RESUMEN
Noroviruses can establish chronic infections with active viral shedding in healthy humans but whether persistence is associated with adaptive immune dysfunction is unknown. We used genetically engineered strains of mouse norovirus (MNV) to investigate CD8+ T cell differentiation during chronic infection. We found that chronic infection drove MNV-specific tissue-resident memory (Trm) CD8+ T cells to a differentiation state resembling inflationary effector responses against latent cytomegalovirus with only limited evidence of exhaustion. These MNV-specific Trm cells remained highly functional yet appeared ignorant of ongoing viral replication. Pre-existing MNV-specific Trm cells provided partial protection against chronic infection but largely ceased to detect virus within 72 hours of challenge, demonstrating rapid sequestration of viral replication away from T cells. Our studies revealed a strategy of immune evasion by MNV via the induction of a CD8+ T cell program normally reserved for latent pathogens and persistence in an immune-privileged enteric niche.
Asunto(s)
Linfocitos T CD8-positivos/inmunología , Infecciones por Caliciviridae/inmunología , Diferenciación Celular/inmunología , Gastroenteritis/inmunología , Norovirus/inmunología , Animales , Linfocitos T CD8-positivos/metabolismo , Linfocitos T CD8-positivos/virología , Infecciones por Caliciviridae/genética , Infecciones por Caliciviridae/virología , Diferenciación Celular/genética , Línea Celular , Microambiente Celular/genética , Microambiente Celular/inmunología , Gastroenteritis/genética , Gastroenteritis/virología , Perfilación de la Expresión Génica/métodos , Ontología de Genes , Células HEK293 , Interacciones Huésped-Patógeno/inmunología , Humanos , Memoria Inmunológica/genética , Memoria Inmunológica/inmunología , Ratones Endogámicos C57BL , Norovirus/fisiología , Análisis de Secuencia por Matrices de Oligonucleótidos/métodosRESUMEN
BACKGROUND & AIMS: Exhaustion of CD8 T cells has been suggested to inform different clinical outcomes in Crohn's disease, but detailed analyses are lacking. This study aimed to identify the role of exhaustion on a single-cell level and identify relevant CD8 T cell populations in Crohn's disease. METHODS: Blood and intestinal tissue from 58 patients with Crohn's disease (active disease or remission) were assessed for CD8 T cell expression of exhaustion markers and their cytokine profile by highly multiplexed flow and mass cytometry. Key disease-associated subsets were sorted and analyzed by RNA sequencing. CD39 inhibition assays were performed in vitro. RESULTS: Activated CD39+ and CD39+PD-1+ CD8 T cell subsets expressing multiple exhaustion markers were enriched at low frequency in active Crohn's disease. Their cytokine production capacity was inversely linked to the Harvey-Bradshaw Index. Subset-level protein and transcriptome profiling revealed co-existence of effector and exhaustion programs in CD39+ and CD39+ PD-1+CD8 T cells, with CD39+ cells likely originating from the intestine. CD39 enzymatic activity controlled T cell cytokine production. Importantly, transcriptional exhaustion signatures were enriched in remission in CD39-expressing subsets with up-regulation of TOX. Subset-level transcriptomics revealed a CD39-related gene module that is associated with the clinical course. CONCLUSIONS: These data showed a role for the exhaustion of peripheral CD39-expressing CD8 T cell subsets in Crohn's disease. Their low frequency illustrated the utility of single-cell cytometry methods for identification of relevant immune populations. Importantly, the link of their exhaustion status to the clinical activity and their specific gene signatures have implications for exhaustion-based personalized medicine approaches.
Asunto(s)
Apirasa , Linfocitos T CD8-positivos , Enfermedad de Crohn , Apirasa/sangre , Apirasa/genética , Apirasa/inmunología , Biomarcadores/sangre , Linfocitos T CD8-positivos/inmunología , Enfermedad de Crohn/sangre , Enfermedad de Crohn/genética , Enfermedad de Crohn/inmunología , Citocinas/inmunología , Humanos , Pronóstico , Receptor de Muerte Celular Programada 1/genética , Receptor de Muerte Celular Programada 1/inmunología , Subgrupos de Linfocitos TRESUMEN
[This corrects the article DOI: 10.1371/journal.ppat.1005684.].
RESUMEN
In order for a virus to persist, there must be a balance between viral replication and immune clearance. It is commonly believed that adaptive immunity drives clearance of viral infections and, thus, dysfunction or viral evasion of adaptive immunity is required for a virus to persist. Type I interferons (IFNs) play pleiotropic roles in the antiviral response, including through innate control of viral replication. Murine norovirus (MNoV) replicates in dendritic cells (DCs) and type I IFN signaling in DCs is important for early control of MNoV replication. We show here that the non-persistent MNoV strain CW3 persists systemically when CD11c positive DCs are unable to respond to type I IFN. Persistence in this setting is associated with increased early viral titers, maintenance of DC numbers, increased expression of DC activation markers and an increase in CD8 T cell and antibody responses. Furthermore, CD8 T cell function is maintained during the persistent phase of infection and adaptive immune cells from persistently infected mice are functional when transferred to Rag1-/- recipients. Finally, increased early replication and persistence are also observed in mixed bone marrow chimeras where only half of the CD11c positive DCs are unable to respond to type I IFN. These findings demonstrate that increased early viral replication due to a cell-intrinsic innate immune deficiency is sufficient for persistence and a functional adaptive immune response is not sufficient for viral clearance.
Asunto(s)
Infecciones por Caliciviridae/inmunología , Células Dendríticas/inmunología , Células Dendríticas/virología , Interferón Tipo I/inmunología , Receptor de Interferón alfa y beta/inmunología , Inmunidad Adaptativa/inmunología , Animales , Modelos Animales de Enfermedad , Ensayo de Inmunoadsorción Enzimática , Citometría de Flujo , Inmunidad Innata/inmunología , Ratones , Ratones Endogámicos C57BL , Ratones Noqueados , Norovirus , Reacción en Cadena en Tiempo Real de la Polimerasa , Receptor de Interferón alfa y beta/deficiencia , Replicación Viral/fisiologíaRESUMEN
The role of Ab and B cells in preventing infection is established. In contrast, the role of B cell responses in containing chronic infections remains poorly understood. IgG2a (IgG1 in humans) can prevent acute infections, and T-bet promotes IgG2a isotype switching. However, whether IgG2a and B cell-expressed T-bet influence the host-pathogen balance during persisting infections is unclear. We demonstrate that B cell-specific loss of T-bet prevents control of persisting viral infection. T-bet in B cells controlled IgG2a production, as well as mucosal localization, proliferation, glycosylation, and a broad transcriptional program. T-bet controlled a broad antiviral program in addition to IgG2a because T-bet in B cells was important, even in the presence of virus-specific IgG2a. Our data support a model in which T-bet is a universal controller of antiviral immunity across multiple immune lineages.
Asunto(s)
Subgrupos de Linfocitos B/inmunología , Linfocitos B/inmunología , Coriomeningitis Linfocítica/inmunología , Proteínas de Dominio T Box/inmunología , Animales , Separación Celular , Enfermedad Crónica , Modelos Animales de Enfermedad , Ensayo de Inmunoadsorción Enzimática , Citometría de Flujo , Inmunoglobulina G/inmunología , Virus de la Coriomeningitis Linfocítica , Ratones , Ratones Transgénicos , Análisis de Secuencia por Matrices de OligonucleótidosRESUMEN
Norovirus (NV) gastroenteritis is a major contributor to global morbidity and mortality, yet little is known about immune mechanisms leading to NV control. Previous studies using the murine norovirus (MNV) model have established a key role for T cells in MNV clearance. Despite these advances, important questions remain regarding the magnitude, location, and dynamics of the MNV-specific T cell response. To address these questions, we identified MNV-specific major histocompatibility complex (MHC) class I immunodominant epitopes using an overlapping peptide screen. One of these epitopes (amino acids 519 to 527 of open reading frame 2 [ORF2(519-527)]) was highly conserved among all NV genogroups. Using MHC class I peptide tetramers, we tracked MNV-specific CD8 T cells in lymphoid and mucosal sites during infection with two MNV strains with distinct biological behaviors, the acutely cleared strain CW3 and the persistent strain CR6. Here, we show that enteric MNV infection elicited robust T cell responses primarily in the intestinal mucosa and that MNV-specific CD8 T cells dynamically regulated the expression of surface molecules associated with activation, differentiation, and homing. Furthermore, compared to MNV-CW3 infection, chronic infection with MNV-CR6 resulted in fewer and less-functional CD8 T cells, and this difference was evident as early as day 8 postinfection. Finally, MNV-specific CD8 T cells were capable of reducing the viral load in persistently infected Rag1(-/-) mice, suggesting that these cells are a crucial component of NV immunity. Collectively, these data provide fundamental new insights into the adaptive immune response to two closely related NV strains with distinct biological behaviors and bring us closer to understanding the correlates of protective antiviral immunity in the intestine.
Asunto(s)
Linfocitos T CD8-positivos/inmunología , Infecciones por Caliciviridae/inmunología , Gastroenteritis/inmunología , Mucosa Intestinal , Norovirus/inmunología , Animales , Infecciones por Caliciviridae/virología , Enfermedad Crónica , Epítopos de Linfocito T , Femenino , Citometría de Flujo , Gastroenteritis/virología , Epítopos Inmunodominantes , Mucosa Intestinal/inmunología , Mucosa Intestinal/virología , Activación de Linfocitos , Complejo Mayor de Histocompatibilidad , Ratones , Ratones Endogámicos C57BLRESUMEN
A duodenal-cecal fistula is characterized as an unnatural connection between the duodenum and cecum. Here, we present the case of a 40-year-old male with unintentional weight loss and a history of foreign body ingestion a few years prior. Computerized tomography (CT) small bowel enterography showed a linear soft tissue tract extending from the inferior aspect of the distal duodenum to the cecum. Ultimately, a diagnosis of duodenal-cecal fistula was made following esophagogastroduodenoscopy (EGD) revealing a fistula in the third part of the duodenum. A duodenal-cecal fistula secondary to foreign body ingestion is rare, with surgical intervention or endoscopic fibrin glue closure being potential treatment modalities if the fistula fails to close spontaneously. Duodenal-cecal fistulas are generally seen secondary to malignancies of the duodenum or colon, peptic ulcers, or inflammatory bowel disease. However, a duodenal-cecal fistula due to a foreign body is rare, thus highlighting the importance of keeping a broad differential, as appropriate in the clinical context.
RESUMEN
The intestinal epithelium is a key physical interface that integrates dietary and microbial signals to regulate nutrient uptake and mucosal immune cell function. The transcriptional programs that regulate intestinal epithelial cell (IEC) quiescence, proliferation, and differentiation have been well characterized. However, how gene expression networks critical for IECs are posttranscriptionally regulated during homeostasis or inflammatory disease remains poorly understood. Herein, we show that a conserved family of microRNAs, miR-181, is significantly downregulated in IECs from patients with inflammatory bowel disease and mice with chemical-induced colitis. Strikingly, we showed that miR-181 expression within IECs, but not the hematopoietic system, is required for protection against severe colonic inflammation in response to epithelial injury in mice. Mechanistically, we showed that miR-181 expression increases the proliferative capacity of IECs, likely through the regulation of Wnt signaling, independently of the gut microbiota composition. As epithelial reconstitution is crucial to restore intestinal homeostasis after injury, the miR-181 family represents a potential therapeutic target against severe intestinal inflammation.
Asunto(s)
Colitis , MicroARNs , Animales , Colitis/inducido químicamente , Colitis/genética , Células Epiteliales/metabolismo , Inflamación/genética , Inflamación/metabolismo , Mucosa Intestinal , Ratones , MicroARNs/genética , MicroARNs/metabolismoRESUMEN
BACKGROUND & AIMS: Noroviruses (NoVs) are the leading cause of acute gastroenteritis worldwide and are associated with significant morbidity and mortality. Moreover, an asymptomatic carrier state can persist following acute infection, promoting NoV spread and evolution. Thus, defining immune correlates of NoV protection and persistence is needed to guide the development of future vaccines and limit viral spread. Whereas antibody responses following NoV infection or vaccination have been studied extensively, cellular immunity has received less attention. Data from the mouse NoV model suggest that T cells are critical for preventing persistence and achieving viral clearance, but little is known about NoV-specific T-cell immunity in humans, particularly at mucosal sites. METHODS: We screened peripheral blood mononuclear cells from 3 volunteers with an overlapping NoV peptide library. We then used HLA-peptide tetramers to track virus-specific CD8+ T cells in peripheral, lymphoid, and intestinal tissues. Tetramer+ cells were further characterized using markers for cellular trafficking, exhaustion, cytotoxicity, and proliferation. RESULTS: We defined 7 HLA-restricted immunodominant class I epitopes that were highly conserved across pandemic strains from genogroup II.4. NoV-specific CD8+ T cells with central, effector, or tissue-resident memory phenotypes were present at all sites and were especially abundant in the intestinal lamina propria. The properties and differentiation states of tetramer+ cells varied across donors and epitopes. CONCLUSIONS: Our findings are an important step toward defining the breadth, distribution, and properties of human NoV T-cell immunity. Moreover, the molecular tools we have developed can be used to evaluate future vaccines and engineer novel cellular therapeutics.
Asunto(s)
Linfocitos T CD8-positivos/inmunología , Infecciones por Caliciviridae/prevención & control , Epítopos/inmunología , Antígenos HLA/inmunología , Intestinos/inmunología , Leucocitos Mononucleares/inmunología , Norovirus/inmunología , Adulto , Infecciones por Caliciviridae/inmunología , Femenino , Voluntarios Sanos , Humanos , Masculino , Persona de Mediana Edad , Biblioteca de Péptidos , Adulto JovenRESUMEN
The developmental origins of memory T cells remain incompletely understood. During the expansion phase of acute viral infection, we identified a distinct subset of virus-specific CD8+ T cells that possessed distinct characteristics including expression of CD62L, T cell factor 1 (TCF-1), and Eomesodermin; relative quiescence; expression of activation markers; and features of limited effector differentiation. These cells were a quantitatively minor subpopulation of the TCF-1+ pool and exhibited self-renewal, heightened DNA damage surveillance activity, and preferential long-term recall capacity. Despite features of memory and somewhat restrained proliferation during the expansion phase, this subset displayed evidence of stronger TCR signaling than other responding CD8+ T cells, coupled with elevated expression of multiple inhibitory receptors including programmed cell death 1 (PD-1), lymphocyte activating gene 3 (LAG-3), cytotoxic T-lymphocyte-associated protein 4 (CTLA-4), CD5, and CD160. Genetic ablation of PD-1 and LAG-3 compromised the formation of this CD62Lhi TCF-1+ subset and subsequent CD8+ T cell memory. Although central memory phenotype CD8+ T cells were formed in the absence of these cells, subsequent memory CD8+ T cell recall responses were compromised. Together, these results identify an important link between genome integrity maintenance and CD8+ T cell memory. Moreover, the data indicate a role for inhibitory receptors in preserving key memory CD8+ T cell precursors during initial activation and differentiation. Identification of this rare subpopulation within the memory CD8+ T cell precursor pool may help reconcile models of the developmental origin of long-term CD8+ T cell memory.
Asunto(s)
Linfocitos T CD8-positivos/inmunología , Listeriosis/inmunología , Coriomeningitis Linfocítica/inmunología , Células T de Memoria/inmunología , Células Precursoras de Linfocitos T/inmunología , Animales , Antígenos CD/genética , Linfocitos T CD8-positivos/metabolismo , Diferenciación Celular/genética , Diferenciación Celular/inmunología , Daño del ADN/inmunología , Modelos Animales de Enfermedad , Femenino , Factor Nuclear 1-alfa del Hepatocito/metabolismo , Humanos , Memoria Inmunológica/genética , Listeria monocytogenes/inmunología , Listeriosis/microbiología , Activación de Linfocitos , Coriomeningitis Linfocítica/virología , Virus de la Coriomeningitis Linfocítica/inmunología , Masculino , Células T de Memoria/metabolismo , Ratones , Ratones Noqueados , Células Precursoras de Linfocitos T/metabolismo , Receptor de Muerte Celular Programada 1/genética , Proteína del Gen 3 de Activación de LinfocitosRESUMEN
Simultaneous analyses of peripheral and mucosal immune compartments can yield insight into the pathogenesis of mucosal-associated diseases. Although methods to preserve peripheral immune cells are well established, studies involving mucosal immune cells have been hampered by lack of simple storage techniques. We provide a cryopreservation protocol allowing for storage of gastrointestinal (GI) tissue with preservation of viability and functionality of both immune and epithelial cells. These methods will facilitate translational studies allowing for batch analysis of mucosal tissue to investigate disease pathogenesis, biomarker discovery and treatment responsiveness.
Asunto(s)
Criopreservación/métodos , Inmunofenotipificación/métodos , Mucosa Intestinal/inmunología , Intestinos/fisiología , Supervivencia Celular , Perfilación de la Expresión Génica , Humanos , Intestinos/patologíaRESUMEN
A general consensus exists that IBD is associated with compositional and metabolic changes in the intestinal microbiota (dysbiosis). However, a direct causal relationship between dysbiosis and IBD has not been definitively established in humans. Findings from animal models have revealed diverse and context-specific roles of the gut microbiota in health and disease, ranging from protective to pro-inflammatory actions. Moreover, evidence from these experimental models suggest that although gut bacteria often drive immune activation, chronic inflammation in turn shapes the gut microbiota and contributes to dysbiosis. The purpose of this Review is to summarize current associations between IBD and dysbiosis, describe the role of the gut microbiota in the context of specific animal models of colitis, and discuss the potential role of microbiota-focused interventions in the treatment of human IBD. Ultimately, more studies will be needed to define host-microbial relationships relevant to human disease and amenable to therapeutic interventions.
Asunto(s)
Disbiosis/inmunología , Disbiosis/microbiología , Microbioma Gastrointestinal/inmunología , Enfermedades Inflamatorias del Intestino/inmunología , Enfermedades Inflamatorias del Intestino/microbiología , Animales , HumanosRESUMEN
BACKGROUND: There is a need for simple, noninvasive patient-driven disease assessment instruments in ulcerative colitis (UC). We sought to further assess and refine the previous described 6-point Mayo score. METHODS: A cross-sectional study of 282 UC patients was conducted assessing the correlation of the 2 patient-reported Mayo score components (6-point Mayo score) with the simple clinical colitis activity index (SCCAI) and a single Likert scale of patient-reported disease activity. Spearman's correlation, sensitivity, specificity, and area under the receiver operating curves (AUC) were calculated. A separate validation study in 59 UC patients was also conducted. RESULTS: Participants predominantly had long-standing disease (83%) and were in self-reported remission (63%). The 6-point Mayo score correlated well with the SCCAI (rho = 0.71; P < 0.0001) and patient-reported disease activity (rho = 0.65; P < 0.0001). Using a cutpoint of 1.5, the 6-point Mayo score had 83% sensitivity and 72% specificity for patient-defined remission, and 89% sensitivity and 67% specificity for SCCAI-defined remission (score, <2.5). The 6-point Mayo score and SCCAI had similar accuracy of predicting patient-defined remission (AUC = 0.84 and 0.87, respectively). Addition of the SCCAI general well-being question to the 6-point Mayo improved the predictive ability for patient-defined remission; and a new weighted score had an AUC of 0.89 in the development cohort and 0.93 in the validation cohort. The optimal cutpoint was 1.6. CONCLUSIONS: The patient-reported UC severity index that includes stool frequency, bleeding, and general well-being accurately measures clinical disease activity without requiring direct physician contact.
Asunto(s)
Colitis Ulcerosa/diagnóstico , Colitis Ulcerosa/fisiopatología , Encuestas Epidemiológicas/normas , Autoinforme/normas , Índice de Severidad de la Enfermedad , Adulto , Estudios Transversales , Defecación , Femenino , Hemorragia Gastrointestinal/diagnóstico , Hemorragia Gastrointestinal/fisiopatología , Humanos , Masculino , Persona de Mediana Edad , Servicios Postales , Estudios Prospectivos , Curva ROC , Sensibilidad y EspecificidadRESUMEN
The mammalian intestine is colonized by beneficial commensal bacteria and is a site of infection by pathogens, including helminth parasites. Helminths induce potent immunomodulatory effects, but whether these effects are mediated by direct regulation of host immunity or indirectly through eliciting changes in the microbiota is unknown. We tested this in the context of virus-helminth coinfection. Helminth coinfection resulted in impaired antiviral immunity and was associated with changes in the microbiota and STAT6-dependent helminth-induced alternative activation of macrophages. Notably, helminth-induced impairment of antiviral immunity was evident in germ-free mice, but neutralization of Ym1, a chitinase-like molecule that is associated with alternatively activated macrophages, could partially restore antiviral immunity. These data indicate that helminth-induced immunomodulation occurs independently of changes in the microbiota but is dependent on Ym1.
Asunto(s)
Infecciones por Caliciviridae/inmunología , Coinfección/inmunología , Gastroenteritis/inmunología , Inmunomodulación , Lectinas/inmunología , Microbiota/inmunología , Norovirus/inmunología , Trichinella/inmunología , Triquinelosis/inmunología , beta-N-Acetilhexosaminidasas/inmunología , Animales , Linfocitos T CD8-positivos/inmunología , Coinfección/microbiología , Coinfección/parasitología , Gastroenteritis/virología , Vida Libre de Gérmenes , Intestinos/inmunología , Intestinos/microbiología , Intestinos/virología , Activación de Macrófagos , Macrófagos/inmunología , Ratones , Ratones Endogámicos C57BLRESUMEN
The identification of host cell factors for virus replication holds great promise for the development of new antiviral therapies. Recently, high-throughput screening methods have emerged as powerful tools to identify candidate host factors for therapeutic intervention. The development of assay systems suitable for large-scale automated screening is of particular importance for novel viruses with high pathogenic potential for which limited biological information can be developed in a short period of time. This report presents a general enzymatic reporter system for the detection and characterization of multiple enveloped viruses that does not rely on engineering of the virus. Instead, reporter enzymes are incorporated into virus particles by targeting to lipid microdomains in producer cells. The approach allows a variety of human pathogenic enveloped viruses to be detected by sensitive, inexpensive and automatable enzymatic assays. Tagged viruses can be purified quickly and efficiently by a magnetic bead-based capture method. The method allows general detection of enveloped viruses without prior reference to their sequence.