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Infection and Immunity, March 2006, p. 1890-1895, Vol. 74, No. 3
0019-9567/06/$08.00+0 doi:10.1128/IAI.74.3.1890-1895.2006
Copyright © 2006, American Society for Microbiology. All Rights Reserved.
Immunobiology Unit, Institute of Child Health, University College London, 30 Guilford Street, London WC1N 1EH, United Kingdom
Received 2 September 2005/ Returned for modification 14 October 2005/ Accepted 19 December 2005
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In addition to supporting polysaccharide-specific B cells, DCs have recently been shown to present at least certain polysaccharides derived from bacterial capsules, including pneumococcal polysaccharide type 1, in the context of MHC class II to CD4+ T cells. Activation of CD4+ cells in this manner causes abscess formation in a rodent model of intra-abdominal abscess formation (12). All the polysaccharides found so far that are able to activate T cells share a zwitterionic charge motif. They are processed to low-molecular-weight carbohydrates inside DCs by a nitric oxide-mediated mechanism, loaded onto MHC, and shuttled to the surface for presentation to T cells. Intriguingly, zwitterionic polysaccharides induced abscess formation only when administered with a sterile cecal contents adjuvant, and subcutaneous administration of zwitterionic polysaccharides alone protected animals from abscess formation after infection with abscess-inducing bacterial pathogens (19).
Immunity against Streptococcus pneumoniae and other encapsulated bacteria such as Haemophilus influenzae type b and Neisseria meningitidis relies on the generation of antibodies against their capsular polysaccharides. Purified capsular polysaccharides, when incorporated into vaccines, are, however, poorly immunogenic TI-2 antigens. They induce a poor antibody response with mainly low-affinity IgM and do not elicit conventional T-cell help, and thus responses fail to demonstrate antibody affinity maturation, isotype switching, or memory formation (13). In addition, some studies report immunological hyporesponsiveness to a second dose of the same vaccine months to years after the original polysaccharide vaccination (8, 20). The limited response to purified polysaccharides has, however, been overcome by coupling the polysaccharides to a highly immunogenic protein carrier. Such glycoconjugate vaccines induce T-dependent responses with good affinity maturation, isotype switching, and memory formation and, most importantly, induce antibodies in the very young, who are particularly susceptible to infection with encapsulated bacteria (9).
Little is known about the role of DCs in the immune response to either purified bacterium-derived polysaccharides or glycoconjugate vaccines in humans. In this study we have thus explored the interaction between purified capsular pneumococcal polysaccharides or protein-polysaccharide conjugate vaccines and human myeloid (monocyte-derived) DCs. Uptake and trafficking, as well as the effect of polysaccharides on DC maturation, have been evaluated. DC cytokine secretion is critical for influencing T-cell immune function in response to antigen presentation, and thus these studies have focused on production of cytokines after incubation of DCs with polysaccharides directly and after lipopolysaccharide (LPS) stimulation of polysaccharide-exposed DCs.
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Fluorescence-activated cell sorter (FACS) analysis was performed using the following antibodies: CD11c (S-HCL-3); CD25 (M-A251); CD45 (2D1); CD83 (HB15e); CD86 (2331); CD40 (5C3); CD14 (M5E2); a Lin-1 cocktail containing antibodies against CD3, CD14, CD16, CD19, CD20, and CD56; and appropriate isotype control antibodies; all were obtained from Becton Dickinson (San Jose, CA).
Generation of DCs. Peripheral blood mononuclear cells (PBMCs) were isolated from healthy adult volunteers by the standard Ficoll-Paque method using Lymphoprep (Nycomed, Roskilde, Denmark). For DC preparations, CD14+ monocytes were positively selected from PBMCs using magnetic anti-CD14 microbeads (Miltenyi Biotec, Bergisch Gladbach, Germany) and cultured for 6 days in RPMI 1640 with 25 mM HEPES and L-glutamine (Invitrogen/Life Technologies, Carlsbad, CA) supplemented with 1% penicillin-streptomycin (10,000 IU/ml; Invitrogen/Life Technologies, Carlsbad, CA) and 10% fetal bovine serum in the presence of 100 ng/ml recombinant human granulocyte-macrophage colony-stimulating factor (Leucomax; Sandoz Pharmaceuticals, Camberley, United Kingdom) and 25 ng/ml recombinant human interleukin-4 (gift from D. Katz, University College London, United Kingdom). A specialized batch of fetal bovine serum with no/low endotoxin contamination (Myoclone Superplus; Invitrogen/Life Technologies) was used to minimize unwanted maturation of the generated DCs. On day 6, nonadherent, immature DCs were harvested. This procedure gave pure preparations of immature DCs as assessed routinely by FACS analysis of a panel of antibodies including CD11c, Lin-1, CD14, HLA-DR, CD83, CD86, CD40, CD1a, -b, -c, -d, and appropriate isotype controls.
DCs were activated and matured in some experiments by addition of 0.5 µg/ml LPS (Escherichia coli 026:B6; Sigma, St. Louis, MO) on day 6 of culture for 24 h.
Confocal microscopy. DCs in quantities of 1 x 104 to 2 x 104 were fed antigen for indicated periods of time. They were plated onto 18- by 18-mm coverslips (BDH) coated with 10 µg/ml human fibronectin (Sigma, St. Louis, MO) and allowed to adhere and polarize at 37°C for 30 min to 2 h. They were fixed in 4% paraformaldehyde-3% glucose in phosphate-buffered saline (PBS), permeabilized in 0.5% Triton X-100, and blocked with 1% bovine serum albumin in PBS. Cells were stained with 0.1 µg/ml rhodamine phalloidin for localization of filamentous actin and with 2 µM TO-PRO 3-iodide (both from Molecular Probes, Eugene, OR) for visualization of the nuclei. For colocalization with markers of endocytic organelles, cells were incubated with unconjugated, monoclonal mouse anti-human antibodies against CD71 (transferrin receptor, TfnR, specific for early endosomes), CD107a (lysosome-associated membrane protein-1 [LAMP-1], specific for late endosomes and lysosomes), or HLA-DR. HLA-DR localizes to late endosomes and lysosomes in immature DCs and to the cell surface in mature DCs. Alexa 488- or Alexa 546-conjugated antimouse antibodies were used as the second layer. All antibodies were obtained from Molecular Probes (Eugene, OR) and diluted in PBS to 1:40 (primary antibodies) or 1:100 (secondary antibodies). Cells were washed in PBS and distilled H2O, mounted on glass microscope slides with a drop of Citifluor, and sealed with nail varnish.
Confocal images were obtained using a confocal laser scanning microscope system (TCS NT; Leica, Switzerland) fitted with appropriate filter sets. To combine a three-dimensional z series into a two-dimensional image, 10 to 20 optical sections (0.5 µm) spanning the entire cell were projected and superimposed. In double-labeling experiments, bleedthrough corrections were done according to the manufacturer's instructions. To visualize colocalization of two fluorochromes, the images in the two channels were merged. A yellow signal was interpreted as colocalization. Images were processed with the TCS Leica Start and Adobe Photoshop 5.0 software.
In endocytosis experiments, adhered, polarized cells were fed fluorescently labeled antigen for the indicated period of time before fixation, permeabilization, and staining as described above.
Flow-cytometric endocytosis assay. Immature DCs were incubated for the indicated times with FITC-labeled antigen in the dark. Samples were set up in duplicate and incubated either at 37°C, to allow uptake, or on ice, to quantify background staining. In some experiments, cells were preincubated with 10 nM cytochalasin D or 100 nM wortmannin (both from Sigma, St. Louis, MO). Surface-bound antigen was quenched with 75 µl quenching solution (ORPEGEN Pharma, Heidelberg, Germany); cells were washed in PBS and analyzed immediately on a Beckman Coulter XL flow cytometer with Expo2 software.
Cytokine measurements. Cytokine production was analyzed from lymphocyte culture supernatants sampled after 22 h of stimulation. Commercial kits for IL-12 (BD Biosciences Pharmingen, San Diego, CA) and IL-10 (eBioscience, San Diego, CA) were used according to instructions supplied by the manufacturers. Results are expressed as the concentration of cytokine (pg/ml) in the culture supernatant of 4 x 106 cells/ml.
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FIG. 1. Internalization of pneumococcal polysaccharides. (Top) Immature DCs were incubated for 1 h with 60 µg/ml PPS14, fixed, stained with rhodamine-phalloidin (green) and TO-PRO (blue) to visualize filamentous actin and the nucleus, respectively, and examined using a confocal microscope. (Bottom) DCs were incubated with 60 µg/ml PPS14 for the periods of time indicated. Surface-bound antigen was quenched and cells were immediately analyzed by flow cytometry. Background uptake on ice was negligible. Results are representative of three independent experiments. Similar results were obtained for PPS9N.
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FIG. 2. Inhibition of uptake of pneumococcal polysaccharide type 14. Immature dendritic cells were incubated with 60 µg/ml PPS14 for 2 h on ice (A) or at 37°C (B) to determine background staining and internalization, respectively. Cultures run in parallel were preincubated for 30 min with 10 nM cytochalasin D (C) or 100 nM wortmannin (D). After incubation, surface-bound antigen was quenched and cells were immediately analyzed by flow cytometry. Similar results were obtained in two further experiments and for PPS9N.
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FIG. 3. Intracellular processing of pneumococcal polysaccharide type 14. Immature dendritic cells were incubated with 60 µg/ml FITC-labeled PPS14 (green) for 24 h, fixed, stained with specific markers for various endocytic organelles as indicated (Alexa 568, red) and a DNA label (TO-PRO, blue), and processed for confocal microscopy. Yellow staining in the merged images indicates colocalization of Alexa 568 and FITC. Insets in the merged images are close-ups of the regions of interest.
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FIG. 4. Effect of PPS/PPS-TT on DC phenotype. Immature DCs were incubated overnight with PPS or PPS-TT (types 1, 6B, 9N, 14, 19F, or 23F) or LPS, and expression of HLA-DR, CD40, and CD86 was analyzed by flow cytometry. As there were no differences between the various serotypes in surface marker expression, data were pooled and represent the means of six different serotypes and of five independent experiments. *, P < 0.001 using Student's paired t test. MFI, mean fluorescence intensity.
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FIG. 5. Effect of PPS/PPS-TT/TT on LPS-induced DC cytokine production. Immature DCs were incubated for 24 h with PPS, PPS-TT, or TT in the absence or presence of 0.5 µg/ml LPS. IL-12 and IL-10 levels in the culture supernatants were measured by standard enzyme-linked immunosorbent assay. Two different serotypes were used (14 and 19F). As there were no differences between the various serotypes in cytokine production, data were pooled and represent the means of two different serotypes and nine independent experiments.
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Uptake of pneumococcal polysaccharides does not in itself induce DC maturation or cytokine production. In this respect, PPS are similar to most other antigens, including many proteins, in that they do not induce DC maturation alone. Turley et al. (21) have shown that such antigens are stored in their native form inside DCs until the DCs receive a second signal that induces their maturation. Only then will processing and MHC loading commence. Interestingly, Colino and colleagues (4) have recently shown that intact heat-killed S. pneumoniae cells induce phenotypic maturation of DCs and the secretion of tumor necrosis factor alpha, IL-12, and IL-10 and that pulsed bone marrow-derived DCs were then able to support both antipneumococcal protein and polysaccharide responses after transfer to naïve mice. The difference between the effect of intact heat-killed pneumococci on murine DCs in Colino's studies and the results of our studies in human DCs and purified capsular polysaccharides is likely to be due to the choice of antigen, as heat-killed bacteria are also a stimulus for the maturation of human DCs on the basis of results of studies in our laboratory (results not shown). This is likely to be mediated by noncapsular components, and heat-killed bacteria are likely to contain many surface-exposed molecules that are stimulatory for DCs.
Exposure of DCs to pneumococcal polysaccharides in the presence of a second signal such as LPS dramatically altered the response of DCs in our studies. Activation of monocyte-derived DCs with LPS normally induces strong upregulation of MHC class II and costimulatory and adhesion molecules as well as the release of a variety of pro- and anti-inflammatory cytokines, among them IL-12 and IL-10. Preincubation with pneumococcal polysaccharides still allows phenotypic maturation of DCs but predisposes them to release very high levels of IL-10 upon stimulation with LPS. This cytokine has potent immunosuppressive effects on a large number of components of the immune system, among them negative feedback regulation of the DCs themselves, as well as an important role in the induction of adaptive regulatory T cells, which can suppress effector cells in an antigen-specific manner. Thus, secretion of high levels of IL-10 by DCs after PPS/LPS stimulation may have profound effects on DC-induced T-cell differentiation. In a recent paper by Sen and colleagues (18), purified pneumococcal polysaccharides were shown to contain impurities that bind TLR2 ligands, and in other model systems these may be critical costimulators. In our studies, PPS alone did not stimulate IL-10, although TLR2 ligands may have a role in the subsequent secretion of IL-10 following LPS stimulation.
Recently, similar imbalances between IL-10 and IL-12 production by DCs have been described in the context of mycobacterial infection. Macrophages infected with Mycobacterium tuberculosis, the causative agent of tuberculosis, release large amounts of the mycobacterial cell wall component lipoarabinomannan (LAM). LAM binds its main in vivo receptor DC-SIGN with high affinity (7) but is also recognized by other receptors such as the MR, CD11b, and CD11c (14). Binding of LAM to DC-SIGN and MR delivers a negative signal to DCs, resulting in the release of high levels of IL-10 and reduced levels of IL-12, respectively, in response to LPS (7, 17). LAM is structurally very similar to naturally occurring pneumococcal polysaccharides. CD11b is part of the CR3 receptor (CD11b/CD18, also called Mac-1). CR3 is another receptor which is targeted by a microbial molecule, in this case Bordetella pertussis-derived filamentous hemagglutinin, to induce high levels of IL-10 production and inhibit IL-12 production in DCs in response to LPS (16). Interestingly, Colino and Snapper (5) have suggested that IL-10 has a critical role in optimizing the DC induction of in vivo humoral responses to S. pneumoniae. In their studies of murine APC function, they were able to show the critical role of IL-10 in supporting both antiprotein and antipolysaccharide pneumococcal responses following pulsing of DCs by whole, heat-killed bacteria. They hypothesize that IL-10 has a critical role in limiting the time frame during which DCs can respond to continued exposure to bacteria by delaying the onset of apoptosis.
High levels of IL-10 are also released by DCs in the respiratory tract after exposure to an inhaled, innocuous antigen, such as ovalbumin. Exposure results in the rapid migration of pulmonary DCs to the draining lymph node. DCs mature during transit but produce high levels of IL-10 rather than IL-12, resulting in the induction of adaptive regulatory cells which will delete or anergize antigen-specific T cells (1). Such DCs are omnipotent cells that have the capacity to induce effector type 1 and 2 responses, but they are predisposed to production of IL-10 by exposure to suppressive factors present in the local microenvironment of the respiratory tract. In our studies, incubation of DCs with polysaccharides and LPS also results in a mature, IL-10-producing DC population, a phenotype associated with priming of adaptive regulatory cells. Exposure to a vaccine containing purified polysaccharide of meningococcal serogroup C results in subsequent hyporesponsiveness to a second dose (8). Recently, Torling and colleagues have shown a similar effect for the pneumococcal polysaccharide vaccine administered to the elderly (20). The mechanism explaining this hyporesponsiveness remains elusive. While it is possible that large doses of polysaccharides may cause apoptosis of antigen-specific B cells, thus reducing the number of B cells available to respond in a subsequent challenge, it is unclear why the B-cell pool should not be replenished, particularly as the phenomenon with meningococcal serogroup C has been described in young individuals and, furthermore, can be overcome by the use of a conjugate vaccine (3). Induction of anergy or immunoregulation by polysaccharides in the way described in these studies may help to explain the hyporesponsiveness observed after repeated vaccination with pure polysaccharides, although the immunomodulating effect of preexisting polysaccharide-specific IgM (binding via inhibitory Fc receptors) may also be a factor.
Our studies illustrate that the polysaccharide capsule of the pneumococcus is not only a bacterial virulence factor and a target for protective antibodies but may also subtly influence immune responses to it via interaction with dendritic cells in a unique way not previously described for encapsulated bacteria.
We thank Chris Jones, National Institute for Biological Standards and Control, Potters Bar, United Kingdom, for help making labeled polysaccharides.
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