Characterization of murine lung dendritic cells: similarities to Langerhans cells and thymic dendritic cells.

Dendritic cells (DC) are potent accessory cells (AC) for the initiation of primary immune responses. Although murine lymphoid DC and Langerhans cells have been extensively characterized, DC from murine lung have been incompletely described. We isolated cells from enzyme-digested murine lungs and bronchoalveolar lavages that were potent stimulators of a primary mixed lymphocyte response (MLR). The AC had a low buoyant density, were loosely adherent and nonphagocytic. AC function was unaffected by depletion of cells expressing the splenic DC marker, 33D1. In addition, antibody and complement depletion of cells bearing the macrophage marker F4/80, or removal of phagocytic cells with silica also failed to decrease AC activity. In contrast, AC function was decreased by depletion of cells expressing the markers J11d and the low affinity interleukin 2 receptor (IL-2R), both present on thymic and skin DC. AC function was approximately equal in FcR+ and FcR- subpopulations, indicating there was heterogeneity within the AC population. Consistent with the functional data, a combined two-color immunofluorescence and latex bead uptake technique revealed that lung cells high in AC activity were enriched in brightly Ia+ dendritic-shaped cells that (a) were nonphagocytic, (b) lacked specific T and B lymphocyte markers and the macrophage marker F4/80, but (c) frequently expressed C3biR, low affinity IL-2R, FcRII, and the markers NLDC-145 and J11d. Taken together, the functional and phenotypic data suggest the lung cells that stimulate resting T cells in an MLR and that might be important in local pulmonary immune responses are DC that bear functional and phenotypic similarity to other tissues DC, such as Langerhans cells and thymic DC.

Immunity to a pulmonary Cryptococcus neoformans infection requires both CD4+ and CD8+ T cells.

The role of CD4+ and CD8+ T cells in mediating pulmonary clearance of a cryptococcal infection was investigated. Intratracheal inoculation of BALB/c and C.B-17 mice with a moderately virulent strain of Cryptococcus neoformans (52D) resulted in a pulmonary infection, which was cleared by a T cell-dependent mechanism. During this clearance, there was a significant influx of both CD4+ and CD8+ T cells into the lungs. Depletion of CD4+ T cells by injections of CD4-specific monoclonal antibody (mAb) prevented pulmonary clearance and also resulted in significant colonization of the brain and spleen of infected mice. CD4 depletion did not prevent the influx of CD8+ T cells into the lungs. Surprisingly, depletion of CD8+ T cells by mAb also ablated pulmonary clearance. CD8-depleted mice also had a small but significant increase in brain and spleen colony-forming unit compared to control mice by the end of the study. CD4+ T cell pulmonary influx was independent of the presence of CD8+ T cells. The lungs of T cell-depleted mice were examined histologically. CD4+ and CD8+ T cells each mediated a degree of inflammatory influx seen in the lungs of infected mice and raised the possibility that CD4+ and CD8+ T cells may synergize to generate the inflammatory response in the lungs. Numerous phagocytized but intact cryptococci were seen in the inflammatory foci of CD8-depleted mice but not in control or CD4-depleted mice. We propose that CD4+ T cells may recruit and activate effector phagocytes while CD8+ T cells predominantly function to lyse cryptococcus-laden unactivated phagocytes similar to the function of CD8+ T cells during listeria and mycobacteria infections.

The regulation of pulmonary immunity.

No evidence has emerged which suggests that the principles of immunity derived from studies on cells from other body sites are contradicted in the lung and its associated lymphoid tissue. What is clear, however, is that the environment dictates the types of cells, their relationship to one another, and what perturbing events will set in motion either the development of an "active" immune response or tolerance. Investigating mechanisms for the development of lung immunity has increased our understanding of how human diseases develop and is continuing to suggest new ways to manipulate pulmonary immune responses. Demonstration that lung cells regulate both nonspecific inflammation and immunity through the expression of adhesion molecules and the secretion of cytokines offers hope for ways to design more effective vaccines, enhance microbial clearance in immunosuppressed hosts, and to suppress manifestations of immunologically mediated lung disease. Important lung diseases targeted for intensive research efforts in the immediate future are tuberculosis, asthma, and fibrotic lung disease. Perhaps even the common cold might be conquered. Considering the pace of current research on lung immunity, it may not be too ambitious to predict that these diseases may be conquered in the next decade.

Mononuclear cells from human lung parenchyma support antigen-induced T lymphocyte proliferation.

We have previously demonstrated that there is a subpopulation of loosely adherent pulmonary mononuclear cells that can be isolated from minced and enzyme-digested lung tissue with a potent capacity to stimulate allogeneic T lymphocyte proliferation. We now demonstrate that these cells are also capable of stimulating an autologous mixed leukocyte reaction (AMLR) and presenting antigen to autologous T lymphocytes. These loosely adherent mononuclear cells (LAM) were more effective than either alveolar macrophages or monocytes as antigen-presenting cells. Depletion of phagocytic or Fc receptor-positive cells from the LAM population enhanced the stimulation of an reaction AMLR while preserving antigen-induced T lymphocyte proliferation. These results indicate that there are nonphagocytic, Fc receptor-negative accessory cells in human lung parenchyma capable of activating resting T cells in an AMLR and supporting antigen-specific T lymphocyte proliferation. The identity of these cells is uncertain, but the data strongly suggest that the cell is not a classical monocyte-derived macrophage. These antigen-presenting cells may be critical in the initiation of immune responses within the lung.

Separation of potent and poorly functional human lung accessory cells based on autofluorescence.

Human alveolar macrophages obtained by bronchoalveolar lavage are usually poor accessory cells in in vitro lymphoproliferation assays. However, we recently described a subpopulation of pulmonary mononuclear cells, obtained from minced and enzyme-digested lung, which were potent stimulators of allogeneic T-lymphocyte proliferation. These cells were enriched in loosely adherent mononuclear cell (LAM) fractions, but further study of these accessory cells was hampered by the heterogeneous nature of LAM. It was observed that in the majority of lung tissue sections, most alveolar macrophages were autofluorescent, whereas most interstitial HLA-DR positive cells were not. Therefore autofluorescence was utilized to fractionate LAM in an attempt to remove alveolar macrophages and selectively purify interstitial accessory cells. LAM were separated by flow cytometry using forward and side scatter to exclude lymphocytes, and red autofluorescence to obtain brightly autofluorescent (A pos) and relatively nonautofluorescent (A neg) mononuclear cells. Although both populations contained over 80% HLA-DR positive cells, A pos cells were poor accessory cells, whereas A neg cells were extremely potent stimulators of a mixed leukocyte reaction at all stimulator ratios tested. When A pos cells were added to A neg cells, T-cell proliferation was markedly suppressed in the majority of experiments. Morphologically, A pos cells appeared similar to classical alveolar macrophages with 95% of the cells being large and intensely nonspecific esterase positive. In contrast, the majority of A neg were smaller, B-cell antigen-negative, nonspecific esterase negative, and had a distinctive morphology on Wright-stained smears. We conclude that fractionation of LAM based on autofluorescence is a powerful tool to isolate and characterize lung mononuclear cells that act either as stimulators or as suppressors of immune responses in the lung.

The role of CD4+ and CD8+ T cells in the protective inflammatory response to a pulmonary cryptococcal infection.

Moderately virulent strains of Cryptococcus neoformans, inoculated via the trachea, cause a pulmonary infection in BALB/c mice that was gradually resolved by T lymphocyte-dependent mechanisms. The current studies, using monoclonal antibodies to deplete T cell subsets, demonstrated that CD4+ and CD8+ T cells combined to mediate a prominent pulmonary inflammatory infiltrate that included lymphocytes, macrophages, neutrophils, and eosinophils. The inflammatory response peaked 2 weeks after infection and coincided with the beginning of gradual pulmonary clearance of the infection. CD4/CD8 double deficiency (4-8-) markedly reduced the influx of all cells into the lungs. A CD4 deficiency had a more profound effect on the total number of inflammatory cells recruited to the lungs than a CD8 deficiency. Depletion of either CD8+ or CD4+ T cells significantly decreased pulmonary macrophages and neutrophils, but only a CD4 deficiency prevented the influx of eosinophils. Recruitment of CD8+ T cells occurred independently of CD4+ T cells, but CD4+ T cell recruitment to the lungs was significantly reduced in CD8-deficient mice. Mitogen-stimulated infiltrating lung lymphocytes from infected 4+8+ mice secreted both T helper cell type 1 (Th1) [interferon-gamma (IFN-gamma) and interleukin-2 (IL-2)] and Th2 (IL-4, IL-5, and IL-10) cytokines. CD4 deficiency resulted in loss of T cells secreting IL-4, IL-5, and IL-10. However, residual CD8+ T cells still secreted IL-2 and IFN-gamma. Lung T cells from CD8-deficient mice secreted similar levels of IL-4, IL-5, and IL-10 on a per lung basis compared with 4+8+ mice despite decreased numbers of CD4+ T cells, but secreted reduced levels of IFN-gamma. These experiments indicate that (1) CD4+ T cells play a dominant role in recruiting macrophages and granulocytes to the lung and (2) CD8+ T cells also mediate cellular recruitment, increase the magnitude of CD4+ T cell numbers in the infiltrate, and contribute to the local secretion of IFN-gamma. Thus, these studies demonstrate that CD8+ T cells can independently mediate an inflammatory response to a large, particulate, extracellular antigen, a role heretofore attributed almost solely to CD4+ T cells.

Ovalbumin aerosols induce airway hyperreactivity in naïve DO11.10 T cell receptor transgenic mice without pulmonary eosinophilia or OVA-specific antibody.

The pathobiology of allergic asthma is being studied using murine models, most of which use systemic priming followed by pulmonary challenges with the immunizing antigen. In general, mice develop eosinophilic pulmonary inflammation, increased antigen-specific immunoglobulins, and airway hyperreactivity (AHR), all of which are dependent on antigen-specific T cell activation. To establish a model of allergic asthma, which did not require systemic priming, we exposed DO11.10 T cell receptor transgenic mice, which have an expanded repertoire of ovalbumin (OVA), peptide-specific T cells, to limited aerosols of OVA protein. DO11.10 +/- mice developed AHR in the absence of increases in total serum IgE, OVA-specific IgG, or eosinophilia. The AHR was accompanied by pulmonary recruitment of antigen-specific T cells with decreased expression of CD62L and CD45RB and increased expression of CD69, a phenotype indicative of T cell activation. Our results support recent hypotheses that T cells mediate AHR directly.

Lung defenses against opportunistic infections.

This review has examined the possible role of CMI in providing protection against three pathogens that can be opportunists in the lung. Monoclonal antibodies that identify the cellular components of the immune response and recombinant cytokines are important tools to better understand how pulmonary immunity is regulated. Although not discussed in detail, recombinant microbial antigens are useful for understanding various aspects of protective immunity and immunosuppression as well as for advancing vaccine development. There are important problems to address in order to continue steady progress in understanding pulmonary defenses, including some of those mentioned in this brief review. There should be an increased use of infectious models that more closely mimic naturally occurring infections, and comparisons should be made between results obtained with parenteral versus intrapulmonary routes of infection.

Postmortem diagnosis of acute anaphylaxis by serum tryptase analysis. A case report.

Systemic anaphylaxis is an acute allergic emergency resulting from generalized mast cell degranulation. In the United States, it is estimated that anaphylaxis accounts for about 500 deaths each year. Hymenoptera-sting hypersensitivity is one of the most common causes of systemic anaphylaxis. The authors report a case of a healthy 26-year-old man who developed acute anaphylaxis after a bee sting, could not be resuscitated, and died within 1 hour. At autopsy, performed 14 hours after the event, the only pathologic findings were laryngeal edema and congestion of lung. Postmortem tryptase levels in the blood were obtained and were instrumental in confirming a diagnosis of acute anaphylaxis. This case is reported to discuss the difficulties associated with using traditional histamine levels in making a diagnosis of anaphylaxis and to validate the value of using tryptase levels to document acute anaphylaxis as a cause of death, even when serum is not obtained until many hours after death.

Reappraisal of the specificity of the Crithidia luciliae assay for nDNA antibodies: evidence for histone antibody kinetoplast binding.

Five different high-titer histone antibody-containing sera were assayed by the Crithidia luciliae indirect immunofluorescence (CLIF) technic. Three of these sera produced kinetoplast binding at titers of 1/40 to 1/80. The kinetoplast binding activity was abolished by HCl acid pretreatment of the Crithidia substrate, suggesting that the kinetoplast binding activity was not due to antibodies against native DNA (nDNA). Histone antibodies were purified from two of the three positive sera by affinity chromatography utilizing purified preparations of histone. Both purified antibody preparations also had kinetoplast-binding activity, confirming that the Crithidia kinetoplast contains histone-like proteins. Therefore, Crithidia luciliae (CL) kinetoplast binding activity does not necessarily indicate the presence of anti-nDNA antibodies. Routinely pretreating the CL substrate with 0.1 N HCl would eliminate the possibility of histone antibody kinetoplast binding in the CLIF assay. Whether such pretreatment would alter the binding of anti-NDNA to the kinetoplast remains to be determined.

The role of T lymphocytes in pulmonary microbial defense mechanisms.

Understanding how lung immunity develops against pulmonary pathogens should lead to more rational approaches in vaccine design and to the use of recombinant cytokines in lung disease. T lymphocytes are central to the development of effective immune responses; therefore, understanding how lung immunity develops will require a study of how and where T cells respond to respiratory antigens. Our laboratory has helped define the phenotype and function of lung dendritic cells, which likely play an essential role in stimulating naive T cells to respond to antigens. We found that both interstitial and alveolar macrophages can regulate the function of these cells, the former to enhance activity, the latter to suppress. In addition, we developed a murine pulmonary infection model using the fungus, Cryptococcus neoformans, in which T-cell-mediated immunity is essential for effective host clearance of the organism. The role of T cells in this model is to recruit and activate effector cells to resolve the lung infection; both CD4 and CD8 T-cell subsets are required for optimal effector cell recruitment. These studies are summarized as examples of current approaches to understanding pulmonary immunity.

Dendritic cells: pulmonary immune regulation and asthma.

Dendritic cells (DCs) may play a pivotal role in the initiation and establishment of chronic T-helper cell (Th)-2 mediated lung inflammation as seen in asthma. Current in vitro data indicate that the haemopoietic lineage of the DC or the local environment in which a DC matures, or both acting together, can instruct the DC to become a Th1- or Th2-inducing antigen-presenting cell. Once allergen-specific Th2 memory cells are drawn into the lung, repeated allergen presentation by lung DCs may drive the persistent stimulation of allergen-specific memory Th2 cells and precipitate a state of chronic inflammation that contributes to the remodelling and hyperreactive airways that characterize asthma. In addition, the persistent stimulation of effector Th2 cells and the subsequent Th2 cytokine secretion can create a Th2 cytokine milieu in the lung that may influence the differentiation of antigen-specific Th0 in the lung and naive Th in the lung-associated lymph nodes to develop into Th2 effector cells. Immunoglobulin E receptors on antigen-presenting cells may facilitate chronic T-helper cell-2 inflammation directly by focusing allergen to dendritic cells for uptake and indirectly by stimulating alveolar macrophages to secrete mediators that lead to the maturation of dendritic cells with a low capacity to secrete interleukin-12.

Role for C5 and neutrophils in the pulmonary intravascular clearance of circulating Cryptococcus neoformans.

Although C5a-induced intravascular pulmonary sequestration of neutrophils has been investigated with regards to lung injury, relatively few studies have addressed the possible role for this mechanism in the intravascular clearance of circulating microorganisms. A murine model was used in which the complement-fixing, encapsulated yeast Cryptococcus neoformans (Cne) was inoculated intravenously (IV), and lung clearance of the organism was measured 24 h later. In normal mice, clearance was remarkably effective, but in leukocyte-depleted or C5-deficient (C5-) animals, clearance was significantly decreased. In vitro assays indicated that C5 was necessary for neutrophils to kill encapsulated Cne and evidence was obtained that C5a was involved. In vivo studies using light and electron microscopy demonstrated that 30 min after an IV inoculation of encapsulated yeast into C5-sufficient (C5+) mice, neutrophils accumulated in pulmonary vessels and engulfed Cne. However, in C5- mice, neutrophils failed to accumulate in pulmonary vessels and there was no endocytosis of encapsulated yeasts. These studies suggested that following Cne interaction with complement in the blood, release of C5a activated circulating neutrophils to adhere to Cne, and perhaps to adjacent endothelium, which facilitated rapid phagocytosis and killing of the organism. In contrast to the IV infection model, when Cne was inoculated into the tracheas of C5+ and C5- mice, no evidence was obtained for an early PMN-C5-dependent clearance mechanism. C5a-dependent neutrophil killing in the lung vasculature may provide important host protection against Cne during vascular dissemination and perhaps against other disseminating microorganisms that activate complement.

Alveolar macrophages in pulmonary immune responses. I. Role in the initiation of primary immune responses and in the selective recruitment of T lymphocytes to the lung.

Antigen inoculated intratracheally (IT) into animals can induce primary immune responses and selectively recruit specific T cells to the lung. In the current study, the role of alveolar macrophages (AM) in these two responses was investigated. Antigen-pulsed bronchoalveolar cells (BAC) inoculated IT into guinea pigs generated a population of immune T cells that proliferated in vitro on reexposure to antigen-pulsed macrophages (Mø). The possibility that antigen-pulsed donor BAC shed antigen that was subsequently processed and presented by host Mø was ruled out by genetic experiments. Thus, peritoneal exudate lymphocytes (PEL) from (2 X 13)F1 guinea pigs primed with antigen-pulsed BAC from strain 2 animals responded preferentially to antigen-pulsed strain 2 Mø rather than to antigen-pulsed strain 13 Mø. In a second set of studies, antigen-pulsed BAC inoculated IT into guinea pigs selectively recruited antigen-specific T cells to the lung. Genetic experiments verified that inoculated BAC were the source of the antigen-presenting cells responsible for selective recruitment. Thus, antigen-pulsed strain 2 BAC inoculated IT recruited a greater proportion of (2 X 13)F1 T cells that recognized antigen in the context of strain 2 Mø than F1 T cells that recognized antigen on strain 13 Mø. Taken together, these studies suggest that AM contribute to the regulation of pulmonary immunity by both inducing T lymphocyte immunity and selectively recruiting specific T cells to the lung.

Comparison of lung dendritic cells and B cells in stimulating naive antigen-specific T cells.

Dendritic cells (DCs) are specialized APCs that are important in priming naive T cells and can be manipulated in vitro and in vivo to enhance immunizations against microorganisms and tumors. A limitation in the development of suitable immunotherapeutic vaccines for the lung is incomplete information on the role of DCs and other potential APCs in the lung in priming naive T cells. In the current study, we analyzed the relative contributions of murine lung DCs and B cells to process and present OVA to naive CD4+ OVA323-339-specific (DO11.10) T cells in vitro. We also examined their expression of MHC class II and accessory molecules before and after maturation in culture. Similar to DCs from other sites, freshly isolated lung DCs can process OVA, spontaneously up-regulate MHC class II and accessory molecules during overnight culture, and stimulate naive T cells in an Ag-specific manner. In contrast, freshly isolated lung B cells were unable to both process and present native OVA. Furthermore, under conditions of limited OVA323-339 peptide exposure, B cells had a significantly diminished capacity to stimulate T cells, and this correlated with a decreased density of both MHC class II and important costimulatory molecules as compared with lung DCs.

Immune dysregulation as a cause for allergic asthma.

Allergic asthma is being increasingly understood as a disease caused by Th2-mediated immune responses to inhaled allergens. Most individuals fail to respond to allergens with a Th2 response, and thus, allergic asthma can be considered the result of an abnormally regulated or dysregulated immune response. The prevalence of asthma has risen precipitously in urbanized cultures, as contrasted with third world countries. This observation underlies the heightened efforts in the past few years of basic and applied research efforts to gain a better understanding of both normal and dysregulated immunity to antigens introduced via the airways. This review focuses on recent human studies into the immune dysregulation that results in the asthma phenotype, but also cites selected relevant papers from research with experimental animals.