Successful treatment of autoimmunity in NZB/NZW F1 mice with monoclonal antibody to L3T4.

Autoimmune NZB/NZW mice were treated with weekly injections of monoclonal antibody (mAb) to L3T4, an antigen expressed on a distinct subpopulation of T cells that respond to class II major histocompatibility antigens. Treatment with anti-L3T4 depleted circulating target cells, reduced autoantibody production, retarded renal disease, and prolonged life relative to control mice treated either with saline or with purified nonimmune rat IgG. These findings establish that autoimmune disease in NZB/NZW mice is regulated by T cells. In contrast to mice treated with nonimmune rat IgG, mice treated with rat anti-L3T4 mAb developed little or no antibody to rat Ig. Thus, the benefits of treatment with anti-L3T4 were achieved while minimizing the risks associated with a host immune response to therapy. This study raises the possibility that treatment with mAb against Leu-3/T4, the human homologue for L3T4 might be effective in the treatment of certain autoimmune diseases in people.

Monocytosis in the BXSB model for systemic lupus erythematosus.

Autoimmunity in BXSB mice is associated with a progressive increase in the number of peripheral blood mononuclear cells (PBMC). This is due to a marked rise in circulating monocytes, identified by: (a) their appearance on light and electron microscopy; (b) their surface antigenic characteristics; (c) their expression of Fc receptors; and (d) their capacity for phagocytosis. Among murine models for systemic lupus erythematosus, only the BXSB strain is characterized by monocytosis, suggesting that cells of monocytic lineage may contribute significantly to the pathogenesis of autoimmune disease in BXSB mice.

Deficient interleukin 2 activity in MRL/Mp and C57BL/6J mice bearing the lpr gene.

Spleen cells from MRL-lpr and B6-lpr mice have a marked defect in the ability to produce interleukin 2 (IL-2) in response to concanavalin A stimulation. This defect precedes the onset of clinical illness, increases with age, and eventually becomes virtually absolute. It is not due to cellular suppression of IL-2 production, nor does it reflect the presence of a soluble inhibitor of IL-2 activity. Failure to restore IL-2 production with macrophage-replacing factors, such as interleukin 1 and phorbol myristic acetate, suggests that IL-2 deficiency reflects a primary T cell defect rather than a macrophage defect. MRL-lpr and B6-lpr spleen cells also have an age-dependent reduction in IL-2 response that apparently results from a deficiency of cell surface receptors for IL-2. Congenic MRL-+/+ and B6-+/+ mice, which lack the lpr gene responsible for accelerated autoimmunity and lymphoproliferation, have normal IL-2 activity. These findings suggest that a defect in IL-2 activity may contribute to impaired immunoregulation in mice bearing the lpr gene. The absence of such a defect in MRL-+/+ and B6-+/+ mice further suggests that a single autosomal recessive gene is responsible for IL-2 deficiency.

Treatment of murine lupus with CTLA4Ig.

The interaction of B7-related molecules on antigen-presenting cells with CD28 or CTLA-4 antigens on T cells provides a second signal for T cell activation. Selection inhibition of the B7-CD28 or B7-CTLA-4 interactions produces antigen-specific T cell unresponsiveness in vitro and suppresses immune function in vivo. To determine whether selective inhibition of the B7-CD28 or B7-CTLA-4 interactions could suppress spontaneous autoimmune disease, a B7-binding protein was generated by genetic fusion of the extracellular domain of murine CTLA-4 to the Fc portion of a mouse immunoglobulin G2a monoclonal antibody (muCTLA4Ig). In lupus-prone NZB/NZW filial generation (F1) mice, treatment with muCTLA4Ig blocked autoantibody production and prolonged life, even when treatment was delayed until the most advanced stage of clinical illness. These findings suggest a possible role for human CTLA4Ig in the treatment of autoimmune diseases in humans.

Interleukin 6 promotes murine lupus in NZB/NZW F1 mice.

To investigate the role of IL-6 in systemic lupus erythematosus (SLE), we selectively inhibited IL-6 in lupus-prone NZB/NZW F1(B/W) mice by chronic administration of a rat mAb to mouse IL-6. Anti-IL-6 alone elicited an anti-rat response that blocked its biologic effects. To circumvent this problem, we rendered B/W mice tolerant to the rat mAb by administration of anti-CD4 concurrent with the first dose of anti-IL-6. Thereafter, the mice received weekly injections of anti-IL-6 alone. There were two control groups: one group received the tolerizing regimen of anti-CD4 along with a control rat IgG1 mAb (GL113) instead of anti-IL-6; the other control group received PBS. Mice that received anti-CD4 were tolerant to the rat mAb for 6 mo. Throughout this period, treatment with anti-IL-6 prevented production of anti-dsDNA, significantly reduced proteinuria, and prolonged life. Mice that received anti-IL-6 without anti-CD4 developed an immune response to the rat mAb and then developed anti-dsDNA antibodies, proteinuria, and mortality comparable with control mice. These findings establish that IL-6 promotes autoimmunity in B/W mice. They further indicate that, although mAb to IL-6 can suppress murine lupus, the development of host immunity to the mAb abrogates its beneficial effects. Finally, this is the first study to demonstrate that a brief course of anti-CD4 can induce tolerance to another therapeutic mAb, in this case an anti-cytokine mAb.

The CD28-B7 costimulatory pathway and its role in autoimmune disease.

The activation of naive CD4+ T cells requires two discrete signals: a signal delivered by the T cell receptor following recognition of antigen and an accessory signal transduced when costimulatory receptors interact with their ligands. Particularly important in the development of an immune response to foreign antigens is the T cell molecule CD28, which delivers a potent costimulus when engaged by ligands, B7-1 and B7-2, on antigen-presenting cells. It is interesting that blockade of B7 molecules, which disrupts interactions with CD28 and prevents delivery of the CD28 costimulus, also alters the immune responses to self antigens and prevents the development of clinical disease in murine models of systemic and organ-specific autoimmunity. Herein we review the roles of CD28 and its B7 ligands in the pathogenesis of autoimmunity, discuss efforts to treat animal models of autoimmunity by modifying the CD28 signal, and consider the mechanisms by which manipulation of the CD28 signal alters the course of experimental autoimmune disease.

T-cell homeostasis: implications in HIV infection .

Evidence is presented that a homeostatic mechanism exists that maintains a normal T-cell count, but is unresponsive to abnormalities in CD4+ T-cell count and CD8+ T-cell count. Specifically, we hypothesize that in all cases of T-cell loss, whether selective or not, both CD4+ T cells and CD8+ T cells will be produced until the absolute T-cell count returns to normal, even if this produces or exacerbates abnormalities in the absolute CD4+ T-cell count and absolute CD8+ T-cell count. This hypothesis implies that the selective loss of CD4+ T cells will induce the production of both CD4+ T cells and CD8+ T cells with the result that T-cell count will return to normal, but a persistent CD8+ T-cell lymphocytosis and CD4+ T-cell lymphopenia will be produced. To test this hypothesis, we monitored T-cell reconstitution in mice selectively depleted of CD4+ T cells through treatment with a CD4-specific monoclonal antibody (mAb). Consistent with our hypothesis, the absolute peripheral blood T-cell count in treated mice returned to that of controls after approximately 4 months. However, the absolute CD8+ cell count became 163% of controls and the absolute CD4+ cell count remained less than 63% of controls. Our hypothesis may have implications regarding the pathogenesis and treatment of human immunodeficiency virus (HIV) infection. In particular, the hypothesis implies that the unresolved CD4+ T-cell lymphopenia seen in the first several years of HIV infection is the "natural" consequence of the interaction of a selective CD4+ T-cell depleting virus and a nonselective T-cell replacing homeostatic mechanism.(ABSTRACT TRUNCATED AT 250 WORDS)

Analysis of the function of L3T4+ T cells by in vivo treatment with monoclonal antibody to L3T4.

We have used MAb to L3T4 to examine the function of L3T4+ T cells in normal and autoimmune mice. Treatment of mice with MAb to L3T4 profoundly depleted L3T4+ cells from the blood, spleen, and lymph nodes, but not the thymus. In BALB/c and C57BL/6 mice, selective depletion of L3T4+ cells blocked both primary and secondary humoral immune responses and inhibited, but did not prevent, cellular immune responses. In lupus-prone B/W and BXSB mice, depletion of L3T4+ cells significantly retarded autoimmune disease. Because the L3T4 antigen in mice is homologous to the CD4 antigen in humans, these findings have implications regarding the function of CD4+ T cells and the prospects for using MAb to CD4 as therapeutic agents.

Rejection of skin grafts and generation of cytotoxic T cells by mice depleted of L3T4+ cells.

In mice, "helper/inducer" T cells can be depleted by treatment with a rat monoclonal antibody to the cell surface antigen, L3T4, which is homologous to the human antigen T4 (CD4). In order to examine the contribution of "helper/inducer" T cells to cellular immunity, C57BL/6 (H-2b) mice were treated weekly with 1 mg i.v. of a monoclonal antibody to L3T4. Three days after the first injection, the mice received skin grafts from BALB/c (H-2d) mice. The mice were then examined for skin graft rejection and for the development of cytotoxic cells. Treatment with anti-L3T4 prolonged skin graft survival from 9 to 18 days. Graft rejection was associated with the development of cellular cytotoxicity against H-2d targets. Cytotoxicity developed despite greater than or equal to 90% depletion of splenic L3T4+ cells. Allospecific cytotoxic T cells could also be generated in vitro from C57BL/6 spleen cells depleted of L3T4+ cells, when these were exposed in a mixed leukocyte culture to irradiated, T-cell-depleted, BALB/c spleen cells. In a mixed leukocyte culture using responder spleen cells from untreated C57BL/6 mice, both proliferation and interleukin 2 production were inhibited in the presence of antibody to L3T4 and, to a lesser extent, by antibody to Lyt-2. Complete inhibition was achieved by the presence of both antibodies. In a mixed leukocyte culture using responder spleen cells from C57BL/6 mice that had been treated with anti-L3T4, both proliferation and interleukin 2 production were inhibited largely by antibody to Lyt-2, although the presence of both anti-Lyt-2 and anti-L3T4 was most inhibitory. These findings indicate that graft rejection and cellular cytotoxicity can be generated in mice depleted of L3T4+ cells by methods that have previously been shown to abrogate humoral immunity. Cellular immunity appears to require few, if any, L3T4+ cells. These findings have implications for the clinical use of antibodies to "helper/inducer" T cells.