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Alvarez Salazar EK, Cortés-Hernández A, Alemán-Muench GR, Alberú J, Rodríguez-Aguilera JR, Recillas-Targa F, Chagoya de Sánchez V, Cuevas E, Mancilla-Urrea E, Pérez García M, Mondragón-Ramírez G, Vilatobá M, Bostock I, Hernández-Méndez E, De Rungs D, García-Zepeda EA, Soldevila G. Methylation of FOXP3 TSDR Underlies the Impaired Suppressive Function of Tregs from Long-term Belatacept-Treated Kidney Transplant Patients. Front Immunol 2017; 8:219. [PMID: 28316600 PMCID: PMC5334349 DOI: 10.3389/fimmu.2017.00219] [Citation(s) in RCA: 24] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/12/2016] [Accepted: 02/15/2017] [Indexed: 12/28/2022] Open
Abstract
Regulatory T cells (Tregs) are considered key players in the prevention of allograft rejection in transplanted patients. Belatacept (BLT) is an effective alternative to calcineurin inhibitors that appears to preserve graft survival and function; however, the impact of this drug in the homeostasis of Tregs in transplanted patients remains controversial. Here, we analyzed the phenotype, function, and the epigenetic status of the Treg-specific demethylated region (TSDR) in FOXP3 of circulating Tregs from long-term kidney transplant patients under BLT or Cyclosporine A treatment. We found a significant reduction in the proportion of CD4+CD25hiCD127lo/−FOXP3+ T cells in all patients compared to healthy individual (controls). Interestingly, only BLT-treated patients displayed an enrichment of the CD45RA+ “naïve” Tregs, while the expression of Helios, a marker used to identify stable FOXP3+ thymic Tregs remained unaffected. Functional analysis demonstrated that Tregs from transplanted patients displayed a significant reduction in their suppressive capacity compared to Tregs from controls, which is associated with decreased levels of FOXP3 and CD25. Analysis of the methylation status of the FOXP3 gene showed that BLT treatment results in methylation of CpG islands within the TSDR, which could be associated with the impaired Treg suppression function. Our data indicate that analysis of circulating Tregs cannot be used as a marker for assessing tolerance toward the allograft in long-term kidney transplant patients. Trial registration number IM103008.
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Affiliation(s)
- Evelyn Katy Alvarez Salazar
- Departmento de Inmunología, Instituto de Investigaciones Biomédicas, Universidad Nacional Autónoma de México , Ciudad de México , Mexico
| | - Arimelek Cortés-Hernández
- Departmento de Inmunología, Instituto de Investigaciones Biomédicas, Universidad Nacional Autónoma de México , Ciudad de México , Mexico
| | - Germán Rodrigo Alemán-Muench
- Departmento de Inmunología, Instituto de Investigaciones Biomédicas, Universidad Nacional Autónoma de México , Ciudad de México , Mexico
| | - Josefina Alberú
- Departmento de Trasplantes, Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán , Ciudad de México , Mexico
| | - Jesús R Rodríguez-Aguilera
- Departamento de Genética Molecular, Instituto de Fisiología Celular, Universidad Nacional Autónoma de México , Ciudad de México , Mexico
| | - Félix Recillas-Targa
- Departamento de Genética Molecular, Instituto de Fisiología Celular, Universidad Nacional Autónoma de México , Ciudad de México , Mexico
| | - Victoria Chagoya de Sánchez
- Departamento de Genética Molecular, Instituto de Fisiología Celular, Universidad Nacional Autónoma de México , Ciudad de México , Mexico
| | - Eric Cuevas
- Departmento de Trasplantes, Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán , Ciudad de México , Mexico
| | - Eduardo Mancilla-Urrea
- Departamento de Nefrología, Instituto Nacional de Cardiología Ignacio Chávez , Ciudad de México , Mexico
| | - María Pérez García
- Departamento de Nefrología, Instituto Nacional de Cardiología Ignacio Chávez , Ciudad de México , Mexico
| | | | - Mario Vilatobá
- Departmento de Trasplantes, Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán , Ciudad de México , Mexico
| | - Ian Bostock
- Departmento de Trasplantes, Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán , Ciudad de México , Mexico
| | - Erick Hernández-Méndez
- Departmento de Trasplantes, Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán , Ciudad de México , Mexico
| | - David De Rungs
- Departmento de Trasplantes, Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán , Ciudad de México , Mexico
| | - Eduardo A García-Zepeda
- Departmento de Inmunología, Instituto de Investigaciones Biomédicas, Universidad Nacional Autónoma de México , Ciudad de México , Mexico
| | - Gloria Soldevila
- Departmento de Inmunología, Instituto de Investigaciones Biomédicas, Universidad Nacional Autónoma de México , Ciudad de México , Mexico
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Baatjes AJ, Smith SG, Dua B, Watson R, Gauvreau GM, O'Byrne PM. Treatment with anti-OX40L or anti-TSLP does not alter the frequency of T regulatory cells in allergic asthmatics. Allergy 2015. [PMID: 26213896 DOI: 10.1111/all.12708] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/02/2023]
Abstract
OX40-OX40L interactions and thymic stromal lymphopoietin (TSLP) are important in the induction and maintenance of Th2 responses in allergic disease, whereas T regulatory cells (Treg) have been shown to suppress pro-inflammatory Th2 responses. Both OX40L and TSLP have been implicated in the negative regulation of Treg. The effect of anti-asthma therapies on Treg is not well known. Our aim was to assess the effects of two monoclonal antibody therapies (anti-OX40L and anti-TSLP) on Treg frequency using a human model of allergic asthma. We hypothesized that the anti-inflammatory effects of these therapies would result in an increase in circulating Treg (CD4(+) CD25(+) CD127(low) Foxp3(+) cells) frequency. We measured Treg using flow cytometry, and our results showed that neither allergen challenge nor monoclonal antibody therapy altered circulating Treg frequency. These data highlight the need for assessment of airway Treg and for a more complete understanding of Treg biology so as to develop pharmacologics/biologics that modulate Treg for asthma therapy.
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Affiliation(s)
- A. J. Baatjes
- Department of Medicine; Michael G DeGroote School of Medicine; McMaster University; Hamilton ON Canada
| | - S. G. Smith
- Department of Medicine; Michael G DeGroote School of Medicine; McMaster University; Hamilton ON Canada
| | - B. Dua
- Department of Medicine; Michael G DeGroote School of Medicine; McMaster University; Hamilton ON Canada
| | - R. Watson
- Department of Medicine; Michael G DeGroote School of Medicine; McMaster University; Hamilton ON Canada
| | - G. M. Gauvreau
- Department of Medicine; Michael G DeGroote School of Medicine; McMaster University; Hamilton ON Canada
| | - P. M. O'Byrne
- Department of Medicine; Michael G DeGroote School of Medicine; McMaster University; Hamilton ON Canada
- Firestone Institute of Respiratory Health; Michael G DeGroote School of Medicine; McMaster University; Hamilton ON Canada
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Abstract
The biologics used in transplantation clinical practice include several monoclonal and polyclonal antibodies aimed at specific cellular receptors. The effect of their mechanisms of action includes depleting or blocking specific cell subpopulations, complement system, or removing circulating preformed antibodies and blocking their production. They are used in induction, desensitization ABO-incompatible renal transplantation, rescue therapy of steroid-resistant acute rejection, treatment of posttransplant recurrence of primary disease such as nephrotic syndrome or atypical hemolytic-uremic syndrome, and in late humoral rejection. There are various indications for the use of biologic agents before and early or late after renal transplantation in both high- and low-risk recipients. In the latter situation, the biologics-based induction is used to further minimize immunosuppression maintenance. The targets of several biologic agents are present across a variety of cells, and manipulation of the immune system with biologics may be associated with significant risk of acute and late-onset adverse events; therefore, clinical risk-versus-benefit ratio must be carefully balanced in every case. Several trials on novel biologics are reported in adults but not in the pediatric population.
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Affiliation(s)
- Ryszard Grenda
- Department of Nephrology & Kidney Transplantation, The Childrens Memorial Health Institute, Warsaw, Poland,
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Gallon L, Traitanon O, Sustento-Reodica N, Leventhal J, Ansari MJ, Gehrau RC, Ariyamuthu V, De Serres SA, Alvarado A, Chhabra D, Mathew JM, Najafian N, Mas V. Cellular and molecular immune profiles in renal transplant recipients after conversion from tacrolimus to sirolimus. Kidney Int 2014; 87:828-38. [PMID: 25354238 PMCID: PMC4382402 DOI: 10.1038/ki.2014.350] [Citation(s) in RCA: 28] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/17/2014] [Revised: 08/26/2014] [Accepted: 08/28/2014] [Indexed: 02/01/2023]
Abstract
Tacrolimus and Sirolimus are commonly used maintenance immunesuppressants in kidney transplantation. Since their effects on immune cells and allograft molecular profiles have not been elucidated, we characterized the effects of Tacrolimus to Sirolimus conversion on frequency and function of T cells, and on graft molecular profiles. Samples from renal transplant patients in a randomized trial of 18 patients with late Sirolimus conversion and 12 on Tacrolimus maintenance were utilized. Peripheral blood was collected at 0, 6, 12 and 24-months post-randomization with T cell subpopulations analyzed by flow cytometry and T cell alloreactivity tested by IFN-γ ELISPOT. Graft biopsy samples obtained 24-months post-randomization were used for gene expression analysis. Sirolimus conversion led to an increase in CD4+25+++Foxp3+ regulatory T cells. While Tacrolimus-maintained patients showed a decrease in indirect alloreactivity over time post-transplant, Sirolimus conversion increased indirect alloreactive T cell frequencies compared to Tacrolimus-maintained patients. No histological differences were found in graft biopsies, but molecular profiles showed activation of the antigen presentation, IL-12 signaling, oxidative stress, macrophage-derived production pathways, and increased inflammatory and immune response in Sirolimus-converted patients. Thus, chronic immune alterations are induced after Sirolimus conversion. Despite the molecular profile being favorable to calcineurin inhibitor-based regimen, there was no impact in renal function over 30 months of follow-up.
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Affiliation(s)
- Lorenzo Gallon
- 1] Comprehensive Transplant Center, Northwestern University, Chicago, Illinois, USA [2] Department of Medicine-Nephrology, Northwestern University, Chicago, Illinois, USA
| | - Opas Traitanon
- 1] Department of Medicine-Nephrology, Northwestern University, Chicago, Illinois, USA [2] Department of Medicine-Nephrology, Thammasart University Hospital, Pathumthani, Thailand
| | | | - Joseph Leventhal
- Comprehensive Transplant Center, Northwestern University, Chicago, Illinois, USA
| | - M Javeed Ansari
- 1] Comprehensive Transplant Center, Northwestern University, Chicago, Illinois, USA [2] Department of Medicine-Nephrology, Northwestern University, Chicago, Illinois, USA
| | - Ricardo C Gehrau
- University of Virginia, Department of Surgery, Charlottesville, Virginia, USA
| | - Venkatesh Ariyamuthu
- Department of Medicine-Nephrology, Northwestern University, Chicago, Illinois, USA
| | - Sacha A De Serres
- 1] Transplantation Research Center, Division of Nephrology, Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts, USA [2] Department of Nephrology, Cleveland Clinic Florida, Cleveland, Florida, USA
| | - Antonio Alvarado
- 1] Comprehensive Transplant Center, Northwestern University, Chicago, Illinois, USA [2] Department of Medicine-Nephrology, Northwestern University, Chicago, Illinois, USA
| | - Darshika Chhabra
- Advocate Christ Medical Center, Kidney Transplant, Oak Lawn, Illinois, USA
| | - James M Mathew
- Comprehensive Transplant Center, Northwestern University, Chicago, Illinois, USA
| | - Nader Najafian
- 1] Transplantation Research Center, Division of Nephrology, Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts, USA [2] Department of Nephrology, Cleveland Clinic Florida, Cleveland, Florida, USA
| | - Valeria Mas
- University of Virginia, Department of Surgery, Charlottesville, Virginia, USA
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Abstract
Infection incidence among athletes is highest during periods of intensified training and competition and after strenuous long-distance events. Which aspects of depressed immune function are responsible for this increased infection risk are not known, but our hypothesis is that lower salivary immunoglobulin A (IgA) secretion and a higher antiinflammatory cytokine response to antigen exposure are key determinants of infection risk.
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Handzlik MK, Shaw AJ, Dungey M, Bishop NC, Gleeson M. The influence of exercise training status on antigen-stimulated IL-10 production in whole blood culture and numbers of circulating regulatory T cells. Eur J Appl Physiol 2013; 113:1839-48. [PMID: 23435500 DOI: 10.1007/s00421-013-2614-y] [Citation(s) in RCA: 54] [Impact Index Per Article: 4.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/26/2012] [Accepted: 02/12/2013] [Indexed: 12/18/2022]
Abstract
Highly trained athletes are associated with high resting antigen-stimulated whole blood culture interleukin (IL)-10 production. The purpose of the present study was to examine the effects of training status on resting circulating T regulatory (Treg) cell counts and antigen-stimulated IL-10 production and the effect of acute bout of exercise on the Treg response. Forty participants volunteered to participate and were assigned to one of the four groups: sedentary (SED), recreationally active (REC), sprint-trained athletes and endurance-trained athletes (END). From the resting blood sample, CD4(+)CD25(+)CD127(low/-) Treg cells and in vitro antigen-stimulated IL-10 production were assessed. Ten REC subjects performed 60 min cycling at 70 % of maximal oxygen uptake and blood samples for Treg analysis were collected post- and 1 h post-exercise. IL-10 production was greater in END compared with the other groups (P < 0.05). END had a higher Treg percentage of total lymphocyte count compared with SED (P < 0.05). A smaller proportion of Treg CD4(+) cells were observed in SED compared with all other groups (P < 0.05). IL-10 production significantly correlated with the proportion of Tregs within the total lymphocyte population (r s = 0.51, P = 0.001). No effect of acute exercise was evident for Treg cell counts in the REC subjects (P > 0.05). Our results demonstrate that high training loads in END are associated with greater resting IL-10 production and Treg cell count and suggest a possible mechanism for depression of immunity commonly reported in athletes engaged in high training loads.
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Affiliation(s)
- Michal K Handzlik
- School of Sport Exercise and Health Sciences, Loughborough University, Ashby Road Loughborough, Leicestershire LE10 2LF, UK
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Cicora F, Stringa P, Guerrieri D, Roberti J, Ambrosi N, Toniolo F, Cicora P, Palti G, Vásquez D, Raimondi C. Amelioration of renal damage by administration of anti-thymocyte globulin to potential donors in a brain death rat model. Clin Exp Immunol 2012; 169:330-7. [PMID: 22861373 DOI: 10.1111/j.1365-2249.2012.04617.x] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/21/2023] Open
Abstract
Brain death (BD), a non-immunological factor of renal injury, triggers an inflammatory process causing pathological signs of cell death in the kidney, such as necrosis and apoptosis. Kidneys from brain dead donors show lower success rates than kidneys from living donors and one strategy to improve transplantation outcome is to precondition the donors. For the first time, anti-rat thymoglobulin (rATG) was administered in an experimental brain death animal model to evaluate if it could ameliorate histopathological damage and improve organ function. Animals were divided into three groups: V (n=5) ventilated for 2h; BD (n=5) brain death and ventilated for 2h; and BD+rATG (n=5) brain death, ventilated for 2h, rATG was administered during brain death (10mg/kg). We observed lower creatinine levels in treatment groups (means): V, 0·88±0·22 mg/dl; BD, 1·37±0·07 mg/dl; and BD+rATG, 0·64±0·02 mg/dl (BD versus BD+rATG, P<0·001). In the BD group there appeared to be a marked increase of ATN, whereas ATN was decreased significantly in the rATG group (V, 2·25±0·5 versus BD, 4·75±0·5, P<0·01; BD+rATG, 2·75±0·5 versus BD 4·75±0·5 P<0·01). Gene expression was evaluated with reverse transcription-polymerase chain reaction; tumour necrosis factor (TNF)-α, interleukin (IL)-6, C3, CD86 showed no significant difference between groups. Increased IL-10 and decreased CCL2 in BD+rATG compared to BD (both cases P<0·01). Myeloperoxidase was increased significantly after the brain death setting (V: 32±7·5 versus BD: 129±18). Findings suggest that rATG administered to potential donors may ameliorate renal damage caused by BD. These findings could contribute in the search for specific cytoprotective interventions to improve the quality and viability of transplanted organs.
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Affiliation(s)
- F Cicora
- Transplant Program, Medicine Faculty, National University of La Plata, La Plata, Argentina
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Peterson RA. Regulatory T-cells: diverse phenotypes integral to immune homeostasis and suppression. Toxicol Pathol 2012; 40:186-204. [PMID: 22222887 DOI: 10.1177/0192623311430693] [Citation(s) in RCA: 166] [Impact Index Per Article: 13.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/26/2022]
Abstract
Regulatory T-cells (T(REG)) are diverse populations of lymphocytes that regulate the adaptive immune response in higher vertebrates. T(REG) delete autoreactive T-cells, induce tolerance, and dampen inflammation. T(REG) cell deficiency in humans (i.e., IPEX [Immunodysregulation, Polyendocrinopathy and Enteropathy, X-linked syndrome]) and animal models (e.g., "Scurfy" mouse) is associated with multisystemic autoimmune disease. T(REG) in humans and laboratory animal species are similar in type and regulatory function. A molecular marker of and the cell lineage specification factor for T(REG) is FOXP3, a forkhead box transcription factor. CD4(+) T(REG) are either natural (nT(REG)), which are thymus-derived CD4(+)CD25(+)FOXP3(+) T-cells, or inducible (i.e., Tr1 cells that secrete IL-10, Th3 cells that secrete TGF-β and IL-10, and Foxp3(+) Treg). The proinflammatory Th17 subset has been a major focus of research. T(H)17 CD4(+) effector T-cells secrete IL-17, IL-21, and IL-22 in autoimmune and inflammatory disease, and are dynamically balanced with T(REG) cell development. Other lymphocyte subsets with regulatory function include: inducible CD8(+) T(REG), CD3(+)CD4(-)CD8(-) T(REG) (double-negative), CD4(+)Vα14(+) (NKT(REG)), and γδ T-cells. T(REG) have four regulatory modes of action: secretion of inhibitory cytokines (e.g., IL-10 and TGF-β), granzyme-perforin-induced apoptosis of effector lymphocytes, depriving effector T-cells of cytokines leading to apoptosis, or inhibition of dendritic cell function. The role of T(REG) in mucosal sites, inflammation/infection, pregnancy, and cancer as well as a review of T(REG) as a modulatory target in drug development will be covered.
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Newell KA, Phippard D, Turka LA. Regulatory cells and cell signatures in clinical transplantation tolerance. Curr Opin Immunol 2011; 23:655-9. [DOI: 10.1016/j.coi.2011.07.008] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/11/2011] [Accepted: 07/18/2011] [Indexed: 01/25/2023]
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