John F. Dunne

Experimentally Induced Recruitment of Plasmacytoid (CD123high) Dendritic Cells in Human Nasal Allergy

Recent evidence suggests that the previously enigmatic cell type designated plasmacytoid monocytes can function as dendritic cells and contribute substantially to both innate and adaptive immunity. This cell type has previously been described only in bone marrow, blood, and organized lymphoid tissue, but not at effector sites with direct Ag exposure such as the mucosae. Plasmacytoid dendritic cells (P-DCs) matured in vitro can induce T cells to produce allergy-promoting Th2 cytokines; therefore, their possible occurrence in nasal mucosa during experimentally elicited allergic rhinitis was examined. Patients with silent nasal allergy were challenged topically with relevant allergen daily for 7 days. Biopsy specimens as well as blood samples were obtained before and during such provocation, and P-DCs were identified by their high expression of CD123 (IL-3R α-chain), together with CD45RA. Our results showed that P-DCs were present in low and variable numbers in normal nasal mucosa but increased dramatically during the allergic reaction. This accumulation concurred with the expression of the L-selectin ligand peripheral lymph node addressin on the mucosal vascular endothelium. The latter observation was particularly interesting in view of the high levels of L-selectin on circulating P-DC precursors and of previous reports suggesting that these cells can enter organized lymphoid tissue via high endothelial venules (which express peripheral lymph node addressin constitutively). Together, our findings suggested that P-DCs are involved in the triggering of airway allergy and that they are directed to allergic lesions by adhesion molecules that normally mediate leukocyte extravasation in organized lymphoid tissue.

Secretion capture and report web: use of affinity derivatized agarose microdroplets for the selection of hybridoma cells.

A novel assay is described which allows the entrapment and detection of the immunoglobulin secreted from individual viable hybridoma cells using a secretion capture and reporter web (SCRW). By encapsulating the cells in agarose microdroplets which have been derivatized to create a fluorescent antigen-specific sandwich assay, flow cytometry can be used to identify and sort productive cells from a heterogeneous population. Using agarase, the cells can be recovered from the microdroplets and clonally expanded after selection. The assay has been used to reclone rare secretors from hybridoma cultures and to enhance the production of cultures with poor producers. The assay is easily generalized for the detection of any secreted protein for which specific antibodies or other ligands are available.

A flow cytometric immune function assay for human peripheral blood dendritic cells.

CD11c+ and CD11c− (CD123+) dendritic cells (DCs) have been described in blood. Both cell types express high levels of HLA‐DR and lack the lineage markers CD3, CD14, CD19, CD20, CD16, and CD56. These immunophenotypic properties were used along with analysis of activation‐related surface antigens and intracellular staining of cytokines to characterize functional responses of these DC subsets to stimuli in whole human blood (WB). Samples from healthy donors were activated with lipopolysaccharide (LPS) or phorbol 12‐myristate 13‐acetate plus ionomycin (PMA+I). The only distinct response in CD11c−DCs was the expression of CD25 upon PMA+I activation. CD11c+ cells responded to LPS stimulation by producing high levels of interleukin‐1β (IL‐1β) and tumor necrosis factor α (TNF‐α), and lower levels of IL‐6, IL‐1Ra, and IL‐8 and an increased expression of accessory molecules (CD25, CD40, CD80, CD86, HLA‐DR, and HLA‐DQ). PMA+I activation of CD11c+ cells resulted in high levels of IL‐1p and lower levels of IL‐8, IL‐1Ra, and TNF‐ct and up‐regulation of CD80, CD86, HLA‐DR, and HLA‐DQ. Our data support prior observations of functional differences between peripheral blood DC subsets and demonstrate the power of multiparameter flow cytometry to characterize the pleiotropic responses of these cells to various stimuli. J. Leukoc. Biol. 67: 536–544; 2000.

Functional T Cell Responses to Tumor Antigens in Breast Cancer Patients Have a Distinct Phenotype and Cytokine Signature

The overall prevalence with which endogenous tumor Ags induce host T cell responses is unclear. Even when such responses are detected, they do not usually result in spontaneous remission of the cancer. We hypothesized that this might be associated with a predominant phenotype and/or cytokine profile of tumor-specific responses that is different from protective T cell responses to other chronic Ags, such as CMV. We detected significant T cell responses to CEA, HER-2/neu, and/or MAGE-A3 in 17 of 21 breast cancer patients naive to immunotherapy. The pattern of T cell cytokines produced in response to tumor-associated Ags (TAAs) in breast cancer patients was significantly different from that produced in response to CMV or influenza in the same patients. Specifically, there was a higher proportion of IL-2-producing CD8+ T cells, and a lower proportion of IFN-γ-producing CD4+ and/or CD8+ T cells responding to TAAs compared with CMV or influenza Ags. Finally, the phenotype of TAA-responsive CD8+ T cells in breast cancer patients was almost completely CD28+CD45RA− (memory phenotype). CMV-responsive CD8+ T cells in the same patients were broadly distributed among phenotypes, and contained a high proportion of terminal effector cells (CD27−CD28−CD45RA+) that were absent in the TAA responses. Taken together, these results suggest that TAA-responsive T cells are induced in breast cancer patients, but those T cells are phenotypically and functionally different from CMV- or influenza-responsive T cells. Immunotherapies directed against TAAs may need to alter these T cell signatures to be effective.

Flow cytometric ratio analysis of the Hoechst 33342 emission spectrum: multiparametric characterization of apoptotic lymphocytes

The apoptotic response to various stimuli is an important part of immune regulation, and the ability to identify apoptotic lymphocytes within a complex population is a prerequisite to a more detailed understanding of its role in vivo, We described a flow cytometric technique which utilizes viable cells and enables simultaneous identification of apoptotic cells and analyses of immunophenotype, cell cycle progression, membrane integrity and light scatter properties. It is based upon analysis of two regions of the emission spectrum of the DNA-binding vital dye hoechst 33342. We established a precise correlation between the ratio of red to blue fluorescence emission and apoptosis based upon nuclear morphology and the presence of characteristic DNA degradation patterns. In human peripheral blood lymphocytes (PBL) and mouse thymocytes we incorporated light scatter properties, cell cycle stage, relevant cell surface immunophenotypic markers (CD25 or CD4) and CD8) and a marker of plasma membrane integrity (merocyanine 540) to enable multiparametric phenotyping of apoptotic cells. We show that staurosporine-induced apoptosis of ConA-stimulated PBL is not correlated with cell cycle stage but is selective for activated cells since the frequency of large, CD25+ cells is decreased by staurosporine. Dexamethasone and ionomycin differ in their ability to induce apoptosis selectively in murine thymocyte subsets. Dexamethasone kills a broad spectrum of the CD4/8 immunophenotypes with no selectively for cell cycle stage. Ionomycin selectively deplete CD4+8+ cells, especially those in the Go/G1 region of the cell cycle, and spared CD4-8+ cells. This technique is broadly advantageous for in vitro and ex vivo models of apoptosis in that it interrogates individual viable cells and correlates membrane and nuclear apoptotic changes with standard flow cytometric immunophenotyping.

An analytical workflow for investigating cytokine profiles

Understanding cytokine profiles of disease states has provided researchers with great insight into immunologic signaling associated with disease onset and progression, affording opportunities for advancement in diagnostics and therapeutic intervention. Multiparameter flow cytometric assays support identification of specific cytokine secreting subpopulations. Bead‐based assays provide simultaneous measurement for the production of ever‐growing numbers of cytokines. These technologies demand appropriate analytical techniques to extract relevant information efficiently. We illustrate the power of an analytical workflow to reveal significant alterations in T‐cell cytokine expression patterns in type 1 diabetes (T1D) and breast cancer. This workflow consists of population‐level analysis, followed by donor‐level analysis, data transformation such as stratification or normalization, and a return to population‐level analysis. In the T1D study, T‐cell cytokine production was measured with a cytokine bead array. In the breast cancer study, intracellular cytokine staining measured T cell responses to stimulation with a variety of antigens. Summary statistics from each study were loaded into a relational database, together with associated experimental metadata and clinical parameters. Visual and statistical results were generated with custom Java software. In the T1D study, donor‐level analysis led to the stratification of donors based on unstimulated cytokine expression. The resulting cohorts showed statistically significant differences in poststimulation production of IL‐10, IL‐1β, IL‐8, and TNFβ. In the breast cancer study, the differing magnitude of cytokine responses required data normalization to support statistical comparisons. Once normalized, data showed a statistically significant decrease in the expression of IFNγ on CD4+ and CD8+ T cells when stimulated with tumor‐associated antigens (TAAs) when compared with an infectious disease antigen stimulus, and a statistically significant increase in expression of IL‐2 on CD8+ T cells. In conclusion, the analytical workflow described herein yielded statistically supported and biologically relevant findings that were otherwise unapparent.

Modeling individual variation in biomarker response to combination immunosuppression with stimulated lymphocyte responses—potential clinical implications

BACKGROUND In mitogen-stimulated lymphocyte responses (sLR), cytokines and cell-surface receptors in peripheral human blood lymphocytes (PBL) are sensitive to cyclosporine (CsA), and can predict its in vivo effect with pharmacodynamic (PD) modeling. This is not known for multiple-agent combinations. METHODS Twenty-five concentration mixtures of CsA (0-1200 ng/ml) plus sirolimus (SRL, 0-30 ng/ml) were added to whole blood from five normal human subjects (NHS) for effect on a limited array of six targets. Effect-concentration relationships were analyzed with E(max) PD equations, and expressed as the range of concentration mixtures associated with one-half of maximal inhibitory effect (EC(50)) on a model biomarker target. This predicted range was examined to see whether it contained representative concentration mixtures of these two drugs, which were associated with a stable post-transplant outcome in a logistic regression model of 1039 clinical trial patients. RESULTS PD analyses suggested that in NHS samples containing CsA+SRL (n=5), (1) PMA-Ionomycin-stimulated T-cell expression of intracellular IL-2, TNF-alpha, and IFN-gamma was inhibited by CsA, and minimally by SRL, and (2) the two agents inhibited pokeweed mitogen (PWM)-stimulated B-cell expression of CD54 and CD95, but not CD86 (ICAM-1, Fas antigen, and B7.2), synergistically. With CD54 as the model biomarker, contour plots also predicted a wide range of concentration mixtures of the two agents across which an EC(50) could be predicted for CsA+SRL in a population (e.g., CsA-72 ng/ml+SRL 15 ng/ml, n=5), as well as in the individual subject (e.g., CsA-0 ng/ml+SRL-13.75 ng/ml in NHS-D310). Logistic regression analysis of clinical outcomes in 1039 patients suggested that the concentration mixture of CsA congruent with 50-150 ng/ml+SRL congruent with 10 ng/ml was associated with a stable post-transplant course. The EC(50) contour plot for CD54 suggested a nearly identical CsA concentration of 120 ng/ml in the presence of 10 ng/ml of sirolimus. CONCLUSIONS Our data suggest that pharmacodynamic evaluation of immunosuppressive agents with biomarkers may be an efficient process with which to characterize immunosuppressive effect of combination agents in individual patients and in patient populations.

Cytokines and Cell Surface Receptors as Target End Points of Immunosuppression with Cyclosporine A

Targets of cyclosporine (CsA) were identified from an array of stimulated lymphocyte responses (sLR) comprising 34 stimulation conditions in whole blood from 3 normal human volunteers (NHV) containing clinically relevant CsA concentrations (0-1200 ng/ml) in vitro. In whole blood from 5 additional NHV, selected targets (intracellular interleukin-2 [IL-2], tumor-necrosis factor-alpha [TNF-alpha], and interferon-gamma [IFN-gamma]) were measured in phorbol myristate acetate (PMA)-ionomycin-stimulated T lymphocytes. Effect:concentration relationships were analyzed with E(max) pharmacodynamic (PD) equations and expressed as the concentration associated with one-half maximal inhibitory effect (EC(50)). CsA demonstrated a rich matrix of inhibitory effects on T cells (CD3(+)), B cells (CD19(+)), dendritic cells (DC) (CD11c(+)), and basophils (CD123(+)) but not on monocytes (CD14(+)) (n = 3). PD analyses suggested that the EC(50) of CsA (1) for IL-2 in CD3(+) cells in NHV (n = 8) was similar to the EC(50) demonstrated by us previously in CD4(+) cells from transplanted patients (n = 13) (EC(50) = 260 ng/ml vs. 249 ng/ml), (2) for each cytokine was different under identical stimulation conditions (TNF-alpha, 324 ng/ml; IFN-gamma, 504 ng/ml), and (3) was relatively constant for a given cytokine under different stimulation conditions (e.g., PMA-ionomycin or the staphylococcal enterotoxin B [SEB] superantigen). In conclusion, inhibition of cytokine targets by CsA is concentration dependent. Further, a given CsA concentration may produce similar inhibitory effects across different stimulation conditions. Measurement of cytokine target expression may, therefore, allow effect-controlled administration of CsA during clinical transplantation.

Automation of Cytokine Flow Cytometry Assays

Cytokine flow cytometry (CFC) is a multiparameter assay of antigen-specific T cell function, potentially useful in the monitoring of experimental vaccines and progression of infectious diseases and cancer. Automation of CFC assays would greatly facilitate their use in clinical trials and involves several components. We describe here the migration of these assays to 96-well plates, the use of sample-handling robotics, and the use of lyophilized antigen and antibody plates to help automate CFC. Together, these elements can produce an integrated system capable of walkaway automation of an entire assay, resulting in the reproducible processing of potentially hundreds of samples per day. Implementation of such systems has begun to be undertaken by our group and others.

B3 Flow cytometry

Various technologies exist for analyzing cells in suspension using optical or electrical interrogation techniques. This chapter focuses on flow cytometers, tools that have optimized fluidics, electronics and optics to generate extraordinary measurement precision and high dimensionality on samples of cells moving through an image plane. Other devices, including scanning cytometers, optical microscopes, and counting devices based on electrical impedance measurements, are outside the scope of this discussion.