Role of Natural Killer Cell Subsets in Cardiac Allograft Rejection

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Role of Natural Killer Cell Subsets in Cardiac Allograft Rejection American Journal of Transplantation 2006; 6: 505–513 ⃝C 2006 The Authors Blackwell Munksgaard Journal compilation ⃝C 2006 The American Society of Transplantation and the American Society of Transplant Surgeons doi: 10.1111/j.1600-6143.2005.01226.x Role of Natural Killer Cell Subsets in Cardiac Allograft Rejection M. E. McNerneya,†, K.-M. Leeb,†, P. Zhouc,†, Introduction L. Molineroc, M. Mashayekhic, D. Guziora, H. Sattarc, S. Kuppireddia, C.-R. Wanga, Understanding acute allograft rejection is of critical impor- V. Kumara,‡ and M.-L. Alegrec,∗,† tance for achieving successful organ transplant outcomes. In mice, CD4+ T cells are necessary and sufficient for acute + aDepartment of Pathology, The University of Chicago, rejection of cardiac allografts (1–5). Although the CD4 re- Chicago, Illinois, USA sponse is attenuated by disruption of CD28-B7 interaction, bDepartment of Biochemistry and Division of Brain Korea CD28-deficient mice retain the ability to acutely reject car- 21, Program for Biomedical Science, Korea University diac allografts (6–8). This is due to a rejection pathway that, College of Medicine, Seoul, Korea unlike in wild-type recipients, depends on CD4+, CD8+ cDepartment of Medicine, The University of Chicago, T cells (8) and NK1.1+ cells (9). However, the subset and Chicago, Illinois, USA mechanism by which NK1.1+ cells promote rejection re- ∗ Corresponding author: Maria-Luisa Alegre, mains unknown. CD28−/− mice have normal numbers of [email protected] NK and NKT cells. Whereas function of NK cells is normal (10), NKT cells may have impaired cytokine response to To achieve donor-specific immune tolerance to allo- alpha-GalCer (11,12). Thus, either of these NK1.1+ popula- geneic organ transplants, it is imperative to under- tions may contribute to rejection. stand the cell types involved in acute allograft rejec- + tion. In wild-type mice, CD4 T cells are necessary and In this study, we found that NK cells and not NKT cells pro- sufficient for acute rejection of cardiac allografts. How- mote acute rejection of H-2d cardiac grafts in H-2b CD28−/− ever, when T-cell responses are suboptimal, such as in mice. A small subset of NK cells was sufficient to induce mice treated with costimulation-targeting agents or in CD28-deficient mice, and perhaps in transplanted pa- rejection and was regulated by the classical ‘missing-self’ tients taking immunosuppressive drugs, the participa- response characteristic of NK cells. We have previously re- tion of other lymphocytes such as CD8+ T cells and ported that H-2b NK cell rejection of H-2d bone marrow is NK1.1+ cells becomes apparent. We found that host dependent on the H-2Dd-binding activating receptor Ly49D NK but not NKT cells were required for cardiac rejec- (13). Herein, we determined that Ly49D was not required tion. Ly49G2+ NK cells suppressed rejection, whereas a for the NK cell response to H-2d cardiac transplants, sug- subset of NK cells lacking inhibitory Ly49 receptors for gesting that NK cell responses to allogeneic solid organs donor MHC class I molecules was sufficient to promote and bone marrow are markedly different. In addition, we rejection. Notably, rejection was independent of the demonstrate that NK cells promote proliferation and effec- activating receptors Ly49D and NKG2D. Finally, our ex- tor function of alloreactive T cells. periments supported a mechanism by which NK cells promote expansion and effector function of alloreac- tive T cells. Thus, therapies aimed at specific subsets of NK cells may facilitate transplantation tolerance in Materials and Methods settings of impaired T-cell function. Mice Key words: Costimulation, mouse, NK cells, tolerance, C57BL/6 (H-2b), BALB/c (H-2d), C57BL/6 X BALB/c (H-2dxb), RAG-1−/− and transplantation CD28−/− (C57BL/6 background) mice were purchased from Jackson Labo- ratories. CD1−/−/CD28−/− mice (C57BL/6 background) (14) and 2C TCR Tg Received 11 July 2005, revised 31 October 2005 and RAG-1−/− were maintained at the University of Chicago. All experiments accepted for publication 17 November 2005 performed were approved by the University of Chicago Animal Care and Use Committee and according to NIH guidelines. Antibodies Antibodies were injected i.p. Anti-2B4 (20 lL ascitis, days −2 and +3); anti-asialo-GM1 (10 lL ascitis, Wako days −2, +3); anti-Ly49G2 (4D11, 150 lL ascitis, days −2, +1); anti-Ly49C/I (5E6, 100 lL ascitis, days −2, +1); †Equal co-first authors anti-Ly49D (12A8, 200 lg, days −2, +1; or 4E5, 150 lg, days −2, +1); anti- ‡Equal co-senior authors NKG2D (CX5, eBioscience, 133 or 200 lg, days −1, 0, +4) (15). Subset 505 McNerney et al. depletion and NKG2D blockade were always confirmed by PBL FACS anal- ysis. A Ly49G2 (4D11) and Ly49A (YE1/32) mAbs were purified from hy- 6 Untreated Untreated bridomas and fluorescently labeled (University of Chicago). Fluorescent- Anti-2B4 Anti-2B4 labeled mAbs purchased from BD Biosciences were anti-Ly49A (A1), 5 anti-Ly49A/D (12A8), anti-Ly49C/I (5E6), anti-Ly49D (4E5), anti-Ly49I (YLI90), 4 SA-PE, SA-APC and isotype controls. Purified and fluorescently labeled mAbs purchased from eBioscience were anti-NK1.1 (PK136), anti-NKG2D 3 BIO (CX5) and anti-CD3 (145-2C11). Cardiac transplantation 2 The abdominal heterotopic cardiac transplantation protocol was performed as previously described (16). 1 %NK1.1+ CD3- NK cells Flow cytometry 0 Flow cytometry was performed as previously described (17). For analy- Day 3 Day23 sis of heart-infiltrating lymphocytes, cardiac transplants were rinsed in situ Days after treatment with HBSS/heparin, explanted, cut and digested with collagenase IV (Sigma- Aldrich, 400U/mL) and DNase I (MP Biomedicals, 0.01%) in HBSS for 40 min at 37◦C. Mononuclear cells were isolated following density gradient cen- B trifugation over a 44.5% Nycodenz solution, washed and analyzed by FACS. 100 Mixed lymphocyte reaction 80 C57BL/6 NK cells were derived by culture of RAG-1−/− splenocytes as described previously (17). On day 4, NK cells were plated with IL-2 in wells coated with anti-NK1.1 (1 lg/mL) for 2 days, washed extensively and added 60 to MLR cultures. 40 T cells were purified from C57BL/6 lymph nodes by negative selection us- survival % graft ing MACS columns (Miltenyi Biotec). T cells were labeled with CFSE (In- 20 vitrogen, 1 lM, 10 min at 37◦C). c -irradiated (2500 rad) splenocytes (8 × 105/well) were used to stimulate responder T cells (2 × 105/well). NK cells 0 were added at the indicated NK cell:T-cell ratios. 020406080100 IFNc ELISPOTs days post heart transplant ELISPOTs were performed as previously described (16). BALB/c → CD28-/- BALB/c → CD28-/- + anti-asialo-GM1 Statistical analysis BALB/c → CD28-/- + anti-2B4 Differences between mean survival times (MST) were compared using BALB/c → CD28-/-/CD1-/- Kaplan-Meier/log rank test methods. Student’s t-test compared T-cell func- tional readouts. Figure 1: Classical NKT cells are not necessary for cardiac allograft rejection in CD28−/− mice. CD28−/− C57BL/6 mice Results were untreated (n = 7), or treated with anti-asialo-GM1 (n = 4), or anti-2B4 (n = 6) and transplanted with allogeneic BALB/c cardiac Recipient classical NKT cells are not required for grafts. CD1−/−/CD28−/− recipients (n = 6) also received BALB/c + − acute cardiac allograft rejection hearts. (A) The percentage of NK1.1 CD3 NK cells in the periph- −/− It has been reported that NK1.1+ cells are required for eral blood of untreated and anti-2B4-treated CD28 mice was measured on days 3 and 24 after treatment. (B) Allogeneic graft acute cardiac allograft rejection by CD28-deficient mice (9). survival was monitored over time. NK1.1 is expressed on both NK and NKT cells (18–22). To test the role for host NKT cells in acute cardiac allograft rejection we used CD1-deficient mice, which lack classi- Semi-allogeneic cardiac grafts are accepted in cal NKT cells (14). As reported previously using anti-NK1.1 CD28−/− mice (9), depletion of NK and NKT cells using anti-2B4 (23) or NK cells are regulated by MHC class I expression on tar- anti-asialo-GM1 resulted in acceptance of most BALB/c get cells as described in the missing-self hypothesis (24). cardiac grafts by CD28−/− recipients (Figure 1). In con- As such, allogeneic bone marrow transplants are elimi- trast, CD1−/−CD28−/− mice acutely rejected heart trans- nated by NK cells, but semi-identical F1 bone marrow is plants similar to CD28−/− recipients. Therefore, recipient not rejected because of self-MHC coexpression (22). To NKT cells are not required for acute cardiac allograft rejec- confirm a role for NK cells in cardiac allograft rejection, tion in CD28−/− mice. Anti-2B4 treatment did not deplete we transplanted C57BL/6 CD28−/− mice with F1 semi- T cells, as T cells constituted 41 ± 3% of PBLs in control identical hearts. In agreement with a previous report (9), mice and 43 ± 9% in anti-2B4-treated mice. F1 cardiac transplants were accepted by CD28−/− mice but 506 American Journal of Transplantation 2006; 6: 505–513 NK Cells Promote Alloresponses frequency of NK cells within syngeneic transplants hin- 100 dered conclusive assessment of Ly49 receptor expression (Figure 3C). In allogeneic hearts, a higher proportion of NK 80 cells were Ly49D+ on day 6 post-allogeneic transplanta- tion when compared with splenic NK cells (Figure 3C). In 60 contrast, NK cells expressing inhibitory receptors for H- 2Dd were underrepresented in cardiac allografts with fewer 40 than 6% of NK cells expressing Ly49G2, compared to 30% % graft survival in the spleen. Ly49C/I/A were also expressed on a lower 20 fraction of allograft infiltrating NK cells than in the spleen, although differences were less dramatic.
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