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HLA-Restricted, Processing- and Metabolism-Independent Pathway of Drug Recognition by Human Alpha Beta T Lymphocytes

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HLA-Restricted, Processing- and Metabolism-Independent Pathway of Drug Recognition by Human Alpha Beta T Lymphocytes HLA-restricted, processing- and metabolism-independent pathway of drug recognition by human alpha beta T lymphocytes. M P Zanni, … , S Valitutti, W J Pichler J Clin Invest. 1998;102(8):1591-1598. https://doi.org/10.1172/JCI3544. Research Article T cell recognition of drugs is explained by the hapten-carrier model, implying covalent binding of chemically reactive drugs to carrier proteins. However, most drugs are nonreactive and their recognition by T cells is unclear. We generated T cell clones from allergic individuals specific to sulfamethoxazole, lidocaine (nonreactive drugs), and cef-triaxone (per se reactive beta-lactam antibiotic) and compared the increase of intracellular free calcium concentration ([Ca2+]i) and the kinetics of T cell receptor (TCR) downregulation of these clones by drug-specific stimulations. All drugs tested induced an MHC-restricted, dose- and antigen-presenting cell (APC)-dependent TCR downregulation on specific CD4(+) and CD8(+) T cell clones. Chemically nonreactive drugs elicited an immediate and sustained [Ca2+]i increase and a rapid TCR downregulation, but only when these drugs were added in solution to APC and clone. In contrast, the chemically reactive hapten ceftriaxone added in solution needed > 6 h to induce TCR downregulation. When APC were preincubated with ceftriaxone, a rapid downregulation of the TCR and cytokine secretion was observed, suggesting a stable presentation of a covalently modified peptide. Our data demonstrate two distinct pathways of drug presentation to activated specific T cells. The per se reactive ceftriaxone is presented after covalent binding to carrier peptides. Nonreactive drugs can be recognized by specific alphabeta+ T cells via a nonconventional presentation pathway based on a labile binding […] Find the latest version: https://jci.me/3544/pdf HLA-restricted, Processing- and Metabolism-independent Pathway of Drug Recognition by Human ab T Lymphocytes Martin P. Zanni, Salome von Greyerz, Benno Schnyder, Karl A. Brander, Karin Frutig, Yvonne Hari, Salvatore Valitutti,* and Werner J. Pichler Institute of Immunology and Allergology, Inselspital, Bern, Switzerland; and *Institute of Biochemistry, University of Lausanne, Epalinges, Switzerland Abstract 3). These are presented to ab1 T cells by CD1 molecules which display a specificity for hydrophobic antigens (4, 5). A T cell recognition of drugs is explained by the hapten-car- second class of nonpeptide antigens includes phosphorylated rier model, implying covalent binding of chemically reactive molecules such as isopentenyl pyrophosphate and phosphory- drugs to carrier proteins. However, most drugs are nonre- lated sugars (6, 7). Their presentation to gd1 T cells is indepen- active and their recognition by T cells is unclear. We gen- dent from uptake and processing and does not require MHC erated T cell clones from allergic individuals specific to sul- or CD1 molecules (8). A third group of nonpeptide antigens famethoxazole, lidocaine (nonreactive drugs), and cef-triaxone comprise metals, which are recognized by ab1 T cells without (per se reactive b-lactam antibiotic) and compared the in- need of prior uptake and processing (9, 10). Recently, Corinti 21 crease of intracellular free calcium concentration ([Ca ]i) et al. described a distinctive pollen antigen, most likely a car- and the kinetics of T cell receptor (TCR) downregulation of bohydrate, which does not require MHC or CD1 presentation these clones by drug-specific stimulations. All drugs tested and is recognized by CD81 ab1 T cells exclusively (11). induced an MHC-restricted, dose- and antigen-presenting An additional group of nonpeptide antigens is represented cell (APC)-dependent TCR downregulation on specific by drugs, such as penicillins, sulfonamides, or local anesthetics, CD41 and CD81 T cell clones. Chemically nonreactive that are often responsible for allergic reactions. As far as ana- 21 1 drugs elicited an immediate and sustained [Ca ]i increase lyzed, most drug-specific T cell clones (TCC) obtained from and a rapid TCR downregulation, but only when these allergic individuals are MHC-restricted CD41 or CD81, ab1 T drugs were added in solution to APC and clone. In contrast, cells, although two gd1 lidocaine-specific clones were de- the chemically reactive hapten ceftriaxone added in solu- scribed as well (12–16). In contrast to the above-mentioned tion needed . 6 h to induce TCR downregulation. When nonpeptide antigens, they trigger ab1 T cells in an MHC- APC were preincubated with ceftriaxone, a rapid downreg- restricted way. Previously it was postulated that the immuno- ulation of the TCR and cytokine secretion was observed, genicity of drugs is due to their hapten feature. b-lactam anti- suggesting a stable presentation of a covalently modified biotics such as penicillins or cephalosporins represent per se peptide. Our data demonstrate two distinct pathways of reactive drugs; their core structure, the b-lactam ring, opens drug presentation to activated specific T cells. The per se re- spontaneously under physiological conditions. The formed active ceftriaxone is presented after covalent binding to car- penicilloyl can covalently bind to lysine residues of proteins rier peptides. Nonreactive drugs can be recognized by spe- (17, 18). Modification of soluble (i.e., penicilloyl-modified hu- cific ab1 T cells via a nonconventional presentation man serum albumin) or membrane-bound proteins leads to pathway based on a labile binding of the drug to MHC–pep- presentation of b-lactam–modified peptides to T cells (pro- tide complexes. (J. Clin. Invest. 1998. 102:1591–1598.) Key cessing-dependent pathway) (14, 15). Alternatively, b-lactams words: drug hypersensitivity • T cell receptor downregula- appear to be able to bind directly to immunogenic peptides tion • ab1 T lymphocytes • nonpeptide T cell antigens • within MHC molecules (processing-independent pathway) drug presentation (14, 15). However, most drugs are not chemically reactive per se. It Introduction was postulated that they gain chemical reactivity upon drug metabolism (19). However, we showed recently that fixed anti- Nonpeptide antigens comprise a heterogeneous group of mol- gen-presenting cells (APC) were still capable of presenting ecules which are able to stimulate ab1 and gd1 T cells (1). A nonreactive drugs like sulfamethoxazole (SMX) or lidocaine first category of nonpeptide antigens is represented by lipids or to drug-specific TCC. Strikingly, APC pretreated with drugs glycolipids such as mycolic acids and lipoarabinomannan (2, and washed were not stimulatory, suggesting a rather labile drug interaction with the MHC–peptide complex (20). This in- dicates that nonreactive drugs can be presented in a process- ing-independent and probably noncovalent way to activated T Address correspondence to Werner J. Pichler, Institute of Immunol- cells (20). ogy and Allergology, Inselspital, 3010 Bern, Switzerland. Phone: 41- To better define this new mechanism of drug presentation 31-632-22-64; FAX: 41-31-381-57-35; E-mail: [email protected] to specific T cells, we measured early parameters of T cell re- Received for publication 27 March 1998 and accepted in revised form 13 August 1998. J. Clin. Invest. 1. Abbreviations used in this paper: APC, antigen-presenting cell; 21 © The American Society for Clinical Investigation, Inc. B-LCL, B lymphoblastoid cell lines; [Ca ]i, intracellular free calcium 0021-9738/98/10/1591/08 $2.00 concentration; CM, culture media; SEB, staphylococcus enterotoxin Volume 102, Number 8, October 1998, 1591–1598 B; SMX, sulfamethoxazole; TCC, T cell clone; TCR, T cell receptor; http://www.jci.org TT, tetanus toxoid. Distinct Pathways of Drug Presentation to Specific T Lymphocytes 1591 ceptor (TCR) engagement such as TCR downregulation and were gated out using both forward and side scatter and green fluores- 21 intracellular free calcium ([Ca ]i) mobilization in drug-spe- cence. The CD3 fluorescence was analyzed on an EPICS profile II cific TCC (21, 22). We report that, unlike T cell stimulation by flow cytometer in triplicates (Coulter Corp., Hialeah, FL). CD25 up- soluble protein antigens, nonreactive drugs stimulate T cells regulation after 48 h was determined by using an anti-CD25 mAb in- via a rapid and labile binding to MHC molecules, similar to the stead of an anti-CD3 mAb (all mAb were obtained from DAKO Di- agnostics, Zug, Switzerland). The time of incubation, the dose of recognition of peptides, alloantigens, and superantigens. Our antigen, and the number of APC used were altered as described. data support the concept of a distinct pathway of T cell stimu- 100% values corresponds to the mean CD3 fluorescence of clones lation by nonreactive drugs which is independent of processing conjugated with APC without antigen. 21 and metabolism. Flow cytometric determination of (Ca )i. TCC were loaded with 5 mM Indo-1 (Sigma Chemical Co., St. Louis, MO) for 45 min at 378C in 5% FCS, Hepes-buffered RPMI, washed twice with the same me- Methods dium, mixed with B-LCL only, with unpulsed B-LCL and antigen, or with antigen-pulsed B-LCL. The cells were centrifuged at 1,500 rpm Culture media (CM). CM consisted of RPMI 1640 supplemented for 1 min, incubated for 1 min at 378C, resuspended, and analyzed on ® with 10% pooled heat-inactivated human AB serum (Swiss Red a FACS flow cytometer (Becton Dickinson, Mountain View, CA). 21 Cross, Bern, Switzerland), 25 mM Hepes buffer, 2 mM L-glutamine, To detect [Ca ]i in T cell–APC conjugates, only live, Indo-1–loaded, 10 mg/ml streptomycin, and 100 U/ml penicillin. CM1 used to culture and conjugated T cells were included in the analysis. The 405/525 nm TCC was enriched with 20 U/ml recombinant IL-2 (Dr. A. Cerny, In- fluorescence ratio of all the acquired events is reported. selspital, Bern, Switzerland). The medium for culture of EBV-trans- formed B lymphoblastoid cell lines (B-LCL) was RPMI 1640 supple- mented with 10% heat-inactivated FCS (Gibco, Paisley, UK), 25 mM Results Hepes buffer, but no L-glutamine and no antibiotics. B-LCL were generated as described (23).
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