Local assessment of the immunohistochemical expression of Foxp3+ regulatory T lymphocytes in the different pathological forms associated with bovine paratuberculosis

Background

Mycobacterium avium subsp. paratuberculosis infected animals show a variety of granulomatous lesions, from focal forms with well-demarcated granulomas restricted to the gut-associated lymphoid tissue (GALT), that are seen in the initial phases or latency stages, to a diffuse granulomatous enteritis, with abundant (multibacillary) or scant (paucibacillary) bacteria, seen in clinical stages. Factors that determine the response to the infection, responsible for the occurrence of the different types of lesion, are still not fully determined. It has been seen that regulatory T cells (Treg) play an important role in various diseases where they act on the limitation of the immunopathology associated with the immune response. In the case of paratuberculosis (PTB) the role of Treg lymphocytes in the immunity against Map is far away to be completely understood; therefore, several studies addressing this subject have appeared recently. The aim of this work was to assess, by immunohistochemical methods, the presence of Foxp3⁺ T lymphocytes in intestinal samples with different types of lesions seen in cows with PTB.

Methods

Intestinal samples of twenty cows showing the different pathological forms of PTB were evaluated: uninfected controls (n = 5), focal lesions (n = 5), diffuse paucibacillary (n = 5) and diffuse multibacillary (n = 5) forms. Foxp3⁺ lymphocyte distribution was assessed by differential cell count in intestinal lamina propria (LP), gut-associated lymphoid tissue (GALT) and mesenteric lymph node (MLN).

Results

A significant increase in the number of Foxp3⁺ T cells was observed in infected animals with respect to control group, regardless of the type of lesion. However, when the different categories of lesion were analyzed independently, all individuals with PTB lesions showed an increase in the amount of Foxp3⁺ T lymphocytes compared to the control group but this increase was only significant in cows with focal lesions and, to a lesser extent, in animals with diffuse paucibacillary forms. The former showed the highest numbers, significantly different from those found in cows with diffuse lesions, where no differences were noted between the two forms. No specific distribution pattern was observed within the granulomatous lesions in any of the groups.

Conclusions

The increase of Foxp3⁺ T cells in focal forms, that have been associated with latency or resistance to infection, suggest an anti-inflammatory action of these cells at these stages, helping to prevent exacerbation of the inflammatory response, as occurs in diffuse forms, responsible for the appearance of clinical signs.

Efficient short-term expansion of human peripheral blood regulatory T cells for co-culture suppression assay

Regulatory T cells (Tregs) are a small population of CD4+ lymphocytes and play a key role as suppressors of the immune system, a role that can be identified by employing a co-culture suppression assay. Conventional protocol requires a long period of in vitro expansion of Treg numbers; hence, this study describes an establishment of a co-culture suppression assay using a short-term expansion of peripheral blood (PB) Tregs and autologous T cells (Tconvs) IL-2-pre-cultured in parallel for the same length of time, thereby obviating the need of freeze/thawed autologous Tconvs. Tregs and Tconvs were isolated from PB mononuclear cells employing magnetic bead-aided depletion of CD8+ cells followed by cell sorting of CD4+ CD25high+CD127low- (Treg) and CD4+ CD25-CD127+ (Tconv) cell populations. Following a 3-day co-cultivation period under optimized conditions, Treg suppression activity was monitored by comparing using flow cytometry the number of carboxyfluorescein succinimidyl ester-labeled Tconvs to that of Treg-minus control. The assay allowed significant differentiation between Treg suppression activity of patients with active rheumatoid arthritis and those in remission. This method should be more convenient and time-saving than the conventional Treg suppression assay in current use.

Correlation of CD8+ Expression, Foxp3+ Expression, and CD8+/Foxp3+ Ratio with Triple Negative Breast Cancer Stage in Sanglah General Hospital

BACKGROUND:

Triple negative breast cancer (TNBC) is a breast cancer sub-type that lacks ER, PR and HER-2 expression. This type tends to be more aggressive than other types of breast cancer, with poor prognosis, distant metastases, higher recurrence rate, and lower overall survival. The TNBC is resistant to hormonal therapy, but generally very susceptible to chemotherapy. Expression of CD8+ and Foxp3+ were parts of the TIL, which often found in TNBC as an immune response to tumour antigens following antigens presenting cell (APC) stimulation.

AIM:

This study was conducted to find out whether the expression of CD8+, Foxp3+ and CD8+/Foxp3+ ratio was associated with the stage of TNBC.

METHODS:

This cross-sectional study was conducted from January 2014 until December 2016 at Sanglah Hospital with 46 research subjects. Two paraffin blocks were prepared for each sample to examine the CD8+ expression and Foxp3+ expression. Data were analysed using the Chi-Square test or Fisher’s Exact tests as an alternative for bivariate analysis and logistic regression for multivariate analysis.

RESULTS:

On bivariate analysis, we found a low of CD8+ expression in advanced stage (p < 0.001 with OR 3.5; CI 1.611-7.727). Expression Foxp3+ in advanced stage (p = 0.482; OR 0.8; CI 0.497-1.374), while the ratio of CD8+/Foxp3+ (p = 0.213; OR 2.2; CI 0.650-7.132). On multivariate analysis, a low of CD8+ expression (adjusted OR 16.5; CI 3.735-7.370; p < 0.001) was obtained.

CONCLUSION:

Low expression of CD8+ was associated with the advanced stage of TNBC. The risk of becoming an advanced stage in TNBC patients with low CD8+ expression was 16.5 times higher than those with high of CD8+ expression. High expression of Foxp3+ was not associated with an advanced stage of TNBC. The low CD8+/Foxp3+ ratio was not associated with the advanced stage of TNBC.

Clinicopathological and prognostic significance of regulatory T cells in patients with non-small cell lung cancer: A systematic review with meta-analysis

The prognostic and clinicopathological value of regulatory T cells (Tregs) infiltration in patients with non-small cell lung cancer (NSCLC) remains undetermined. A comprehensive literature search of electronic databases (up to December 2015) was conducted. Relationship between Tregs infiltration and clinicopathological features, recurrence-free survival (RFS) and overall survival (OS) was investigated by synthesizing the qualified data. A total of 1303 NSCLC patients from 11 studies were included. The pooled hazard ratio (HR) for survival showed that high Tregs infiltration had no effect on RFS (HR = 2.03, 95% CI: 0.61–3.44, P = 0.708) and OS (HR = 1.20, 95% CI: 0.58–1.62, P = 0.981). High FoxP3⁺ Tregs infiltration was significantly associated with poor OS in NSCLC (HR = 3.88, 95% CI: 2.45–5.40, P = 0.000). Test methods, ethnicity and types of specimens had no effect on predicting prognosis of Tregs infiltration. While high Tregs infiltration was significantly correlated with smoking status [odds ratios (ORs) = 1.54, 95% CI: 1.15–2.08; P = 0.004], none of other clinicopathological characteristics such as gender, histological type, lymph node metastasis status, tumor size, vascular invasion, lymphatic invasion and pleural invasion were associated with Tregs infiltration. The present study demonstrated that high FoxP3⁺ Tregs infiltration was significantly associated with poor prognosis in NSCLC and smoking status.

Oral contraceptive pills: Risky or protective in case of Trichinella spiralis infection?

The aim of this study was to investigate how Trichinella spiralis infection can be affected by contraceptive pills in vivo. Methods included six groups of female Wistar rats; healthy, Trichinella infected, receiving combined contraceptive pills (COCPs), receiving progestin only pills (POPs), infected receiving COCPs and infected receiving POPs. Parasite burden was measured; adult worm counts, gravidity, larvae and reproductive capacity index). Histopathological examination, immunohistochemical detection of C-kit+ mast cells and Foxp3+ T-reg. cells in intestinal sections, eosinophils muscle infiltration and CPK level were performed. Rats infected and receiving COCPs showed a significant increase in parasitic burden, and infected receiving POPs showed a significant reduction compared to infected only, with a significant increase in nongravid females (Mean total worms=964.40±55.9, 742±52.63, 686±31.68, larvae/g=5030±198.75, 2490±143.18 and 4126±152,91, respectively). Intestinal sections from infected receiving COCPs showed intact mucosa (though the high inflammatory cells infiltrate), and significant increase in C-kit+ mast cells number and intensity (30.20±4.15 and 60.40±8.29), and Foxp3+ T-reg. cells (10±1.58). Infected receiving POPs showed a significantly less CPK (5886±574.40) and eosinophilic muscle infiltration (58±13.51). Oestrogen-containing pills established a favourable intestinal environment for Trichinella by enhancing Foxp+T-reg. cells and stabilizing C-kit+mast cells, while POPs gave a potential protection with less gravidity, larval burden and eosinophilic infiltrate.

Alteration of CD4CD25Foxp3 T cell level in Kawasaki disease

PURPOSE

Exaggerated pro-inflammatory reactions during the acute phase of Kawasaki disease (KD) suggest the role of immune dysregulation in the pathogenesis of KD. We investigated the profiles of T regulatory cells and their correlation with the clinical course of KD.

METHODS

Peripheral blood mononuclear cells were collected from 17 KD patients during acute febrile and subacute afebrile phases. T cells expressing CD4, CD25, and Foxp3 were analyzed using flow cytometry, and the results were correlated with the clinical course of KD.

RESULTS

The percentage of circulating CD4(+)CD25(high)Foxp3(+) T cells among CD4(+) T cells was significantly higher during the subacute afebrile phase than during the acute febrile phase (1.10%±1.22% vs. 0.55%±0.53%, P=0.049). Although levels of CD4(+)CD25(low)Foxp3(+) T cells and CD4(+)CD25(-)Foxp3(+) T cells were only slightly altered, the percentage of CD4(+)CD25(+)Foxp3(-) T cells among CD4(+) T cells was significantly lower during the subacute afebrile phase than during the acute febrile phase (2.96%±1.95% vs. 5.64%±5.69%, P=0.036). Consequently, the ratio of CD25(high)Foxp3(+) T cells to CD25(+)Foxp3(-) T cells was higher during the subacute afebrile phase than during the acute febrile phase (0.45%±0.57% vs. 0.13%±0.13%, P=0.038).

CONCLUSION

Decreased CD4(+)CD25(high)Foxp3(+) T cells and/or an imbalanced ratio of CD4(+)CD25(high)Foxp3(+) T cells to CD4(+)CD25(+)Foxp3(-) T cells might play a role in KD development. Considering that all KD patients were treated with intravenous immunoglobulin (IVIG), recovery of CD4(+)CD25(high)Foxp3(+) T cells during the subacute afebrile phase could be a mechanism of IVIG.