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The Presence of a Marked Imbalance Between Regulatory T Cells and Effector T Cells Reveals That Tolerance Mechanisms Could Be Compromised in Heart Transplant Children. Transplant Direct 2021; 7:e693. [PMID: 33928185 PMCID: PMC8078462 DOI: 10.1097/txd.0000000000001152] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/08/2021] [Revised: 03/05/2021] [Accepted: 03/06/2021] [Indexed: 12/19/2022] Open
Abstract
Regulatory T cells (Treg) are crucial for the induction and maintenance of graft tolerance. In pediatric heart transplant procedures, the thymus is routinely excised, removing the primary source of T-cell replenishment. Consequently, thymectomy joined to the effects of immunosuppression on the T-cell compartment may have a detrimental impact on Treg values, compromising the intrinsic tolerance mechanisms and the protective role of Treg preventing graft rejection in heart transplant children.
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Weiss ARR, Lee O, Eggenhofer E, Geissler E, Korevaar SS, Soeder Y, Schlitt HJ, Geissler EK, Hoogduijn MJ, Dahlke MH. Differential effects of heat-inactivated, secretome-deficient MSC and metabolically active MSC in sepsis and allogenic heart transplantation. Stem Cells 2020; 38:797-807. [PMID: 32101344 DOI: 10.1002/stem.3165] [Citation(s) in RCA: 18] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/28/2019] [Accepted: 02/10/2020] [Indexed: 02/06/2023]
Abstract
Mesenchymal stem cells (MSCs) are used in various clinical and preclinical models for immunomodulation. However, it remains unclear how the immunomodulatory effect of MSC is communicated. MSC-induced immunomodulation is known to be mediated through both MSC-secreted cytokines and direct cell-cell interactions. Recently, it has been demonstrated that metabolically inactive, heat-inactivated MSCs (HI-MSCs) have similar anti-inflammatory capacities in LPS-induced sepsis compared with viable MSC. To further investigate the immunomodulatory effects of MSC, we introduced MSC and HI-MSC in two animal models with different immunological causes. In the first model, allogeneic hearts were transplanted from C57BL/6 mice to BALB/c recipients. MSC in combination with mycophenolate mofetil (MMF) significantly improved graft survival compared with MMF alone, whereas the application of HI-MSC had no effect on graft survival. We revealed that control MSC dose-dependently inhibited CD3+ and CD8+ T-cell proliferation in vitro, whereas HI-MSC had no effect. In the second model, sepsis was induced in mice via cecal ligation and puncture. HI-MSC treatment significantly improved the overall survival, whereas control MSCs had no effect. in vitro studies demonstrated that HI-MSCs are more effectively phagocytosed by monocytes than control MSCs and induced cell death in particular of activated CD16+ monocytes, which may explain the immune protective effect of HI-MSC in the sepsis model. The results of our study demonstrate that MSC-mediated immunomodulation in sepsis is dependent on a passive recognition of MSC by monocytes, whereas fully functional MSCs are required for inhibition of T-cell-mediated allograft rejection.
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Affiliation(s)
- Andreas R R Weiss
- Department of Surgery and Experimental Surgery, University Medical Center, Regensburg, Germany.,Trinity Translational Medicine Institute, Department of Surgery, Trinity College Dublin, St. James' Hospital, Dublin, Ireland
| | - Olivia Lee
- Nephrology and Transplantation, Department of Internal Medicine, Erasmus MC, Rotterdam, The Netherlands.,Biomedical Sciences, University of Guelph, Ontario, Canada
| | - Elke Eggenhofer
- Department of Surgery and Experimental Surgery, University Medical Center, Regensburg, Germany
| | - Elisabeth Geissler
- Department of Surgery and Experimental Surgery, University Medical Center, Regensburg, Germany
| | - Sander S Korevaar
- Nephrology and Transplantation, Department of Internal Medicine, Erasmus MC, Rotterdam, The Netherlands
| | - Yorick Soeder
- Department of Surgery and Experimental Surgery, University Medical Center, Regensburg, Germany.,Department of Surgery, Robert Bosch Health Campus, Stuttgart, Germany
| | - Hans J Schlitt
- Department of Surgery and Experimental Surgery, University Medical Center, Regensburg, Germany
| | - Edward K Geissler
- Department of Surgery and Experimental Surgery, University Medical Center, Regensburg, Germany
| | - Martin J Hoogduijn
- Nephrology and Transplantation, Department of Internal Medicine, Erasmus MC, Rotterdam, The Netherlands
| | - Marc H Dahlke
- Department of Surgery and Experimental Surgery, University Medical Center, Regensburg, Germany.,Department of Surgery, Robert Bosch Health Campus, Stuttgart, Germany
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Tietze JK, Angelova D, Heppt MV, Reinholz M, Murphy WJ, Spannagl M, Ruzicka T, Berking C. The proportion of circulating CD45RO +CD8 + memory T cells is correlated with clinical response in melanoma patients treated with ipilimumab. Eur J Cancer 2017; 75:268-279. [PMID: 28242504 DOI: 10.1016/j.ejca.2016.12.031] [Citation(s) in RCA: 51] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/05/2016] [Revised: 12/01/2016] [Accepted: 12/22/2016] [Indexed: 12/24/2022]
Abstract
BACKGROUND Immune checkpoint blockade (ICB) has been a breakthrough in the treatment of metastatic melanoma. But with only about 20-40% long-term responders and severe side-effects in about 12-17%, finding predictive markers for treatment response is of great interest. METHODS We prospectively assessed clinical data, haematologic parameters and freshly isolated peripheral blood mononuclear cells of 30 patients treated with ipilimumab (n = 21) and pembrolizumab (n = 9) prior to the first 4 cycles with ICB and before the first tumour assessment. RESULTS We discovered that the baseline levels of CD45RO+CD8+ T cells significantly differed among the patients. Thirteen (43%) of our patients had normal baseline levels of CD45RO+CD8+ T cells, whereas 17 (57%) patients were low on CD45RO+CD8+ T cells. The baseline levels of CD45RO+CD8+ T cells correlated significantly with the response to ipilimumab but not pembrolizumab. Patients with baseline levels of lower/equal 25% of CD45RO+CD8+ T cells did not respond to treatment with ipilimumab. Phenotyping the CD8+ T cells in patients treated with ipilimumab revealed an activated HLA-DR+CD25- phenotype, implying antigen non-specific stimulation. The levels of the HLA-DR+CD25-CD8+ T cells were significantly higher in patients with a normal baseline of CD45RO+CD8+ T cells and even increased significantly during treatment. Furthermore, proliferation of melanoma antigen recognized by T cells 1 (MART-1)-specific CD8+ T cells was not observed. Patients with normal baseline levels of CD45RO+CD8+ T cells showed a significant longer overall survival when treated with ipilimumab but not pembrolizumab. CONCLUSION Patients with normal baseline levels of CD45RO+CD8+ T cells respond significantly more frequently to treatment with ipilimumab and the CD8+ T cells appear to be antigen non-specifically activated. The baseline level of CD45RO+CD8+ T cells represents a promising factor as biomarker for the prediction of the response to ipilimumab.
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Affiliation(s)
- Julia K Tietze
- Department of Dermatology and Allergy, University Hospital Munich (LMU), Frauenlobstr. 9-11, 80337 Munich, Germany.
| | - Daniela Angelova
- Department of Dermatology and Allergy, University Hospital Munich (LMU), Frauenlobstr. 9-11, 80337 Munich, Germany
| | - Markus V Heppt
- Department of Dermatology and Allergy, University Hospital Munich (LMU), Frauenlobstr. 9-11, 80337 Munich, Germany
| | - Markus Reinholz
- Department of Dermatology and Allergy, University Hospital Munich (LMU), Frauenlobstr. 9-11, 80337 Munich, Germany
| | - William J Murphy
- Department of Dermatology, School of Medicine, University of California, Davis, 3301 C Street, Sacramento, CA 95816, USA
| | - Michael Spannagl
- Department of Internal Medicine, University Hospital Munich (LMU), Ziemssenstr. 1, 80336 Munich, Germany
| | - Thomas Ruzicka
- Department of Dermatology and Allergy, University Hospital Munich (LMU), Frauenlobstr. 9-11, 80337 Munich, Germany
| | - Carola Berking
- Department of Dermatology and Allergy, University Hospital Munich (LMU), Frauenlobstr. 9-11, 80337 Munich, Germany
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Lanio N, Sarmiento E, Gallego A, Navarro J, Palomo J, Fernandez-Yañez J, Ruiz M, Fernandez-Cruz E, Carbone J. Kinetics of functionally distinct T-lymphocyte subsets in heart transplant recipients after induction therapy with anti-CD25 monoclonal antibodies. Transpl Immunol 2013; 28:176-82. [DOI: 10.1016/j.trim.2013.04.005] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/09/2013] [Revised: 04/13/2013] [Accepted: 04/15/2013] [Indexed: 12/18/2022]
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Changes in the number of circulating T CM and T EM subsets in renal transplantation: relationship with acute rejection and induction therapy. Kidney Int Suppl (2011) 2011; 1:31-35. [PMID: 25018900 PMCID: PMC4089667 DOI: 10.1038/kisup.2011.9] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/12/2023] Open
Abstract
Effector (TEM) and central memory (TCM) T cells have been recently described as the main memory T-cell subsets generated after primary immune response, with a potential role in graft rejection after rechallenge with alloantigen. Because of their effector function, they could be involved in driving the response against the allograft, leading to rejection. In this study, we sought to investigate the different memory T-cell subpopulations in peripheral blood from a cohort of 90 patients who underwent consecutive renal transplant, and their association with acute rejection (AR) episodes and induction therapy. Twenty-one of them were monitored in the short term during the first 2 months after transplantation. Three of them suffered an AR but no changes in the circulating levels of either CD4+ or CD8+ TEM were observed as compared with rejection-free renal transplant patients. In total, 69 patients out of 90 were monitored in the long term. Even 2 years after transplantation, maintained increased numbers of peripheral blood CD4+ TEM were observed in patients suffering with AR. Interestingly, induction therapy with thymoglobulin, but not with basiliximab, produced an increase in circulating CD4+ TEM cells at 6 months after transplantation. In conclusion, our data suggest that AR episodes favor the induction of TEM cells in the periphery of renal transplant patients in the long term. It remains to be determined whether such an effect has any impact on long-term renal transplantation.
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Heidt S, San Segundo D, Shankar S, Mittal S, Muthusamy ASR, Friend PJ, Fuggle SV, Wood KJ. Peripheral blood sampling for the detection of allograft rejection: biomarker identification and validation. Transplantation 2011; 92:1-9. [PMID: 21494177 DOI: 10.1097/tp.0b013e318218e978] [Citation(s) in RCA: 67] [Impact Index Per Article: 5.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/08/2023]
Abstract
Currently, acute allograft rejection can only be detected reliably by deterioration of graft function confirmed by allograft biopsy. A huge drawback of this method of diagnosis is that substantial organ damage has already taken place at the time that rejection is diagnosed. Discovering and validating noninvasive biomarkers that predict acute rejection, and chronic allograft dysfunction, is of great importance. Many studies have investigated changes in the peripheral blood in an attempt to find biomarkers that reflect changes in the graft directly or indirectly. Herein, we will review the promises and limitations of the peripheral blood biomarkers that have been described in the literature so far.
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Affiliation(s)
- Sebastiaan Heidt
- Transplant Research Immunology Group, Nuffield Department of Surgical Sciences, University of Oxford, Oxford, UK
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Zhao Y, Shan Z, Li Q, Zhou Y, Zeng X, Fan Q, Liao C, Zhu Y, Zhao Y, Lu X, Liu J. Effect of CD4+ Memory T Cells on Rejection Response of Ectopic Heart Transplantation in Mice. Transplant Proc 2011; 43:1989-93. [DOI: 10.1016/j.transproceed.2010.12.054] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/25/2010] [Revised: 11/05/2010] [Accepted: 12/13/2010] [Indexed: 11/29/2022]
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Chen M, Mohtize M, Matteï MF, Villemot JP, Kohler C, Faure GC, Béné MC, de Carvalho Bittencourt M. Reduced levels of both circulating CD4+ CD25+ CD127(low/neg) and CD4+ CD8(neg) invariant natural killer regulatory T cells in stable heart transplant recipients. Clin Exp Immunol 2010; 163:104-12. [PMID: 21039425 DOI: 10.1111/j.1365-2249.2010.04281.x] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/29/2022] Open
Abstract
A cross-regulation between two regulatory T cell (T(reg) ) subsets [CD4(+) CD25(+) and invariant natural killer (NK) T - iNK T] has been described to be important for allograft tolerance induction. However, few studies have evaluated these cellular subsets in stable recipients as correlates of favourable clinical outcome after heart transplantation. T(reg) and iNK T cell levels were assayed by flow cytometry in peripheral blood samples from 44 heart transplant recipients at a 2-year interval in 38 patients, and related to clinical outcome. Multi-parameter flow cytometry used CD4/CD25/CD127 labelling to best identify T(reg) , and a standard CD3/CD4/CD8/Vα24/Vβ11 labelling strategy to appreciate the proportions of iNK T cells. Both subtypes of potentially tolerogenic cells were found to be decreased in stable heart transplant recipients, with similar or further decreased levels after 2 years. Interestingly, the patient who presented with several rejection-suggesting incidents over this period displayed a greater than twofold increase of both cell subsets. These results suggest that CD4(+) CD25(+) CD127(low/neg) T(reg) and iNK T cells could be involved in the local control of organ rejection, by modulating immune responses in situ, in clinically stable patients. The measurement of these cell subsets in peripheral blood could be useful for non-invasive monitoring of heart transplant recipients, especially in the growing context of tolerance-induction trials.
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Affiliation(s)
- M Chen
- Laboratory of Immunology Department of Cardiothoracic Surgery, University Hospital of Nancy and Nancy Université, Allée du Morvan, Vandoeuvre-lès-Nancy, France
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