Estradiol Enhances CD4+ T-Cell Anti-Viral Immunity by Priming Vaginal DCs to Induce Th17 Responses via an IL-1-Dependent Pathway.

Clinical and experimental studies have shown that estradiol (E2) confers protection against HIV and other sexually transmitted infections. Here, we investigated the underlying mechanism. Better protection in E2-treated mice, immunized against genital HSV-2, coincided with earlier recruitment and higher proportions of Th1 and Th17 effector cells in the vagina post-challenge, compared to placebo-treated controls. Vaginal APCs isolated from E2-treated mice induced 10-fold higher Th17 and Th1 responses, compared to APCs from progesterone-treated, placebo-treated, and estradiol-receptor knockout mice in APC-T cell co-cultures. CD11c+ DCs in the vagina were the predominant APC population responsible for priming these Th17 responses, and a potent source of IL-6 and IL-1ß, important factors for Th17 differentiation. Th17 responses were abrogated in APC-T cell co-cultures containing IL-1ß KO, but not IL-6 KO vaginal DCs, showing that IL-1ß is a critical factor for Th17 induction in the genital tract. E2 treatment in vivo directly induced high expression of IL-1ß in vaginal DCs, and addition of IL-1ß restored Th17 induction by IL-1ß KO APCs in co-cultures. Finally, we examined the role of IL-17 in anti-HSV-2 memory T cell responses. IL-17 KO mice were more susceptible to intravaginal HSV-2 challenge, compared to WT controls, and vaginal DCs from these mice were defective at priming efficient Th1 responses in vitro, indicating that IL-17 is important for the generation of efficient anti-viral memory responses. We conclude that the genital mucosa has a unique microenvironment whereby E2 enhances CD4+ T cell anti-viral immunity by priming vaginal DCs to induce Th17 responses through an IL-1-dependent pathway.

Correction: Estradiol Enhances CD4+ T-Cell Anti-Viral Immunity by Priming Vaginal DCs to Induce Th17 Responses via an IL-1-Dependent Pathway.

[This corrects the article DOI: 10.1371/journal.ppat.1005589.].

The Mucosal Adjuvant Activities of ADP-Ribosylating Bacterial Enterotoxins.

The bacterial enterotoxins, cholera toxin and the heat labile toxin of E. coli, are well known adjuvants for mucosal immune response. Their common A chain mediates the toxigenic mechanism by causing ADP ribosylation of G proteins and subsequent elevation of cAMP in target cells. A large IgA and IgG antibody response to admixed protein antigen (Ag) is the hallmark of these adjuvants and is clearly associated with the A chain activity. Expansion of Ag-specific B and T cells, alteration of T cell cytokine production, and changes in regulatory T cells have been reported as adjuvant mechanisms. The B chain derivatives of these toxins can also weakly enhance immune response, especially if covalently associated with Ag and used for nasophyrangeal immunization. Importantly, these toxins or their B chain derivatives can alter the normal immune regulation that produces oral tolerance. This indicates that they modulate mechanisms operative between the mucosal and systemic immune systems. There are some discrepancies between in vitro models of CT or LT activity and in vivo manifestations of their adjuvant activities. Interpretation of current data regarding in vivo mechanism is hampered by an incomplete understanding of how mucosal B and T cells can interact with systemic lymphoid tissue and vice versa. More important, there is no clear understanding of the early effects of the toxins on the local (and draining) mucosal lymphoid tissues. This is especially true in the critical areas of antigen presentation, T and B cell activation, and cytokine production.

The effect of rituximab on vaccine responses in patients with immune thrombocytopenia.

B-cell depletion may impair vaccine responses and increase infection risk in patients with immune thrombocytopenia (ITP). We investigated the effects of rituximab on antibody and cellular responses to Streptococcus pneumoniae polysaccharide and Haemophilus influenzae type b (Hib) vaccines in ITP patients. Of 60 patients in the main trial, 24 patients received both vaccines 6 months after rituximab (n = 17) or placebo (n = 7). Among 20 evaluable patients, 3 of 14 (21%) in the rituximab group and 4 of 6 (67%) in the placebo group achieved a fourfold increase in anti-pneumococcal antibodies (P = .12). For anti-Hib antibodies, 4 of 14 (29%) and 5 of 6 (83%), respectively, achieved a fourfold increase (P < .05). Fewer patients in the rituximab group demonstrated Hib killing (2 of 14 [14%], 5 of 6 [83%], P < .05). Three of 14 rituximab-treated patients failed to respond to vaccines by any criteria. After vaccinations, preplasma cell blasts and interferon-γ-secreting T cells were reduced in rituximab-treated patients. Antibody responses were impaired for at least 6 months after rituximab. Cellular immunity was reduced in parallel with depleted B-cell pools. These findings have implications for the timing of vaccinations and the mechanism of infection after rituximab in ITP patients.

HIV-1 gp120 induces TLR2- and TLR4-mediated innate immune activation in human female genital epithelium.

Although women constitute half of all HIV-1-infected people worldwide (UNAIDS World AIDS Day Report, 2011), the earliest events in the female reproductive tract (FRT) during heterosexual HIV-1 transmission are poorly understood. Recently, we demonstrated that HIV-1 could directly impair the mucosal epithelial barrier in the FRT. This suggested that the HIV-1 envelope glycoprotein gp120 was being recognized by a membrane receptor on genital epithelial cells, leading to innate immune activation. In this study, we report that pattern-recognition receptors TLR2 and -4 bind to HIV-1 gp120 and trigger proinflammatory cytokine production via activation of NF-κB. The gp120-TLR interaction also required the presence of heparan sulfate (HS). Bead-binding assays showed that gp120 can bind to HS, TLR2, and TLR4, and studies in transfected HEK293 cells demonstrated that HS and TLR2 and -4 were necessary to mediate downstream signaling. Exposure to seminal plasma from HIV-1-infected and uninfected men with gp120 added to it induced a significant proinflammatory cytokine response from genital epithelial cells and disruption of tight junctions, indicating a role for gp120 in mucosal barrier disruption during HIV-1 heterosexual transmission. These studies provide, for the first time to our knowledge, a possible mechanism by which HIV-1 gp120 could directly initiate innate immune activation in the FRT during heterosexual transmission.

Polymeric IgA-secreting and mucosal homing pre-plasma cells in normal human peripheral blood.

Clear identification of recently activated mucosal B cells in human blood would greatly facilitate study of mucosal vaccines, immune response to infection and the ongoing mucosal IgA response. We examined blood lymphocytes from normal, healthy individuals to identify IgA-secreting pre-plasma cells' (PPC) functional and phenotypic relevance to mucosal antibody production, in the absence of infection, disease or recent vaccination. PPC are the most recently activated B lymphocytes in blood and are considered in transit between lymphoid tissue and effector tissues, where they terminally differentiate into plasma cells. We observed that all IgA-secreting PPC expressed surface IgA (sIgA) and intracellular IgA (icIgA) and secreted primarily polymeric IgA (pIgA), as determined by flow cytometry, ELISPOT and size exclusion chromatography. A large sub-population of PPC in blood expresses the mucosal chemokine receptor CCR10 and contains the largest fraction of sIgA and icIgA PPC that secrete pIgA. The majority of CCR10(+) PPC expresses high levels of Ki67, indicative of recently activated blasts. In contrast, most CCR10(-) PPC secrete IgG, but a small population secretes pIgA and stains for icIgA. The mucosal integrin alpha(4)beta(7) was detected on a subset of PPC, but this subset did not account for all CCR10(+) PPC or all PPC with sIgA expression. Our data clearly demonstrate that PPC defined by surface expression of CD19, CD27(hi), IgA and CCR10 secrete only pIgA and are the dominant mucosal PPC subset in human blood. These mucosal PPC can now be investigated routinely as indicators of recent human mucosal IgA responses.

IL-17 Production by γδ+ T Cells Is Critical for Inducing Th17 Responses in the Female Genital Tract and Regulated by Estradiol and Microbiota.

IL-17 can be produced by adaptive immune cells such as Th17 cells and by immune cells that produce IL-17 without prior priming. This latter category, which we will refer to as "innate," includes innate cells such as NK cells and innate lymphoid cells and innate-like T cell populations such as NKT cells and γδ+ T cells. Studies in mucosal tissues have shown that the induction of Th17 immunity is amplified by innate IL-17 produced within those tissues. However, the role of innate IL-17 and its effect on Th17 induction in the female genital tract (FGT) is largely unknown. In this study, we characterize the primary source of IL-17-secreting vaginal cells and show that innate IL-17 plays a critical role in priming adaptive Th17 responses in the FGT. Under homeostatic conditions, γδ+ T cells were the predominant source of innate IL-17 in the murine FGT, and this population was modulated by both the sex hormone estradiol and the presence of commensal microbiota. Compared with wild-type C57BL/6 mice, vaginal APCs isolated from IL-17A-deficient (IL-17A-/- ) mice were severely impaired at priming Th17 responses in APC-T cell cocultures. Furthermore, the defect in Th17 induction in the absence of innate IL-17 was associated with impairment of IL-1ß production by vaginal CD11c+ dendritic cells. Overall, our study describes a novel role for IL-17 in the FGT and further demonstrates the importance of factors in the vaginal microenvironment that can influence adaptive immune responses.

Immunological changes in response to exercise: influence of age, puberty, and gender.

PURPOSE: This study tested the hypothesis that exercise-induced perturbation and recovery of the immune system would vary with age, puberty, and gender in healthy children and adolescents. METHODS: Twelve-year-old girls (YG; N = 14) and boys (YB; N = 20), and 14-yr-old girls (OG; N = 11) and boys (OB; N = 13) cycled for 60 min at 70% VO2max. Blood was collected before, at 30 and 60 min of exercise, and at 30 and 60 min of recovery to measure total leukocytes, leukocyte and lymphocyte subsets, and cytokines. Age and pubertal (Tanner stage) effects within genders and gender effects within age and pubertal groups were determined. RESULTS: Exercise-induced increases in lymphocytes, CD3-CD16+CD56+ counts, and IL-6 were approximately 83, 90, and 390% greater in OG versus YG (P < 0.05). Recovery leukocytosis and neutrophilia were approximately 56 and 35% greater in OB versus YB (P < 0.05). Pubertal stage did not have a statistically significant influence on responses in girls, but the lowest pubertal stage consistently showed smaller changes in lymphocytes and CD3-CD16+CD56+ counts. Recovery neutrophilia was approximately 120% greater in postpubertal boys versus prepubertal or pubertal boys (P < 0.05). Responses of lymphocytes and CD3-CD16+CD56+ counts, respectively, were approximately 120 and 82% greater in OG versus OB (P < 0.05), with no differences between YG and YB. Exercise-induced increases in total leukocytes, lymphocytes, and CD3-CD16+CD56+ counts were at least 35% greater in girls versus boys of similar pubertal status (P < 0.05). Regardless of age, puberty, or gender, IL-8 levels were significantly higher during recovery versus rest (P < 0.05). CONCLUSION: These results highlight the need to control for age, puberty, and gender when interpreting immunologic responses to exercise in a pediatric population.

Puberty effects on NK cell responses to exercise and carbohydrate intake in boys.

UNLABELLED: Previous research has demonstrated that younger versus older animals and humans experience smaller perturbations in natural killer (NK) cells in response to physiological stress. PURPOSE: To determine whether the smaller perturbations in NK cells induced by strenuous exercise and carbohydrate (CHO) intake, previously reported in children, are influenced by puberty. METHODS: Twenty 12-yr-old boys, distinguished as prepubertal (Tanner (T) 1, N = 7), early pubertal (T2, N = 7), or pubertal (T3-5, N = 6), cycled for 60 min at 70% VO(2max) while drinking 6% CHO (CT) or flavored water (WT). Blood was collected at rest and during (30 and 60 min) and following (30 and 60 min) exercise to identify NK cells as CD3(-)CD56(dim) or CD3(-)CD56(dim). CD69 expression on CD3(-)CD56(+) cells was also determined. RESULTS: A puberty x CHO x exercise interaction was found for the proportion, but not number, of CD56(dim) cells (P = 0.06). CD56(dim) cell counts were lower in CT versus WT (P < 0.001). Responses of CD56(bright) proportions (P = 0.007) and counts (P = 0.03) depended on pubertal status, but not CHO. The CD56(bright):CD56(dim) ratio remained stable during exercise, but during recovery was higher in T1 and T3-5 versus T2 (P = 0.08) and in CT versus WT (P = 0.04). During recovery, CD3(-)CD56(+) cells expressed higher levels of CD69 (P = 0.01), with no change in the proportion of CD69(+) cells. CONCLUSION: These results confirm the influence of puberty on the distribution of NK cell subsets in response to exercise and CHO intake. Increased CD69 expression suggests that NK cells increase activation status during recovery from physiological stress.

Imaging Biomarkers in Immunotherapy.

Immune-based therapies have been in use for decades but recent work with immune checkpoint inhibitors has now changed the landscape of cancer treatment as a whole. While these advances are encouraging, clinicians still do not have a consistent biomarker they can rely on that can accurately select patients or monitor response. Molecular imaging technology provides a noninvasive mechanism to evaluate tumors and may be an ideal candidate for these purposes. This review provides an overview of the mechanism of action of varied immunotherapies and the current strategies for monitoring patients with imaging. We then describe some of the key researches in the preclinical and clinical literature on the current uses of molecular imaging of the immune system and cancer.

High Physiological Concentrations of Progesterone Reverse Estradiol-Mediated Changes in Differentiation and Functions of Bone Marrow Derived Dendritic Cells.

Female sex steroids, estradiol (E2) and progesterone (P4), play a key role in regulating immune responses in women, including dendritic cell (DC) development, and functions. Although the two hormones co-occur in the body of women throughout the reproductive years, no studies have explored their complex combinatorial effects on DCs, given their ability to regulate each other's actions. We examined murine bone marrow derived dendritic cells (BMDC) differentiation and functions, in the presence of a wide range of physiological concentrations of each hormone, as well as the combination of the two hormones. E2 (10(-12) to 10(-8)M) enhanced the differentiation of CD11b+CD11c+ DCs from BM precursor cells, and promoted the expression of CD40 and MHC Class-II, in a dose-dependent manner. In contrast, P4 (10(-9) to 10(-5)M) inhibited DC differentiation, but only at the highest concentrations. These effects on BMDCs were observed both in the presence or absence of LPS. When both hormones were combined, higher concentrations of P4, at levels seen in pregnancy (10(-6)M) reversed the E2 effects, regardless of the concentration of E2, especially in the absence of LPS. Functionally, antigen uptake was decreased and pro-inflammatory cytokines, IL-12, IL-1 and IL-6 production by CD11b+CD11c+ DCs, was increased in the presence of E2 and these effects were reversed by high concentrations of P4. Our results demonstrate the distinct effects of E2 and P4 on differentiation and functions of bone marrow myeloid DCs. The dominating effect of higher physiological concentrations of P4 provides insight into how DC functions could be modulated during pregnancy.

Stimulation of anti-polio and anti-HSV IgA pre-plasma cell response in blood following parenteral immunization with tetanus-diphtheria vaccine.

Systemic immunization can elicit a significant response of IgG producing activated B cell subsets in human blood, part of which is not toward the vaccine. However, the effect of vaccination on IgA antibody secreting B cell subsets has had limited investigation. We immunized healthy, adult volunteers with a tetanus/diphtheria vaccine and observed a significant burst of IgA-secreting pre-plasma cells (PPC). Isolated PPC produced IgG, but not IgA antibody to tetanus antigen, and produced IgA and IgG antibody specific for poliovirus and herpes simplex virus. Thus, a vaccine that generates a systemic recall response to tetanus also induces blood PPC secreting IgA and IgG antibody relevant to mucosal protection.

Intranasal and subcutaneous immunization under the effect of estradiol leads to better protection against genital HSV-2 challenge compared to progesterone.

This study examined the effect of hormonal environment on intranasal and subcutaneous routes of immunization in a genital herpes infection model. Ovariectomized mice were treated with estradiol (E(2)), progesterone (P(4)) or placebo hormone pellets and immunized intranasally (i.n.) or subcutaneously (s.c.) with attenuated HSV-2. Immunized mice were subsequently challenged, intravaginally, with wild-type HSV-2. Mice immunized under the influence of E(2) showed higher survival rates, reduced pathology and significantly lower viral shedding compared with those immunized under the influence of P(4) or placebo, by both i.n. and s.c. routes. Vaginal and serum anti-HSV-2 IgG, but not IgA, levels correlated with decreased pathology in E(2)-treated, i.n. immunized mice. We conclude that immunization under the influence of E(2) afforded better protection compared to placebo and P(4), by both routes of immunization. Female sex hormones can influence immune responses and outcome of viral challenge in the genital tract following systemic immunization.

Role for cysteinyl leukotrienes in allergen-induced change in circulating dendritic cell number in asthma.

BACKGROUND: Dendritic cells are important antigen-presenting cells. After an allergen inhalation, their numbers rapidly decrease in circulation and increase in the airway mucosa. OBJECTIVE: To investigate whether allergen-induced changes in the number of circulating dendritic cells are mediated by cysteinyl leukotrienes. METHODS: In a randomized, double-blind, crossover study, we examined the effects of 2 weeks of treatment with pranlukast (a cysteinyl leukotriene 1 [CysLT1] receptor antagonist) 300 mg twice daily and placebo on allergen-induced changes in airway responses and circulating dendritic cells in 15 subjects with mild asthma. We examined by flow cytometry, before and at 3 hours and 24 hours after allergen inhalation, the proportion of myeloid (CD33+) and plasmacytoid (CD123+) dendritic cells (HLA-DR+, CD14-, CD16-) among all peripheral blood mononuclear cells. The fraction of dendritic cells expressing CysLT1 receptor was also determined. RESULTS: Compared with placebo, pranlukast significantly attenuated both the maximum early (by 55%) and the late (by 39%) asthma responses, the allergen-induced methacholine airway hyperresponsiveness, and the increase in macrophage inflammatory protein 1alpha and 3alpha in induced sputum. A significantly greater proportion of CD33+ cells (55%) expressed CysLT1 receptor compared with CD123+ cells (11%). Consistent with this, pranlukast prevented the allergen-induced decrease in CD33+ dendritic cells at 3 hours postallergen (mean Delta from baseline, +4.4%) compared with placebo (mean Delta, -8.4; P <.05), but not CD123+ cells. CONCLUSION: Pretreatment with pranlukast attenuated allergen-induced airway responses and the decrease in circulating myeloid dendritic cells, demonstrating a novel role of cysteinyl leukotrienes in dendritic cell trafficking.