2 antibody was
procured from Biolegend (San Diego, CA)
Cytokine ELISA
Cytokines IFNγ, TNF-α, IL-2, IL-4 and IL-10 were quantified
by ELISA (Duo Set ELISA Development System, R&D System,
USA) as per manufacturer's protocol.
Tetramer assay
Analysis for Mart-127-35 antigen specific and MP58-66 antigen
specific TCR bearing T cells has been described previously
[5, 8, 9]. The cells from IVC were washed twice in PBS and
then incubated with 1 μl of MP58-66 or Mart-127-35 conjugated to
Allophycocyanin HLA-A2 tetramer (Beckman Coulter Inc., USA),
and CD4/CD8 conjugated to FITC or PE (BD Biosciences, USA),
at room temperature for 30 minutes. The stained cells were
washed twice, and re-suspended in FACS buffer. Thereafter,
the number of tetramer positive cells was determined using
FACSCalibur (Becton Dickinson, USA) or MACSQuant (Miltenyi
Biotech, Bergisch, Gladbach, Germany), and the acquired cytofluorographic data were analyzed using the FlowJo software
(TreeStar, Ashland, OR).
Tumor Infiltrating Lymphocyte (TIL) isolation and
culture
This has been described earlier [10-12] briefly tumor tissue
surgically removed from a melanoma patient was washed in
complete medium and cut into very fine pieces with a sterile
scissor and then mechanically disrupted by repeated pipetting.
A portion of cell suspension obtained from these tissue samples
were characterized at day zero for the baseline. While another
portion of the cell suspension was cultured in complete medium
with or without IL-2 (100 U/ml) for the TILs to proliferate
and melanoma tumor cells to adhere to the base of the culture
dish. In the mean time peripheral blood was obtained from the
same donor and PBL was isolated as described above. Once the
autologous tumor line was ready PBL IVC was setup in presence
of autologous tumor and 100 U/ml of IL-2. These cells were
allowed to proliferate for 2-3 weeks before isolating CD8+ and
CD4+ cells. These cells were cultured separately for 2-3 days in
the presence of 100 U/ml IL-2 before characterization of these
cells with or without re-stimulation with anti-CD3 antibody.
ELISA was performed with the supernatant as described earlier.
Statistical Analysis
Statistical analysis was performed according to standard
methods for in vitro experiments. Student's T-test was used to
derive the statistical significance (p value 0.05) with figure 6a.
Results
Expansion of CD8+ CTL for Mart-127-35 and FLU
MP58-66 epitopes with purified CD8+ cells and with
unfractionated PBL in co-cultures
We tested the proliferation of Flu MP58-66 and Mart-127-35
epitope specific naturally present CD8+ T cell precursors in cocultures
with respective peptide pulsed autologous DC. Figure 1a
& 1b show an example of tetramer assay used for determining the
expansion of MP58-66 and Mart-127-35 epitope specific CD8+ T cells,
respectively. As shown, specific precursors for both the epitopes
exhibited substantial expansion following antigen presentation.
MP58-66 antigen specific CD8+ cells always gave better response
than Mart-1s27-35 antigen specific CD8+. Figure 1c and 1d represent
MP58-66 and Mart-127-35 antigen specific intracellular IFN-γ
production by in vitro expanded CD8+T cells. MP58-66 and Mart-
127-35 antigen specific CTL showed specific intracellular IFN-γ
production and it was further confirmed by ELISA. IFN-γ response
by antigen specific CD8+ T cells upon in vitro are stimulation
shown in (Figure 1e). There were variations in the precursor
frequencies for the two epitopes MP58-66 from 0.05-1.4 and Mart-
127-35 from 0.01 to 0.50 (data not shown) amongst individual
donors, but when compared for fold expansion of the respective
epitope specific precursors following stimulation, both MP58-66
and Mart-127-35 epitope specific precursors expanded remarkably
well after primary stimulation (Figure 1b). Interestingly, while
the fold expansion of Mart-127-35 and Flu MP58-65 epitope specific
T cells following 1st stimulation was comparable, the MP58-66 epitope specific T cells were significantly higher following 2nd
stimulation (Figure 1b). After four weeks of initiation of the
cultures both Mart-127-35 and Flu58-66 specific CTL were very active
and secreted significant amount of IFN-γ upon stimulation with
appropriate antigens (Table 1 and 2).
We then used the same in vitro Co-culture (IVC) method
to expand antigen specific CD8+ cells using total PBL (unfractionated).
PBL from donors were stimulated with respective
autologous matured DC pulsed with either Mart-127-35 peptide
or Flu (MP58-66) peptide. Cultures were kept in IL-2 (100U/
ml) medium. Cultures were re-stimulated with DC pulsed with
peptide every 7-10 days. Each time before re-stimulation some
cells were taken out for tetramer analysis (Table 3 and 4). Table
3 shows that the expansion of Mart-127-35 antigen specific CD8+
CTL in the co-cultures using PBL from six donors. It is evident
from the table that within 21 days Mart-127-35 specific CD8+ T cells
disappeared from the co-cultures. Whereas Table 4 indicates
that Flu58-66 specific CD8+ CTL continued to expand and remained
functional even after 35 days of culture. With all the donors we
noticed Mart-1 specific CD8+ T cells in PBL IVC disappeared post
third stimulation. These observations led us to three different
thoughts; (a) The above phenomena might be due to significant
difference between the binding affinity of Mart-1 and Flu peptide
with A2 molecules on the DCs used for stimulation of the CD8+
cells in PBL IVC, that led to the faster elimination or loss of activity
in responding CD8+ cells; or (b) Since DCs die after antigen
presentation in 24 h the degree of expression of MHC –II molecule
by activated T cells could make the difference. (c) There could be
a significant difference between the phenotypic and functional
properties of the expanding CD4+ cells, the induced Treg cells, in
the co-cultures.
Difference in binding affinity to A2 for Mart-1 and Flu
peptide
We used T2 cells, a gift from Dr. Cresswell (Yale University)
[13] to test the binding affinity and stability of the Mart-127-
35 peptide and Flu (MP58-66) peptides on A2 molecule. Figure
2a describes the binding abilities of those two peptides to A2
molecules. No significant difference in binding affinity between
Mart-127-35 peptide and Flu (MP58-66) peptides were found. There
was a possibility that the two peptides in question have different
dissociation time but we found no significant difference in
dissociation time between Mart-127-35 peptide and Flu (MP58-66)
peptides.
MHC-II expression by CD4+, CD8+ and DC
MHC-II expression on CD4+ and CD8+ cells were tested before
and after stimulation (Figure 2b). Freshly isolated CD4+ and CD8+
cells were predominantly negative for MHC-II, but a clear spike in
MHC-II expression was seen in both activated CD4+ and CD8+ cells
(Figure 2b). Both DC and activated CD8+ cells in culture expressed
MHC-II but there was a significant difference in MFI of MHC-II
expressed by DC than activated CD8+ cells (Fig. 2c and 2d).
Characterization of activated CD4+ cells induced in the
PBL IVCs
Figure 3 shows a representative data with purified CD4+ cells
Table 1: Functional characterization of expanded CD8+ Mart-1 antigen specific cells after initial stimulation and re-stimulation with appropriate
antigen
Donor |
After 1st week of IVC (IFNγ pg/ml) |
After 2nd week of IVC (IFNγ pg/ml) |
None |
T2 |
T2+M1 |
T2+M3 |
None |
T2 |
T2+M1 |
T2+M3 |
1 |
0.00 |
20.00 |
320.00 |
25.00 |
0.00 |
10.00 |
110.00 |
30.00 |
2 |
0.00 |
0.00 |
140.00 |
10.00 |
50.00 |
50.00 |
210.00 |
40.00 |
3 |
10.00 |
40.00 |
200.00 |
55.00 |
0.00 |
50.00 |
100.00 |
30.00 |
4 |
0.00 |
40.00 |
300.00 |
120.00 |
0.00 |
10.00 |
80.00 |
0.00 |
5 |
50.00 |
120.00 |
510.00 |
125.00 |
0.00 |
0.00 |
110.00 |
70.00 |
6 |
0.00 |
60.00 |
220.00 |
75.00 |
0.00 |
0.00 |
60.00 |
0.00 |
Table 2: Functional characterization of expanded CD8+ Flu antigen specific cells after initial stimulation and re-stimulation with appropriate antigen.
Donor |
After 1st week of IVC (IFNγ pg/ml) |
After 2nd week of IVC (IFNγ pg/ml) |
None |
T2 |
T2+Flu |
T2+M3 |
None |
T2 |
T2+Flu |
T2+M3 |
1 |
0.00 |
20.00 |
720.00 |
125.00 |
0.00 |
110.00 |
650.00 |
130.00 |
2 |
0.00 |
0.00 |
440.00 |
110.00 |
50.00 |
50.00 |
820.00 |
240.00 |
3 |
0.00 |
140.00 |
1200.00 |
255.00 |
0.00 |
150.00 |
900.00 |
330.00 |
4 |
0.00 |
70.00 |
300.00 |
120.00 |
0.00 |
110.00 |
380.00 |
100.00 |
5 |
50.00 |
220.00 |
410.00 |
125.00 |
0.00 |
0.00 |
610.00 |
190.00 |
6 |
0.00 |
60.00 |
520.00 |
185.00 |
0.00 |
110.00 |
1060.00 |
330.00 |
Table 3: Percent of CD8+ Mart-1 Tetramer positive cells post 1st, 2nd, 3rd and 4th Mart-127-35 antigen specific stimulation in Mart-1 PBL IVC.
Donors |
7-10 Days of culture (1st) |
14-16 Days of culture (2nd) |
21-24 days of culture (3rd) |
28-30 days of culture (4th) |
1 |
1.20 |
3.10 |
0.02 |
0.00 |
2 |
2.20 |
0.80 |
0.00 |
0.00 |
3 |
0.90 |
1.60 |
0.00 |
0.00 |
4 |
0.70 |
4.20 |
0.10 |
0.00 |
5 |
1.60 |
2.30 |
0.00 |
0.00 |
6 |
2.10 |
1.40 |
0.00 |
0.00 |
Table 4: Percent of CD8+ Flu Tetramer positive cells post 1st, 2nd, 3rd and 4th MP58-66 antigen specific stimulation in Flu PBL IVC.
Donors |
7-10 Days of culture 1st |
14-16 Days of culture 2nd |
21-24 days of culture 3rd |
28-30 days of culture 4th |
1 |
2.40 |
3.60 |
3.02 |
3.40 |
2 |
1.70 |
2.80 |
2.00 |
2.00 |
3 |
0.90 |
2.90 |
1.80 |
2.50 |
4 |
0.70 |
6.20 |
5.10 |
5.30 |
5 |
1.90 |
4.30 |
2.20 |
3.10 |
6 |
2.20 |
2.40 |
3.00 |
5.60 |
from the cultures. Significantly higher number of CD4+ Foxp3+
cells, were detected in PBL IVCs with Mart-1 peptide (Figure
3a). Before the initiation of the IVCs the percentage of CD4+ and
FoxP3+ cells varied from 2.1 to 3.2 in the total PBL (data not
shown). When we analyzed for the expression of CD62L, homing
receptor and for central memory on these CD4+ cells, we found
CD62L is much higher in CD4+ cells taken from Flu IVCs figure 3b.
While comparing the CD4+ cells isolated from two different IVCs
we found 3 times more of CD4+ cells from Mart-1 IVC, expressing
OX40. We did not detect any significant difference in expression of 4-1BB between these CD4+ cells taken from two different IVCs
(Figure 3b).
CD4+ cells from the PBL IVCs with Mart-1 and Flu were
purified by positive selection with magnetic beads. These CD4s+
cells were then re-stimulated with plate bound anti-CD3 or
with autologous DC (responder: stimulator = 10:1). Figure 4
describes functional profile of CD4+ cells taken from the PBL
cultures by intracellular staining. We found significantly higher
levels of IL-10 synthesized by CD4+ cells taken from Mart-1 IVC

Figure 1: Expansion of Flu MP58-66 and Mart-127-35 antigen specific tetramer positive cells in CD8+ IVC. Flu MP58-66 and Mart-127-35 antigen specific
tetramer positive CD8+ cells at baseline (a) and post first two stimulations with autologous APC in an antigen specific manner (b). Intracellular IFNγ
expression by expanded Flu MP58-66 (c) and Mart-127-35 (d) tetramer positive CD8+ cells on co-culture with T2A2 cells pulsed with either control peptide
(MAGE-3271-279) or cognate peptide (Flu MP58-66 or Mart-127-35), respectively. Antigen specific IFNγ release in the supernatant was estimated ~16
hours post co-culture by ELISA (e).
than from Flu IVC. IFN-γ, IL-2 and TNF-α, synthesized by these
CD4+ cells purified from two different IVCs (Mart-1 and Flu) were
comparable (Figure 4).
CD25, FoxP3 and IL-10 expression in CD4+ cells derived
from TIL and PBL- IVC
We also looked at the regulatory phenotype of CD4+ cells from
freshly obtained tumor tissues (TILs) and PBL tumor IVC in the presence of IL-2. We found 35.5 % TIL derived CD4+ cells were
CD25 positive (Figure 5a upper panel). Around 12.1 % of these
cells were FoxP3 positive while 13.2 % of these cells were IL-
10 positive (Figure 5a upper panel). In case of PBL + tumor IVC
derived CD4+ cells about 34.7 % were CD25+, 16.8 % were FoxP3
positive and a total of 62.8 % CD4+ cells were IL-10 positive
(Figure 5a lower panel). Further analysis of PBL + autologous
tumor IVC derived CD4+CD25+ cells revealed that 42.1 % of these

Figure 2: Binding affinity of Mart-127-35 and Flu (MP58-86) peptides with HLA A2 and MHC II expression on activated T cells. MFI of Mart-127-35
and Flu (MP58-86) peptide bound HLA A2 molecule on T2 cells were analyzed at 0-4 hour time point (a). MHC II expression was checked by FACS on
freshly isolated and activated lymphocytes peripheral (b). The FSC and SSC of activated CD8 and DC's were different. Hence a graph was plotted to
show difference between MHC II expression by activated CD8 and DC's. Ratios between MFI of MHC II stained and unstained sample from three individual
was used to plot the graph (c). Histogram shows the MFI shift in activated CD8 cells and DC's after staining them with MHC II antibody (d).
cells were Foxp3+ and 80.0 % of these FoxP3 + cells were IL-
10 positive (Figure 5b). Around 38 % of CD4+CD25+ cells were
both IL-10 and Foxp3 positive. From this study it was clear that a
significant number of these CD4+CD25+cells stained for IL10 and
not all the IL-10 producing CD4+CD25+ cells from PBL tumor IVC
were Foxp3 positive (Figure 5b).
Cytokine ELISA with CD4+ cells from PBL tumor IVC on
re-stimulation
PBL tumor IVC derived purified CD4+ cells did not secret
either IL-2 or IL-4 when stimulated with anti CD3 antibody.
But these cells did secret low levels of IFNγ and TNFα (Figure
6a). These CD4+ cells upon stimulation with anti CD3, secreted
very high levels of IL-10. We also found PBL tumor IVC derived
purified CD8+ cells secreted insignificant amount of IL-4 and no
IL-10 when stimulated with anti CD3 antibody, but were also
found to secret IL-2, IFNγ and TNFα when re-stimulated with
anti CD3 antibody (Figure 6a).We then looked at the cytokine
secretion profiles of CD8+ and CD4+ cells taken out from mixed culture and again mixed together in different CD8:CD4 ratios
along with anti CD3 antibody. As we increased the number of
CD4+ cells in the cultures of fixed number ofCD8+ cells stimulated
with anti-CD3 we did not detect any significant increase in IFNγ
or TNFα secretion by CD8+ cells by intracellular cytokine staining
indicating no further help to those CD8+ cells. On the contrary at
1:1 ratio (CD8:CD4) the CD4+ cells got additional stimulation and
significantly increased the level of IL-10 in the cultures (Figure
6a). A dose dependent response of IL-10 secretion by CD4+
cells was observed when CD4+ cells were mixed in the cultures
of CD8+ cells with anti CD3 antibody stimulation (Figure 6a). In
the cultures where equal numbers of CD8+ and CD4+ cells were
present, CD4+ cells secreted significantly higher levels of IL-10
(difference mean ~ 200 pg/ml) which is significant (p<0.05) than
that of those secreted by same number of CD4+ cells alone upon
stimulation with anti CD3 antibody (Figure 6a). These CD4+ cells
possibly got additional stimulation provided by CD8+ cells that
helped resulting in increased secretion of IL-10.

Figure 3: Phenotypic characterization of CD4+ cells isolated from
Flu MP58-66 and Mart-127-35 PBL IVC. CD4+cells were isolated from
Flu MP58-66 and Mart-127-35antigen specific PBL IVCs after 4thstimulation.
Phenotypic analysis of the purified CD4+ cells from PBL IVC were
performed by staining these cells with CD4+, CD25 and Foxp3 (a) and
CD62L, OX40 and 4-1-BB (b).
Cytokine profile of CD4+ cells in freshly isolated TILs
We analyzed lymphocytes from freshly isolated from
melanoma tumor tissue before putting them in culture. We
observed that significant number of CD4+ cells were positive for
IL-10. So we asked, if CD4+ cells at the tumor site in the presence
of very high number of autologous tumor load give a similar
response in terms of IL-10 production (Figure 6b). We gated the
tumor tissue single cell suspension first for lymphocytes and
then sub gated them for CD4+ cells. Analysis of CD4+ cells showed
that they were negative for IFNγ, TNFα, IL-2 and IL-4 cytokines
(Figure 6b). But 29.2 % of these CD4+ cells were positive for
intracellular IL-10 (Figure 6b).
Discussion
CD4+CD25+ and Foxp3+(or FoxP3 negative) regulatory T cells
(Tregs) play a critical role in all aspects of immune responses
and the control of immune homeostasis [6]. It has become
clear that the major population of Foxp3+ Treg is generated
in the thymus, previously known as nTreg now it is called
tTreg [3, 14]. It is also clear that certain percentage of Tregs
Figure 4: Functional characterization of CD4+ cells isolated from
Mart-127-35 and Flu MP58-66 PBLC:\Users\onlinepc014\Documents\
Downloads\Doc1.docx IVC. CD4+ were isolated from Mart-127-35 and
Flu MP58-66antigen specific PBL IVC after 4th. These CD4+ cells were left
un-stimulated, stimulated with autologous APC and stimulated with
anti-CD3 antibody, respectively. Intracellular level of cytokines IFNγ,
TNFα, IL-2, IL-4 and IL-10 were tested by FACS.

Figure 5: Comparative phenotypic analysis of CD4+ cells isolated from TIL and PBL Tumor IVC. Autologous tumor cell line was generated from
surgically removed tumor tissue from a melanoma patient. TILs obtained from the single cell suspension from the tissues were tested. PBL tumor IVC
was setup with autologous tumor line in the presence of 100 U/ml IL-2, and allowed to proliferate for 2-3 weeks before we used them. We looked at
the expressions of CD25, Foxp3 and IL-10 on TIL and PBL tumor IVC derived CD4+ cells (a). We further gated CD4+CD25+ cells from PBL tumor IVC
and reanalyzed the data for Foxp3 and IL-10 expression (b).

Figure 6: Characterization of CD4+ cells isolated from PBL IVC or TILs. IVCs with PBL and autologous tumor were setup in the presence of 100
U/ml IL-2. Two weeks after culture, CD8+ T cells (> 99 % purity) were separated from the culture using Dynal beads while remaining cells were CD4+
(>93% purity). Functional characterization of these CD8+ cells (2 x 105 cells/well) or CD4+ cells (2 x 105 cells/well) or CD8+ and CD4+ cells mixed together
(CD8:CD4 ratio of 10:1, 5:1, 2:1 and 1:1) was performed with or without stimulation with anti CD3 antibody (1 μg/well). Culture supernatants
wee collected and analyzed for cytokines by ELISA (a). Surgically removed melanoma tissue sample was used to generate single cell suspension of
Infiltrating Lymphocytes (TIL). Intracellular cytokine (IL-10, IL-4, IL-2, IFNγ and TNFα) staining was done immediately after isolation of TIL from
tumor tissue and analyzed by FACS. The samples were first gated for lymphocytes and then sub gated for CD4+ cells (b).
is generated from T-conventional (Tconv) cells in peripheral
sites. It has been proposed that such cell populations be termed
peripherally derived Tregs (pTregs) [15]. Specificity of tTregs
is not established. Although there could be a specific reason
for induction of pTregs but how these cells are induced in the
periphery, is also not known [14]. It remains unclear whether in
vitro induced iTregs and peripherally induced pTregs are similar
and that might use the same mechanism for suppression [3, 6]
of effector immune response. In this article we tried to address
the important issues regarding the induction and functions
of these pTreg and/or iTreg subpopulations in an in vitro set
up. A detailed characterization of these subpopulations has
important clinical implications in cellular immunotherapy for
cancer [3, 6, 14]. Use of tumor associated antigen specific CD8+
CTL have shown considerable promise in translational tumor
immunotherapy [16]. Variety of intrinsic regulatory processes
within T cells as well as a number of microenvironment-based
extrinsic mechanisms have turned out to be serious impediments
in achieving robust and sustained outcomes of CTL mediated
immunotherapy for cancer [16]. A great deal of effort is underway
to understand to over come these impediments. Polyclonal tTreg
cells do not always influence the immune response by mediating
immune suppression or completely shutting down T-cell
activation. Thus, polyclonal tTreg cells would not necessarily
lead to global immune suppression or the inhibition of effector
responses to all antigens [3]. Polyclonal tTregs might specifically
target trafficking pathways and not allowing immunity to develop
in lymphoid organs. By limiting the number of potentially autoreactive
T cells that are allowed to migrate and enter tissues. That
could be the reason for the existence of tumor specific CD8+ CTL
in tumor tissues. In such conditions a specific Treg cells might
be induced from conventional CD4+ CD25- T cells to work against
those auto-reactive T cells that are generated in the periphery [4,
5, 17-20].
We have made an attempt to understand the functional
properties of the CD4+ cells isolated from the co-cultures with
unfractionated PBL. IL-10 secreted by these cells could dampen
the antigen presenting ability of DC as it is already known that
iTreg cells suppress DC function and subsequently do suppress T
effector function via IL-10 [5, 12, 21].
Naive and activated T cells are known to express different
adhesion molecules and are thought to exhibit different migratory
patterns that result from their expression of discrete adhesion
molecules. Two known adhesion molecules that have been
associated with differentiating the naive and activated/memory
T cells are CD62L (L-selectin) and CD44 (H-CAM) [22, 23]. In our
in vitro CD8+ CTL generation experiments against Mart-1 and
Flu we found a marked difference in lymphoid homing receptor
expression. It has been demonstrated previously that naive T
cells express a CD62LhiCD44lo phenotype, whereas memory T
cells exhibit a CD62LloCD44hi phenotype [22, 23]. In this regards
increased number of CD62L expressing CD4+ cells from Flu IVC,
could be indicative of memory cells against Flu matrix protein
derived antigens, as most of us are exposed to Flu antigen at least
once in life time where as Mart-1 being a self antigen no such
thing as memory cells were seen.
Analysis of regulatory phenotype of lymphocytes from
tumor tissue (TILs) or PBL IVC derived CD4+ cells revealed that,
a substantial population of these cells were CD25+. The number
of CD4+ cells expressing CD25 or Foxp3 from those two cultures
(TIL or PBL + Tumor IVC) were comparable (Figure 5a). This
can be explained by the fact that in both conditions (TIL or
PBL+Tumor IVC) CD4+ cells have already seen the autologous
tumor antigen. So in either case the CD4+ T cells have seen the
tumor antigen and behaved as T regulatory cells to prevent tumor
(auto) destruction. The expression of Foxp3 has been shown in
both tumor-infiltrating Tregs and melanoma cells by immune
histochemical analysis of human melanoma tissue sections [24].
In humans CD4+CD25- effector T cells can also up regulate Foxp3
expression transiently [4, 20].
Although this work was done with a small group of donors, a
difference in pathways for the induction of CD4+ pTreg (or iTreg)
phenotype (difference in number or function) are clearly seen
when antigen specific CTLs (with Mart-127-35 and Flu58-66 peptides)
were induced. In this study CTL were generated using identically
matured autologous DC. When Flu specific CTLs were induced in
long term cultures with total PBL, CD8+ CTL remained active for
significantly longer period. CD4+ cells in cultures and were found
to secrete higher amounts of helper cytokine IFNγ than IL-10.
Since all other conditions remained same, probable indication
goes towards the difference in type of antigens. Previously we
have shown that CD4+ clones, derived from melanoma involved
lymph nodes or PBL stimulated by autologous melanoma cells
selectively down regulated the induction of cytotoxic immune
response against the autologous melanoma cells [7]. We have
also shown that repetitive in vitro stimulation with antigen
loaded APC could lead to the emergence of non cytolytic CD4+
T cells secreting suppressor factor in culture supernatant. This
inhibitory effect of supernatant factor could be abrogated by
neutralizing IL-10 with anti IL-10 antibody [12].
Expression of MHC II molecules by activated T cells from
humans is regulated by CIITA-PIII subtype of the class II trans
activator (CIITA) [25]. Direct ex vivo expression of MHC-II in the
context of CD [25] high identifies a mature, functionally distinct
regulatory T cell population involved in contact dependent in
vitro suppression [26]. So circulating human peripheral blood
derived T cells can express MHC class II [27, 28], but mice T
cells cannot transcribe CIITA required for MHC II expression
[29, 30]. It has been shown earlier that MHC II DR on human T
cells, primarily being regarded as a marker for activation [30-
32]. The expression of class II on CD4+ T cells is inducible and
Class II+ CD4+ T cells can present antigen in the absence of APC
[33]. It has been reported that suppression of TCR transgenic
CD8+ T cells stimulated with soluble peptide was mediated
via a T-T interaction with activated CD4+ CD25+ T cells [34].
Antibody blocking of MHC II on human activated regulatory T
cells abrogated their suppressive potential [35]. In our study
we also found that naïve CD8+ cells do not express MHC-II
molecules. After stimulation with DC pulsed with HLA A2 binding
peptides or tumor cells expression of MHC-II molecule (newly
synthesized) was seen. MHC-II expressed by activated CD8+ cells
were not simply shaded off MHC-II molecules from the DCs in the cultures (Figure 2b). Purified CD8+ CTL from the cultures
maintained their expression of MHC-II molecules as long as they
survived (4-8 weeks) in cultures. Newly expressed MHC II on
CD8+ activated cells and the additional stimulatory effect of such
cells on expanding CD4+ cells (Figure 6a) indicated that activated
CD8+ CTL could also provide important signal for the outcome of
the immune reaction (rejection or tolerance).The IL-10 secreted
by CD4+ cells was able to suppress CD8+ CTL expansion in IVC
with PBL plus autologous tumor. It has been reported earlier that
iTregs could regulate CTL response through IL-10 in vitro and
also in vivo [3, 5, 12, 21, 26]. Further detailed work is needed to
understand the mechanism behind this differential activation of
induced Treg (or pTregs) cells and the role of MHC-II+ CD8+ CTLs
to that.
Tumor associated peptide antigen pulsed DC or whole
tumor cells when presented to autologous lymphocytes in the in
vitro cultures, induced a class of CD4+CD25+ cells that secreted
significant amount of IL-10 and controlled the expansion of CD8+
CTLs. A similar picture was seen in vivo, where we analyzed
freshly isolated lymphocytes from the surgically removed tumor
tissues. Whether peptide antigens or tumor cells when used to
stimulate autologous lymphocytes in cultures a clonal (oligo
or polyclonal) population of CD4+ were induced that secreted
significant amount of IL-10 and controlled CTL expansion. An
identical in vivo picture was seen when we analyzed freshly
isolated lymphocytes from surgically removed tumor tissues.
Hence the overall negative regulation is maintained by induced
CD4+CD5+ cells (possibly) pTregs via IL-10, and MHC-II+ CD8+
activated T cells could also provide signals through newly
synthesized MHC molecules in the in vivo micro environment and
in vitro cultures.
Acknowledgements
This work was supported by a grant from Richard and Jane
Lublin (UPH), and MO 1RR06192 from GCRC, UCHC.
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