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Blood, Vol. 95 No. 8 (April 15), 2000: pp. 2482-2483

FOCUS ON HEMATOLOGY

Introduction: TH2-inducing DC2 for immunotherapy

Yong-Jun Liu and Bianca Blom

From the Department of Immunobiology, DNAX Research Institute of Molecular and Cellular Biology, 901 California Avenue, Palo Alto, CA 94306.


    Introduction
Top
Introduction
Acknowledgments
References

The concept of tolerogenic dendritic cells (DCs) came from experiments in mice showing that thymic DCs mediated clonal deletion of emerging autoreactive T cells within thymus.1 The finding that lymphoid precursors give rise to both T cells and CD8+CD11b- DCs within the thymus suggests the existence of a lymphoid pathway, in addition to a well-established myeloid DC pathway giving rise to CD8-CD11b+ DCs.2 In mouse spleen, both CD8-CD11b+ myeloid DCs and CD8+CD11b- lymphoid DCs were identified. The finding that lymphoid DCs express higher levels of self-peptide-MHC class II complex3 and FAS-binding protein4 suggests that lymphoid DCs may be tolerogenic for T cells, in contrast to immunogenic myeloid DCs. This hypothesis was not, however, supported by studies showing that CD8+CD11b- lymphoid DCs produce a high level of IL-12 and induce potent TH1 response to foreign antigens.5-8 The existence of tolerogenic or TH2-inducing DCs in peripheral tissues was, however, further suggested by studies of DCs from Peyer's patches, liver, and lung. These DCs were shown to preferentially induce TH2 responses, in contrast to splenic DCs and bone-marrow-derived DCs that preferentially induce TH1 responses.9-11 The TH2-inducing function of Peyer's patch DCs and liver DCs may contribute to the mechanism underlying tolerance to food antigens or to allo-liver transplants, respectively.


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TH2-inducing dendritic cell precursors (pre-DC2) are derived from hematopoietic stem cells (HSC) in bone marrow. Signals regulating HSC differentiation into pre-DC2 are currently unknown. G-CSF appears to mobilize bone marrow pre-DC2 into peripheral blood. Recipients of blood stem cell transplantation from G-CSF-treated donors received 5- to 6-fold more pre-DC2 than did recipients of bone marrow stem cell products. Pre-DC2 may capture alloantigen and undergo maturation after transfer into the host. These DC2 may present alloantigen to donor T cells and induce them to undergo TH2 differentiation and to limit GVHD.

To find tolerogenic or TH2-inducing DCs in humans and to develop a way to grow and manipulate these DCs for use in immunotherapy for autoimmune diseases and GVHD have been an immunologist's fantasy. Recently, human lymphoid DCs (DC2) have been generated from human blood CD4+IL-3Ralpha ++CD11c- precursors (pre-DC2) in culture with IL-3 and CD40-ligand.13-17 In contrast to CD40-ligand-activated monocyte-derived DC1 that produce a large amount of IL-12 and induce TH1 differentiation, CD40-ligand-activated DC2 produce a lower amount of IL-12 and induce TH2 differentiation.13 Although TH1-inducing myeloid DC1 and CD11c+ blood DCs have been used in immunotherapy for certain human cancers,18-21 potential application of TH2-inducing DC2 in immunotherapy for autoimmune diseases and GVHD has been limited. This is because the frequency of pre-DC2 in human blood is low (0.2% to 0.8%), and the identity and function of mature DC2 in vivo is unclear.

In this issue of Blood, Dr Arpinati and colleagues report a major advancement in human DC biology, which may pave the way toward DC2-based immunotherapy for autoimmune disease and GVHD.22 They show that G-CSF treatment, which is widely used to mobilize hematopoietic stem cells into blood for stem cell transplantation, induced a more than 5-fold increase in blood pre-DC2 numbers. Interestingly, the number of blood myeloid CD11c+DC were found unchanged in the same donor. The authors further showed that while DC1 derived from CD11c+ blood immature DCs cultured with GM-CSF, IL-3, and TNF-a preferentially induced TH1 differentiation, pre-DC2-derived DC2 cultured with the same cytokines preferentially induced TH2 differentiation. Together with a recent study by Rissoan et al,13 Arpinati's study suggests that T helper cell differentiation depends not only on the maturation stage of DCs, but also on the type of DCs.

The question is what the functional consequence is of transferring more DC2 or pre-DC2 into patients. This study showed that recipients of blood stem cell preparations from G-CSF-treated donors received 5- to 6-fold more pre-DC2 than did recipients of bone marrow stem cell products. Interestingly, human G-CSF-mobilized blood stem cells do not cause a higher incidence of GVHD than marrow grafts,23,24 despite containing 10-fold more T cells.25 In mice, pretreatment of donor mice with G-CSF enhances TH2-cytokine production and reduces severity of experimental GVHD.26,27 These studies suggest that pre-DC2 in G-CSF-treated blood may capture alloantigen and undergo maturation after transfer into the host. These DC2 may present alloantigen to donor T cells and induce them to undergo TH2 differentiation and to limit GVHD (Figure).

The combination of G-CSF treatment and blood leukapheresis may offer, for the first time, the possibility of generating sufficient DC2s for immunotherapy of certain autoimmune diseases and GVHD. Understanding the developmental pathway and regulation of pre-DC2 from hematopoietic stem cells will be the next critical step in generating a large number of DC2 for immunotherapy. Because the identity of mature DC2 in vivo and the fate of the transferred pre-DC2 in recipient patients are unclear, a direct correlation between pre-DC2 transfer with an increased TH2 differentiation and a decreased GVHD remains to be established.


    Acknowledgments
Top
Introduction
Acknowledgments
References

We thank Dr M. Andonian for graphic works and M. Gilliet for critical reading of the manuscript. DNAX Research Institute is fully supported by Schering-Plough.


    Footnotes

Reprints: Yong-Jun Liu, Department of Immunobiology, DNAX Research Institute of Molecular and Cellular Biology, 901 California Avenue, Palo Alto, CA 94306.

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 U.S.C. section 1734.


    References
Top
Introduction
Acknowledgments
References

1. Brocker T, Riedinger M, Karjalainen K. Targeted expression of major histocompatibility complex (MHC) class II molecules demonstrates that dendritic cells can induce negative but not positive selection of thymocytes in vivo. J Exp Med. 1997;185:541[Abstract/Free Full Text].

2. Shortman K, Vremec D, Corcoran LM, Georgopoulos K, Lucas K, Wu L. The linkage between T-cell and dendritic cell development in the mouse thymus. Immunol Rev. 1998;165:39[Medline] [Order article via Infotrieve].

3. Inaba K, Pack M, Inaba M, Sakuta H, Isdell F, Steinman RM. High levels of a major histocompatibility complex II-self peptide complex on dendritic cells from the T cell areas of lymph nodes. J Exp Med. 1997;186:665[Abstract/Free Full Text].

4. Suss G, Shortman K. A subclass of dendritic cells kills CD4 T cells via Fas/Fas-ligand-induced apoptosis. J Exp Med. 1996;183:1789[Abstract/Free Full Text].

5. Sousa CR, Hieny S, Scharton-Kersten T, et al. In vivo microbial stimulation induces rapid CD40 ligand-independent production of interleukin 12 by dendritic cells and their redistribution to T cell areas. J Exp Med. 1997;86:1819.

6. Pulendran B, Smith JL, Caspary G, et al. Distinct dendritic cell subsets differentially regulate the class of immune response in vivo. Proc Natl Acad Sci U S A. 1999;96:1036[Abstract/Free Full Text].

7. Maldonado-Lopez R, De Smedt T, Michel P, et al. CD8alpha+ and CD8alpha- subclasses of dendritic cells direct the development of distinct T helper cells in vivo. J Exp Med. 1999;189:587[Abstract/Free Full Text].

8. Smith AL, de St Groth BF. Antigen-pulsed CD8alpha+ dendritic cells generate an immune response after subcutaneous injection without homing to the draining lymph node. J Exp Med. 1999;189:593[Abstract/Free Full Text].

9. Iwasaki A, Kelsall BL. Freshly isolated Peyer's patch, but not spleen, dendritic cells produce interleukin 10 and induce the differentiation of T helper type 2 cells. J Exp Med. 1999;190:229[Abstract/Free Full Text].

10. Stumbles PA, Thomas JA, Pimm CL, et al. Resting respiratory tract dendritic cells preferentially stimulate T helper cell type 2 (Th2) responses and require obligatory cytokine signals for induction of Th1 immunity. J Exp Med. 1998;188:2019[Abstract/Free Full Text].

11. Khanna A, Morelli AE, Zhong C, Takayama T, Lu L, Thomson AW. Effects of liver-derived dendritic cell progenitors on Th1- and Th2-like cytokine responses in vitro and in vivo. J Immunol. 2000;164:1346[Abstract/Free Full Text].

12. Smith AL, de St Groth BF. Antigen-pulsed CD8alpha+ dendritic cells generate an immune response after subcutaneous injection without homing to the draining lymph node. J Exp Med. 1999;189:593.

13. Rissoan M-C, Soumelis V, Kadowaki N, et al. Reciprocal control of T helper cell and dendritic cell differentiation. Science. 1999;283:1183[Abstract/Free Full Text].

14. Grouard G, Rissoan MC, Filgueira L, Durand I, Banchereau J, Liu Y-J. The enigmatic plasmacytoid T cells develop into dendritic cells with interleukin (IL)-3 and CD40-ligand. J Exp Med. 1997;185:1101[Abstract/Free Full Text].

15. Olweus J, BitMansour A, Warnke R, et al. Dendritic cell ontogeny: a human dendritic cell lineage of myeloid origin. Proc Natl Acad Sci U S A. 1997;94:12,551[Abstract/Free Full Text].

16. O'Doherty U, Peng M, Gezelter S, et al. Human blood contains two subsets of dendritic cells, one immunologically mature and the other immature. Immunology. 1994;82:487[Medline] [Order article via Infotrieve].

17. Res PC, Couwenberg F, Vyth-Dreese FA, Spits H. Expression of pTalpha mRNA in a committed dendritic cell precursor in the human thymus. Blood. 1999;94:2647[Abstract/Free Full Text].

18. Hsu FJ, Benike C, Fagnoni F, et al. Vaccination of patients with B-cell lymphoma using autologous antigen-pulsed dendritic cells. Nat Med. 1996;2:52[Medline] [Order article via Infotrieve].

19. Nestle FO, Alijagic S, Gilliet M, et al. Vaccination of melanoma patients with peptide- or tumor lysate-pulsed dendritic cells. Nat Med. 1998;4:328[Medline] [Order article via Infotrieve].

20. Thurner B, Haendle I, Roder C, et al. Vaccination with mage-3A1 peptide-pulsed mature, monocyte-derived dendritic cells expands specific cytotoxic T cells and induces regression of some metastases in advanced stage IV melanoma. J Exp Med. 1999;190:1669[Abstract/Free Full Text].

21. Salgaller ML, Thurnher M, Bartsch G, Boynton AL, Murphy G. Report from the International Union Against Cancer (UICC) Tumor Biology Committee: UICC workshop on the use of dendritic cells in cancer clinical trials. Cancer. 1999;86:2674[Medline] [Order article via Infotrieve].

22. Arpinati M, Green CL, Heimfeld S, Anasetti C. G-CSF mobilizes T helper 2-inducing dendritic cells. Blood. 2000;95:2484[Abstract/Free Full Text].

23. Beelen DW, Ottinger HD, Elmaagacli A, et al. Transplantation of filgrastim-mobilized peripheral blood stem cells from HLA-identical sibling or alternative family donors in patients with hematologic malignancies: a prospective comparison on clinical outcome, immune reconstitution, and hematopoietic chimerism. Blood. 1997;90:4725[Abstract/Free Full Text].

24. Aversa F, Tabilio A, Velardi A, et al. Treatment of high-risk acute leukemia with T-cell-depleted stem cells from related donors with one fully mismatched HLA haplotype. N Engl J Med. 1998;339:1186[Abstract/Free Full Text].

25. Bensinger WI, Clift RA, Anasetti C, et al. Transplantation of allogeneic peripheral blood stem cells mobilized by recombinant human granulocyte colony stimulating factor. Stem Cells. 1996;14:90[Abstract].

26. Pan L, Delmonte J Jr, Jalonen CK, Ferrara JL. Pretreatment of donor mice with granulocyte colony-stimulating factor polarizes donor T lymphocytes toward type-2 cytokine production and reduces severity of experimental graft-versus-host disease. Blood. 1995;86:4422[Abstract/Free Full Text].

27. Zeng D, Dejbakhsh-Jones S, Strober S. Granulocyte colony-stimulating factor reduces the capacity of blood mononuclear cells to induce graft-versus-host disease: impact on blood progenitor cell transplantation. Blood. 1997;90:453[Abstract/Free Full Text].


© 2000 by The American Society of Hematology.
 

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