George Makedonas

Perforin Expression Directly Ex Vivo by HIV-Specific CD8+ T-Cells Is a Correlate of HIV Elite Control

Many immune correlates of CD8+ T-cell-mediated control of HIV replication, including polyfunctionality, proliferative ability, and inhibitory receptor expression, have been discovered. However, no functional correlates using ex vivo cells have been identified with the known ability to cause the direct elimination of HIV-infected cells. We have recently discovered the ability of human CD8+ T-cells to rapidly upregulate perforin—an essential molecule for cell-mediated cytotoxicity—following antigen-specific stimulation. Here, we examined perforin expression capability in a large cross-sectional cohort of chronically HIV-infected individuals with varying levels of viral load: elite controllers (n = 35), viremic controllers (n = 29), chronic progressors (n = 27), and viremic nonprogressors (n = 6). Using polychromatic flow cytometry and standard intracellular cytokine staining assays, we measured perforin upregulation, cytokine production, and degranulation following stimulation with overlapping peptide pools encompassing all proteins of HIV. We observed that HIV-specific CD8+ T-cells from elite controllers consistently display an enhanced ability to express perforin directly ex vivo compared to all other groups. This ability is not restricted to protective HLA-B haplotypes, does not require proliferation or the addition of exogenous factors, is not restored by HAART, and primarily originates from effector CD8+ T-cells with otherwise limited functional capability. Notably, we found an inverse relationship between HIV-specific perforin expression and viral load. Thus, the capability of HIV-specific CD8+ T-cells to rapidly express perforin defines a novel correlate of control in HIV infection.

Increased HIV-specific CD8 + T-cell cytotoxic potential in HIV elite controllers is associated with T-bet expression

Recent data suggest that CD8+ T-cell effector activity is an important component in the control of HIV replication in elite controllers (ECs). One critical element of CD8+ T-cell effector function and differentiation is the T-box transcription factor T-bet. In the present study, we assessed T-bet expression, together with the effector proteins perforin, granzyme A (Grz A), granzyme B (Grz B), and granulysin, in HIV-specific CD8+ T cells from ECs (n = 20), chronically infected progressors (CPs; n = 18), and highly active antiretroviral therapy (HAART)-suppressed individuals (n = 19). Compared with the other cohort groups, HIV-specific CD8+ T cells among ECs demonstrated a superior ability to express perforin and Grz B, but with no detectable difference in the levels of Grz A or granulysin. We also observed higher levels of T-bet in HIV-specific CD8+ T cells from ECs, with an ensuing positive correlation between T-bet and levels of both perforin and Grz B. Moreover, HIV-specific CD8+ T cells in ECs up-regulated T-bet to a greater extent than CPs after in vitro expansion, with concomitant up-regulation of perforin and Grz B. These results suggest that T-bet may play an important role in driving effector function, and its modulation may lead to enhanced effector activity against HIV.

Polyfunctional analysis of human t cell responses: importance in vaccine immunogenicity and natural infection

More than 25 million people have died of AIDS as a result of infection with the human immunodeficiency virus (HIV), and between 36 and 45 million individuals are living with the virus. While HIV is rampant in subSaharan Africa and the Caribbean, there are growing epidemics in Eastern Europe and Central Asia. Despite significant advances in our understanding of the virus, increased public awareness and intervention, and the development of effective treatment regimens, the annual rate of new HIV infections threatens to increase around the world without some kind of novel intervention, according to recent projections by UNAIDS. There is, thus, a desperate need for the development of a preventative vaccine against HIV infection. HIV vaccine development has been hindered primarily by the difficulty of inducing antibodies capable of neutralizing the virus. Antibody-producing B cells recognize the variable loops of gp120, but the high error rate of viral reverse transcriptase (RT), along with the rapid turnover of plasma virions, provides a broad base of variants that escape detection by humoral immunity [1, 2]. The infidelity of RT during viral replication also promotes changes in envelope glycosylation patterns that render neutralization-sensitive domains inaccessible to HIV-specific antibodies [3–6]. In the simian immunodeficiency virus (SIV)/non-human primate model of HIV infection, no vaccine candidate to date has been shown to stimulate effective neutralizing antibodies capable of protecting its host against a heterologous virus challenge. Furthermore, a study in which neutralizing antibodies were passively transferred into rhesus macaques necessitated unreasonably high titers of antibody to achieve protection from infection [7]. Similar studies in HIV-infected humans have not only yielded very limited evidence of protection but have even suggested the promotion of viral escape [8]. Although efforts continue in the hope of developing an immunogen that will induce neutralizing antibodies, researchers have more recently focused on vaccine candidates that will primarily stimulate cellular immune responses against HIV. The cellular immune responses are known to provide effective control of several chronic human pathogens, including Epstein–Barr virus (EBV) [9, 10], cytomegalovirus (CMV) [11–13], and hepatitis viruses B [14–16] and C [17]. The cytotoxic CD8 T lymphocytes (CTL) are thought to be the primary mediators of control of viral replication due to their ability to recognize and eliminate infected autologous cells. CD4 T helper (Th) cells also play a critical role in protection from viral and bacterial pathogens, as these cells provide support for both cellular and humoral immune responses. The precise mechanism(s) of control in different pathogenic settings, however, remains elusive. The SIV/rhesus macaque experimental system has provided compelling evidence in support of a role for T cells in the control of HIV/SIV replication. The depletion of CD8 T cells during either primary or chronic SIV infection in Mamu A*01-positive rhesus macaques is directly correlated to an increase in SIV viral load [18, 19]. In addition, the presence of vaccine-induced SIV-specific CD4 and CD8 T cells leads to a reduction in viral load during primary SIV infection [20–22]. A similar in vivo evidence in the setting of HIV infection has been difficult to Springer Semin Immun (2006) 28:209–219 DOI 10.1007/s00281-006-0025-4

Perforin and IL-2 Upregulation Define Qualitative Differences among Highly Functional Virus-Specific Human CD8(+) T Cells

The prevailing paradigm of T lymphocyte control of viral replication is that the protective capacity of virus-specific CD8+ T cells is directly proportional to the number of functions they can perform, with IL-2 production capacity considered critical. Having recently defined rapid perforin upregulation as a novel effector function of antigen-specific CD8+ T cells, here we sought to determine whether new perforin production is a component of polyfunctional CD8+ T cell responses that contributes to the control of several human viral infections: cytomegalovirus (CMV), Epstein-Barr virus (EBV), influenza (flu), and adenovirus (Ad). We stimulated normal human donor PBMC with synthetic peptides whose amino acid sequences correspond to defined CTL epitopes in the aforementioned viruses, and then used polychromatic flow cytometry to measure the functional capacity and the phenotype of the responding CD8+ T cells. While EBV and flu-specific CD8+ T cells rarely upregulate perforin, CMV-specific cells often do and Ad stimulates an exceptionally strong perforin response. The differential propensity of CD8+ T cells to produce either IL-2 or perforin is in part related to levels of CD28 and the transcription factor T-bet, as CD8+ T cells that rapidly upregulate perforin harbor high levels of T-bet and those producing IL-2 express high amounts of CD28. Thus, “polyfunctional” profiling of antigen-specific CD8+ T cells must not be limited to simply the number of functions the cell can perform, or one particular memory phenotype, but should actually define which combinations of memory markers and functions are relevant in each pathogenic context.

Mutations in GATA2 cause human NK cell deficiency with specific loss of the CD56(bright) subset.

Mutations in the transcription factor GATA2 underlie the syndrome of monocytopenia and B- and natural killer (NK)-cell lymphopenia associated with opportunistic infections and cancers. In addition, patients have recurrent and severe viral infections. NK cells play a critical role in mediating antiviral immunity. Human NK cells are thought to mature in a linear fashion, with the CD56(bright) stage preceding terminal maturation to the CD56(dim) stage, considered the most enabled for cytotoxicity. Here we report an NK cell functional defect in GATA2-deficient patients and extend this genetic lesion to what is considered to be the original NK cell-deficient patient. In most cases, GATA2 deficiency is accompanied by a severe reduction in peripheral blood NK cells and marked functional impairment. The NK cells detected in peripheral blood of some GATA2-deficient patients are exclusively of the CD56(dim) subset, which is recapitulated on in vitro NK cell differentiation. In vivo, interferon α treatment increased NK cell number and partially restored function but did not correct the paucity of CD56(bright) cells. Thus, GATA2 is required for the maturation of human NK cells and the maintenance of the CD56(bright) pool in the periphery. Defects in GATA2 are a novel cause of profound NK cell dysfunction.

Baseline Ad5 serostatus does not predict Ad5 HIV vaccine-induced expansion of adenovirus-specific CD4+ T cells.

The mechanisms underlying possible increased HIV-1 acquisition in adenovirus 5 (Ad5)-seropositive subjects vaccinated with Ad5–HIV-1 vectors in the Merck STEP trial remain unclear. We find that Ad5 serostatus does not predict Ad5-specific CD4+ T cell frequency, and we did not observe durable significant differences in Ad5-specific CD4+ T cells between Ad5-seropositive and Ad5-seronegative subjects after vaccination. These findings indicate no causative role for Ad5-specific CD4+ T cells in increasing HIV-1 susceptibility in the STEP trial.

Living in a house of cards: re-evaluating CD8+ T-cell immune correlates against HIV.

Summary:  The Merck STEP and the Thai RV144 human immunodeficiency virus (HIV) vaccine trials confirmed that we still have a long way to go before developing a prophylactic HIV vaccine. The main issue at hand is that we have yet to identify an immunological correlate of protection against HIV. While many question the T‐cell‐based approach towards vaccine development, it is likely that T cells will be a necessary part of any vaccine strategy. CD8+ T cells remain an attractive option because of their ability to specifically recognize and eliminate virally infected host cells. In this review, we recapitulate the evidence for CD8+ T cells as an immunological correlate against HIV, but more importantly, we assess the means by which we evaluate their antiviral capacity. To achieve a breakthrough in the domain of T‐cell‐based HIV vaccine development, it has become abundantly clear that we must overhaul our system of immune monitoring and come up with a ‘rational’ tactic to evaluate the efficacy of HIV‐specific CD8+ T cells.

Differential Localization of T-bet and Eomes in CD8 T Cell Memory Populations

In mice, two T-box transcription factors, T-box expressed in T cells (T-bet) and eomesodermin (Eomes), drive the differentiation of CD8 T cell lineages; however, little is known regarding their role in human CD8 T cell differentiation. In this study, we characterized T-bet and Eomes expression and localization within human CD8 memory T cell populations. We find that T-bet and Eomes are broadly expressed in human memory CD8 T cells, with increasing levels of T-bet and Eomes strongly correlating with differentiation from central memory to effector memory and effector subpopulations. In resting T cells, T-bet levels directly correlate to subcellular localization, with a higher propensity for nuclear expression of T-bet within T-bethi cells and predominantly cytoplasmic expression in T-betlo cells. In addition, Eomes is also localized to either the nucleus or the cytoplasm. Upon TCR stimulation, the percentage of T cells that express T-bet dramatically increases, whereas the percentage of cells expressing Eomes remains largely unchanged across all memory populations. Of interest, T-bet, but not Eomes, relocalizes to the nucleus in the majority of cells across all populations within 24 h post stimulation. These data indicate that T-bet and Eomes are likely regulated at the level of subcellular localization, potentially via different mechanisms. Together, these findings suggest a novel model for CD8 T cell differentiation in humans that is based on the localization of T-bet and Eomes.

Adenovirus-specific human T cells are pervasive, polyfunctional, and cross-reactive.

Pre-existing immunity to adenovirus (Ad) reduces the efficacy of Ad-based vaccines. The goal of this study was to define the prevalence, magnitude, functionality and phenotype of Ad-specific human T cells directly ex vivo. To study the magnitude of T-cell responses to Ad, we developed a highly reproducible whole Ad vector stimulation assay for use with polychromatic flow cytometry. Ad-specific CD4(+) and CD8(+) T-cells were detected in all 17 human subjects tested and were capable of proliferating upon restimulation. Ad5-specific CD4(+) T cells were primarily monofunctional CD4(+) T cells that produced IL-2, IFN-gamma or TNFalpha and expressed the memory markers CD27 and CD45RO. In contrast, Ad5-specific CD8(+) T cells were more polyfunctional, expressing effector-like combinations of IFN-gamma, MIP1alpha and perforin, and generally lacked CD27 and CD45RO expression. Ad-specific CD4(+) and CD8(+) T-cell responses against chimpanzee-derived AdC6 and AdC7 were found in all subjects, indicating the commonality of cross-serotype reactivity of Ad-specific T cells. This cross-reactivity is due in part to extensive CD4(+) and CD8(+) T-cell recognition of hexon regions conserved between multiple Ad serotypes. The prevalence, cross-reactivity and effector-like functions of Ad-specific T cells in humans may affect the efficacy of Ad vector-based vaccines by eliminating vector infected cells even when rare serotype Ad vectors are employed.

Rapid Up-Regulation and Granule-Independent Transport of Perforin to the Immunological Synapse Define a Novel Mechanism of Antigen-Specific CD8+ T Cell Cytotoxic Activity

CTL are endowed with the ability to eliminate pathogens through perforin-mediated cytotoxic activity. The mechanism for perforin-mediated Ag-specific killing has been solely attributed to cytotoxic granule exocytosis from activated CD8+ T cells. In this study, we redefine this mechanism, demonstrating that virus-specific CD8+ T cells rapidly up-regulate perforin in response to stimulation temporally with IFN-γ and CD107a expression. Following Ag-specific activation, newly synthesized perforin rapidly appears at the immunological synapse, both in association with and independent of cytotoxic granules, where it functions to promote cytotoxicity. Our work suggests a novel mechanism of CTL cytotoxicity and identifies a novel correlate of CD8+ T cell-mediated immunity.