Mesenchymal stromal cells fail to alleviate experimental graft-versus-host disease in rats transplanted with major histocompatibility complex-mismatched bone marrow.

Mesenchymal stromal cells (MSC) can be used to treat graft-versus-host disease (GVHD) caused by allogeneic stem cell transplantation (allo-SCT). The effectiveness of this therapy has been variable in clinical trials and in experimental animal models. In this study, we investigated the ability of bone marrow (BM)-derived MSC to alleviate GVHD in an experimental rat model of allo-SCT using two different combinations of major histocompatibility complex (MHC) mismatch with survival as the primary endpoint. Recipient rats received total body irradiation and a transplant of T cell-depleted donor BM cells with either a full [PVG.7B → BN] or a partial MHC mismatch [PVG.1U → PVG.R23] restricted to the class II and non-classical class I sub-regions (RT1-B/D-CE/N/M). GVHD was invoked by infusion of graded doses of donor leukocytes 2 weeks after allo-SCT. Weekly doses of MSC were injected starting on the day of donor leukocyte infusion. No significant overall improvement of mortality and morbidity was observed in the two transplantation settings. Stimulation of MSC with exogenous tumor necrosis factor α and interferon (IFN)γ prior to infusion could not rescue BM-transplanted rats from lethal acute GVHD. In conclusion, repeated administrations of MSC failed to alleviate GVHD after fully or partially MHC-mismatched allo-SCT in the rat.

The role of natural killer cells in resistance to the intracellular bacterium Listeria monocytogenes in rats.

We have investigated the influence of early innate immune resistance mechanisms on infection with the intracellular bacterium Listeria monocytogenes in rats. Rats were injected i.v. with various amounts of Listeria and the number of bacterial colonies in the spleen was determined at different time points after infection. A bacterial dose as low as 2 x 10(4) cells gave reproducible infection within the spleen. Athymic nude rats lacking normal T cells but with a robust NK cell repertoire for MHC antigens were more resistant to bacterial replication within the spleen than were normal littermate rats and eliminated the infection within 3 days. In vivo depletion of NK cells, or NK subpopulations expressing Ly49 receptors, increased the bacterial load in the spleen, indicating that these cells were important in the initial control of Listeria infection. An increased frequency of Ly49 expressing NK cells in Listeria-infected rats further supported this notion. As several rat strains, unlike mice, display a large repertoire of MHC-recognizing activating Ly49 receptors, these observations raise the interesting possibility that NK cells may recognize alterations in the MHC-I molecules on Listeria-infected cells leading to their elimination before the adaptive immune system comes into play.

Investigation of lipopolysaccharide receptor expression on human monocytes after major orthopaedic surgery.

BACKGROUND: The innate immune system is suppressed after major orthopaedic surgery, implicating a risk of septic complications. Whole-blood ex vivo testing with lipopolysaccharide (LPS) has shown a depression of the tumour necrosis factor alpha (TNF-alpha) production until 12 days postoperatively. As part of the innate immune system, the Toll-like receptors TLR2 and TLR4 recognize antigens from Gram-positive and Gram-negative bacteria, respectively. The receptors CD14 and CD11b are involved in the LPS receptor complex, whereas human lymphocyte antigen (HLA)-DR binds endotoxin peptides. It is still uncertain whether the expression of all these receptors changes after major surgery. METHODS: In 6 patients undergoing hip arthroplasty, we investigated three times the display of TLR4, TLR2, CD14, CD11b, and HLA-DR on monocytes by fluorescence-activated cell sorting and white blood cell counts during 12 days postoperatively. At the same time, the plasma levels of interleukin (IL)-1beta, IL-4, IL-6, IL-10, IL-13, and TNF-alpha were measured. RESULTS: There was no significant change in the expression of TLR4, CD14, CD11b, HLA-DR, and TLR2. Monocyte count and cytokine analysis did not differ from the ones pre-operatively taken. CONCLUSIONS: After aseptic orthopaedic surgery, there is no change in the display of the LPS receptor complex on monocytes. Other mechanisms have to be investigated to gain insight into the decrease of the TNF-alpha production capacity postoperatively.

Phenotype and natural killer cell sensitivity of a radiation-induced acute T-cell leukaemia (Roser leukaemia) in PVG rats.

A radiation-induced T-cell leukaemia [Roser leukaemia (RL)] in the rat was conditioned for growth in vitro by repeated in vivo-in vitro passages. This in vitro cell line, termed RL-T, maintained its leukaemia-inducing property when transferred to syngeneic PVG rats. It expresses several T-cell markers and the T-cell alpha/beta receptor-CD3 complex. RL-T, furthermore, expresses major histocompatibility complex (MHC) I antigens, both classical (RT1.A) and nonclassical (RT1.C), which makes it susceptible to killing by alloreactive natural killer cells in vitro.

The effect of in vivo depletion of NKR-P1+ or CD8+ lymphocytes on the acute rejection of allogeneic lymphocytes (ALC) in the rat.

We have depleted lymphocyte subsets in PVG and AO rats with MoAbs 3.2.3 (against NKR-P1 on NK and NK/T cells) and OX-8 (against CD8 on CTL and NK cells), and examined the effect on the killing of YAC-1 target cells in vitro and the effect on the acute rejection of small allogeneic lymphocytes in vivo (allogeneic lymphocyte cytotoxicity, ALC). While 3.2.3 treatment led to only a partial depletion of 3.2.3-positive cells in PVG rats, this treatment drastically reduced the number of NKR-P1+ cells in AO rats, abolished splenic NK activity against the NK-sensitive tumour target YAC-1, and markedly diminished the ALC response. Rats treated with OX-8 for 1 day showed a similar loss of NK cell function in vivo and in vitro. However, in rats treated with OX-8 for 3 days a 3.2.3+ and OX-8- population consisting of NK cells appeared, restoring ALC. The results demonstrate that NK cell responses can be greatly diminished after in vivo treatment with these MoAbs. Furthermore, they demonstrate that ALC is not necessarily linked to expression of the CD8 molecule.

Rat natural killer cell receptor systems and recognition of MHC class I molecules.

Rat natural killer (NK) cells recognize MHC-I molecules encoded by both the classical (RT1-A) and non-classical (RT1-C/E/M) MHC class I (MHC-I) regions. We have identified a receptor, the STOK2 antigen, which belongs to the Ly-49 family of killer cell lectin-like receptors, and we have localized the gene encoding it to the rat natural killer cell gene complex. We have also shown that it inhibits NK cytotoxicity when recognizing its cognate MHC-I ligand RT1-A1c on a target cell. This is the first inhibitory Ly-49-MHC-I interaction identified in the rat and highlights the great similarity between rat and mouse Ly-49 receptors and their MHC ligands. However, the mode of rat NK-cell recognition of target cells indicates that positive recognition of allo-MHC determinants, especially those encoded by the RT1-C/E/M region, is a prevalent feature. NK cells recruited to the peritoneum as a consequence of alloimmunization display positive recognition of allodeterminants. In one case, NK cells activated in this way have been shown to be specific for the immunizing, non-classical class I molecule RT1-Eu. These findings show that allospecific NK cells sometimes show features reminiscent of the adaptive immune response.

Long-term donor chimerism after MHC (RT1) mismatched bone marrow transplantation in the rat: the role of host alloreactive NK cells.

We have investigated the role of major histocompatibility complex (MHC) (RT1) disparities in the engraftment of bone marrow (BM) cells after whole body irradiation of rats. Mononuclear BM cells from PVG.RT7.2 (RT1c) rats were injected i.v. into sublethally (10Gy) whole body irradiated PVG (RT1c) rats and RT1 congenic and recombinant PVG rats. Repopulation of the BM, spleen, and blood with donor cells was assessed by FACS analysis of cells labelled with the fluorescein isothiocyanate (FITC)-labelled HIS41 monoclonal antibody (MoAb) against the RT7.2 marker. In RT1 matched (PVG.RT7.2 --> PVG) and RT1-mismatched combinations (PVG.RT7.2 --> PVG.1AV1), where radioresistant host natural killer (NK) cells could not recognize the BM inoculum as foreign, a donor chimerism close to 100% was observed after 6-8 weeks. However, in rat strain combinations where host NK cells could recognize an RT1 mismatch, almost no donor cells survived, and the rats were repopulated with leukocytes of host origin. In intra-MHC recombinant rat strains the element determining rejection or acceptance of the allograft mapped to the RT1-B/D-C/E/M region in PVG.R8 and PVG.R23 rats, in accordance with the patterns of NK alloreactivity in these strain combinations. NK cells may therefore be a primary obstacle to successful allogeneic BM engraftment in this model.

Release from tonic inhibition of T cell activation through transient displacement of C-terminal Src kinase (Csk) from lipid rafts.

In resting peripheral T cells, Csk is constitutively present in lipid rafts through an interaction with the Csk SH2-binding protein, PAG, also known as Cbp. Upon triggering of the T cell antigen receptor (TCR), PAG/Cbp is rapidly dephosphorylated leading to dissociation of Csk from lipid rafts. However, tyrosine phosphorylation of PAG/Cbp resumes after 3--5 min, at which time Csk reassociates with the rafts. Cells overexpressing a mutant Csk that lacks the catalytic domain, but displaces endogenous Csk from lipid rafts, have elevated basal levels of TCR-zeta-chain phosphorylation and spontaneous activation of an NFAT-AP1 reporter from the proximal interleukin-2 promoter as well as stronger and more sustained responses to TCR triggering than controls. We suggest that a transient release from Csk-mediated inhibition by displacement of Csk from lipid rafts is important for normal T cell activation.

C1qRp elicits a Ca++ response in rat NK cells but does not influence NK-mediated cytotoxicity.

The cell surface receptor C1qRp (receptor for C1q, regulating phagocytosis) present on macrophages and neutrophils, is presumed to stimulate phagocytosis in these cells. However, C1qRp is also present on natural killer (NK) cells, and in these cells its physiological function is not currently known. We have investigated putative functions of this cell surface molecule in rat NK cells with the aid of two novel monoclonal antibodies (MoAb) LOV3 and LOV8 against rat C1qRp. NK cells are known to be potent cytotoxic effector cells, both through specific recognition of ligands on a target cell and killing of antibody-coated target cells (antibody-dependent cellular cytotoxicity, ADCC). NK cells prestimulated with MoAbs LOV3 or LOV8 did not exhibit altered ADCC. Furthermore, the addition of MoAb LOV3 or LOV8 to cytotoxic cultures of NK cells and Fc-receptor positive tumour cells did not affect killing in a redirected killing assay, indicating that the receptor did not influence NK cytotoxicity. However, this is the first paper to show that an intracellular Ca++-response is induced in rat NK cells upon stimulation of C1qRp with LOV3 and LOV8. The response induced by the antibodies was only minimally reduced in the presence of EGTA, indicating that most of the response is owing to the Ca++ mobilization from intracellular calcium stores.

A soluble LAT deletion mutant inhibits T-cell activation: reduced recruitment of signalling molecules to glycolipid-enriched microdomains.

The type III transmembrane adaptor protein linker for activation of T cells (LAT) is essential for membrane recruitment of signalling molecules following TCR activation. Here we show that although LAT deleted in the transmembrane domain is completely soluble, it can be tyrosine phosphorylated after anti-CD3 stimulation or pervanadate treatment. Overexpression of this deletion mutant in transiently transfected Jurkat TAg cells inhibits transcriptional activation of nuclear factor of activated T cells (NF-AT)/AP-1 reporter construct in a concentration-dependent manner. Furthermore, by selection of transiently transfected cells, a clear reduction of TCR-induced CD69 expression was observed in cells expressing the mutant. These dominant negative effects seemed to be dependent both on the ability of the membrane deletion mutant to reduce phosphorylation of endogenous LAT and to reduce interaction of endogenous LAT with PLC-gamma1 and Grb2. Consistent with this, the redistribution of PLC-gamma1 and Grb2 to glycolipid-enriched microdomains, called lipid rafts, after stimulation was inhibited when the soluble form of LAT was overexpressed. We suggest that the dominant negative effect is caused by the ability of the mutant to sequester signalling molecules in cytosol and thereby inhibit redistribution of signalling molecules to lipid rafts upon T-cell activation.

The athymic nude rat: an animal experimental model to reveal novel aspects of innate immune responses?

Athymic nude rats resemble nude mice in their lack of a normal thymus and functionally mature T cells. They have been useful in the study of mechanisms of tumor growth or graft rejection in immunocompromised hosts since they can accept major histocompatibility complex (MHC) mismatched organ allografts or xenografts for several months and because a number of tumor cell lines of human and rodent origin grow well in these rats. Injection of a few helper T (Th) cells from euthymic littermate rats partly restores the pool of mature T cells as well as full immunocompetence to reject organ allografts and has helped to reveal some of the cell interactions necessary for rejection to occur In contrast, immunologically naive athymic nude rats of certain strains, acutely reject allografts consisting of lymphocytes or bone marrow cells, which is due to the presence of alloreactive natural killer cells. These cells can recognize and kill MHC incompatible hematopoietic cells through the recognition of both mismatches within the classical (RT1.A) and nonclassical (RT1.C/E) MHC class I regions with a repertoire of inhibitory and activating killer lectin-like receptors (KLR) for MHC-I molecules, encoded by the Ly-49 portion of the rat natural killer cell gene complex (NKC). Some of these receptors have been identified and molecularly cloned and show similarities with NK receptors identified in the mouse. Other leukocytes in nude rats, such as dendritic cells, may also contribute to specific innate immune responses in the absence of mature T cells. Nude rats develop T-like cells expressing CD3 and T-cell receptor (TCR) with increasing age. Though their phenotype in peripheral lymphatic tissues resembles that of normal T cells, consisting mainly of CD4+ or CD8+ cells, they lack alloreactivity in vivo and their TCR repertoire is more of an oligoclonal nature. Their contribution to allograft rejection in T-cell-reconstituted rats is therefore questionable, and their role in innate immune response in these rats still enigmatic.

Utilizing a systems approach to implement pressure ulcer prediction and prevention.

Efficient, effective patient care is an objective shared by all healthcare settings and systems. It is generally accepted that using national clinical guidelines facilitates pursuit of this objective. However, implementation of a guideline, or any process improvement activity, requires a systematic, collaborative approach from which new processes can be purposefully designed. This article reviews systems theory, presents the steps for process improvement using the Plan/Do/Check/Act cycle, and references a recent statewide quality improvement study conducted by the authors in collaboration with Stratis Health, a Minnesota Medical Peer Review Organization.

Examining threats to skin integrity.

Intact skin serves a vital role in maintaining homeostasis of the body and is regarded as the body's first line of defense against invading micro-organisms. The skin's barrier function can be jeopardized or threatened by several events: aging, dryness, bathing technique, activities of daily living, and soaps. In this paper, the authors review the structures of the skin that facilitate moisture retention and examine bathing practices that threaten the integrity of the skin. Finally, wound and skin care nurses, as well as generalist nurses, are encouraged to critically review the type of soap and the techniques used for bathing.

Characterization and molecular cloning of rat C1qRp, a receptor on NK cells.

Here we report the generation of monoclonal antibodies (mAb) LOV3 and LOV8 to a 110-130-kDa membrane glycoprotein expressed by rat NK cells. This NK surface molecule was identified by eucaryotic expression cloning as the structural orthologue of the phagocytosis-stimulating receptor for complement factor C1q and mannose-binding lectin on human macrophages, C1qRp. Rat C1qRp is a monomeric type I integral membrane protein consisting of 643 amino acids with an N-terminal lectin-like domain, five epidermal growth factor-like domains, a transmembrane domain and a 45-residue cytoplasmic domain. It is encoded by a single gene on rat chromosome 3q41-q42 and is 67% and 87.5% identical at the amino acid level to human and mouse C1qRp, respectively. Rat C1qRp is expressed by resting and by activated NK cells, on subpopulations of NKR-P1(+) T cells (NK/T cells), dendritic cells, macrophages and granulocytes, but not by B cells or NKR-P1(-) T cells. Expression of this innate immune receptor is therefore not restricted to hematopoietic cells of the myeloid lineage, but is also expressed on subsets of cells of lymphoid origin. The mAb did not affect the cytotoxic function of NK cells, and C1qRp on NK cells may have functions not related to NK killing.

[Natural killer cells--important in the immunologic defense]. / Naturlige drepeceller--viktig immunologisk førstelinjeforsvar.

Natural Killer (NK) cells are a group of lymphocytes with a characteristic morphology and function. They are abundant in blood, spleen, liver and lungs. They are distinct from both T and B lymphocytes in their circulation patterns, profile of surface antigens, receptor repertoire and the way they discriminate between self and nonself. This latter NK function can partly be explained by an array of recently characterised NK receptors that can recognise and accurately discriminate between normal and altered MHC class I determinants. The basis for this discrimination is different from that of T cells and is discussed in this article. The role of NK cells in antimicrobial defense is well demonstrated, particularly that against viruses belonging to the herpesvirus group. A case report of a patient with a selective defect in NK cells and with recurrent viral infections is described. The role of NK cells in defense against malignant cells is more circumstantial, but NK cells do possess receptors which recognise tumour cells and kill them efficiently in vitro. A receptor which can recognise determinants unique for cancer cells has recently been described.

Natural killing of xenogeneic cells mediated by the mouse Ly-49D receptor.

NK lymphocytes lyse certain xenogeneic cells without prior sensitization. The receptors by which NK cells recognize xenogeneic targets are largely uncharacterized but have been postulated to possess broad specificity against ubiquitous target ligands. However, previous studies suggest that mouse NK cells recognize xenogeneic targets in a strain-specific manner, implicating finely tuned, complex receptor systems in NK xenorecognition. We speculated that mouse Ly-49D, an activating NK receptor for the MHC I ligand, H2-Dd, might display public specificities for xenogeneic target structures. To test this hypothesis, we examined the lysis of xenogeneic targets by mouse Ly-49D transfectants of the rat NK cell line RNK-16 (RNK. Ly-49D). Of the xenogeneic tumor targets tested, RNK.Ly-49D, but not untransfected RNK-16, preferentially lysed tumor cells derived from Chinese hamsters and lymphoblast targets from rats. Ly-49D-dependent recognition of Chinese hamster cells was independent of target N-linked glycosylation. Mouse Ly-49D also specifically stimulated the natural killing of lymphoblast targets derived from wild-type and MHC-congenic rats of the RT1lv1 and RT1l haplotypes, but not of the RT1c, RT1u, RT1av1, or RT1n haplotypes. These studies demonstrate that Ly-49D can specifically mediate cytotoxicity against xenogeneic cells, and they suggest that Ly-49D may recognize xenogeneic MHC-encoded ligands.

Genes in two major histocompatibility complex class I regions control selection, phenotype, and function of a rat Ly-49 natural killer cell subset.

We have generated a monoclonal antibody (STOK2) which reacts with an inhibitory MHC receptor on a subset of alloreactive NK cells in the rat. This receptor, termed the STOK2 antigen (Ag), belongs to the Ly-49 family of lectin-like molecules and displays specificity for the classical MHC class I molecule RT1-A1c of PVG rats. Here, we have investigated the influence of the MHC on the selection, phenotype and function of the STOK2+ NK subset in a panel of MHC congenic and intra-MHC recombinant strains. STOK2 receptor density was influenced by the presence of its classical MHC I ligand RT1-A1c, as evidenced by a reduction of STOK2 Ag on the surface of NK cells from RT1-A1c+, as compared with RT1-A1c-, strains. In addition, a role for nonclassical MHC I RT1-C/E/M alleles in the selection of the STOK2 Ag was demonstrated. The relative number of STOK2+ NK cells was fivefold higher in rats expressing the RT1-C/E/M(av1) as compared with those expressing the RT1-C/E/M(u) class Ib haplotype. The STOK2 ligand RT1-A1c inhibited cytotoxicity of STOK2+ NK cells regardless of effector cell MHC haplotype. Allospecificity of STOK2+ NK cells varied markedly with effector cell MHC, however, and suggested that inhibitory MHC I receptors apart from STOK2 were variably co-expressed by these cells. These data provide evidence for the MHC-dependent regulation of the allospecific repertoire within a subset of potentially autoreactive Ly-49+ rat NK cells.

Recruitment of pleckstrin and phosphoinositide 3-kinase gamma into the cell membranes, and their association with G beta gamma after activation of NK cells with chemokines.

The role of phosphoinositide 3 kinases (PI 3-K) in chemokine-induced NK cell chemotaxis was investigated. Pretreatment of NK cells with wortmannin inhibits the in vitro chemotaxis of NK cells induced by lymphotactin, monocyte-chemoattractant protein-1, RANTES, IFN-inducible protein-10, or stromal-derived factor-1 alpha. Introduction of inhibitory Abs to PI 3-K gamma but not to PI 3-K alpha into streptolysin O-permeabilized NK cells also inhibits chemokine-induced NK cell chemotaxis. Biochemical analysis showed that within 2-3 min of activating NK cells, pleckstrin is recruited into NK cell membranes, whereas PI 3-K gamma associates with these membranes 5 min after stimulation with RANTES. Recruited PI 3-K gamma generates phosphatidylinositol 3,4,5 trisphosphate, an activity that is inhibited upon pretreatment of NK cells with wortmannin. Further analysis showed that a ternary complex containing the beta gamma dimer of G protein, pleckstrin, and PI 3-K gamma is formed in NK cell membranes after activation with RANTES. The recruitment of pleckstrin and PI 3-K gamma into NK cell membranes is only partially inhibited by pertussis toxin, suggesting that the majority of these molecules form a complex with pertussis toxin-insensitive G proteins. Our results may have application for the migration of NK cells toward the sites of inflammation.

RT1-U: identification of a novel, active, class Ib alloantigen of the rat MHC.

In common with other mammalian species, the laboratory rat (Rattus norvegicus) expresses MHC class I molecules that have been categorized as either classical (class Ia) or nonclassical (class Ib). This distinction separates the class Ia molecules that play a conventional role in peptide Ag presentation to CD8 T cells from the others, whose function is unconventional or undefined. The class Ia molecules are encoded by the RT1-A region of the rat MHC, while the RT1-C/E/M region encodes up to 60 other class I genes or gene fragments, a number of which are known to be expressed (or to be expressible). Here we report upon novel MHC class Ib genes of the rat that we have expression cloned using new monoclonal alloantibodies and which we term RT1-U. The products detected by these Abs were readily identifiable by two-dimensional analysis of immunoprecipitates and were shown to be distinct from the class Ia products. Cellular studies of these molecules indicate that they function efficiently as targets for cytotoxic killing by appropriately raised polyclonal alloreactive CTL populations. The sequences of these class Ib genes group together in phylogenetic analysis, suggesting a unique locus or family. The combined serological, CTL, and sequence data all indicate that these products are genetically polymorphic.