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Infection and Immunity, April 2007, p. 1852-1860, Vol. 75, No. 4
0019-9567/07/$08.00+0 doi:10.1128/IAI.01814-06
Copyright © 2007, American Society for Microbiology. All Rights Reserved.

Benaroya Research Institute at Virginia Mason, 1201 Ninth Avenue, Seattle, Washington,1 Emory Vaccine Center, Emory University School of Medicine, Atlanta, Georgia,2 University of Washington School of Medicine, Seattle, Washington3
Received 15 November 2006/ Returned for modification 15 December 2006/ Accepted 22 January 2007
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MHC proteins bind peptide antigens for presentation to T lymphocytes, enabling the development of technologies using soluble pMHC for analysis of T-cell specificity. Soluble pMHC class I tetramers have been used extensively for studies of CD8+ T cells and are particularly informative for evaluating the class I-restricted response to viral infection and viral vaccines (5, 9, 10, 21). This utility reflects the importance of lysis of virus-infected host cells by CD8+ cytolytic T cells for protective cellular immune responses to most viruses. In contrast, bacterial infections are cleared predominantly by other immune mechanisms, including a role for the CD4+ T-cell compartment generating cytokines and providing T-cell help for the antibody response. In order to efficiently monitor this latter pathway, various lymphocyte activation assays have been used, often involving the activation or proliferation of CD4+ T cells in vitro as an indirect measure of antigen-specific responses. With the development of pMHC class II tetramers, it is now possible to directly assay the CD4+ T-cell population for antigen-specific phenotypes (2, 3, 7, 12-14, 22).
Routine use of pMHC class II tetramers is challenged by two important biological and technical issues: first, antigen-specific CD4+ T cells are present in the peripheral blood at a very low frequency, generally between 1:3,000 and 1:30,000 cells; second, the avidity of T-cell receptor (TCR)-pMHC recognition tends to be heterogeneous, with functionally relevant cells often showing low-avidity recognition properties. In our previous studies of class II-restricted CD4+ T-cell responses to antigens associated with autoimmune diseases, we developed a protocol to compensate for these challenges, in which peripheral blood lymphocytes are exposed to class II-restricted peptides, followed by selection of cells using flow cytometry to isolate the rare cells which bind specific pMHC tetramers (16, 17). Cloning of the tetramer-positive lymphocytes sorted by flow cytometry provides a population of expanded antigen-specific T cells suitable for further analysis. We have now used this antigen-MHC-directed system to identify and characterize CD4+ T cells responding to PA.
Epitopes on PA that are recognized by neutralizing antibodies have been defined (reviewed in reference 11), but factors affecting the development of antigen-specific T-cell-dependent help for the production of anti-PA antibodies and memory B cells, and the T-cell epitopes that are recognized by these helper T cells, are uncharacterized. Humans immunized with AVA develop antibodies and a detectable proliferative response to PA, but the magnitude of the proliferative response is relatively low (4). These findings, and the need for annual boosters to maintain antibodies, suggest that the antigen-specific memory B-cell and T-cell responses to Bacillus anthracis protective antigen are relatively weak. Defining these responses and determining if enhancement of T-cell immunity can also improve efficacy against Bacillus anthracis infections could lead to improved vaccines.
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Vaccination and sample collection. Peripheral blood was obtained with informed consent from a normal volunteer laboratory worker (HLA DRB1*1302 DRB1*0407) who received conventional AVA (BioPort Corp., Lancing, MI) as prophylaxis while working in a high-risk laboratory facility. The individual received the full schedule of five subcutaneous immunizations and was given a booster within 2 years prior to sample collection.
In vitro expansion culture. For studies of fresh blood, peripheral blood mononuclear cells (PBMC) were separated by gradient centrifugation (Lymphoprep; Nycomed, Oslo, Norway); for experiments with frozen PBMC, cells were thawed in 10% fetal bovine serum (FBS) with 20 U/ml DNase (Worthington Biochemical Corp., Lakewood, NJ). PBMCs (3.5 million) were cultured per well in a 24-well plate with pooled PA peptides (10 µg/ml each) and medium (10% pooled human serum) in RPMI medium containing L-glutamine and HEPES with 1 mM pyruvate, 0.01 U/ml penicillin, and 0.01 µg/ml streptomycin. Interleukin 2 (IL-2; 1-to-20 final dilution; Hemagen, Columbia, MD) was added on day 7, and medium was replenished between days 9 and 11. At day 13, the cultured PBMC were harvested, and tetramer analysis was performed.
Tetramer preparation. The production of MHC class II tetramers is described elsewhere (14). Briefly, DRB1*0404 or DRB1*1302 monomers containing a biotinylation sequence at the 3' end were generated in a Cu-inducible Drosophila melanogaster expression vector. The monomers were purified and biotinylated prior to peptide loading for 48 to 72 h at 37°C, after which the tetramers were assembled by the addition of phycoerythrin (PE)-labeled streptavidin.
Tetramer analysis. Cells were washed in Dulbecco's phosphate-buffered saline (D-PBS) and resuspended in fresh medium at 2 to 6 million cells per ml for staining with PE-labeled DRB1*1302 or DRB1*0404 tetramers. PE-labeled tetramers (10 µg/ml) were added, and the samples were incubated for 2.5 h at 37°C. Fluorescein isothiocyanate (FITC)- or peridinin chlorophyll protein (PerCP)-labeled anti-CD4 was added for 30 min on ice. After samples were washed with D-PBS containing 1% FBS (HyClone, Logan, VT), the cells were analyzed using a Becton Dickinson FACSCalibur flow cytometer, and CellQuest (Becton Dickinson, Franklin Lakes, NJ) and FlowJo (Ashland) were used for data analysis. The numbers reported in the dot plots shown in Fig. 2 to Fig. 4 are percentages based on cells in the live lymphocyte gate, and the quadrants are based on single-color control samples.
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FIG. 2. Flow cytometry of PBMC from an AVA-vaccinated donor, using PE-labeled PA tetramers (vertical axis) and PerCP- or allophycocyanin-labeled anti-CD4 staining (horizontal axis). (A) Frozen PBMC were thawed and incubated in the presence of PA peptides. After 12 to 14 days of expansion, the sample was stained with DRB1*1302 PA tetramers and a negative control tetramer (DRB1*1302 mortalin10A; peptide sequence, AIKGAVVGIALG). (B) Fresh PBMC were cultured with PA peptides for 12 to 14 days and stained with the specific DRB1*0404 PA 112-127 tetramer or the negative control tetramer DRB1*0404 mortlin10A. The DRB1*0404 tetramers were added in an attempt to detect a response mediated through the DRB1*0407 haplotype of the patient, since DRB1*0407 tetramers were not available. The numbers reported are percentages based on cells in the live lymphocyte gate.
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FIG. 4. Characterization of the BRI4PA clones by tetramer staining and proliferation to PA 112-127. (A) BRI4PA clones were generated by single-cell sorting the tetramer-positive PA 112-127 population, followed by 12 to 14 days of mitogen stimulation and 12 to 14 days of antigen-specific stimulation. The clones were tetramer stained with DRB1*0404 mortalin10A, as a negative control, and the DRB1*0404 PA112-127 specific tetramer; subsequently, samples were stained with anti-CD4 monoclonal antibody and analyzed by flow cytometry. (B) BRI4PA clones were exposed to PA 112-127 in the presence of human DRB1*1302, DRB1*0404, and DRB1*0407 antigen-presenting cells (APC); [3H]thymidine incorporation after 72 h is shown. (C) BRI4PA.18 cells were labeled with CFSE prior to specific stimulation with 10 µg/ml PA 112-127 and irradiated DRB1*0407 PBMC. Six days after stimulation, the sample was tetramer stained with the same tetramers as described for panel A. The percentages reported for flow cytometry are based on all cells in the live lymphocyte gate. On the histogram plot, the black line is the CFSE profile of the culture containing PA 112-127, and the gray line is the profile of a culture without peptide.
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Proliferation assay. To confirm peptide specificity and evaluate cytokine profiles produced in response to antigen, T-cell clones were evaluated using proliferation assays. Clones were harvested from days 11 to 14 poststimulation, washed with D-PBS, and resuspended in medium. Fifty thousand cells were added per well in a round-bottom 96-well plate. PBMC matched with the tetramer for HLA type were used as antigen-presenting cells, pulsed with antigen (at least 1 h for peptide and at least 4 hours for whole protein) at 37°C prior to irradiation with 5,000 rads. Recombinant PA was provided by NIAID's BEI Resources program (Manassas, VA). Antigen-pulsed presenting cells (100,000 per well) were added, and supernatants were harvested at 48 h for a cytokine assay (Cytometric Bead Array; BD Biosciences, San Jose, CA). [3H]thymidine was added to the wells, and proliferation was measured 20 to 24 h later by scintillation counting.
Magnetic bead separation for CD14+ cells. PBMC were washed and suspended in separation buffer (0.5% bovine serum albumin [Sigma, St. Louis, MO], 2 mM EDTA [Sigma, St. Louis, MO] in D-PBS [pH 7.2]) at 125 million cells per ml. Cells were incubated with CD14 Microbeads (Miltenyi Biotech, Auburn, CA) at 20 µl per 10 million cells for 15 min at 4 to 8°C. The labeled cells were separated over a magnetic LS column (Miltenyi Biotech, Auburn, CA). All fractions were collected and analyzed for purity by flow cytometry using FITC-labeled CD19, PE-labeled CD14, allophycocyanin-labeled CD3, and PerCP-labeled CD4 antibodies.
Carboxyfluorescein diacetate succinimidyl ester staining. For analysis of proliferation by flow cytometry, T-cell clones were washed two times with PBS, followed by incubation with 200 nM carboxyfluorescein diacetate succinimidyl ester (CFSE) (Invitrogen, Carlsbad, CA) for 10 min at 37 oC. FBS was added for 2 min, and the cells were washed once with D-PBS and two more times with medium. CFSE-labeled cells (250,000) were then cultured in a 48-well plate in the presence of irradiated PBMC with 10 µg/ml PA peptide. Seven days later, the clones were tetramer and anti-CD4 stained as described above.
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TABLE 1. IC50 of PA peptide binding to HLA class II moleculesa
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FIG. 1. Competition binding of PA peptides to HLA DRB1*1302. Six PA peptides and a positive control (HA 306-317) were each incubated with purified recombinant HLA DRB1*1302 at the concentration shown and then challenged with 0.1 µM biotinylated HA 306-318. The DRB1 molecules were captured with anti-MHC monoclonal antibodies on an enzyme-linked immunosorbent assay plate, followed by the addition of europium-labeled streptavidin, and developed using europium activation buffer.
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Very-low-level staining with the DR13 tetramer was observed, with the PA 381-392 tetramer binding only slightly higher than the background binding seen with the control tetramer. Reactivity with the DR4 tetramer was seen by using PA 112-127, with more tetramer-positive cells, particularly in the CD4 population. These profiles were suggestive of low-level (i.e., low-frequency) T-cell responses to the specific PA peptides, so each putative tetramer-stained sample was subjected to cell sorting using a high-speed flow cytometer, followed by expansion and analysis of the tetramer-binding population.
Figure 3 summarizes the findings after cells were sorted within the 1.26% positive-stained population using the DRB1*1302 PA 381-392 tetramer. First, the positive tetramer-sorted population was expanded using mitogen stimulation and then reanalyzed (Fig. 3A). Readily apparent tetramer staining with the DRB1*1302 PA 381-392 tetramer as well as with the longer, overlapping peptide PA 373-393 was seen, verifying the enrichment of the previously rare antigen-specific population. From the tetramer-positive population, a number of clones were then generated by several rounds of antigen-specific stimulation of single cells, in which clones BRI13PA.66 and BRI13PA.155 were representative examples. The specificity of these clones was confirmed by antigen-specific proliferation using human DRB1*1302 PBMC as antigen-presenting cells (Fig. 3B) and by specific PA tetramer binding (Fig. 3C). Interestingly, both clones recognized both PA 381-392 and PA 373-393, although there were subtle differences between the proliferative and the tetramer binding results: in a proliferation assay, the BRI13PA clones responded more to PA 373-393 than to PA 381-392, while the tetramer staining intensities with these long and short peptides were fairly equal.
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FIG. 3. Characterization of the DRB1*1302 PA-positive tetramer population, BRI13PA cells, by tetramer staining and proliferation assay. (A) Tetramer staining of the bulk-sorted DRB1*1302 PA 381-392 sample after expansion with mitogen stimulation. The DRB1*1302 tetramers individually loaded with mortalin10A (Negative Control peptide) or PA peptides were incubated with cells for 2.5 h at 37°C, followed by CD4 staining for 30 min on ice. (B) BRI13PA clones proliferated to specific PA peptides in the presence of irradiated DRB1*1302 PBMC. [3H]thymidine was added 48 h after antigen and detected by scintillation counting 20 to 24 h later. Greater proliferation to the longer PA 373-393 peptide sequence correlates with the relative strength of peptide binding. (C) BRI13PA clones were stained with a negative control tetramer (DRB1*1302 mortalin10A; peptide sequence, AIKGAVVGIALG), DRB1*1302 PA 373-393, and DRB1*1302 PA 381-392 and analyzed by flow cytometry. The flow cytometry plots show cells in the live lymphocyte gate.
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Characterization of the PA-specific CD4+ T-cell response.
Supernatants from the proliferation assays whose results are shown in Fig. 3B and Fig. 4B were analyzed for the production of the cytokines gamma interferon (IFN-
), tumor necrosis factor alpha (TNF-
), IL-10, IL-5, IL-4, and IL-2. All BRI13PA clones made a large amount of IFN-
and a small amount of TNF-
, requiring a fairly high peptide concentration for stimulation. An example is shown in Fig. 5 for one of these clones, reflecting a characteristic TH1 phenotype. In contrast, the BRI4PA clones had a TH2 cytokine profile. Large amounts of IL-5 were detected at the high peptide concentrations for all the BRI4PA clones, along with low levels of IL-4 (Fig. 5). The same cytokine profiles were seen when antigen was presented with the DRB1*0404 and DRB1*0407 antigen-presenting cells.
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FIG. 5. Cytokines produced by the BRI13PA and BRI4PA clones. Supernatants from every condition and clone shown in Fig. 3B and Fig. 4B were tested for a panel of T-cell-derived cytokines using the BD Biosciences Cytometric Bead Array. Each set of clones produced similar cytokines, and the two graphs shown are representative examples. APC, antigen-presenting cell.
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FIG. 6. Proliferative response of PA-specific clones presented with whole-PA protein by HLA DRB1*1302 or DRB1*0407 antigen-presenting cells. PBMC, CD14+ PBMC, and CD14 PBMC, separated with magnetic beads, were pulsed with PA protein antigen for at least 4 hours prior to irradiation. The HLA DRB1-matched antigen-presenting cells were added at a 1:1 volume with 50,000 cloned T cells of each specificity. At 48 h, [3H]thymidine was added, and incorporation was measured by scintillation counting 20 to 24 h later. Top panels, recombinant PA; bottom panels, synthetic peptides.
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The strategy illustrated in this study represents a general approach to epitope identification for vaccine and infectious disease immune profiling. The most direct way to evaluate a T-cell response which occurs at low frequency in blood is to directly interrogate individual T cells within the large pool of multispecific circulating lymphocytes. The tetramer-based method described here has several differences compared to other assays, such as enzyme-linked immunospot assay and limiting-dilution cloning, which have been successfully used in the past. First, the use of computer-assisted predictive algorithms, followed by analysis of MHC binding, facilitates the analysis of large, complex proteins or proteomes, by generating a panel of potential epitopes prior to the more laborious functional cellular studies. Second, the primary outcome measure is the binding properties of the T cell itself, thereby providing a direct measurement, rather than an indirect readout potentially sensitive to bystander effects. Third, the method directly generates antigen-specific human T-cell clones, which can then be used for further studies of lineage and function.
A commitment has been made in the United States to vaccinate large numbers of persons against anthrax. However, the current AVA regimen is administered as six subcutaneous injections and requires annual boosters. Passive protection studies of animals and some epidemiological data from workers in at-risk industries indicate that antibodies to PA correlate with immunity to anthrax. However, very little is known about the T-cell response, particularly in humans. An Institute of Medicine report in 2002 recommended that efforts be made to develop immune correlates of vaccine response, which could be used to guide next-generation vaccine development (8). Anthrax is well suited to the use of a tetramer-based monitoring strategy, since PA is known to be the major immunogenic component of AVA, and it is highly conserved in sequence among all reported anthrax strains (15). Sequence conservation is important, since antigenic variation due to selective pressure might defeat peptide-based strategies for immune profiling or protection. Our initial panel of potential epitopes corresponds to HLA genotypes carried by the majority of the population, and the examples of successful tetramer-derived T-cell profiling presented in this study demonstrate the feasibility of this approach.
Recombinant Bacillus anthracis protective antigen protein was provided by the Biodefense and Emerging Infections Research Resources Repository.
We thank K. Arumuganatha for expert assistance in cell sorting; Vivian Gersuk and the BRI Clinical Core Laboratory for HLA typing; Jason Berger for peptide synthesis; Tuan Nguyen, Kelly Geubtner, and Sharon Kochik for technical assistance; and Janice Abbas and Ellen Corke for preparation of the manuscript.
Published ahead of print on 5 February 2007. ![]()
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