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Blood, 1 October 2005, Vol. 106, No. 7, pp. 2228-2229.

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InsideBlood

IMMUNOBIOLOGY

Comment on Braun et al, page 2375, and comment on Potula et al, page 2382

IDO production, adaptive immunity, and CTL killing

Thomas Luft, Eugene Maraskovsky, and Max Schnurr

THE GERMAN CANCER RESEARCH CENTER; CSL LIMITED; AND THE UNIVERSITY OF MUNICH

Indoleamine 2,3-dioxygenase, an enzyme induced in antigen-presenting cells by specific proinflammatory mediators such as prostaglandin E2 (PGE2) or viral infection, can inactivate specific T-cell functions.

Dendritic cells (DCs) are key regulators of immune responses capable of promoting and suppressing T-cell activation. This functional plasticity is the net result of DCs integrating a plethora of signals in their local microenvironment. Most DC studies examine signals required for inducing protective immunity rather than tolerance. An interesting candidate for the latter is indoleamine 2,3-dioxygenase (IDO), a rate-limiting enzyme in tryptophan catabolism, which is expressed by antigen-presenting cells (APCs) such as macrophages and DC populations.

IDO production can suppress adaptive immunity and has a complex role in immunoregulation, such as T-cell tolerance to cancer and allografts, protection of the allogeneic fetus, resistance to autoimmune diabetes,1 and regulation of fungal pathogenicity.2 Tolerance induction by IDO appears, at least in part, to be attributed to depletion of the amino acid tryptophan, and resultant increase in metabolites (eg, kynurenine). Interferon-{gamma} (IFN-{gamma}) or cytotoxic T-lymphocyte antigen 4 (CTLA-4)/B7 engagement induce IDO in APCs.1 In this issue of Blood, 2 groups report novel insights that further elucidate the regulatory role and potential pharmacologic intervention of IDO activity in immunity.

Braun and colleagues describe a 2-step induction of IDO in human monocyte-derived DCs (MoDCs), a widely used in vitro model for studying DC function. Affymetrix gene array analysis indicated that DCs matured with tumor necrosis factor-{alpha} (TNF-{alpha}) and prostaglandin E2 (PGE2), expressed 100-fold higher IDO mRNA. Interestingly, although PGE2 was responsible for IDO transcriptional up-regulation, other stimuli (such as TNF-{alpha} or Toll-like receptor [TLR] ligands) were required for its functional activation. Finally, PGE2 mediated IDO induction via the E prostanoid-2 (EP2) receptor and cyclic adenosine monophosphate (cAMP) signaling.

These findings shed new light on IDO regulation by inflammatory mediators and explain why mRNA expression did not strictly correlate with IDO activity in previous reports. They also highlight a novel role of PGE2 (and perhaps other cAMP agonists such as adenosine triphosphate [ATP]) in modulating DC functional capacity via IDO induction. PGE2 (and ATP) can induce DC migration towards lymph node-directing chemokines,3-5 attenuate interleukin-12p70 (IL-12p70) and IL-27 production and induce IL-23 production for memory T-cell activation.6 PGE2 is frequently used in maturing MoDCs used for cancer immunotherapy, and so PGE2 induction of IDO has implications for this strategy. However, do these findings indicate that PGE2-matured DCs are immunosuppressive or rather that they attenuate the magnitude of responses to avoid excessive tissue damage? Although the functional consequences of DC-derived IDO on T cells was not addressed by this group, previous reports by Terness and colleagues7 demonstrate that inhibition of T-cell activation by IDO+ DCs may not be a pre-ponderant effect but may depend on the activation context.

What are the consequences of APCs producing IDO? A second paper appearing in this edition may shed light on this question. Potula and colleagues report that HIV-1 infection induces IDO+ macrophages that are subsequently protected from cytotoxic T lymphocyte (CTL) killing. Their persistence in the brain likely causes HIV-encephalitis (HIVE). Furthermore, pharmacologic inhibition of IDO enhanced CTL function and clearance of virally infected brain macrophages, highlighting that virally induced IDO in APCs may represent a unique viral escape mechanism. It is unclear whether IDO inhibits CTL development per se, since increased CTL numbers were found with IDO+ macrophages in HIVE brains. Munn et al recently showed that IDO+ plasmacytoid DCs directly suppress T-cell function via activation of the general control kinase 2 (GCN2) kinase pathway.8 Thus, IDO+ APCs may inactivate CTL function and escape CTL lysis.

Although APC resistance to CTL lysis appears deleterious in HIVE, it may be beneficial in certain contexts such as protecting antigen (Ag)-loaded, migratory DCs (activated via PGE2) from CTL attack en route to lymph nodes. It is unclear from current studies whether IDO production is continuous or transient upon stimulus withdrawl. Closer examination of IDO+ APC and CTL interactions are required to more fully understand the implications. However, these 2 studies indicate that therapeutic inhibition of IDO may prove promising for enhancing (antiviral and tumor) or attenuating (autoimmune and transplantation) immune responses in a context-dependent manner. A better understanding of the regulation of IDO expression within the immune system may open new avenues for manipulating immunity in health and disease. {blacksquare}

References

  1. Mellor AL, Munn DH. IDO expression by dendritic cells: tolerance and tryptophan catabolism. Nat Rev Immunol. 2004;4: 762-774.[CrossRef][Medline] [Order article via Infotrieve]

  2. Bozza S, Fallarino F, Pitzurra L, et al. A crucial role for tryptophan catabolism at the host/Candida albicans interface. J Immunol. 2005;174: 2910-2918.[Abstract/Free Full Text]

  3. Luft T, Jefford M, Luetjens P, et al. Functionally distinct dendritic cell (DC) populations induced by physiologic stimuli: prostaglandin E(2) regulates the migratory capacity of specific DC subsets. Blood. 2002;100: 1362-1372.[Abstract/Free Full Text]

  4. Scandella E, Men Y, Gillessen S, Forster R, Groettrup M. Prostaglandin E2 is a key factor for CCR7 surface expression and migration of monocyte-derived dendritic cells. Blood. 2002;100: 1354-1361.[Abstract/Free Full Text]

  5. la Sala A, Sebastiani S, Ferrari D, et al. Dendritic cells exposed to extracellular adenosine triphosphate acquire the migratory properties of mature cells and show a reduced capacity to attract type 1 T lymphocytes. Blood. 2002;99: 1715-1722.[Abstract/Free Full Text]

  6. Schnurr M, Toy T, Shin A, Wagner M, Cebon J, Maraskovsky E. Extracellular nucleotide signaling by P2 receptors inhibits IL-12 and enhances IL-23 expression in human dendritic cells: a novel role for the cAMP pathway. Blood. 2005;105: 1582-1589.[Abstract/Free Full Text]

  7. Terness P, Chuang JJ, Bauer T, Jiga L, Opelz G. Regulation of human auto- and alloreactive T cells by indoleamine 2,3-dioxygenase (IDO)-producing dendritic cells: too much ado about IDO? Blood. 2005;105: 2480-2486.[Abstract/Free Full Text]

  8. Munn DH, Sharma MD, Baban B, et al. GCN2 kinase in T cells mediates proliferative arrest and anergy induction in response to indoleamine 2,3-dioxygenase. Immunity. 2005;22: 633-642.[CrossRef][Medline] [Order article via Infotrieve]


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