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Blood, 1 April 2007, Vol. 109, No. 7, pp. 2806-2814. Prepublished online as a Blood First Edition Paper on December 19, 2006; DOI 10.1182/blood-2006-06-030213.
HEMOSTASIS, THROMBOSIS, AND VASCULAR BIOLOGY Expression and release of soluble HLA-E is an immunoregulatory feature of endothelial cell activation1 Institut National de la Santé et de la Recherche Médicale, Unit 643, Institut de Transplantation et de Recherche en Transplantation, Nantes, France; 2 Service d'Anatomo-Pathologie, Centre Hospitalo-Universitaire (CHU) Hôtel-Dieu, Nantes, France; 3 Service de Médecine Interne, CHU Hôtel-Dieu, Nantes, France; 4 Institute of Molecular Genetics, Academy of Sciences of the Czech Republic, Prague, Czech Republic
Human leukocyte antigen (HLA)E belongs, with HLA-G and HLA-F, to the nonclassic major histocompatibility complex (MHC) class I (Ib) molecules, broadly defined by a limited polymorphism and a restricted pattern of cellular expression. In contrast to HLA-G, the expression and function of HLA-E and HLA-F in physiologic and pathologic processes remain poorly established. In the present study, we show that HLA-E protein expression in normal human nonlymphoid organs is mainly restricted to endothelial cells (ECs). HLA-E is also basally expressed by B and T lymphocytes, natural killer (NK) cells and by macrophages. We demonstrate that tumor necrosis factor (TNF ), interleukin-1ß (IL-1ß), and interferon (IFN ) up-regulate the cell-surface expression of HLA-E on ECs in vitro and induce the release of soluble HLA-E (sHLA-E). HLA-E up-regulation protects IFN -activated ECs from NK-mediated cell lysis, while sHLA-E protects bystander cells. Finally, sHLA-E is not detected in normal sera, and increased serum levels correlate with disease activity in patients with antineutrophil cytoplasmic antibodyassociated systemic vasculitis. Thus, HLA-E expression and release of sHLA-E are features of EC activation and emphasize immunoregulatory functions of the endothelium. The present identification of soluble HLA-E molecules may have important implications in understanding the pathogenesis of immune-mediated vascular diseases and for the diagnosis and monitoring of patients.
Human leukocyte antigen (HLA)E belongs, with HLA-G and HLA-F, to the nonclassical major histocompatibility complex (MHC) class I (Ib) molecules, broadly defined by a limited polymorphism and a restricted pattern of cellular expression.1 HLA-G plays an important role in immune tolerance during pregnancy, and in the escape of tumors from immune control. By contrast, the expression and function of HLA-E and HLA-F in physiologic and pathologic processes remain poorly established. Among Ib molecules, HLA-E was initially characterized by a broad pattern of mRNA expression in different cell types.2 Nevertheless, the surface expression of HLA-E requires the availability of a set of highly conserved nonameric peptides derived from the leader sequence of various HLA class I molecules, including HLA-A, HLA-B, HLA-C, and HLA-G,3,4 suggesting that HLA-E cell-surface expression may be limited to some cell type and/or cell-activation processes.
HLA-E has been identified as a ligand of CD94/NKG2A and CD94/NKG2C receptors expressed on natural killer (NK) cells and a subset of T cells.5,6 The interaction of HLA-E with the inhibitory CD94/NKG2A receptor results in inhibition of NK cell and cytotoxic T lymphocyte (CTL)dependent lysis.5,7 HLA-E molecules not only provide a protective pathway but also play a role in the regulation of T-cell function. HLA-E complexed with peptides can interact with The endothelium is a functional barrier between the vessel wall and the bloodstream. It exhibits a variety of important functions, including control of coagulation, fibrinolysis, vascular tone, growth, and immune responses.20 It is now clear that activation of the endothelium disturbs the physiologic protective regulatory balance; this is a critical factor in the progression of inflammatory and autoimmune diseases, as well as in atherosclerosis and in transplant rejection.21 Human vascular ECs basally display classes I and II MHC peptide complexes on their surface as well as some costimulatory molecules, enabling them to activate CD8+ and CD4+ T cells.22 For instance, the vascular endothelium of an allograft is a primary target for immune-mediated rejection and activation of resting CD8+ T cells to effector CTLs, occurring after recognition of MHC class Iexpressing ECs that leads to EC damage and vascular injury.23 Endothelial graft cells may also elicit humoral, donor-specific, anti-MHC response following transplantation. We have shown that, beyond complement activation, antibody-mediated cross-linking of donor MHC class I24 and class II25 molecules on human ECs results in EC activation, implicating specific signaling pathways. However, whether other MHC-related molecules, including the nonclassical class I MHC molecules, could be expressed on ECs and trigger either humoral or cellular response, or both, has been proposed but remains to be studied. Here, we investigated HLA-E protein expression in vivo and explored both regulation and function of HLA-E molecules on vascular endothelium in vitro and in vivo.
Tissue samples and sera
Comparative expression of HLA-E and HLA-G proteins was studied in various normal human tissues, including first-trimester placenta tissue, kidney, lymph node, spleen, salivary gland, urinary bladder, thyroid, endometrium, skin, stomach, and liver. For each tissue, at least 3 independent samples were immunostained and analyzed. Tissues were fixed in 10% formalin and routinely processed for paraffin embedding. Serum samples (n = 22) from 10 patients with antineutrophil cytoplasmic antibody (ANCA)associated vasculitis (Wegener granulomatosis [WG] and microscopic polyangiitis [MPA]) were analyzed. Disease activity was scored using the validated Birmingham Vasculitis Scoring Index (BVAS). Serum samples were obtained in the active phase (at diagnosis or relapse) and in remission (6 to 9 months later). The study was performed according to the guidelines of the local ethics committee (Comité Consultatif de Protection des Personnes dans la Recherche Biomédicale [CCPRB], CHU de Nantes, France). Sera from healthy blood donors (n = 9 individuals and a pool of 20 donors) were provided by Establissement Français du Sang (EFS) (Nantes, France) and used as controls. Human aortic endothelial cells (HAECs) were isolated from unused aortic pieces collected at the time of kidney transplantation and harvested according to good medical practice and stored in the DIVAT Biocollection (French Health Minister Project no. 02G55). C-reactive protein (CRP) levels were determined by turbidimetry. Quantification of the levels of soluble interleukin-2 receptor (sIL-2R AntiHLA-Especific antibodies The following antiHLA-Especific monoclonal antibodies (mAbs) were used: MEM-E/02, MEM-E/07, and MEM-E/08 in which HLA-E specificity was previously defined by flow cytometry on the Third International Conference on HLA-G (Paris, July 2003) and confirmed in independent studies.19,26 These antibodies were produced and provided by Pr. Vaclav Horejsi (Institute of Molecular Genetics, Praha, Czech Republic). MEM-E/02 recognizes the denaturated form of HLA-E molecules and was used for Western blotting and immunohistochemistry. MEM-E/07 and MEM-E/08 mAbs recognize the native surface HLA-E molecule, and were used for confocal microscopy, fluorescence-activated cell sorting (FACS) analysis and cytotoxicity assays. In contrast with MEM-E/03 and MEM-E/06, which exhibit the broadest cross-reactivities, MEM-E/02, MEM-E/07, and MEM-E/08 are specific antiHLA-E mAbs that exhibit only minimal cross-reactivities with some classical MHC antigens. MEM-E/02 (IgG1) does not cross-react with HLA-A, HLA-B, HLA-C, or HLA-G. MEM-E/07 (IgG1) cross-reacts with some classical MHC class I molecules: HLA-B7 (strongly); HLA-B8 (moderately); and HLA-B27 and HLA-B44 (weakly). MEM-E/08 (IgG1) is remarkably specific for HLA-E; it only shows weak cross-reactivity with the following classical MHC class I molecules: HLA-A24, HLA-B7, HLA-B27, HLA-B51, HLA-B54, and HLA-C7. Mouse IgG1 mAb MEM-G/01 reacts with the denatured HLA-G heavy chain of all isoforms and was purchased from Serotec (Cergy Saint-Christophe, France). Cell culture
Human umbilical vein ECs (HUVECs), HAECs and vascular smooth muscle cells (SMCs) were isolated and cultured as described.24,25 ECs were HLA typed and selected to avoid nonHLA-Especific cross-reactivity with the antiHLA-E mAbs listed earlier in "Materials and methods." The following EC types were used: HUVEC no. Gd (HLA-A02, HLA-A26, HLA-B08, and HLA-B515); HAEC no. 8186 (HLA-A01, HLA-A02, HLA-B51,5 and HLA-B525); HAEC no. 9007 (HLA-01,0 HLA-02, HLA-B35, and HLA-B39); HAEC no. 9054 (HLA-A2, HLA-A26, HLA-B51,5 and HLA-B6215); HAEC no. 10238 (HLA-A24,9 HLA-A33,19 HLA-B14, and HLA-B35); HAEC no. 11202 (HLA-A02, HLA-A24, HLA-B18, and HLA-B51); HAEC no. 11636 (HLA-A02, HLA-A29,19 HLA-B44,12 and HLA-B35); and HAEC no. 14756 (HLA-A01, HLA-A30,19 HLA-B18, and HLA-B57). ECs were cultured in EC growth medium (ECBM) supplemented with 10% FCS, 0.004 mL ECG supplement (ECGS)/heparin, 0.1 ng/mL hEGF, 1 ng/mL human basic firbroblast growth factor (hbFGF), 1 µg/mL hydrocortisone, 50 µg/mL gentamicin, and 50 ng/mL amphotericin B (C-22010; PromoCell, Heidelberg, Germany). For activation, confluent EC monolayers were incubated with recombinant human TNF Immunohistochemistry Paraffin sections (4 µm thick) were mounted on pretreated slides, deparaffinized with toluene, rehydrated through a graded series of ethanol, and rinsed in distilled water. Tissue sections were then subjected to epitope retrieval in a microwave oven using citrate buffer (pH 6.0). Tissue sections were stained using a 2-step visualization system based on a peroxidase-conjugated dextran backbone (Dako Envision+ System; Dako, Trappes, France). The following mAbs were used: antihuman HLA-E (MEM-E/02) and antihuman HLA-G (MEM-G/01). Sections were incubated with primary antibody at room temperature (RT) for 30 min and then incubated with the HRP-conjugated secondary antibody for 30 minutes at RT. Immunostaining was visualized using the 3,3-diaminobenzidine/H202 substrate, and tissues were counterstained with haematoxylin. For immunofluorescence, ECs were grown to confluence on glass coverslips. Cultures were washed with PBS and fixed for 20 minutes in PBS containing 4% paraformaldehyde. Cells were incubated overnight (ON) at 4°C with blocking buffer (5% BSA in PBS) and then incubated with an antiHLA class I (W6/32) or antiHLA-E (MEM-E/07) mAbs (10 µg/mL) in blocking buffer with or without Triton X-100 for 1 hours. Slides were rewashed and incubated with FITC-conjugated goat antimouse antibodies (5 µg/mL; Jackson Laboratories, West Grove, PA) for 1 hour. Endoplasmic reticulum (ER) and Golgi staining were performed using rhodamine-B-hexyl ester (2.5 µg/mL; Molecular Probes, Eugene, OR) and anti-Golgi mAbs (5 µg/mL; antigolgin-97, clone CDF4; Molecular Probes), respectively. Anti-Golgi mAbs were revealed using TRITC-conjugated goat antimouse antibodies (5 µg/mL; Jackson Laboratories). Nuclear staining was performed using To-Pro-3 (1:1000 dilution; Molecular Probes). Slides were washed in PBS, dried, and mounted with ProLong antifade reagent (Molecular Probes). Fluorescence microscopy was performed with a Leica DM-IRBE laser-scanning confocal microscope (Leica, Heerbrugg, Switzerland) using a 63 x 1.4 oil p-Aplo lens (Leica) and analyzed using Leica TCS NT software. RNA analysis and reverse transcriptasePCR RNA was isolated using TRIzol reagent (Invitrogen, Carlsbad, CA) and analyzed by competitive polymerase chain reaction (PCR) as described previously.27 Briefly, total RNA (2 µg) was reverse transcribed with oligo (dT), treated with RNase H, and made up to 50 µL. cDNAs were diluted 1:2 for competitions. Competitor templates were initially diluted 1:10,6 followed by 4 serial dilutions of 1:3 each. The primer sequences were: HLA-A (334 bp) sense: 5'-CTACCCTGCGGAGATCA-3', antisense: 5'-GCTCCCTCCTTTTCTATCTG-3'; HLA-B (255 bp) sense: CTACCCTGCGGAGATCA, antisense: ACAGCCAGGCCAGCAACA; HLA-E (257 bp) sense: 5'-CTACCCTGCGGAGATCA-3', antisense: 5'-AGAGAACCAGGCCAGCAAT-3'; and HPRT (78 bp) sense: 5'-GGACAGGACTGAACGTCTTGC-3', antisense: 5'-TTGAGCACACAGAGGGCTACA-3'. PCR products were sequenced by Genosys (Sigma-Aldrich, Saint Quentin Fallavier, France). Internal standards were obtained by mutagene PCR amplifications to generate mutated fragment by the deletion of 5 nucleotides as previously described.28 PCR products were separated on a 4% acrylamide gel and analyzed by capillary electrophoresis on an ABI PRISM 310 DNA Sequencer (PE Applied Biosystems, Foster City, CA) using GeneScan Analysis software (Applied Biosystems). Semi-quantitative PCR for HLA-E and ß-actin was carried out for 20 and 18 cycles, respectively, as follows: 94°C for 30 seconds, 60°C for 30 seconds, and 72°C for 30 seconds, with a final extension at 72°C for 3 minutes. PCR primers were: 5'-CCACCATGGTAGATGGAACCC-3', and antisense: 5'-GCTTTACAAGCTGTCAGACTC-3' for HLA-E; and sense: 5'-AATCTGGCACCACACCTTCTACA-3', and antisense: 5'-CGACGTAGCACAGCTTCTCCTTA-3' for ß-actin. PCR products were separated on 1.5% agarose gels in the presence of ethidium bromide. Western blotting
When applicable, cells were treated for 12 to 72 hours with 100 U/mL TNF Flow cytometry Cells were harvested, washed twice with PBS containing 1% BSA and 0.1% NaN3, and then incubated on ice for 30 minutes with a saturating concentration of the primary antibody. After 3 washes, cells were incubated with an FITC-labeled goat antimouse F(ab')2 IgG antibody (Jackson Laboratories) at 4°C for 30 minutes. Finally, cells were suspended in 1% paraformaldehyde in PBS. Negative controls were performed for each cell treatment by incubating the cells with isotype-matched control antibodies. The mouse mAbs used for this study were antiHLA-A2/A28 (ATCC) and antiHLA-E (MEM-E/07 or MEM-E/08). Fluorescence was measured on 10 000 cells/sample using a FACScalibur (Becton Dickinson, Mountain View, CA) and analyzed using CellQuestPro software (Becton Dickinson). Cytotoxicity assays
ECs were cultured with or without 100 U/mL IFN Statistical analysis The data are expressed as the mean ± SD and were compared using the 1-way ANOVA test. Differences were considered significant at P values less than .05.
HLA-E protein expression is restricted to leucocytes and ECs First, we examined HLA-E expression in human tissues by immunohistochemistry using mAbs specific for HLA-E or HLA-G as a control (Figure 1A). In placenta, comparative immunostaining indicated that HLA-E as well as HLA-G was expressed in extravillous trophoblast cells as previously reported.17,19 In all other normal, nonlymphoid, human tissues tested (kidney, skin, liver, salivary gland, urinary bladder, thyroid, stomach, and endometrium), HLA-E staining was restricted to ECs and was consistently observed on ECs from all types of vessels, including arteries, veins, capillaries, and lymphatics. As illustrated in Figure 1A, endothelial expression for HLA-E in kidney sections was present in vascular, capillary, and glomerular ECs. No staining was observed on mesenchymal, tubular, mesangial, or muscle cells, or adipocytes. In lymphoid organs such as spleen and lymph nodes (Figure 1B) endothelial expression for HLA-E was also observed on high endothelial venules (HEVs), concomitant with a strong expression in B and T lymphocytes as well as monocytes and macrophages (Figure 1B). Megakaryocytes but not erythrocytes also showed HLA-E immunostaining at a basal level. HLA-E distribution among mesenchymal, epithelial, and hematopoietic cells in various tissues is summarized Table S1, available on the Blood website (see the Supplemental Materials link at the top of the online article).
HLA-E expression at mRNA and protein levels was investigated in vitro using primary cultures of human vascular ECs. Because inflammation affects EC phenotype and functions,20,29 we studied the effects of the cytokines TNF , IL-1ß, and IFN on HLA-E expression and regulation. First, we quantified of HLA-A, HLA-B, and HLA-E mRNA levels in cultured ECs by competitive reverse transcription (RT)PCR using locus-specific primers and a competitor template with an internal deletion as previously reported.27 Transcripts encoded by all 3 HLA loci were detected in resting ECs, demonstrating that ECs express HLA-E constitutively. ECs expressed similar levels of HLA-A and HLA-E but lower levels of HLA-B transcripts (Figure 2A; *P < .05). Both TNF and IFN increased HLA-E transcript levels, peaking at 24 hours (Figure 2B).
Endothelial expression for HLA-E protein was investigated further on cultured human ECs. ECs were selected carefully according to their HLA type to avoid the reported cross-reactivity of the antiHLA-Especific mAbs with some classical MHC antigens, as described in "Materials and Methods." Immunofluorescence and confocal microscopy were used as a first attempt to examine surface and intracellular HLA-E expression in HAECs. Although weaker in intensity than staining for HLA-A, HLA-B, and HLA-C, HLA-E staining was found on nonpermeabilized cells (Figure 2C), confirming that HLA-E protein is localized at the outer surface of ECs. Intracellularly, HLA-E had a perinuclear distribution in permeabilized ECs (Figure 2C-D), where HLA-E fully colocalized with the ER, and partly with the Golgi apparatus (Figure 2D), suggesting that HLA-E molecules may be actively secreted. Endothelial expression of HLA-E protein is up-regulated by proinflammatory cytokines
Western blot analysis, performed on total-cell lysates from HAECs and HUVECs and using MEM-E/02 as antiHLA-Especific mAbs, revealed a single band at 42 kDa, consistent with the molecular weight for HLA-E protein (Figure 3A), and distinct from classical HLA class I proteins detected at 45 kDa (Figure 3F). Cell lysates were treated with PNGase F or EndoH and analyzed by Western blot (Figure 3B). Our data indicates that EndoH partially converted the 42-kDa form of HLA-E to a single band of lower molecular weight (40 kDa), indicating that part of the cytoplasmic HLA-E protein was in an EndoH-sensitive form. However, approximately 50% of HLA-E was EndoH resistant, implying passage through the medial Golgi, a feature of mature MHC class I proteins. These HLA-E molecules likely represent the fraction found at the plasma membrane and is consistent with our results from confocal microscopy. In contrast, and as expected, most of HLA-E was PNGase sensitive. Indeed, PNGase F cleaves nearly all types of N-glycans and was used as a control for glycosylation. Using flow cytometry, we were able to detect HLA-E at the cell surface where basal expression of HLA-E protein was low but significant, and this was observed consistently in cultures from HAECs and HUVECs (Figure 3C). Comparative cell-surface expression for HLA-A, HLA-B, HLA-C, and HLA-E was assessed by flow cytometry using W6/32 and MEM-E/07 mAbs on 7 independent HAEC cultures (Figure 3D). Although lower than those of classical HLA class I (HLA-A, HLA-B, and HLA-C), basal expression of HLA-E protein was significant and was consistently observed on the membrane of the different cultures. Similar immunostaining was obtained with 2 different antiHLA-Especific mAbs (MEM-E/07 and MEM-E/08) both recognizing the native HLA-E molecule,26 although immunostaining with MEM-E/08 appeared weaker than with MEM-E/07 mAbs (data not shown). In response to IFN
Next, we compared endothelial expression for HLA-E after stimulation with TNF , IL-1ß, and IFN , alone or in combination. Immunoblotting showed an increase in HLA-E protein in ECs stimulated with these cytokines. Consistent with immunohistochemistry on human tissues, Figure 3E shows that no HLA-G expression was found in cultured ECs, even after treatment with cytokines; immunostaining for VCAM-1 and ß2-microglobulin are shown as controls. FACS analysis confirmed that cytokines resulted in a significant increase in membrane-bound HLA-E compared with constitutive levels (Figure 3G). Combined treatment with TNF and IFN (Figure 3G) produced further increases in HLA-E expression. Although moderate, IFN -induced up-regulation of HLA-E protein expression was dose dependent and paralleled those of classical class I HLA (Figures 3F-G). Indeed, these cytokines induced a 4- to 7-fold increase in HLA-A2 expression in ECs and up to a 3-fold increase in HLA-E over a 48-hour period in ECs. Cytokine-activated ECs produce sHLA-E molecules
Next, we examined whether overexpression of HLA-E might be linked with the release of sHLA-E molecules, as described for other nonclassical class I MHC molecules, including HLA-G. Using Western blotting, we were able to detect the presence of sHLA-E in culture media from cytokine-activated ECs, whereas sHLA-E was below the detection threshold in conditioned medium from untreated ECs. Release of soluble HLA-E molecules was driven equally by TNF
As expected, flow cytometry analysis performed on freshly isolated PBMCs and cell lines (Jurkat, Raji, U937, and NKL) confirmed constitutive HLA-E expression on CD3+, CD4+, CD8+, CD19+, and CD14+ leukocyte subsets (Figure S1). When sHLA-E levels were measured, the presence of the sHLA-E was not detected under most conditions, except for purified NK cells and a NK cell line (NKL) activated by IL-2 (Figure S1). Together, these findings suggest that among HLA-E expressing cells, the production of sHLA-E is limited to a restricted set of activated cells, including endothelial and NK cells. Membrane-bound and soluble endothelial HLA-E molecules protect cells from CD94/NKG2A-mediated cytolysis
The functions of surface-bound and sHLA-E molecules, expressed and released by ECs, were evaluated in cell-mediated cytotoxicity assays. NK cells were purified from PBMCs and used as effector cells in cytotoxicity assays where target cells were the class Ideficient cell lines C1R and K562, and primary cultures of SMCs, which do not express HLA-E, or ECs (resting or activated for 48 hours with IFN
Presence of soluble HLA-E in the patient's sera correlates with disease activity in patients with AASV
As a prerequisite to determine the clinical relevance of sHLA-E in physiologic or pathologic situations, we tested for sHLA-E in the sera of patients with ANCA-associated systemic vasculitis (AASV), including WG and MPA. This well-defined primary vasculitis subgroup is predominantly characterized by systemic inflammation of small vessels, and provides a relevant clinical model to investigate the relation between clinical inflammation and endothelial activation.32,33 Disease activity in 10 patients was assessed according to clinical features and levels of ANCA and CRP. Serum samples of patients (n = 10; 22 sera) with active (diagnosis or relapse) or inactive disease (remission) and of healthy volunteers (n = 9) were collected and assayed for sHLA-E. The presence of sHLA-E in sera, examined by immunoblot analysis of sera, revealed a band at 37 kDa, similar to that of sHLA-E released in cell-culture medium (Figure 6A). No significant amount of sHLA-E was detected in any of the healthy volunteers (Figure 6A; Table 1). In contrast, sera from 9 of 11 sera from patients with active disease (at diagnosis or relapse) showed the presence of sHLA-E, whereas sHLA-E was detectable in sera from only 3 of 11 patients in the remission phase (*P < .01; Table 1). The presence of sHLA-E was correlated with elevated levels of CRP and soluble IL-2Rß (sIL-2Rß), IL-8, VEGF, and thrombomodulin in the patients' sera as determined by enzyme-linked immunosorbent assays (ELISAs) (Figure 6B). In samples collected during the remission phase, we found significant elevations in sIL-2R
Here we found that in contrast to the ubiquitously expressed classical HLA class I molecules, expression of the nonclassical HLA-E was restricted to specific cells, including ECs and immune cells (B, T lymphocytes, NK cells, monocytes, and macrophages). The first conclusion of this study is that although HLA-E transcripts can always be detected,2 the HLA-E protein is not always expressed despite the availability of peptides linked to HLA class I expression in most cells. Therefore, this suggests that specific posttranscriptional regulatory mechanisms might be critical for HLA-E protein expression in endothelial and immune cells. These mechanisms remain to be elucidated. Interestingly, as reported here and in previous studies, and similar to HLA-G, HLA-E is also expressed in trophoblasts, as is HLA-G,16,17,19 and in some tumor cells.18,26,34,35 Here, the expression of HLA-G was checked both in vivo and in vitro and found to be negative in ECs even upon inflammation. Furthermore, we found no evidence for the binding of sHLA-E to an endothelial receptor, as recently reported for soluble HLA-G and the CD160 receptor on ECs36 (data not shown). Therefore, our findings provide another example of constitutive expression for nonclassical class Ib molecules in a selected set of cells and thereby raise the possibility that HLA-E drives specific function in immune and vascular homeostasis. HLA-E is tightly up-regulated upon cytokine-induced activation at the EC surface. This up-regulation paralleled those of the classical HLA class I at the EC surface but remained moderate compared with those HLA class Ia. We also demonstrated a link between increased cell-surface expression and the release of sHLA-E in the extracellular compartment. Functionally, these experiments show the capability of sHLA-E to protect HLA-Enegative cells from NK cytolysis and provide the first evidence for a role of sHLA-E as an immunoregulatory molecule. Consistent with previous studies performed on HLA-Etransfected30 or HLA-Gtransfected37 cells, our experiments using inhibitors of metalloproteinase suggest that HLA-E undergoes proteolysis after reaching the EC surface. Release of a secreted form of HLA-E resulting from alternative gene splicing is also supported by our data and is under further investigation. Soluble isoforms of classical or nonclassical class I HLA molecules have been shown to exhibit various functions. Soluble isoforms of HLA-G have been detected in biological fluids, such as amniotic fluid and serum, they inhibit NK cytolysis,37 and they induce apoptosis of activated T cells.38 Another soluble nonclassical MHC molecule, the MHC class Irelated molecule MICA, acts as a competitive mimic that blocks recognition of membrane-bound ligand and as a suppressor that down-regulates NKG2D expression.39
We have recently shown in a concomitant study that IFN Furthermore, we found that sHLA-E release, as recently reported for HLA-G40 and MICA,41 may correlate with clinical outcome and is of potential relevance for the diagnosis and monitoring of patients. Indeed, we established the presence of sHLA-E in patients with active WG, a form of small-vessel vasculitis where endothelial activation in vessels parallels disease activity and systemic inflammation.33 Although little is known about the etiology of AASV, it is now becoming apparent that EC activation as well as immune mechanisms are central to the pathogenesis of these diseases.
Functionally, we found that enhanced HLA-E expression on IFN
Although not investigated in the present study, we speculate that HLA-E may also affect antigen presentation by the endothelium. Indeed, HLA-E displays features of antigen-presenting molecules whereas ECs display features of antigen-presenting cells (APCs).22,23,43 HLA-E recognition by human CTLs has been reported,10 and TCR Self-peptide presentation by HLA-E is thought to be central in the generation of suppressive CD8+ T cells controlling the expansion of pathogenic autoreactive T cells.14,15 Because the HLA-E peptide complexes can interact with the CD94/NKG2 receptors expressed on NK or classical CD8+ T cells to regulate function either positively or negatively, HLA-E may not only serve as the target of CD8 suppression, but might also regulate the function of CD8+ suppressor T cells via the CD94-NKG2 receptors. Suppressor T cells are essential for the control of autoimmunity and are also involved in the control of the immune response to transplanted allografts.44 In some conditions, ECs also suppress CD8+ T-cell activation by professional APCs, resulting in a form of immune tolerance.45,46 Whether endothelial HLA-E contributes to T-cell suppression rather than to T-cell activation has yet to be elucidated. To conclude, here we have established clearly that HLA-E expression and release of sHLA-E can be considered as markers of EC activation in inflammatory and autoimmune diseases. Given the putative impact of HLA-E bioactivity, we speculate that endothelial HLA-E may play a role in the pathogenesis of vascular diseases. Increased HLA-E and sHLA-E levels in response to inflammatory insults may serve as a protective response of EC to injury aimed at curbing NK-mediated lysis. Moreover, increased expression of HLA-E may either be deleterious through the recognition of this nonclassical HLA molecule by CTLs, mediating allograft rejection, or beneficial through the generation of suppressive CD8+ T cells, as shown in mice models with the Qa-1 molecule. Overall, this implies that endothelial HLA-E may regulate multiple functions and therefore underscores the fundamental role of ECs in immune regulation pathways.
Contribution: S.C. designed the research and performed the experiments; A.M. performed immunohistochemistry analysis; M.H. provided sera from patients with AASV and analyzed the data; V.H. contributed new antiHLA-E monoclonal antibodies; J.P.S. analyzed data; and B.C. designed and performed the experiments and wrote the paper. Conflict-of-interest disclosure: The authors declare no competing financial interests. Correspondence: Béatrice Charreau, INSERM U643, 30 bd J. Monnet, Nantes, F-44093 France; e-mail: Beatrice.Charreau{at}univ-nantes.fr.
The authors wish to thank Jeanne Souchet, Estelle Drouet, and Bernadette Denis for technical assistance, and Annabelle Chauveau for excellent assistance with confocal microscopy. This work was supported by a grant "Recherche et Greffe 2005" from l'Agence de Biomédecine and a grant from the Société de Néphrologie.
Submitted June 22, 2006; accepted November 22, 2006.
Prepublished online as Blood First Edition Paper, December 19, 2006
DOI: 10.1182/blood-2006-06-030213
The publication costs of this article were defrayed in part by page charge payment. Therefore, and solely to indicate this fact, this article is hereby marked "advertisement" in accordance with 18 USC section 1734.
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