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Infection and Immunity, March 2002, p. 1623-1626, Vol. 70, No. 3
0019-9567/02/$04.00+0 DOI: 10.1128/IAI.70.3.1623-1626.2002
Copyright © 2002, American Society for Microbiology. All Rights Reserved.
Protective Immunity against Mycobacterium tuberculosis Induced by Dendritic Cells Pulsed with both CD8+- and CD4+-T-Cell Epitopes from Antigen 85A
Helen McShane,* Shahriar Behboudi, Nilu Goonetilleke, Roger Brookes, and Adrian V. S. Hill
Nuffield Department of Medicine, University of Oxford, John Radcliffe Hospital, Oxford OX3 9DU, United Kingdom
Received 3 July 2001/
Returned for modification 15 August 2001/
Accepted 27 November 2001

ABSTRACT
Immunization with DNA followed by modified vaccinia virus Ankara
strain, both expressing the antigen 85A, induced both CD4
+-
and CD8
+-T-cell responses in BALB/c mice. Following challenge
with
Mycobacterium tuberculosis, this prime-boost regimen produced
protection equivalent to that conferred by
Mycobacterium bovis BCG. Following immunization with dendritic cells pulsed with
an antigen 85A CD4
+- or CD8
+-restricted epitope, alone or in
combination, copresentation of both epitopes on the same dendritic
cell was required for protection, demonstrating that induced
CD8
+ T cells can play a protective role against tuberculosis.

TEXT
Dendritic cells (DCs) are professional antigen-presenting cells
(APCs) and are central to the development of cellular immunity.
Immature DCs undergo activation and maturation upon contact
with pathogens. Mature DCs migrate to secondary lymphoid organs
and prime T cells. DCs can present exogenous antigen directly
to naïve T cells in situ (
11), and this function is likely
to be important in the induction of cellular immunity against
Mycobacterium tuberculosis (
8). CD4
+ T cells are essential for
immunity against
M. tuberculosis (
20). Classical class I-restricted
CD8
+ T cells may also be important (
20), but their functional
significance in vivo remains unclear. A promising candidate
antigen for a new tuberculosis (TB) vaccine is antigen 85A,
which is protective in mice and guinea pigs (
10,
9). Antigen
85A contains several CD4
+-T-cell epitopes and at least one CD8
+-T-cell
epitope in BALB/c mice (
4), and CD4
+- and CD8
+-T-cell responses
have been identified in humans (
12,
18). Heterologous prime-boost
immunization strategies can induce high levels of CD8
+ and CD4
+ T cells in patients with malaria, human immunodeficiency virus,
and TB (
7,
14,
15). We used DNA and recombinant modified vaccinia
virus Ankara strain (MVA) vaccines, each encoding antigen 85A,
to identify two immunodominant epitopes within antigen 85A,
a CD4
+-restricted epitope and a CD8
+-restricted epitope. DCs
pulsed with both of these epitopes but not a mixture of DCs
pulsed with each epitope separately conferred protection against
challenge equivalent to the protection conferred by the prime-boost
immunization regimen and by
Mycobacterium bovis BCG.
M. tuberculosis H37Rv stocks were prepared as previously described (14). The antigen 85A gene and the tissue plasminogen activator leader sequence were ligated together as a single coding sequence in plasmid vector pSG2 and vaccinia virus shuttle vector pSC11. BHK cells were infected with nonrecombinant MVA at a multiplicity of infection of 0.05 and then transfected with the recombinant shuttle vector. Recombinant virus was selected for by plaque purification. Autologous bone marrow cells were cultured in RPMI 1640 containing 10% fetal calf serum (Labtech International, Uckfield, United Kingdom) and 1 ng of recombinant granulocyte-macrophage colony-stimulating factor (Peprotech, Rocky Hill, N.J.) per ml for 7 days. The medium and recombinant granulocyte-macrophage colony-stimulating factor (0.5 ng/ml) were replenished on days 3 and 6. DCs were pulsed with peptide (2 µg/ml) overnight, washed twice, and counted before injection. Incubation of DCs with peptide did not induce DC maturation, as indicated by expression of surface molecules, such as major histocompatibility complex classes I and II, CD86, and CD40 (determined by fluorescence-activated cell sorter analysis) (data not shown). Female BALB/c mice (age, 4 to 6 weeks; Harlan Orlac, Shaws Farm, Blackthorn, United Kingdom) were injected intramuscularly with plasmid DNA (50 µg/immunization). Recombinant MVA (106 PFU) and DCs (106 cells) were injected intravenously. BCG Glaxo (4 x 105 CFU) was injected intradermally at the time of the first immunization. Immunizations were given at 2-week intervals, and immunogenicity was evaluated 2 weeks after the last immunization. Splenocytes were prepared as previously described (14). The number of gamma interferon-secreting specific T cells was determined by using an ex vivo Elispot assay and 20-mer peptides (overlapping by 10 amino acids) spanning the length of antigen 85A (Research Genetics, Huntsville, Ala.) (14). The nonamer H-2Kd-restricted epitope within peptide p11 (WYDQSGLSV) was used for some DC experiments. The numbers of spot-forming cells (SFC) per 106 splenocytes were determined. Cell depletion was performed on cells restimulated in vitro for 7 days as previously described (14). In the challenge experiments, mice were infected with 106 or 5 x 106 CFU of M. tuberculosis by intraperitoneal injection 2 weeks after the final immunization. Organs were homogenized 8 weeks later with a mini-bead beater (Biospec Products, Bartlesville, Okla.), and dilutions were plated onto Middlebrook plates. The plates were incubated for 21 days at 37°C, and the numbers of colony counts per organ were calculated. Data were expressed as the log10 mean and standard error for each experimental group. Student's t test was used to determine statistical significance between groups. The P values presented below are one-tailed values determined by comparing immunized groups with nonimmunized controls.
BALB/c mice were immunized with DNA (D regimen), MVA (M regimen), or a combination of the two (DM or MD regimen). Using an ex vivo Elispot assay, we identified responses to the following four peptides from the splenocytes of immunized mice: p11, p15, p24, and p27 (Table 1). The strongest responses were the responses to peptides p11 and p15. Magnetic bead depletion studies performed with restimulated splenocytes from mice immunized with DNA and then MVA showed that the response to p11 was eliminated by CD8+-T-cell depletion. The responses to p15, p24, and p27 were eliminated by CD4+-T-cell depletion. In this study we focused on the dominant epitopes contained in p11 and p15. Figure 1 shows that the responses generated by single or repeated immunizations with either construct were weak. Heterologous boosting of DNA with MVA resulted in higher frequencies of both the CD4+(p15) and CD8+(p11) T cells. Heterologous boosting of MVA with DNA increased only the frequency of CD4+ T cells. The most immunogenic regimen was three doses of DNA followed by a single boost with MVA (DDDM regimen) (Fig. 1). In challenge studies, the DDDM regimen conferred protection in the lungs equivalent to the protection conferred by BCG (Fig. 2A). Immunization with DNA alone (DDD regimen) or immunization with DNA boosted with nonrecombinant MVA (DDDNRM regimen) conferred no protection. In order to determine whether the protective immunity induced by the DDDM immunization regiment was attributable to T cells specific to the 85A CD4+ and CD8+ epitopes identified in the Elispot assay, peptide-pulsed DCs were used. Mice were immunized intravenously with DCs pulsed with peptides p15 (CD4+) and p11 (CD8+). When challenged, mice immunized with DCs pulsed with both epitopes showed levels of protection in the lungs comparable to the levels of protection obtained with both BCG and the heterologous DDDM regimen (Fig. 2A). Mice immunized with DCs pulsed with either the CD4+- or the CD8+-T-cell epitope alone were not protected against challenge (Fig. 2B). Mice immunized with DCs pulsed with both epitopes simultaneously again were protected against challenge. We then investigated the interaction between the CD4+- and CD8+-T-cell responses by immunizing mice with either a mixture of DCs, 5 x 105 cells of which had been pulsed with the CD4+ epitope and 5 x 105 cells of which had been pulsed with the CD8+ epitope, or with DCs pulsed with both epitopes simultaneously. Three mice from each group were analyzed for immunogenicity. The mean Elispot responses per 106 splenocytes were 57 SFC (p11) and 104 SFC (p15) in the mice immunized with the mixture of DCs, compared with 129 SFC (p11) and 116 SFC (p15) in the mice immunized with DCs pulsed with both peptides simultaneously; the latter immunization regimen also induced cytotoxic T lymphocytes (CTL) to p11 (data not shown). Mice immunized with the DC mixture were not protected against challenge, despite having specific CD4+ and CD8+ T cells against antigen 85A. Mice immunized with DCs pulsed with both epitopes together showed significant protection (Fig. 2C).
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TABLE 1. Prime-boost immunization regimens with DNA and MVA constructs induced responses to four of the overlapping peptides from antigen 85Aa
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We found that induction of classical class I-restricted CD8
+ T cells by vaccination can confer protective immunity against
M. tuberculosis. Direct evidence that these cells play a role
has not been obtained previously. ß2M knockout mice,
which lack functional CD8
+ T cells, are more susceptible to
challenge with
M. tuberculosis (
6), but this does not eliminate
the possibility that nonclassically restricted T cells, which
are well described in TB patients (
13,
19), play a role. The
protective effect of DNA vaccines has been attributed, at least
in part, to the CD8
+ T cells (
10,
21). However, recently, a
DNA vaccine encoding antigen 85A has been shown to induce protective
immunity in ß2M knockout mice, suggesting that the
protective effect of this DNA vaccine is mediated through CD4
+ T cells (
5). The adoptive transfer of CD8
+-T-cell clones induced
by DNA vaccination conferred protection, but these cells were
expanded in vitro before transfer (
2). The results do not indicate
whether CD8
+ T cells can protect when they are present at the
more physiological numbers found in vivo. We found that protection
induced by DC-peptide immunization is dependent on a classically
class I-restricted CTL epitope, suggesting that H-2K
d-restricted
(
4) T cells specific for this epitope mediate protective immunity.
The presence of a CD4
+-T-cell epitope on the same APC was also
required. Our finding is consistent with a model of CTL activation
in which the CD4
+ T cell activates the APC, which in turn activates
the CTL (
1). The CD40 ligand (CD40L) on the surface of activated
CD4
+ T cells interacts with CD40 on the surface of the APC,
which facilitates CTL priming (
16). The mechanism by which this
CD40-CD40L interaction enables CTL priming is unclear. In DCs,
ligation of CD40 by CD40L induces high levels of interleukin-12.
In addition, CD40L is extremely potent at upregulating the expression
of costimulatory molecules on DCs (
3). CTL priming in vivo is
dependant on the maturation of DCs, and DC maturation can be
triggered by CD4
+-T-helper cells, agonistic CD40 antibody, or
lipopolysaccharide (
17). In this study immature DCs were used
in order to allow the CD40-CD40L interaction to induce DC maturation
in vivo. The lack of protection in the mice immunized with the
DDD or DDD(NRM) regimen effectively rules out the possibility
that these vaccines administered 2 weeks before challenge have
a nonspecific protective effect. In addition, the lack of protection
in the DC groups pulsed with either epitope alone (Fig.
2B),
the mixed DC group, or the DC with no peptide group (Fig.
2C)
rules out the possibility that DC immunization 2 weeks prior
to challenge has a nonspecific protective effect. Although the
results obtained with these control groups ruled out the possibility
that there was a nonspecific protective effect, in this study
we did not investigate the durability of the protection observed.
It would be interesting in future studies to increase the time
interval between DC immunization and challenge and assess the
sustainability of the protection conferred in this model. The
aerosol challenge model that is now more widely available is
considered a more relevant model of human TB, and it would be
interesting to see whether the differential protective effect
in the lungs is maintained with an aerosol challenge. It would
also be interesting to investigate the importance of mucosal
immunity by comparing systemic and aerosol delivery of DCs.
We found that induction of classical class I-restricted CD8
+ T cells by immunization conferred protection against challenge
and implicated these cells in protective immunity against TB.
An optimal TB vaccine should aim to induce classically restricted
CD8
+ T cells as well as CD4
+ T cells. Further use of the DC
model should help in the identification of protective antigens
and epitopes and in the optimization of vaccine design.

ACKNOWLEDGMENTS
We thank Jiang-Ting Hu, Magdalena Plebanski, and Ernie Gould
for assistance and advice.
H.M. was supported by an MRC clinical training fellowship. A.V.S.H. is a Wellcome Trust Principal Research Fellow.

FOOTNOTES
* Corresponding author. Mailing address: Level 7, Nuffield Department of Medicine, University of Oxford, John Radcliffe Hospital, Oxford OX3 9DU, United Kingdom. Phone: 44 1865 221609. Fax: 44 1865 221921. E-mail:
helen.mcshane{at}ndm.ox.ac.uk.


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Infection and Immunity, March 2002, p. 1623-1626, Vol. 70, No. 3
0019-9567/02/$04.00+0 DOI: 10.1128/IAI.70.3.1623-1626.2002
Copyright © 2002, American Society for Microbiology. All Rights Reserved.
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