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Infection and Immunity, March 2001, p. 1714-1721, Vol. 69, No. 3
0019-9567/01/$04.00+0 DOI: 10.1128/IAI.69.3.1714-1721.2001
Copyright © 2001, American Society for Microbiology. All rights reserved.
Adoptive Transfer of CD4+ T Cells
Specific for Subunit A of Helicobacter pylori Urease Reduces
H. pylori Stomach Colonization in Mice in the Absence of
Interleukin-4 (IL-4)/IL-13 Receptor Signaling
Bernadette
Lucas,
Dirk
Bumann,
Anna
Walduck,
Jan
Koesling,
Leyla
Develioglu,
Thomas F.
Meyer,* and
Toni
Aebischer
Max-Planck-Institute for Infection Biology,
Department of Molecular Biology, Schumannstraße 21/22, 10117 Berlin, Germany
Received 20 September 2000/Returned for modification 6 November
2000/Accepted 18 December 2000
 |
ABSTRACT |
Protection in the murine model of Helicobacter pylori
infection may be mediated by CD4+ T cells, but the
mechanism remains unclear. To better understand how protection occurs
in this model, we generated and characterized H. pylori
urease-specific CD4+ T cells from BALB/c mice immunized
with Salmonella enterica serovar Typhimurium expressing
H. pylori urease (subunits A and B). The CD4+ T
cells were found to be specific for subunit A (UreA). Upon antigen-specific stimulation, expression of interleukin 4 (IL-4), IL-10, gamma interferon (IFN-
), and tumor necrosis factor alpha was
induced. Immunocytochemical analysis showed that the majority of cells
produced IFN-
and IL-10. Adoptive transfer of the UreA-specific CD4+ T cells into naive syngeneic recipients led to a
threefold reduction in the number of bacteria in the recipient group
when compared to that in the nonrecipient group. Stomach colonization
was also reduced significantly after transfer of these cells into
patently infected mice. Adoptive transfer of UreA-specific
CD4+ T cells into IL-4 receptor
chain-deficient BALB/c
mice indicated that IL-4 and IL-13 were not critical in the control of
bacterial load. In addition, synthetic peptides were used to identify
three functional T-cell epitopes present in subunit A which were
recognized by the UreA-specific T cells. Analysis of H. pylori-specific cellular immune responses in recipient challenged
and nonrecipient infected mice indicated a strong local restriction of
the response in infected animals. The implications of these findings
for the mechanism of protection and the development of peptide-based
vaccination are discussed.
 |
INTRODUCTION |
Helicobacter pylori is a
gram-negative spiral bacterium which colonizes the stomach of humans
and is associated with the development of chronic gastritis, peptic
ulcer, gastric adenocarcinoma, and gastric lymphoma (17, 33,
42). Vaccination against H. pylori is a highly
desirable alternative to antibiotic treatment (2). Successful vaccination trials in animal models have been performed using whole-cell sonicate, native or recombinant proteins from Helicobacter, and mucosal adjuvant (6, 8, 9, 13-15,
19, 20, 22, 25). Protection was dependent on major
histocompatibility complex (MHC) class II-restricted, cell-mediated
mechanisms (12, 32). Mohammadi et al. (26)
showed production of interleukin 4 (IL-4) when immunized mice
challenged with Helicobacter felis were treated with an
anti-gamma interferon (IFN-
) monoclonal antibody (MAb). This was not
the case for nonimmunized infected mice, indicating that immunization
did induce a Th2 response. The results of adoptive transfers of
Helicobacter-specific Th2 cell lines generated from
protected mice also suggested that Th2 cell-mediated immune responses
play a protective role in this system (27). In addition,
Saldinger et al. (36) and Ikewaki et al. (18)
reported that repeated therapeutic mucosal immunization with
recombinant urease B (UreB) and cholera toxin or H. pylori whole-cell lysate induced a Th2 response correlating with elimination of H. pylori. Together the data suggest that a type 2 response is correlated with protection, although the effector mechanism remains unclear.
Studies in this laboratory (16) and by
Corthésy-Theulaz et al. (7) demonstrated that
attenuated recombinant Salmonella enterica serovar
Typhimurium expressing urease from H. pylori also induced
high levels of protection in mice against H. pylori infection. Salmonella replicates directly in the Peyer's
patches and disseminates via the mesenteric lymph nodes to systemic
sites (spleen and liver) (21). It induces CD4+
and CD8+ T-cell responses as well as humoral and secretory
antibody responses (40). However, the delivery of foreign
antigen by live recombinant Salmonella preferentially
induces the development of the Th1 subset of CD4+ T cells
(4, 40, 43).
Here we investigated the role of CD4+ T cells induced by
vaccination with live recombinant Salmonella in the murine
model of H. pylori infection. CD4+ T cells
specific for UreA of H. pylori were generated and
characterized. The epitope specificity was determined by screening
against synthetic peptides. The ability of these UreA-specific
CD4+ T cells to reduce bacterial load in mouse stomachs
prior to infection (prophylactic experiment) or after infection with
H. pylori (therapeutic experiment) was assessed by adoptive
transfers. Furthermore, we analyzed the cellular response in recipient
and nonrecipient mice at the local and systemic levels. Finally, we
addressed the question of the potential role of IL-4 and/or IL-13 in
protection by transferring the cells to IL-4R
chain-deficient mice.
 |
MATERIALS AND METHODS |
Animals.
Specific-pathogen-free female BALB/c mice (6 to 8 weeks old) were obtained from the Federal Institute for Health
Protection of Consumers and Veterinary Medicine (Berlin, Germany). Male
and female BALB/c IL-4R
/
mice (31) were
obtained from the Max-Planck-Institut für Immunobiologie (Freiburg, Germany) and were maintained in our animal facility. Mice
were kept under specific-pathogen-free conditions, and the experiments
were conducted according to the German animal protection law.
Bacterial strains.
Serovar Typhimurium SL3261
aroA mutant was used to express UreA and UreB from the
plasmid pYZ97 as described earlier (16). Wild-type
H. pylori P1 strain, urease-negative H. pylori
P11, and mouse-adapted H. pylori P49 and P76 were described
previously (16). H. pylori strains were grown
on GC (gonococci) agar plates (Gibco, Eggenstein, Germany) containing
10% horse serum (serum plates; Gibco) or in brain heart infusion broth
(Difco, Becton Dickinson, Sparks, Md.) containing 10% fetal calf serum
(FCS) (Gibco) supplemented with 400 µg of streptomycin/ml when appropriate.
Immunization of mice and H. pylori infection.
Immunizations were performed as described in reference 16.
For H. pylori infection, a primary broth culture with an
optical density at 590 nm (OD590) of 0.1 was incubated for
24 h at 37°C under microaerophilic conditions with shaking. A
secondary culture was set up under the same conditions. Bacteria were
harvested by centrifugation, washed twice in phosphate-buffered saline
(PBS), and resuspended in PBS to a final OD590 of 4.0/ml.
An aliquot was taken to determine the number of CFU by replating on
serum plates. Mice were infected with 100 µl of the suspension at an OD590 of 4.0/ml (corresponding to 1.0 × 108 to 1.0 × 109 CFU/mouse) by gastric intubation.
Assessment of H. pylori colonization.
Stomachs
were processed as described earlier (16) and were cut into
three tissue fragments. Each fragment then contained cardia, body, and
antrum. One-third was submitted to a rapid urease test (Jatrox test;
Procter and Gamble, Weiterstadt, Germany) (16). One-third
of the stomach was placed in an Eppendorf tube containing brain heart
infusion medium (150 µl), weighed, and vortexed for 1 min to
resuspend H. pylori. Dilutions of the suspension were plated
on serum plates containing streptomycin. The average number of CFU was
expressed as log10 CFU/gram of tissue ± standard deviation.
Preparation of H. pylori antigens.
Soluble
extracts of H. pylori P49 and P11 were prepared in PBS by
sonicating five times with a Sonifier (Branson, Danbury, Conn.) at 5-s
intervals (35% pulses) for 45 s. This suspension was centrifuged
at 10,000 × g for 10 min at 4°C to remove cell debris. The protein content of the supernatant was determined by
Bio-Rad protein assay (Bio-Rad Laboratories, München, Germany). This supernatant was used to coat plates for enzyme-linked
immunosorbent assay (Nunc, Wiesbaden, Germany). Alternatively it was
detoxified by addition of NaOH to a final concentration of 0.25 M and
was incubated at 37°C for 3 h, followed by the addition of HCl in the
presence of phenol red for neutralization (41). The
preparation was diluted in culture medium, sterile filtered, and used
in cell proliferation assays. UreA was purified from the sonicate by
standard sodium dodecyl sulfate-polyacrylamide gel electrophoresis.
After staining with Coomassie brillant blue (Serva; Boehringer,
Ingelheim, Germany) the band corresponding to UreA (at 30 kDa) was cut
and placed in 10 ml of 50 mM Tris-HCl (pH 8.0) for 30 min under
shaking. The buffer was changed until the pH reached 8.0. The gel was
cut into small pieces and was incubated overnight at room temperature with shaking in 6 ml of 50 mM Tris-HCl (pH 8.0) to elute proteins from
the gel. The eluate was then filtered and used in proliferation assays.
UreB from H. pylori was expressed as a recombinant protein
in Escherichia coli and was purified under denaturing
conditions in 8 M urea by affinity chromatography on
Ni2+-nitrilotriacetic acid resin (Qiagen, Hilden, Germany).
Elution was performed with imidazole (200 mM), and the eluate was
dialyzed overnight against L-arginine, glutathione, and 100 mM Tris-HCl (pH 7.8) and was dialyzed twice for 4 h against 10 mM
Tris-HCl and 100 mM NaCl (pH 7.8). The concentrations of soluble
proteins were quantified by Bradford assay.
Peptides from UreA were designed after predicted T-cell epitopes. All
Ia
d-restricted epitopes that are known to activate T cells
compiled
in the MHCPEP database of MHC-binding peptides
(
http://wehih.wehi.edu.au/mhcpep)
(
5) were identified, and
redundant and overlapping epitopes
were disregarded. Seventy-nine
unique epitopes were aligned using
anchor position 1 with a large
hydrophobic residue (I, L, V, F,
Y, W). Amino acid residue frequencies
for positions

3 to 14 were
determined, and the resulting matrix was
used to scan the
H. pylori UreA gene (sequence expressed in
the vaccine strain SL3261[pYZ97])
for potential T-cell epitopes using
an algorithm developed by
Davenport et al. (
10). The 50 epitopes with the highest score
were analyzed for clustering along the
UreA sequence, which could
be indicative of regions containing
promising candidates (
23).
Based on this analysis, 10 17-mers were chosen (i.e., amino acids,
24 to 40, 28 to 44, 32 to 48, 35 to 51, 42 to 58, 74 to 90, 90
to 106, 170 to 186, 180 to 196, 209 to
225) and were
synthesized.
Lymphocyte proliferation.
Single-cell suspensions were
prepared from spleens as described earlier (29),
resuspended in the antibody cocktail (anti-CD45/B220 [RA3-6B2],
anti-CD8 [53.6], anti-CD11b [M1/70]), and incubated for 20 min on
ice. Magnetic goat anti-rat immunoglobulin G (IgG) beads were used to
deplete cells as described in the manufacturer's instructions
(Vario-MACS; Miltenyi Biotec, Bergisch-Gladbach, Germany). The
resulting population contained over 95% CD4+ T cells as
determined by cytofluorimetry. Magnetic cell sorting-enriched CD4+ T cells were resuspended in complete Dulbecco minimal
essential medium (DMEM) (29). The CD4+ cell
suspension was adjusted to 4 × 105 cells/well in
96-well round-bottomed cell culture plates (Nunc) together with 2 × 105 syngeneic irradiated (2,500 rads) spleen cells from
naive mice in a final volume of 200 µl. Gastric lymph nodes were
harvested, and single-cell suspensions were prepared by forcing the
nodes through nylon cell strainers. Cells were centrifuged for 10 min at 80 × g; the pellet was resuspended in buffered salt
solution-FCS (29); and large particles were sedimented.
The supernatant containing the cells was centrifuged at 80 × g for 10 min; the pellet was resuspended in complete DMEM. Cell
suspensions were dispensed at 4 × 105 cells/well in
96-well round-bottomed cell culture plates (Nunc) in a final volume of
200 µl.
H. pylori P49 lysates or
H. pylori P11 lysates
detoxified by NaOH treatment were added at 2.5 µg/ml. UreA was added
at 25
µl/well, and UreA peptides were added at 10, 1, 0.1, and 0.01
µl/ml. Concanavalin A (Con A; Sigma-Aldrich Chemicals, Deisenhofen,
Germany) was used at 2 µg/ml. Cells were incubated at 37°C and
5%
CO
2 for 2 days (Con A) and for 5 days (antigens) and were
pulsed
with 0.5 µCi of [
3H]thymidine (Amersham
Pharmacia Biotech, Freiburg, Germany) for
16 h. Incorporated
radioactivity was measured in a liquid scintillation
counter. Values
are expressed in counts per minute. Supernatants
(100 µl) were taken
for cytokine
measurement.
Derivation of H. pylori urease-specific
CD4+ T cells.
CD4+ T cells isolated from
the spleens of two SL3261[pYZ97]-immunized BALB/c mice 21 weeks after
immunization were restimulated with detoxified H. pylori P49
lysates (2.5 µg/ml) in the presence of irradiated, syngeneic spleen
cells (106 cells/ml) in complete DMEM. Five days later, the
medium was replaced by complete DMEM containing mouse IL-2 at 20 U/ml.
Cells were stimulated every 2 weeks by using the same procedure and
were tested periodically for specificity by measurement of thymidine uptake after antigen stimulation. Similarly, CD4+ T cells
were generated against ovalbumin from ovalbumin-immunized mice and were
used as a control.
Adoptive transfer protocol.
The CD4+ T cells
(4 × 106/mouse) were administered intravenously to
naive mice or mice infected 10 weeks earlier with H. pylori P76. Recipient naive mice were challenged the following day with H. pylori P76 as described above. Mice were sacrificed at
various time points after infection (prophylactic experiment) or
transfer (therapeutic experiment) and were evaluated for H. pylori colonization, cellular proliferation, cytokine production,
and serum antibodies.
Cytokine measurement.
IL-4 and IFN-
levels were
determined by bioassay as described previously (30, 35).
Briefly, WEHI-279 cells were used as indicator cells for the presence
of IFN-
. CT4-S cells were used to determine IL-4 levels. Serial
dilutions of culture supernatants taken between 48 and 72 h after
stimulation were performed, and 2 × 105 WEHI-279
cells/ml or 1.6 × 105 CT4-S indicator cells/ml were
added to each well. Plates were incubated for 72 h (WEHI-279
cells) or 24 h (CT4-S cells) at 37°C in a CO2
incubator, and 10 µl of WST-1 (Boehringer GmbH, Mannheim, Germany)
was added per well. Absorbance was measured at 450 nm using a
microtiter plate reader (Titertek Multiskan MCC/340).
Expression of IL-10 and TNF-

mRNA was determined by semiquantitative
reverse transcriptase (RT)-PCR as previously described
(
34). Briefly, total RNA from UreA-specific
CD4
+ T cells stimulated with urease-positive
H. pylori lysate or from
unstimulated control cells was extracted
using a RNeasy Kit (Qiagen)
and was reverse transcribed by SuperScript
II RT (Gibco) using
random hexamer primers (Promega, Mannheim,
Germany). PCR was performed
in the presence of a polycompetitor DNA
construct containing IL-10,
tumor necrosis factor alpha (TNF-

), and
hypoxanthine-guanine
phosphoribosyltransferase (HPRT) gene segments
(
34), generously
provided by Richard Locksley (University
of California at San
Francisco). The cDNA samples were first normalized
on the basis
of the levels of the constitutively expressed HPRT by
using 10-fold
dilutions of the cDNA. Tenfold dilutions of the equalized
cDNA
were then used in the presence of a fixed concentration of the
polycompetitor DNA to determine the relative amounts of IL-10
and
TNF-

mRNA by PCR. The point of equivalence in intensity of
the
competitor and cDNA sample allows comparison of cytokine mRNA
levels
between stimulated and unstimulated cells. Primer sequences
and PCR
conditions were as described by Reiner et al. (
34).
Amplification products were resolved on 2% agarose gels (FCM
Bioproduct,
Rockland, Maine) and were stained with ethidium bromide
(Fluka
Chemicals, Seelze,
Germany).
For detection of intracellular cytokines, resting UreA-specific
CD4
+ T cells were stimulated for 6 h at 37°C on
plate-bound anti-CD3
MAbs (clone 145-2C11) in the presence of brefeldin
A (Sigma) at
12 µg/ml. Cells were fixed for 20 min in 2%
paraformaldehyde-100
mM HEPES (pH 7.0), washed twice in PBS, and
incubated for 20 min
at room temperature in PBS containing 2% FCS and
0.1% saponin
(Fluka Chemicals, Seelze, Germany) (buffer 1). Cells were
incubated
for 20 min with one of the following antibodies: anti-IFN-

(XMG
1.2), anti-IL-4 (11B11), or rat IgG1 isotype control. They were
washed twice in buffer 1 and fluorescein isothiocyanate-labeled
F(ab')
2 goat anti-rat IgG (Biozol, Eching, Germany), which
was
added for 20 min at room temperature. After two washing steps,
labeled cells were analyzed by flow cytometry (FACScan; Becton
Dickinson) using Cell Quest software. Immunocytochemical detection
of
intracellular cytokines was performed according to the standard
protocol as recommended by Pharmingen. Resting UreA-specific
CD4
+ T cells were stimulated overnight with anti-CD3 MAb.
Eight-well
microscope slides were coated with poly-
L-lysine
and washed in
PBS, and cells were added for 10 to 20 min before
fixation with
2% paraformaldehyde-100 mM HEPES (pH 7.0).
Permeabilization of
cells was performed with 0.1% saponin in PBS
containing 0.5% bovine
serum albumin. Anti-IL-10 MAb (JES5-16E3),
anti-IL-4 MAb (11B11)
or anti-IFN-

MAb (clone XMG 1.2) was added for
30 min, and washed
and biotinylated anti-rat IgG antibodies in 2%
rabbit serum were
added for 10 min. After washing, slides were
incubated with avidin-biotin
complex (Vector Laboratories, Burlingame,
Calif.) for 30 min and
were washed again. Labeling was developed with
diaminobenzidine
tetrahydrochloride.
Serum antibodies.
Serum antibody titers specific for urease
were determined by enzyme-linked immunosorbent assay as previously
described (16). Microtiter plates were coated with a
soluble extract of H. pylori P49 (urease positive) (50 µg/ml) or H. pylori P11 (urease negative) (50 µg/ml).
Bound specific antibodies were detected with goat anti-mouse IgG2a or
goat anti-mouse IgG1 conjugated to horseradish peroxidase, used at a
dilution of 1/5,000 (Nordic Immunological Laboratories, Tilburg, The Netherlands).
Statistics.
The statistical significance of results was
determined using the GraphPad Prism program (version 3.0; GraphPad
Software, San Diego, Calif.). An unpaired one-tailed t test
and an unpaired two-tailed t test were used to determine the
P values.
 |
RESULTS |
Characterization of the CD4+ T cells generated against
UreA from H. pylori.
CD4+ T cells were
derived from spleen cells of mice vaccinated with Salmonella
expressing urease (subunits A and B) from H. pylori. By flow
cytometry analysis, the cells were CD3+ CD4+
(>98%) (data not shown). Proliferation assays were performed to
determine antigen specificity. As shown in Fig.
1A, almost no proliferation was observed
when cells were stimulated by the urease-negative H. pylori
P11 lysate. A significant response was obtained with urease-positive
H. pylori P49 lysate and with purified UreA. No
proliferation was obtained with recombinant UreB. To confirm that the
response was specific for UreA, we also investigated whether the T
cells recognized peptides of UreA predicted to contain T-helper cell
epitopes. Different concentrations of peptides were used to stimulate
the T cells, and IFN-
production was measured in culture
supernatants. Peptides corresponding to amino acids 28 to 44, 32 to 48, 35 to 51, 74 to 90, and 209 to 225 induced IFN-
production (Fig.
1B). These data indicated that the CD4+ T cells were
specific for UreA from H. pylori and defined at least three
independent epitopes in H-2d recognized by corresponding T
cells.

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FIG. 1.
The CD4+ T cells isolated from the spleens
of vaccinated mice are specific for subunit A of urease from H. pylori. (A) Cells were restimulated with a lysate from H. pylori containing (+) or not containing ( ) urease (2.5 µg/ml),
with purified UreA (25 µl/ml), or with recombinant UreB (rUreB).
Values represent the average of three wells ± standard error of the
mean. Statistically significant differences were calculated in
comparison with unstimulated cells (P < 0.01, two-tailed
t test) (*). (B) Cells were restimulated with 10 synthetic
UreA peptides at various concentrations (10 to 0.01 µg/ml) or with
urease-positive H. pylori lysate (5 to 0.005 µg/ml).
IFN- was measured in culture supernatant as an indication of T-cell
activation. The horizontal line represents the mean concentration of
IFN- detected in supernatants of unstimulated cells plus 3 standard
deviations. The detection limit of the assay was 0.03 U/ml.
|
|
To further characterize the cells, cytokine secretion was analyzed.
IFN-

(72.5 to 98.5 U/ml) and IL-4 (27.7 to 158 U/ml)
were detected
in culture supernatants taken after restimulation
with urease-positive
H. pylori lysate or UreA but not in culture
supernatants of
unstimulated cells. Intracellular staining for
IFN-

and IL-4 showed
that most of the cells (94.2%) produced
IFN-

(Fig.
2, top). Only a slight shift of the
population was
observed when cells were stained with an anti-IL-4 MAb
(Fig.
2,
top). Immunocytochemical detection of IFN-

, IL-10, and IL-4
showed
that most of the cells produced IFN-

and IL-10, whereas IL-4
was detectable in only a minority of cells (data not shown). Analysis
of IL-10 mRNA expression by RT-PCR confirmed that stimulation
of
cells by urease-positive
H. pylori lysate induces IL-10
production.
Expression of IL-10 was increased 100 times when compared
to that
in unstimulated cells (Fig.
2, bottom). Stimulated cells were
also found to contain 10 times more TNF-

transcript than did
nonstimulated cells (Fig.
2, bottom).

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FIG. 2.
UreA-specific CD4+ T cells produce mainly
IFN- and IL-10 and lower amounts of IL-4 and TNF- .
Fluorescence-activated cell sorter analysis (top) of intracellular
staining for IFN- and IL-4 of cells after restimulation with
plate-bound anti-CD3 MAb was carried out, as was detection of IL-10,
TNF- , and HPRT transcripts (bottom) by RT-PCR in RNA isolated from
cells restimulated with H. pylori lysate containing urease
or in control unstimulated cells. PCR products were separated on 2%
agarose gels and were visualized after ethidium bromide staining. Upper
bands correspond to products obtained for the competitor construct;
lower bands correspond to products obtained for the cDNA isolated from
stimulated cells. Expression of IL-10 was also confirmed by
immunocytochemistry (data not shown).
|
|
In conclusion, we generated CD3
+ CD4
+ T cells
which were specific for the subunit A of urease and produced mainly
IFN-

and
IL-10 in
vitro.
Adoptive transfer of UreA-specific CD4+ T cells into
naive mice reduces gastric colonization by H. pylori.
In order to investigate whether the UreA-specific CD4+ T
cells were able to induce protection against gastric colonization by
H. pylori P76, adoptive transfers were performed into naive mice (prophylactic experiment, 4 × 106 cells/mouse).
Control mice received CD4+ T cells generated against
ovalbumin. A group of mice immunized with Salmonella
expressing UreA and UreB was included in the experiment for comparison.
All recipients were challenged with H. pylori P76 the day
following the transfer. Vaccinated mice and a group of naive mice were
challenged at the same time.
Mice from each group except the recipients of the ovalbumin T cells
were sacrificed on days 7, 21, and 42 after infection.
Mice which
received ovalbumin-specific T cells were sacrificed
on day
42.
The number of
H. pylori CFU recovered from stomachs of mice
receiving UreA-specific CD4
+ T cells was reduced by a
factor of 3 to 4 (
P < 0.05, one- and
two-tailed
t tests) for all time points tested when compared to
the
number of CFU recovered from infected mice (Table
1). The
reduction was observed as early
as 7 days after infection (4.68
± 0.26 CFU/g for mice which
received UreA-specific T cells; 5.28
± 0.27 CFU/g for infected
mice [Table
1]) and persisted through
at least day 42 after infection
(5.00 ± 0.81 CFU/g for recipient
mice; 5.50 ± 0.59 CFU/g
for infected mice [Table
1]). Mice which
received the
ovalbumin-specific CD4
+ T cells did not display any
decrease in the number of CFU (Table
1). As expected, mice vaccinated
with
Salmonella expressing urease
(subunits A and B) from
H. pylori showed a strong reduction in
the colonization of
the stomach (to less than 10% of infected
mice) for all time points
(Table
1) (
16).
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TABLE 1.
Adoptive transfer of UreA-specific CD4+ T
cells to naive mice reduces gastric colonization by H. pylori as early as 7 days after infection
|
|
Adoptive transfer of UreA-specific CD4+ T cells is
therapeutically effective.
Mice which were infected for 10 weeks
with H. pylori P76 were treated by intravenous injection of
4 × 106 UreA-specific CD4+ T cells.
Recipient mice and nonrecipient mice were sacrificed 1, 7, and 14 weeks
after transfer. Figure 3 shows that the
gastric colonization in mice receiving UreA-specific CD4+ T
cells was reduced in a time-dependent manner. One week after transfer,
no differences in the numbers of CFU were observed between recipient
and nonrecipient mice (Fig. 3A). On weeks 7 and 14 after transfer,
however, the level of colonization in recipient mice was significantly
reduced (P < 0.05, one-tailed t test), by
factors of 3 and 3.8, respectively, when compared to the level in
nonrecipient groups (Fig. 3A). This was also reflected in the levels of
the urease activity measured (Fig. 3B).

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FIG. 3.
Adoptive transfer of UreA-specific CD4+ T
cells is therapeutically effective. T cells were transferred to
recipients (UreA recipient) 10 weeks postinfection. Levels of
colonization were assessed by quantitative culture (A) and by urease
activity (B) at different time points after transfer. Results are
expressed as the mean of five mice ± standard deviation.
Statistically significant differences were calculated for nonrecipient
and UreA recipient mice for each time point. The numbers of CFU were
significantly different at weeks 7 (P < 0.05,
one-tailed t test; P = 0.06, two-tailed
t test) and 14 (P < 0.05, one-tailed
t test; P = 0.08, two-tailed t
test) posttransfer. Urease activities were significantly different
(P < 0.05, one- and two-tailed t tests) at
week 14.
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|
Only UreA-specific CD4+ T cells are recovered from
spleens of recipient mice early after challenge infection.
CD4+ T cells were isolated from spleens of recipient and
nonrecipient infected mice. Cells were restimulated with
urease-positive H. pylori lysate (2.5 µg/ml), purified
UreA (25 µl/ml), and urease-negative H. pylori lysate (2.5 µg/ml) in the presence of syngeneic stimulator cells. Similarly,
gastric lymph node cells were isolated from recipient and control
infected mice and were restimulated with either urease-positive
H. pylori lysate, purified UreA, or urease-negative H. pylori lysate.
Six weeks postchallenge, proliferation of splenic CD4
+ T
cells in response to urease-positive
H. pylori lysate and
purified
UreA was observed only with cells from recipient mice (Fig.
4,
prophylactic experiment, SP). These
cells did not proliferate
in response to urease-negative
H. pylori lysate, indicating that
the response is solely due to the
transferred cells. This is supported
by the fact that at 6 weeks
postchallenge, CD4
+ T cells isolated from the spleens of
infected mice did not respond
to any of the tested antigens (Fig.
4,
prophylactic experiment,
SP). They proliferated, however, in response
to Con A in a magnitude
similar to that found in recipient mice (data
not shown). CD4
+ T cells isolated from spleens of naive
mice did not respond to
any of the tested antigens (data not shown). In
contrast, cells
isolated from gastric lymph nodes of recipient and
nonrecipient
mice proliferated when stimulated with urease-positive or
urease-negative
H. pylori lysates to a similar degree,
indicating that the response
is specific mostly for
H. pylori antigens other than urease (Fig.
4, prophylactic
experiment, GLN).

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|
FIG. 4.
Only UreA-specific CD4+ T cells are
recovered from spleens of recipient mice early after challenge.
Proliferation of CD4+ T cells isolated from five to seven
spleens (SP) or proliferation of total cells isolated from gastric
lymph nodes (GLN) after prophylactic (6 weeks after infection) and
therapeutic (24 weeks after infection, 14 weeks after prophylactic
transfer) transfer was measured. Values represent the average of three
wells ± standard error of the mean. Data are representative of
three experiments for prophylactic transfer and one experiment for
therapeutic transfer. Statistically significant differences were
calculated on comparison with findings for unstimulated cells
(P < 0.01, two-tailed t test) (*) or for
cells stimulated with lysate urease ( ) (P < 0.05,
two-tailed t test) (**).
|
|
Twenty-four weeks after infection and 14 weeks after therapeutic
transfer of UreA-specific CD4
+ T cells, splenic
CD4
+ T cells isolated from recipient mice proliferated
specifically
to urease-positive
H. pylori lysate and
purified UreA, indicating
a specific response to urease in the spleens
of recipient animals
(Fig.
4, therapeutic experiment, SP). Splenic
CD4
+ T cells from control mice infected for the same 24 weeks proliferated
in response to urease-positive as well as to
urease-negative lysates,
showing that a systemic response to
Helicobacter antigens is developing
in long-term-infected
mice (Fig.
4, therapeutic experiment, SP).
Cells isolated from gastric
lymph nodes of recipient and nonrecipient
mice clearly responded to
urease-positive and -negative
H. pylori lysates, showing no
specific response to urease, as observed for
cells isolated from
animals 6 weeks postinfection (Fig.
4, therapeutic
experiment, GLN;
prophylactic experiment,
GLN).
Urease-specific antibody titers in recipient mice.
The level
of anti-urease IgG2a and IgG1 antibodies in serum was evaluated 6 weeks
after infection of mice receiving or not receiving UreA-specific
CD4+ T cells. Both subclasses IgG2a and IgG1 were induced
to a higher level in recipient mice than in controls (Fig.
5), indicating functional T-cell help by
the transferred T cells. The average increase in antibody titers in
recipient animals from those in nonrecipient animals was 2.3-fold for
IgG2a (P > 0.1, two-tailed t test) but was
4-fold for IgG1 (P < 0.01, two-tailed t
test). The tendency to have higher antibody titers for IgG1 than for IgG2a in recipient mice compared to control infected animals was noted
in all experiments (n = 4).

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|
FIG. 5.
Mice which received UreA-specific CD4+ T
cells mounted IgG2a and IgG1 antibody responses against urease. Sera
were taken 6 weeks after infection. Results are expressed as mean ± standard deviation. Groups contained five to seven mice.
Statistically significant differences (two-tailed t test)
between recipient and nonrecipient mice were calculated for IgG2a
(P > 0.1) and IgG1 (P < 0.01).
|
|
Adoptive transfer of UreA-specific CD4+ T cells into
naive IL-4R
/
mice reduces gastric colonization by
H. pylori.
The increased IgG1 response in recipient
mice could indicate a significant functional role for IL-4 produced by
the transferred T cells in vivo. This may also be true for the
protective effect exerted by these cells. To test this hypothesis,
UreA-specific CD4+ T cells were adoptively transferred into
naive BALB/c IL-4R
/
mice. These mice have a
disrupted IL-4R
gene and are sensitive neither to IL-4 nor to IL-13
(28, 31). Recipient and nonrecipient mice were infected
the day following transfer with H. pylori P76, and stomach
colonization was determined 34 days later (Fig.
6).

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|
FIG. 6.
Adoptive transfer of UreA-specific CD4+ T
cells to male IL-4R / mice reduces gastric
colonization by H. pylori. Levels of colonization were
assessed by quantitative culture (A) and by urease activity (B).
Results are expressed as mean ± standard deviation. Groups
contained six mice. The difference between values for recipient and
nonrecipient mice was statistically significant (P < 0.01, one- and two-tailed t tests) for both CFU (A,
*) and urease (B, *) activity. A significant reduction
(P < 0.05, one- and two-tailed t tests) in
number of CFU between recipient and nonrecipient female
IL-4R / mice was also observed in two other
independent experiments.
|
|
IL-4R

/
mice which received UreA-specific
CD4
+ T cells had a significantly reduced number of
H. pylori in the stomach (5.25
± 0.26 CFU/g,
P < 0.05 for one- and two-tailed
t tests) when compared
to
nonrecipient control IL-4R

/
mice (6.07 ± 0.39 CFU/g) (see also Fig.
6, top). The protective
effect of UreA-specific
CD4
+ T cells was confirmed by a significant reduction in
urease activity
(Fig.
6,
bottom).
The bacterial load in nonrecipient control IL-4R

/
mice was not significantly higher than in nonrecipient control
wild-type
mice.
H. pylori specific cellular and antibody responses in
IL-4R
/
mice receiving UreA-specific CD4+
T cells.
When CD4+ T cells isolated from spleens of
recipient IL-4R
/
mice were restimulated with
H. pylori lysates in the presence of syngeneic stimulator
cells, specific proliferation to urease-positive lysate was observed
(Fig. 7A). As observed for wild-type
BALB/c mice, no such response was detected with CD4+ T
cells isolated from spleens of infected IL-4R
/
animals. CD4+ T cells from both recipient and nonrecipient
mice proliferated in response to Con A (data not shown). The analysis
of serum antibody responses showed that both recipient and control
infected IL-4R
/
mice were able to mount a specific
IgG2a antibody response (Fig. 7B). Recipient animals had a titer
significantly higher than that in control infected mice. IgG1
antibodies were not detectable in any group.

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|
FIG. 7.
Induction of specific immune responses in
IL-4R / mice receiving UreA-specific CD4+
T cells. (A) Proliferation of splenic CD4+ T cells isolated
from recipient challenged or nonrecipient infected mice. Results are
expressed as mean ± standard error of the mean. (B) Analysis of
IgG2a and IgG1 antibody responses in serum. Results are expressed as
the mean ± standard deviation. IgG2a titers in recipient mice
were significantly higher than in nonrecipient mice (*) (P < 0.05, two-tailed t test). IgG1 was not detectable in
either group.
|
|
 |
DISCUSSION |
Several groups recently identified CD4+ T cells as
mediators of protection against Helicobacter by immunizing
gene knockout mice with urease or Helicobacter lysate in
combination with mucosal adjuvant (3, 12, 32). Here we
demonstrate that immunization with recombinant UreA- and
UreB-expressing Salmonella also induces protective
CD4+ T cells. Transfer of Helicobacter-specific
CD4+ T cells into naive wild-type recipient mice strongly
reduced H. pylori colonization, both prophylactically and
therapeutically. The therapeutic effect in patently infected mice
became detectable only weeks after the transfer. This suggests either
that the mechanism of clearance is slow or that it is inhibited by the
immune response first generated against the infection.
The immune response against H. pylori infection in mice and
humans is ineffective in controlling the bacteria and appears to be
biased towards a Th1 response (1, 11, 26, 38, 39, 44). In
contrast, the results of several studies in mice suggest that type 2 responses characterized by IL-4 secretion are important in immunity
against this pathogen (18, 26, 27, 36, 38), but their
significance has never been tested under stringent conditions. Mohammadi et al. (27) reported that adoptive transfer of a Th2 cell
line but not of a Th1 cell line reduced the magnitude of infection by a
factor of 3 to 4 (as assessed by histological evaluation). These lines
were not characterized with respect to antigen(s) recognized within
H. felis sonicate. We generated CD4+ T cells
which have a defined specificity. Adoptive transfer of these cells also
reduced stomach colonization by a factor of 3 to 4. Moreover, the
CD4+ T cells generated here produced IFN-
and TNF-
as
well as IL-10 and IL-4, indicating a mixed Th1-Th2 phenotype. Most
cells produced IFN-
and IL-10 upon specific restimulation.
Coproduction of these two cytokines by murine CD4+ T cells
has been shown in mice immunized with Salmonella (7, 40). Interestingly, the UreA-specific CD4+ T cells
supported a bias towards Helicobacter-specific IgG1
formation after transfer in vivo. This suggested that IL-4 produced by
these cells is functional in vivo and may play a significant role in reduction of colonization in recipient mice. To clarify the
contribution of IL-4 in control of bacterial load, we transferred the
UreA-specific CD4+ T cells into IL-4R
/
mice and found that H. pylori colonization was reduced to
the same extent as in wild-type animals. We propose therefore that IL-4
and IL-13 play no role in protection mediated by urease-specific CD4+ T cells. It is also unlikely that IFN-
plays a key
role in protection induced by vaccination, because immunization in
IFN-
-deficient mice was reported to be as efficient as in wild-type
animals (37). We are led to conclude that IL-10, TNF-
,
or other as-yet-uninvestigated products of CD4+ T
cells are responsible for protection.
The two chains of urease were the first H. pylori antigens
whose vaccine potential was tested (6, 13, 19, 22, 25). Ferrero et al. (13) found that recombinant UreB but not
UreA alone did protect mice against H. felis infection. The
protective cells that we generated, however, are specific for UreA.
MHC-restricted presentation of UreA may explain why Ferrero and
colleagues, using Swiss Webster mice, did not classify this antigen as
protective (13), since Michetti and colleagues
(25), using BALB/c mice, demonstrated protection with
UreA. We also predicted epitopes within the UreA sequence that should
be presented by H-2d. At least three of these were indeed
recognized by the UreA-specific CD4+ T cells. They
constitute a first set of epitopes defined for an H. pylori
antigen and open the attractive avenue of peptide immunization against
this pathogen.
Detoxified lysates of urease-positive and -negative H. pylori strains enabled us to trace UreA- or UreB-specific T-cell
responses in spleens and gastric lymph nodes of recipient, recombinant
Salmonella-vaccinated, or H. pylori-infected
control mice. This revealed that in the early phase of the infection
(up to 6 weeks), no proliferation of the spleen cells isolated from
infected mice was detectable in response to any H. pylori
antigens. Splenocytes isolated from UreA-specific CD4+
T-cell recipients or from vaccinated mice also did not proliferate to
H. pylori antigens other than urease. By contrast, gastric lymph node cells isolated from all groups of animals proliferated when
stimulated with H. pylori lysates with or without urease. The fact that gastric lymph node cells from recipient mice did not show
a significant increase in proliferation in the presence of urease
suggests that the transferred cells were not homing preferentially to
this lymphoid organ. It is reasonable to assume, however, that they
homed not only to the spleen but also to the gastric mucosa to mediate
protection. Homing may depend on expression of
4
7 integrin, as
Michetti et al. (24) recently reported that T cells homing
to the stomach mucosa preferentially expressed this integrin.
Preliminary analysis indicates that the UreA-specific CD4+
T cells do express both integrin
1 and
7 chains as well as the
4 integrin chain (data not shown).
Interestingly, splenocytes from infected animals did not respond to any
H. pylori antigens in the early phase of infection, but a
response was detectable in the long-term-infected (14 weeks) mice,
indicating that a systemic response against H. pylori
develops only with time. Since reactive cells are, however, present in the gastric lymph nodes early after infection, the immune response to
this pathogen appears to be locally constrained. The stomach may thus
be considered an immunologically contained system as recently suggested
(24). To our knowledge this is the first report where
immune response in gastric lymph nodes was investigated in the
Helicobacter model, and it appears that this organ is likely to be the site of induction of the response to H. pylori
infection. A thorough analysis of the local response prompted by the
observations reported here will help to understand why this immune
response is ineffective in clearing the bacteria.
In conclusion, we generated CD4+ T cells specific for UreA
from recombinant Salmonella-immunized mice, which protect
subjects from stomach colonization by H. pylori. Although
the UreA-specific CD4+ T cells had a mixed Th1-Th2 profile,
IL-4 and IL-13 were not necessary for protection. These T cells allowed
the identification of three independent epitopes that can be used to
explore peptide vaccination. In addition, these T cells will be
valuable tools for investigating homing sites and in situ behavior in
order to study the mechanism that leads to clearance of the bacteria.
 |
ACKNOWLEDGMENTS |
This work was supported by the Fonds der Chemischen Industrie
(T. F. Meyer). B. Lucas was a recipient of grant no. ERBBIO4CT 965114 from the European Community.
We are grateful to F. Brombacher for providing the
IL-4R
/
mice. We thank R. Hurwitz for purification of
urease B, C. Lattemann and V. Spehr for helpful advice, and A. Dietrich
and U. Sack for technical assistance.
 |
FOOTNOTES |
*
Corresponding author. Mailing address:
Max-Planck-Institute for Infection Biology, Department of Molecular
Biology, Schumannstraße 21/22, 10117 Berlin, Germany. Phone: 49 30 28460 400. Fax: 49 30 28460 401. E-mail:
meyer{at}mpiib-berlin.mpg.de.
Editor:
E. I. Tuomanen
 |
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Infection and Immunity, March 2001, p. 1714-1721, Vol. 69, No. 3
0019-9567/01/$04.00+0 DOI: 10.1128/IAI.69.3.1714-1721.2001
Copyright © 2001, American Society for Microbiology. All rights reserved.
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