Induction of specific antibody responses in the human nasopharyngeal mucosa.
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Biomedical subjects
Publications and source records attributed to C Czerkinsky.
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We have developed a simple approach for immunophenotyping of functional lymphoid cell subpopulations. Using this approach we have partly characterized circulating antigen-specific ASC after systemic versus mucosal immunization with respect to maturational and activation stages, and to their anatomic commitment(s). Comparative analyses of mucosally versus systemically activated circulating ASC reveal differences with respect not only to utilization of homing receptor molecules but also to certain activation markers, and especially cell surface MHC class II molecules. We have now extended these studies to several other markers including early and late B-cell maturation markers, and we are currently examining whether differential expression of HLA-DQ molecules on the majority of mucosally activated blood ASC may explain the relative inability of these cells to present soluble antigens to class II-restricted T-cells.
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The rectal and genital tract mucosae are considered to be major sites of entry for the human immunodeficiency virus (HIV) during sexual contact. We now demonstrate that vaginal epithelial cells can be infected by HIV type 1 (HIV-1) via a mechanism similar to that described for neuroglial cells and, more recently, for colorectal epithelial cells, involving initial interaction of the HIV-1 envelope glycoprotein gp120 with a cell-surface glycosphingolipid (sulfated lactosylceramide). A hyperimmune serum against gp120 was able to neutralize HIV-1 infection of vaginal epithelial cells. Site-directed immunization was employed to identify sites on gp120 recognized by antibodies neutralizing HIV-1 infection of vaginal and colonic epithelial cells. Hyperimmune sera were raised in monkeys against a series of 40 overlapping synthetic peptides covering the entire sequence of HIV-1 (HTLV-IIIB) gp120. Antisera raised against five synthetic peptides, corresponding to three relatively conserved regions and to the hypervariable region (V3 loop), efficiently neutralized HIV-1 infection of human vaginal epithelial cells in vitro. Similar results were obtained with the colonic cells. Hyperimmune sera to all five peptides have been shown earlier to neutralize HIV-1 infectivity in CD4+ T cells. These results have obvious implications for the design of mucosal subunit vaccines against sexually transmitted HIV-1 infections.
Oral administration of antigens, including allergens and autoantigens, may be an efficient way to prevent diseases associated with untoward immune responses to self- and non-self-antigens. However, this approach has met with limitations because it usually requires repeated administrations of large doses of antigen and is less efficient in an already immune host, and the effect is of short duration. We report that a single oral administration of minute amounts of particulate or soluble antigen coupled to the B subunit of cholera toxin (CTB) can markedly suppress systemic immune responses in naive and in systemically immune animals. Both early (2-4 hr) and late (24-48 hr) delayed type-hypersensitivity reactivities were strongly suppressed after feeding a single dose of CTB-conjugated antigen. Serum antibody responses were also decreased, although moderately, after oral administration of CTB-conjugated antigen. This strategy of tolerance induction, based on oral administration of small amounts of antigens conjugated to a mucosa-binding molecule, may find broad applications for preventing or abrogating untoward immune responses.
In search for a possible explanation for the different susceptibility to mucosal infections in IgA-deficient (IgAd) individuals, the frequency of total immunoglobulin-secreting cells (ISC) and vaccine-specific antibody-secreting cells (ASC) in intestinal mucosa and peripheral blood was determined by the enzyme-linked immunospot (ELISPOT) assay before and after peroral vaccination with a B subunit-whole cell cholera vaccine. Two groups of IgAd individuals, frequently infected and non-infected respectively, and normal controls were studied. Before cholera vaccination there were significantly higher frequencies of total IgM and IgG ISC in the gut, but not in the blood, in the IgAd individuals than in the controls. However, there were no significant differences between healthy and infection-prone IgAd individuals in this respect. In response to oral cholera vaccination, intestinal cholera toxin (CT)-specific IgG and IgM ASC were significantly more abundant among the IgAd individuals with a history of frequent infections than among the healthy IgAd individuals and controls. A similar difference in IgG and IgM ASC, although not significant, was also noted in blood. In IgAd individuals with frequent infections the vaccine induced variable anti-CT IgM ASC responses in the gut, ranging from no increase to a few strikingly high responses. In the controls, the CT-specific responses were dominated by IgA ASC. The data show that oral cholera vaccination evoked strong CT-specific IgG ASC responses, and in some cases also strong IgM ASC responses in the intestinal mucosa of IgAd patients with a history of frequent infections. The healthy IgAd individuals unexpectedly responded with lower numbers of CT-specific IgG ASC and did not show any increase of CT-specific IgM ASC in the intestinal mucosa. Thus, inability to mount a mucosal immune response to an oral antigen cannot in itself explain recurrent infections among many IgAd individuals.
We have examined whether oral immunization of adult Swedish volunteers with a prototype enterotoxigenic Escherichia coli vaccine would induce antigen-specific T-cell responses in blood. Volunteers were given one to three doses of the whole-cell component of the vaccine, which consisted of formalin-inactivated bacteria expressing the fimbrial colonization factor antigens I and II. Following immunization, in vitro stimulation of blood mononuclear cells with the colonization factor antigens resulted in modest proliferative responses which were accounted for mainly by CD4+ T cells and, to a lesser extent, by CD8+ T cells. A main finding of this study was that a majority of the orally immunized volunteers had circulating T cells capable of producing large quantities of gamma interferon following in vitro exposure to either of the colonization factor antigens. No interleukin 2 production could be detected in the cell cultures. These results suggest that oral immunization of humans induces the migration of specific mucosal T immunocytes from the intestine into peripheral blood.
Although the immune system is remarkably diverse, there is evidence that certain types of immune responses take place and are restricted to certain anatomic locations within the body. The concept of a common mucosal immune system that provides immune reactivity not only at the site of antigen deposition but also at remote mucosal sites may be explained by the utilization of organ-specific recognition molecules by circulating precursors of mucosal immunoblasts and by the production of certain maturation factors (e.g. cytokines, hormones) produced preferentially in certain organs or parts of a given organ. This notion may explain the unification of immune responses in diverse mucosal sites and the physiologic segregation of mucosal from systemic immune mechanisms. Novel methods have been developed to enable studies of antigen specific B and T cell responses in various mucosal and extramucosal tissues in primates and rodents, using cholera toxin or its B subunit as prototype immunogens and mucosal carrier-delivery systems. The tissue localization and isotype commitment of antibody-secreting cells (ASC) and the homing potential of their circulating precursors have also been examined after oral, nasal, intra-tonsillar, rectal and/or genital immunization(s). The anatomical distribution of T- and accessory cell-derived cytokines has also been examined. These tools and approaches are being employed in studies attempting to induce optimal mucosal immune responses to several mucosal pathogens including HIV-1, in certain organs such as the lower gastrointestinal tract and the female urogenital tract.(ABSTRACT TRUNCATED AT 250 WORDS)
The concept of a common mucosal immune system, through which specific antigen-activated lymphocytes from the gut can disseminate immunity both along the intestinal tract and to various other mucosal and glandular tissues, has generated much current interest in the possibility of developing oral vaccines, not only for enteric infections but also for infections in the respiratory and urogenital tracts. However, to date it has proven difficult in practice to stimulate strong mucosal IgA immune responses by either parenteral or oral-mucosal administration of most antigens, and experience with soluble protein antigens has, on the whole, been disappointing. A notable exception in this regard is cholera toxin (CT) and in humans more than in other species, its nontoxic B subunit pentamer moiety (CTB). Based on this, CTB has become an important component in recently developed oral vaccines against cholera as well as against diarrhea caused by enterotoxigenic Escherichia coli producing CT-like heat-labile enterotoxin(s). Since the strong immunogenicity of CT and CTB can, to a large extent, be explained by their ability to bind to receptors on the intestinal mucosal surface, there has recently been much interest in approaches using CTB as an oral delivery carrier system for other vaccine-relevant antigens, and much progress has been made in preparing immunogenic hybrid proteins by coupling various protein or peptide antigens chemically or genetically to CTB. Indeed, in several systems, oral administration of such hybrid antigens has been found to markedly potentiate both intestinal and extraintestinal IgA immune responses against the CTB-coupled antigens and also to elicit substantial circulating antibody responses. Besides the mucosal immunopotentiating effect of either CT or CTB owing to their similar capacity as oral antigen-delivery vehicles, CT, but in most systems tested not CTB, also has strong adjuvant properties for stimulating mucosal IgA immune responses to admixed (not coupled) unrelated antigens after oral immunization. This adjuvant activity appears to be closely linked to the ADP-ribosylating action of CT (and specifically of its A subunit) leading to enhanced cyclic AMP formation in the affected cell, and efforts to eliminate the enterotoxic activity without losing adjuvanticity have so far not met with success.
Cholera toxin (CT) and the analogous heat-labile enterotoxin (LT) from Escherichia coli have several immunomodulating effects which alone or in combination might explain their strong adjuvant action in stimulating mucosal IgA and other immune responses to admixed unrelated antigens after oral immunization. These effects include, depending on animal species and experimental systems, enhanced antigen presentation by a variety of cell types; promotion of isotype differentiation in B cells leading to increased IgA formation; and complex stimulatory as well as inhibitory effects on T-cell proliferation and lymphokine production. This adjuvant activity appears to be closely linked to the ADP-ribosylating action of CT and LT associated with enhanced cyclic AMP formation in the affected cells, and thus it may prove difficult to eliminate the enterotoxic activity without loss of adjuvanticity. However, through a separate mechanism, as an antigen-carrier system providing specific binding to epithelium including the M cells of intestinal Peyer's patches, both CT and its non-toxic binding subunit moiety (CTB) have been shown to markedly enhance the mucosal immune response to various foreign antigens or epitopes covalently linked to these molecules. This gives promise for the future use of CTB or related non-toxic binding derivatives as vehicles to facilitate induction of mucosal immune responses to a broad range of antigens for human vaccination purposes.
Because T-cell responses are critical for defence against viral infections, an ideal vaccine should stimulate these cells. The authors have examined a series of forty overlapping synthetic peptides covering the entire amino acid sequence of the envelope protein gp120 from the human immunodeficiency virus type 1 (HIV-1) HTLV-IIIB isolate, for harbouring putative T-cell recognition sites. The peptide-induced proliferative responses and IL-2 production by blood mononuclear cells were studied from 40 macaques previously immunized with ovalbumin-conjugated HIV-1 peptide(s). These analyses disclosed four major areas of T-cell recognition, including one novel T-cell activating region (located between amino acids 152 and 176) which was also found to harbour a domain recognized by HIV-1 neutralizing antibodies. Recognition of the latter region by CD4+ T cells did not appear to be subject to strong genetic restriction. The results of these studies have obvious implications for the development of synthetic subunit vaccines against the acquired immunodeficiency syndrome (AIDS).
The development of quantitative single-cell immunoassays has provided a novel opportunity to demonstrate the isotype-specific immunoglobulin responses in normal and infected neonates. The reverse enzyme-linked immunospot assay was used to determine the number of immunoglobulin-secreting cells (IgSCs) in peripheral blood. Baseline numbers of IgSCs were established in 69 uninfected term and preterm infants within 5 days of birth; values above the 99th percentile were considered elevated. The IgSCs were also measured in 266 infants with proved or suspected infections or congenital anomalies. A subset of newborn infants was retested weekly. Few IgSCs (mostly IgMSCs) were detected within 5 days of birth in uninfected neonates, but by 1 month 77% had increased numbers of IgSCs, primarily IgASCs. Sixty-three (24%) of 266 study infants had increased IgSCs on initial sampling (predominantly IgMSCs); these included infants as immature as 25 to 27 weeks of gestational age; elevations in IgSCs were most frequent in infants with intrauterine infections. Increased numbers of IgSCs were uncommon in infants with early-onset sepsis in the first 5 days but were frequent by the second week, consistent with acquisition of infection near the time of delivery. We conclude that the presence of elevated numbers of IgSCs soon after birth may be a useful surrogate marker of untreated intrauterine infection. The development of predominantly IgASCs in the first month of life suggests postnatal exposure to common mucosal antigens.
Monocytes, recovered directly from peripheral blood by counter-current centrifugal elutriation (CCE), were shown to provide two regulatory signals for induction of interferon-gamma (IFN-gamma) in natural killer (NK) cells in response to interleukin-2 (IL-2): an upregulating signal and an inhibitory signal. The inhibitory signal was time-dependent, irreversible, and operating on a pretranslational level, as indicated by the inability of enriched NK cells to accumulate IFN-gamma mRNA in the presence of elutriated monocytes. Monocyte-induced inhibition of IFN-gamma production was abrogated by the biogenic amine serotonin, acting via the 5-hydroxytryptamine, or serotonin (5-HT1A), subset of serotonin receptors (5-HTR). Thereby, serotonin effectively promoted IFN-gamma production in the presence of monocytes. We conclude that serotonergic 5-HT1A receptors transduce signals that are required for NK cells to produce IFN-gamma in response to IL-2.
It is now almost axiomatic that vaccines against enteric infections must be able to stimulate the gut lymphoid tissue to be efficacious and that this goal is usually better achieved by administering immunogens orally rather than parenterally. On the basis of the notion of a common mucosal immunologic system that provides immune reactivity not only at the site of antigen deposition but also at remote mucosal sites, there is much interest in developing oral vaccines against infections in the respiratory and urogenital tracts. Recent studies indicate that oral administration of small amounts of protein antigens that are chemically or genetically linked to intestinal binding carrier molecules (such as the B subunit of cholera toxin) can evoke vigorous mucosal and extramucosal immune responses. The apparent compartmentalization of systemic and mucosal immune responses may explain not only why parenteral vaccines are just partly effective in protecting against mucosal pathogens but also why currently employed immunoanalytical methods do not provide accurate information regarding mucosal immune status. Following the developments of oral vaccines against infections due to Vibrio cholerae and enterotoxigenic Escherichia coli, two archetypes of enteropathogens, we have devoted extensive efforts to gaining insight into the humoral and cellular events involved in the development of protective immunity in the human intestinal tract. We have developed preparative and analytical methods for studying vaccine-induced intestinal and extraintestinal immune responses in humans. These include techniques for collecting intestinal fluid and lymphoid cells as well as procedures to quantitate secretory antibodies and lymphokines secreted by activated intestinal immunocytes. These developments should serve the dual purpose of facilitating analyses of human mucosal immune responses in general and assessing the immunogenicity of enteric vaccines in particular.
OBJECTIVE: To examine whether and at what stage mucosal immune responsiveness is impaired during HIV-1 infection. DESIGN: Intestinal and systemic antibody-secreting cell (ASC) responses were examined in eight HIV-1-infected volunteers and 10 seronegative control subjects after oral cholera and parenteral tetanus vaccinations. METHODS: ASC numbers were determined before and after booster vaccinations by the enzyme-linked immunospot (ELISPOT) technique. This technique was performed on cell suspensions obtained from enzymatically dispersed duodenal biopsies and from peripheral blood. RESULTS: Oral cholera vaccination evoked ASC responses in the intestinal mucosa of six out of eight HIV-1-infected volunteers, including patients with advanced disease and very low levels of circulating CD4+ T cells. The intestinal cholera ASC responses in HIV-infected volunteers were comparable to those in uninfected controls with regard to both magnitude and distribution of antibody classes. Most HIV-infected volunteers with only moderately reduced CD4+ T-cell counts also responded with vaccine-specific ASC in the blood, whereas none of the patients with < 200 x 10(6)/l CD4+ T cells per litre blood had detectable circulating ASC. CONCLUSION: These findings indicate that mucosal humoral immune responsiveness to a T-cell dependent antigen is maintained in HIV-infected individuals, despite concomitant systemic humoral hyporesponsiveness.
The frequency of mononuclear cells (MNC) spontaneously secreting interferon-gamma (IFN-gamma) has been examined in freshly isolated cell suspensions from human palatine tonsils. Two-site reverse enzyme-linked immunospot (ELISPOT) analyses, involving short term (20 h) incubation of MNC in the absence of any added exogenous stimulus, revealed that tonsillar MNC suspensions contain exceptionally large numbers of cells secreting IFN-gamma. No significant differences were observed when comparing the frequency of IFN-gamma-producing cells between cell suspensions obtained from hyperplastic and tonsillitis specimens. Cell-sorting experiments disclosed that spontaneous tonsillar IFN-gamma production was essentially contributed by CD4+ T cells, and required the presence of accessory cells and/or soluble factors to be detected. Thus, depletion of plastic adherent cells or monocytes from the tonsillar MNC suspensions resulted in reduced numbers of detectable IFN-gamma-secreting cells. Addition of very small numbers of autologous monocytes restored spontaneous IFN-gamma production in tonsillar MNC cultures depleted of monocytes. Neutralization of endogenous IL-1 beta and IL-2, as well as blocking of the IL-2 receptor, also decreased IFN-gamma production from unfractionated tonsillar cells. Addition of exogenous IL-1 beta restored IFN-gamma production in cultures of tonsillar MNC depleted of plastic adherent cells. Furthermore, IL-1 beta synergized with IL-2 by tonsillar MNC depleted of plastic adherent cells. Furthermore, IL-1 beta synergized with IL-2 by increasing intracellular as well as cell-free levels of IFN-gamma in cultures of unfractionated tonsillar MNC. This study further establishes that the tonsils are highly active immunological organs containing large numbers of T cells spontaneously producing IFN-gamma whose detection is contingent upon the presence of functional accessory cells. It also demonstrates that concomitant production of IL-1 beta and IL-2 occurs in tonsils and is necessary to maintain ongoing synthesis and extracellular accumulation of IFN-gamma in these organs.
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A novel immunoenzyme amplification technique has been evaluated in an ELISPOT assay for the detection of antigen-specific antibody-secreting cells (ASC) in monkeys. In this assay, mononuclear cells containing putative ASC are incubated for a few hours in antigen-coated wells. Following removal of the cells, zones of solid phase bound antibodies secreted by individual ASC are visualized in four consecutive steps. First, a primary biotinylated anti-immunoglobulin (Ig) reagent is added followed by enzyme-labelled avidin. The amplification procedure comprises the addition of biotinylated anti-enzyme antibodies in the third stage, followed by enzyme-conjugated avidin and substrate. When evaluated in a modified ELISPOT assay for the detection of simian B cells secreting antibodies to the envelope glycoprotein gp120 of the human immunodeficiency virus type 1 (HIV-1), this amplification procedure proved to be suitable even when using anti-human Ig antisera as primary antibody reagents. This development should be useful for other ELISPOT assays where species specific anti-Ig reagents are not always available and, most importantly, for enumerating cells producing immunoreactive substances in such minute amounts that they may escape detection by conventional ELISPOT assays. Furthermore, a functional simian HIV-specific ELISPOT assay could prove valuable for assessing the humoral immunogenicity of future candidate vaccines against the acquired immunodeficiency syndrome (AIDS).