DENDRITIC CELLS ACTIVATED IN THE PRESENCE OF GLUCOCORTICOID HORMONES ARE CAPABLE OF SUPPRESSING ANTIGEN-SPECIFIC T CELL RESPONSES

Abstract: The present invention provides novel methods for immunotherapy. The invention provides immune cells and methods to generate them, with the capacity to at least in part reduce an immune response in a host. In one aspect the invention provides a method for generating a dendritic cell with the capacity to tolerise a T cell for antigen said T cell was specific for, comprising culturing peripheral blood monocytes from an individual to differentiate into dendritic cells, activating said dendritic cells in the presence of a glucocorticoid hormone and loading said activated dendritic cell with said antigen T cell was specific for.

Description: Title: Dendritic cell activated in the presence of glucocorticoid hormones are capable of suppressing antigen- specific T cell responses. The invention relates to the field of medicine. More in particular the invention relates to the field of immunotherapy. Background of the invention The remarkable immunostimulatory properties of DC reside in their ability to transport antigens from peripheral tissues to lymphoid organs where they present these antigens to T cells in an optimal costimulatory context (1) . To achieve this complex sequence of events, DC exist in different functional stages. Immature DC behave as sentinels in peripheral tissues where they efficiently capture antigens. Upon pathogen invasion, induction of protective T cell responses requires the activation of immature DC into mature immunostimulatory cells. DC activation is triggered in inflamed tissues by cytokines such as IL-1 and TNF-a and by bacterial components such as LPS (2, 3) . Activated DC migrate to T cell areas in the lymph nodes while upregulating their costimulatory capacities and optimizing their antigen presenting functions. Upon interaction with antigen-specific T cells, DC activation is further completed through engagement of the receptor-ligand (L) pair CD40-CD40L, leading to the production of IL-12 (4, 5, 6), a key cytokine for T helper (Th) type 1 and cytotoxic T lymphocyte (CTL) priming (7) . APC activation through CD40-CD40L interactions represents an important immunoregulatory step for the establishment of protective T cell immunity against pathogens and tumors (8, 9, 10) . This process also plays a key role in the onset of destructive T cell-mediated disorders such as auto- immune diseases, allograft rejection and graft versus host disease (11, 12, 13) . The current treatment of these disorders largely relies on the administration of glucocorticoids (GC) , which exert potent anti- inflammatory and immunosuppressive effects. Because GC negatively interfere with many aspects of T cell activation such as IL- 2 -driven proliferation and inflammatory cytokine production (reviewed in 14) , activated T cells have long been considered as the main targets for GC action. Several lines of evidence now suggest a role for DC in GC-induced immune suppression. Moser et al (15) found that GC prevented the spontaneous activation of murine DC thereby decreasing their T cell stimulatory potential. Kitajima et al (16) showed that GC could hamper the T cell -mediated activation of a murine DC line. Viera et al reported that human DC exposed to GC were poor producers of IL-12 upon LPS stimulation (17) . These findings only concern loss of typical DC features and therefore favor a simple inhibitory role of GC on DC activation. A more complex immunoregulatory action on the DC system has not been considered. The present invention resulted from a detailed analysis of the impact of GC on the CD40-mediated activation of monocyte- derived DC. These DC develop after culture with GM-CSF and IL-4 (2, 18) or after transmigration through endothelial cells (19) and are known to mature into the most potent human Thl-type-inducing APC upon CD40 ligation (5, 20) . Moreover, these APC can easily be generated in large numbers and are thereby the cells of choice for DC-based modulation of T cell immunity (21, 22) . In contrast to previous studies, the present invention shows that GC such as dexamethasone (DEX) do not merely prohibit DC activation, but that it converts CD40 ligation on human monocyte-derived DC is transformed into an alternative activation pathway. DEX profoundly affect the CD40-dependent maturation of human monocyte-derived DC, not only by preventing the upregulation of costimulatory, adhesion and MHC surface molecules, but also by causing these cells to secrete the anti- inflammatory mediator IL-10 instead of the Thl stimulatory cytokine IL-12. In agreement with these phenotypic and functional changes, DC triggered through CD40 in the presence of DEX are poor stimulators of Thl-type responses. Most importantly, the present invention shows that such DC are able to induce a state of hyporesponsiveness in Thl cells, indicating that these cells are capable of active suppression of Thl-type immunity. As already mentioned above, the impact of GC on DC has been the subject of several previous studies by others. However, in contrast with the present invention, these studies only highlighted inhibitory effects of GC on the DC system. DEX was found to block the upregulation of CD80, CD86 and MHC class II molecules upon activation of murine spleen DC (15, 16) , whereas very recently DEX was demonstrated to also prevent the differentiation of DC from monocyte precursors (28) . In these studies, the inability of DC to acquire high expression of costimulatory and MHC molecules was accompanied with a decrease in their T cell stimulatory potential, but the effect of GC on IL-12 production was not investigated. On the other hand, Viera et al found that the effect of GC on LPS- induced DC activation consisted in a 4 -fold reduction of IL-12p70 synthesis (17) . This partial effect on IL-12 secretion contrasts with the complete suppression of IL-12p70 production which is subject of the present invention, and can be explained by the fact that their GC-treated immature DC were extensively washed prior to LPS stimulation. We indeed found that upon removal of GC, the effects of these drugs on immature DC were rapidly reversible. The continuous presence of GC during CD40 triggering of DC was clearly preferred in order to stably and completely modulate DC activation (data not shown) . Taken together, previous findings indicated that the impact of GC on the DC system should be merely interpreted as an inhibitory event. Importantly, the present invention clearly demonstrates that GC such as DEX do not simply suppress DC activation but rather redirect this process towards a distinct functional program. DC activation through engagement of CD40-CD40L is a key stimulatory event for the generation of effective Thl and CD4-dependent CTL responses in vivo (10, 36, 37, 38). This pathway however is also involved in the development of unwanted T cell responses leading to autoimmune disease or organ-transplant rejection (11, 12, 13) . Until now, treatment of patients suffering from such disorders largely relies on the systemic administration of GC hormones. This treatment does not only suppress pathogenic T cell responses but also induces a general state of immunosuppression and metabolic and endocrine side effects. The present invention demonstrates that activation of human monocyte-derived DC through CD40, in the presence of GC such as DEX, results in an IL-10-producing APC that is a poor stimulator for Thl-type responses and that can even confer hyporesponsiveness to Thl cells. The present invention therefore indicates that such DC loaded with appropriate antigens can be exploited as a novel approach for specifically downregula ing unwanted T cell responses in vivo. The dentritic cells of the invention posses different capabilities than previously reported for dendritic cells. One can therefore consider these cells to be part of a class of cells distinct from the class formed by the "classical" dendritic cells. The dendritic cells of the invention can be used in a different way than the classical dendritic cells. The dendritic cells of the invention can for instance be used to suppress, at least in part, an undesired immune response in a host. In one aspect invention therefore provides a method for preparing a pharmaceutical composition for reducing an unwanted T cell response in a host, comprising culturing peripheral blood monocytes from said host to differentiate into dendritic cells, activating said dendritic cells in the presence of a glucocorticoid hormone and loading O 01/24818 ,. PCT/NLOO/00712 said activated dendritic cells with an antigen against which said T cell response is to be reduced. An unwanted T cell response can be any type of T cell response. For instance, but not limited to, a T cell response associated with an auto- immune disease or a transplantation disease such as a graft versus host disease or a host versus graft disease. A pharmaceutical composition of the invention typically comprises a dendritic cell of the invention suspended in a liquid suitable for preserving the function of said dendritic cell in said liquid and/or suitable for administration to a host. A host preferably is a human. Preferably said host is at risk of developing or is suffering from an auto- immune disease or allergy. Preferably, said host suffers from or is at risk of suffering from host versus graft disease and/or graft versus host disease. With the term at risk is meant that one expects that said host may develop said disease, for instance but not limited to a host receiving a transplant. Such a host is considered to at risk of developing host versus graft disease. An antigen typically is a peptide capable of binding to a major histocompatibility complex I and/or II molecule. Such peptides are known in the art and a person skilled in the art is capable of determining whether a given peptide comprises an antigen or not. An antigen may be derived from a naturally occurring protein. An antigen may also be a synthetic peptide or equivalent thereof, preferably with an ammo-acid sequence equivalent to a peptide derived from a protein. In another aspect the invention provides a pharmaceutical composition for reducing an unwanted T cell response m a host, said composition being obtained by culturmg peripheral blood monocytes from said host to differentiate into dendritic cells, activating said dendritic cells m the presence of a glucocorticoid hormone and loading said activated dendritic cells with an antigen against which said T cell response is to be reduced. In one embodiment a method is provided for reducing an unwanted T cell response m a host, comprising administering a composition of the invention to said host . The invention further provides method for reducing an " unwanted T cell response in a host comprising culturing peripheral blood monocytes from said host to differentiate into dendritic cells, activating said dendritic cells and/or their precursors in the presence of a glucocorticoid hormone and loading said activated dendritic cells with an antigen against which said T cell response is to be reduced and administering said composition to said host. In one embodiment of the invention said activation is done through a CD40 receptor. Activation of DC through triggering of the CD40 receptor can involve either incubation with a CD8-CD40L fusion protein, a tπmeric from of CD40L consisting of CD40L-molecules to which a modified leucine zipper has been attached, antι-CD40 antibodies, or cells that express CD40L. Other signals that can be employed for the activation of DC as described in the present invention include lipopolysacchaπde (LPS) and polyl/C. In another aspect the invention provides a method for obtaining an dendritic cell capable of tolerismg a T-cell for an antigen comprising providing said dendritic cell with a glucocorticoid hormone, activating said dendritic cell and providing said dendritic cell with said antigen. With the term tolerismg is meant that said dendritic cell has an immunosuppressive effect on said T cell. A tolerised T cell will essentially not respond with cell division when exposed to a cell presenting an antigen said T cell would in the untolerised state respond to with cell division. A tolerised T cell will essentially not respond with killing a cell presenting an antigen said T cell would m the untolerised state respond to with cell kill. In one embodiment said dendritic cell and/or a precursor thereof is provided with said glucocorticoid hormone in vitro. A T cell of the invention is preferably an antigen specific T cell, preferably a cytotoxic T cell or a Th cell. In another aspect the invention provides an isolated dendritic cell capable of modifying the function of an " antigen specific Th cell , which would otherwise enhance a given immune response, resulting in a T cell that is capable of reducing this immune response. In one embodiment the invention provides a method for modifying an antigen specific T-cell comprising providing an dendritic cell according to the invention with said antigen and co-cultivating said T- cell and said dendritic cell. Preferably, said co-cultivating is performed in vitro. Said method may further comprise multiplying said functionally modified T-cell. The invention also provides an isolated funtionally modified T-cell obtainable by a method according to the invention. In another aspect the invention provides the use of a glucocorticoid hormone for obtaining an dendritic cell capable of functionally modifying a T-cell. The invention also provides a pharmaceutical composition comprising an dendritic cell and/or a functionally modified T-cell according to the invention. The invention further provides the use of a dendritic cell and/or a functionally modified T-cell according the invention for the preparation of a medicament . The invention also provides a method for the treatment of an individual suffering from or at risk of suffering from a disease associated with at least part of the immune system of said individual comprising providing said individual with an dendritic cell and/or a functionally modified T-cell according to the invention. Preferably, said dendritic cell and/or said functionally modified T-cell, or precursors thereof are derived from an HLA-matched donor. Preferably, said HLA-matched donor is said individual. Method of treatments of the invention are preferably use for the treatment of an individual suffering from an auto- immune disease, an allergy, a graft versus host disease and/or a host versus graft disease. Examples Example 1 Impairment of CD40 -CD40L -mediated phenotypic changes by DEX We explored the impact of DEX on the phenotypic changes induced by CD40 ligation on immature monocyte-derived DC. In the absence of DEX, the fusion protein CD8-CD40L induced a strong upregulation of the costimulatory molecules CD80, CD86 and CD40, of the MHC class I and II molecules, of the adhesion markers CD54 and CD58 and of the DC maturation marker CD83 (Fig 1) . In the presence of DEX, these CD8-CD40L- induced phenotypic changes were dramatically impaired: the upregulation of CD80, CD86, CD40, CD54, CD58 and of the MHC class I and II molecules was largely inhibited and CD83 was not expressed (Fig 1) . Importantly, DEX-treated DC did not revert to a monocyte/macrophage stage as shown by the lack of expression of CD14 (Fig 1) . Titration of DEX showed a complete inhibition of CD40 -mediated phenotypic changes at 6 -7 -8 10 ~ M and 10 M, a partial blockade at 10 M and no effect at 10 - 9 M and 10- 10 (data not shown) . In addition, DEX action was dependent on binding to the GC-receptor, since it was asbolished by simultaneous addition of the GC receptor antagonist RU486 (data not shown) . In experiments performed with LPS or TNF-a as activation agents, similar results were obtained. However, the combination of DEX and TNF-alpha induced a massive cell death (viable cell recovery 5-10% of control cultures) , a phenomenon that was not observed when DEX-treated DC were stimulated with LPS or through CD40 (viable cell recovery 60 to 100% of control cultures) (not shown) . We next analyzed whether activated DC could still be affected by DEX. DC incubated with CD8-CD40L for 48h and further exposed to DEX maintained a stable activated phenotype (Fig 2) . We conclude that DEX prevents the phenotypic changes induced by CD40 signals on immature DC and that already activated DC are resistant to DEX action. Example 2 DEX does not interfere wi th the regulation of DC antigen uptake machinery Unlike activated DC, immature DC efficiently internalize antigens through macropinocytosis and mannose receptor- mediated endocytosis (2, 3, 25, 26) . We analyzed whether DEX could affect the DC antigen capture machinery and its downregulation following CD40 cross-linking. As shown in Fig 3, incorporation of FITC-BSA and FITC-mannosylated BSA by immature DC and by DEX-treated immature DC was comparable. Upon CD40 triggering, a similar decrease of FITC-BSA and FITC-mannosylated BSA uptake by both DEX-treated and untreated DC was observed (Fig 3) . These results were the first to indicate to us that DEX does not block all aspects of DC activation, since it does not interfere with the down- regulation of the DC antigen capture machinery. Example 3 DEX-treated CD40- triggered DC secrete IL-10 instead of IL-12 A key feature of CD40-triggered DC for initiating T cell immunity resides in their ability to produce the proinflammatory cytokine IL-12 (5, 6, 27) . We investigated whether DEX affected IL-12 production by DC stimulated through CD40, and we explored the possibility that DEX could promote the secretion of the anti- inflammatory cytokine IL- 10. As shown in Fig 4, CD40 triggering of DC strongly induced IL-12p40 and IL-12p70 secretion (up to 120ng/ml and 170pg/ml respectively) but only poorly stimulated the production of IL-10 (up to 68pg/ml) . In contrast, CD40 triggering of DEX- treated DC resulted in a dramatically reduced IL-12p40 production (up to 100 fold) and in the complete suppression of IL-12p70 secretion, whereas IL-10 production was strongly enhanced (up to 50 fold) (Fig 4) . Immature DC and their DEX- treated counterparts failed to secrete detectable amounts of IL-12 and IL-10 (Fig 4) . Therefore, CD40 ligation of DC ~ in the presence of DEX triggers the secretion of high levels of the anti- inflammatory cytokine IL-10 instead of IL-12. Example 4 DEX- treated CD40 - triggered DC are capable of suppressing Thl - type immuni ty The strikingly modified response of DC to CD40 ligation in the presence of DEX prompted us to compare the T cell stimulatory potential of these cells with that of their DEX- untreated counterparts. In an allogeneic MLR, CD40-triggered DC induced a strong proliferative T cell response whereas the addition of DEX prior to CD40 triggering reduced their T cell stimulatory capacity to that of immature DC (Fig 5) . When tested for their ability to stimulate an hsp65-specific CD4 Thl clone, CD40 -triggered DC pulsed with the hsp65 protein or with the specific peptide epitope p3-13 were found to be potent inducers of both T cell proliferation and T-cell dependent IFN-g production (Fig 5) . In contrast, in the presence of Ag-pulsed DEX-treated CD40 -triggered DC, T cell proliferation and IFN-g production were significantly decreased (p<0.001 and p<0.01 respectively) (Fig 5) . We next investigated whether DEX-treated CD40-triggered DC were simply poor stimulators of Thl cells, or whether they could exert suppressive effects on these T cells. We therefore tested hsp65-specific T cells stimulated with p3-13-pulsed DEX-treated CD40-triggered DC for their capacity to respond to a second potent antigenic challenge. Fig 6 shows that preculturing T cells with CD40-triggered DC led to a strong T cell proliferation and IFN-gamma production upon second antigen-specific restimulation. In contrast, preculture with DEX-treated CD40 -triggered DC resulted in a dramatically reduced proliferative and IFN-gamma production capacity of Thl cells. Thus, CD40 triggering of DC in the presence of DEX results in APC that are not merely poor inducers of T cell responses but that also induce a state of hyporesponsiveness in Thl cells. Example 5 DEX-treated activated DC suppress anti-transplant immunity in vivo In a first attempt to test whether DEX-treated DC could suppress unwanted immunity, a skin transplant model was set up in mice. Skin transplants from C57B1/6 mice, when grafted onto fully allogeneic Balb/c recipient mice, are known to be rapidly rejected as a result of a very strong allo-reactive anti -transplant T cell immune response. Experiments were performed to analyse whether pre-treatment of the recipient mice with DEX-treated DC resulted in suppression of this host versus graft response. We made use of an established murine DC cell line of C57B1/6 origin, named Dl, which exhibits a stable immature phenotype in vitro unless they receive an activating signal through agonistic anti-CD40 antibodies or LPS. This trigger results in fully matured DC that are highly capable of CTL priming in vitro as well as in vivo (39;40) . Maturation of Dl involves strong upregulation of the cell surface expression of the costimulatory molecule CD86 (B7.2), the CD40-receptor and Class II MHC (fig. 7) . Similar to our observations in human DC, maturation of Dl in the presence of DEX largely prevented the upregulation of these molecules at the cell surface (Fig. 7) . This suggested that the DEX- treated Dl cells could be exploited to suppress T cell immunity in vivo. Balb/c mice were therefore injected with Dl cells that had been activated in the absence or presence of DEX. One week after immunisation, the allo-reactive response of splenocytes of these mice, as well as of control mice, was tested in vitro. Mice pre-treated with immature Dl cells that had been cultured in the presence or absence of DEX did not exhibit significantly altered Thl-type alloreactive immunity as compared to control mice (Fig. 8) . This is in accordance with our observations with human DC, which also showed that DEX-treated immature DC did not exhibit different properties than normal immature DC. As expected, mice immunised with fully matured Dl showed enhanced responsiveness. Importantly, mice pre-treated with Dl activated in the presence of DEX displayed greatly decreased Thl-type allo-reactive immunity (fig. 8) . It was subsequently tested whether the reduction of allo- responses in the latter group of mice, as measured in vitro, would reflect decreased allo-reactive immunity in vivo. Groups of Balb/c mice were immunized with Dl cells matured in the absence or presence of DEX. Skin transplants of C57B1/6 origin were grafted onto these mice one week later, and graft survival was monitored. The grafts were rapidly rejected in control mice and mice immunized with normally matured Dl cells (Fig. 9) . Rejection was not enhanced in the latter group, despite the stronger allo-reactive responses in these mice (Fig. 8) . Most likely, the response in the control mice is already sufficient for maximal rejection. Importantly, graft rejection is significantly (p < 0.05) delayed in mice pre-treated with Dl matured in the presence of DEX (fig. 9) . This outcome corresponds with the greatly reduced allo- reactivity in these mice as determined in vitro (Fig. 8) . In conclusion, the skin grafting experiments in mice demonstrate that DC matured in the presence of DEX can indeed be employed to suppress unwanted immunity such as against transplants. Although in the experiments shown the transplants are eventually rejected, it should be noted that donor and recipient displayed large differences with respect to transplantation antigens. In humans, donors and recipients are matched as closely as possible for these antigens. Murine experiments exploiting better matched donor and recipient strains are underway. The data in Fig. 8 and 9 show that pre- treatment with DEX-treated mature DC will result in much more profound effects in a this setting. Materials and Methods Generation of DC Immature DC were generated from peripheral blood monocyte precursors. Human PBMC from healthy donors, isolated through 7 Ficoll-Hypaque density centπfugation were plated at 1.5x10 per well in 6-well plates (Costar Corp., Cambridge, MA) in RPMI 1640 (Life Technologies, Paisley, Scotland) supplemented with 2mM glutamine, lOOUI/ml penicillin and 10% FCS . After 2 h at 37 C, the non adherent cells were removed and the adherent cells were cultured in medium containing 500U/ml IL- 4 (Pepro Tech Inc. Rocky Hill, NJ) and 800U/ml GM-CSF (kindly provided by Dr S . Osanto, LUMC, Leiden, NL) for a total of 7 days . Activation of immature DC wi th a CD8 -CD40L fusion protein Activation of DC though CD40 was performed with a fusion protein made of the extracellular domain of human CD40L and of the murine CD8a chain (CD8-CD40L) . The CD8-CD40L cDNA described by Garrone et al (23) was transferred into an eukaryotic expression vector containing the hygromycin resistance gene, and used for the generation of stably transfected Chinese Hamster Ovary (CHO) cells. Culture supernatants containing the CD8-CD40L fusion protein were concentrated with a pressurized stirred cell system (Amicon, Inc., Beverly, MA), checked for binding to CD40 and tested for optimal DC activation conditions (not shown) . DC were 5 incubated at 5 x 10 /ml/well in a 24-well plate (Costar Corp., Cambridge, MA) and activated in the presence of 1/10 CD8-CD40L supernatant. Cells and supernatants were analyzed after 48 h. Of note, control supernatants obtained from untransfected CHO cells or from CHO cells transfected with the CD8a cDNA lacked DC activating functions and were similar to culture medium. DEX and RU486 treatment of DC — 6 Seven days immature DC were treated with 10 M DEX (Sigma, St Louis, MO) in the presence of GM-CSF and IL-4 or GM-CSF alone. After 24 h, DC were analyzed or were further stimulated via CD40 by adding the CD8-CD40L fusion protein to the cultures as described above. In some experiments, the glucocorticoid receptor antagonist RU485 (Roussel-UCLAF, Romainville, France) was used at lOmM final concentration, alone or in combination with DEX. Analysis of DC surface phenotype by flow cyttometry Cells were stained on ice with FITC or PE-conjugated mouse monoclonal antibodies (MoAb) for 30 min in PBS 1% FCS and ® were analyzed on a FACScan (Becton Dickinson, San Jose, CA) . The following MoAb were used: FITC-anti-CD80 (BB1) , PE-anti- CD86 (FUN-1) , FITC-anti-CD40 (5C3) , PE-anti-CD54 (HA 58) and PE-anti-CD58 (1C3) (Pharmingen, San Diego, CA) , PE-anti-CD14 (L243) and PE-anti-HLA-DR (Mf-P9) (Becton Dickinson) , PE- anti-CD83 (HB15A) (Immunotech, Marseille, France) and PE- anti-HLA class I (Tu 149) (Caltag Laboratories, Burlingame, CA) . Antigen uptake experiments DC were resuspended in medium buffered with 25mM Hepes . FITC- BSA and FITC-mannosylated BSA (both from Sigma) were added at lmg/ml final concentration and the cells were incubated at 37 C, or at 0 C to determine background uptake. After 1 h, DC were washed extensively with iced-cold PBS and analyzed by ® FACS using propidium iodide to eliminate dead cells. Cytokine detection by ELISA Culture supernatants were analyzed m serial twofold dilutions in duplicate. IL-12p70 was detected using a solid phase sandwich ELISA kit (Diaclone Research, Besancon, France) (sensitivity 3pg/ml) . For IL-12p40 and IFN-g detection, capture MoAb and polyclonal biotmylated detection Ab were obtained from Peter van de Meι * jde (BPRC, Rijswijk, NL) (sensitivity lOpg/ml) . IL-10 was detected using the Pelikme compact human IL-10 ELISA kit (CLB, Amsterdam, NL) (sensitivity 3pg/ml) . Allogeneic mixed lymphocyte reaction (MLR) Non adherent allogeneic adult PBMC from an unrelated individual were cultured m 96-well flat-bottom plates (Costar Corp., Cambridge, MA) at a density of 1.5 x 10 /well with various numbers of g-irradiated (3,000 rads) DC, in triplicates. Proliferation was assessed on day 5 by [ H] thymidme uptake (0.5mCι/well , specific activity 5Cι/mMol, Amersham Life Science, Buckinghamshire, UK) during a 16 h pulse. Thl stimulation assays The Mycobacterium tuberculosis and M. leprae hsp65-specific, HLA-DR3 -restricted CD4+ Thl clone Rpl5 1-1 used m this study recognizes an hsp65 determinant corresponding to peptide residues 3 to 13 (p3-13) (24) . HLA-DR-matched DEX-treated immature DC and their DEX-untreated counterparts were pulsed with lOmg/ml of p3-13 or with lOmg/ml of hsp65 for 2 h, washed extensively and stimulated through CD40 as described above. For Ag-pulsed DEX-treated immature DC, CD40 triggering was performed m the presence of DEX. Hsp65 specific T cells 4 (10 ) were cultured with different numbers of g-irradiated (3,000 rads) DC 96-well flat-bottom plates (Costar Corp.) triplicates for 3 days. [ H] thymidme incorporation was measured on day 3 after a 16 h pulse. Before the addition of 3 [ H]thymidine, 50ml of supernatants were collected from each well and supernatants from triplicate wells were pooled to , measure IFN-g production. To test hsp65-specific T cells responsiveness to a second potent antigenic challenge, 10 4 T 3 cells were first cultured for 48h with 5 x 10 peptide-pulsed DC prepared as above, then harvested and allowed to rest in 4 medium containing 5U/ml IL-2. Three days later, 10 viable T 3 cells were restimulated with 5 x 10 peptide-pulsed DC generated from the same donor as used for the first culture and tested for their ability to proliferate and to produce IFN-g as previously described. Statistical analysis Covariance analysis was used to compare T cell proliferation and IFN-g production as a function of DC number, between DEX- treated CD40 -triggered DC and DEX-untreated CD40 -triggered DC (Fig. 5) . Figure legends Fig. 1 Pretreatment with DEX inhibits the phenotypic changes induced by CD40 ligation. Seven days immature DC were cultured for 24h in the absence or the presence of 10 ~ M DEX and activated via CD40 with the CD8-CD40L fusion protein for 48h. The comparison with immature DC maintained in medium alone is shown. Empty histograms show the background staining with isotype controls MoAb and solid histograms represent specific staining of the indicated cell surface markers. Specific mean fluorescence intensities are indicated. Mean fluorescence intensities of isotype controls were between 3 and 4. Data are representative of 4 independent experiments. Fig. 2 DC triggered through CD40 maintain an activated phenotype upon a subsequent DEX exposure . Immature DC were activated with the CD8-CD40L fusion protein. — 6 DEX (10 M) or medium control were added 48h later and cells were analyzed after 2 additional days of culture. The comparison with immature DC maintained in medium alone is shown. Empty histograms show the background staining with isotype controls MoAb and solid histograms represent specific staining of the indicated cell surface markers. Specific mean fluorescence intensities are indicated. Mean fluorescence intensities of isotype controls were between 3 and 5. Data are representative of 2 independent experiments. Fig. 3 Pretreatment with DEX does not affect the regulation of DC antigen uptake machinery. Immature DC were incubated in the absence or the presence of 10 - 6M DEX for 24h and further activated or not via CD40 with the CD8-CD40L fusion protein for 48h. Cells were pulsed for lh with medium containing either lmg/ml FITC-BSA or lmg/ml FITC-mannosylated BSA. Empty histograms show the background autofluorescence, Grey-filled histograms show the background uptake at 0 C and black-filled histograms show the specific, uptake at 37 C. Data are representative of 3 independent experiments . Fig. 4 Pretreatment with DEX alters the cytokine secretion profile of CD40-triggered DC. DEX-exposed or control immature DC were left in culture without further treatment or stimulated with the CD8-CD40L fusion protein. Culture supernatants were harvested 48h later and IL-10, IL-12p40 and IL-12p70 secretion were analyzed by specific ELISA. Data are representative from 6 independent experiments . Fig. 5 Pretreatment with DEX impairs the T cell stimulatory capacities of DC activated via CD40 and leads to a state of hyporesponsiveness of Thl cells. Allogeneic MLR: non adherent allogeneic PBMC were cultured with different numbers of CD40-triggered DC, DEX-treated CD40 -triggered DC or immature DC. The proliferative response was measured on day 5. Thl stimulation assays: Hsp65-specific T cells were cultured with different numbers of HLA-DR matched CD40-triggered DC or with DEX-treated CD40-triggered DC pulsed with the hsp65 protein or with the specific p3-13 peptide epitope. The proliferative response and the T cell dependent IFN-g production were analyzed on day 3. Data are representative of 4 independent experiments. Fig. 6 DEX-treated DC triggered through CD40 induce a state of hyporesponsiveness in Thl cells. Hsp65-specific T cells precultured with CD40-triggered DC or with DEX-treated CD40- triggered DC pulsed with the p3-13 peptide epitope were harvested after 48h, allowed to rest in the presence of 5U/ml IL2 for 3 days, and restimulated with p3-13-pulsed DC. The O 01/24818 -_ 9 PCT/NLOO/00712 proliferative response and IFN-g production were measured on day 3. Similar results were obtained in 2 independent experiments . Fig. 7 Dl cells were left untreated or cultured for two days in the presence of LPS (1 ug/ml) and/or DEX (10-6 M) . Surface expression of CD86 (B7.2), Class II MHC and CD40 was monitored by staining with the appropriate FITC-labeled Ab . and subsequent FACS-analysis . Similar results were obtained for Dl cells matured in the presence of murine CD40L (not shown) . Fig. 8 Balb/c mice were immunised with 10-6 Dl cells that were prepared as indicated. One week later, splenocytes were isolated and tested for their response against C57B1/6 splenocytes in a mixed lymphocyte culture. After 24 h, culture supernatants were tested for IFNg content in a specific ELISA assay. Fig. 9 Balb/c mice (5 per group) were immunised as indicated. One week later, skin transplants of C57B1/6 origin were grafted and graft survival was monitored. REFERENCES 1. Banchereau J, Steinman RM: Dendritic cells and the control of immunity. Nature 392: 248, 1998 2. Sallusto F, Lanzavecchia A: Efficient presentation of soluble antigen by cultured human dendritic cells is maintained by granulocyte/macrophage colony stimulating factor and downregulated by tumor necrosis factor a. J Exp Med 179: 1109, 1994 3. Sallusto F, Cella M, Danieli C, Lanzavecchia A: Dendritic cells use macropinocytosis and the mannose receptor to concentrate macromolecules in the major histocompatibility complex class II compartment: downregulation by cytokines and bacterial products. J Exp Med 182: 389, 1995 4. Caux C, Massacrier C, Vandervliet B, Dubois B, van Kooten C, Durand I, Banchereau J: Activation of human dendritic cells through CD40 cross-linking. J Exp Med 180: 1263, 1994 5. Cella M, Sheidegger D, Palmer-Lehman K, Lane P, Lanzavechia A, Alber G: Ligation of CD40 on dendritic cells triggers production of high levels of interleukin-12 and enhances T cell stimulatory capacity: T-T help via APC activation. J Exp Med 184: 747, 1996 6. Koch F, Stanzl U, Jennevin P, Janke K, Heufler C, Kampgen E, Romani N, Schuler G: High levels IL-12 production by murine dendritic cells: upregulation via MHC class II and CD40 molecules and downregulation by IL-4 and IL-10. J Exp Med 184 : 741, 1996 7. Trinchieri G: Interleukin-12: a proinflammatory cytokine with immunoregulatory functions that bridge innate resistance and antigen-specific adaptive immunity. Annu Rev Immunol 13: 251, 1995 8. Kamanaka M, Yu P, Yasui T, Koshida K, Kawaba T, Horii T, Kishimoto T, Kikutani H: Protective role of CD40 in Leishmania major infection at two distinct phases of cell- mediated immunity. Immunity 4: 275, 1996 9. Yang Y, Wilson JM: CD40 ligand-dependent T cell activation: requirement of B7-CD28 signaling through CD40. Science 273: 1862, 1996 10. Mackey MF, Gunn JR, Ting P, Kikutani H, Dranoff G, Noelle RJ, Barth Jr RJ: Protective immunity induced by tumor vaccines requires interactions between CD40 and its ligand CD154, Cancer Res 57: 2569, 1997 11. Grewal IS, Foellmer HG, Grewal KD, Xu J, Hardardottir F, Baron JL, Janeway Jr CA, Flavell RA: Requirement for CD40 ligand in costimulation induction, T cell activation and experimental allergic encephalomyelitis . Science 273: 1864, 1996 12. Kirk AD, Harlan DM, Armstrong NN, Davis TA, Dong Y, Gray GS, Hong X, Thomas D, Fechner JH, Knechtle SJ : CTLA4-Ig and anti-CD40 ligand prevent renal allograft rejection in primates. Proc Natl Acad Sci USA 94: 8789, 1997 13. Durie FH, Aruffo A, Ledbetter J, Crassi KM, Green WR, Fast LD, Noelle RJ: Antibody to the ligand of CD40, gp39, blocks the occurrence of the acute and chronic forms of graft-vs-host disease. J Clin Invest 94: 1333, 1994 14. Almawi WY, Beyhum HN, Rahme AA, Rieder MJ: Regulation of cytokine and cytokine receptor expression by glucocorticoids. J Leukoc Biol 60: 563, 1996 15. Moser M, De Smedt T, Sornasse T, Tielemans F, and Chentoufi AA: Glucocorticoids down-regulate dendritic cell function in vitro and in vivo. Eur J Immunol 25: 2818, 1995 16. Kitajima T, Ariitzumi K, Bergstresser PR, Takashima A: A novel mechanism of glucocorticoid- induced immune suppression: the inhibition of T cell-mediated terminal maturation of a murine dendritic cell line. J Clin Invest 98: 142, 1996 17. Viera PL, Kalinski P, Wierenga EA, Kapsenberg ML, de Jong EC: Glucocorticoids inhibit bioactive IL-12p70 production by in vitro-generated human dendritic cells without affecting their T cell stimulatory potential. J Immunol 161: 5245, 1998 18. Romani N, Gruner S, Brang D, Kampgen E, Lenz A, Trockenbacher B, Konwalinka G, Fritsch PO, Steinman RM, Schuler G: Proliferating dendritic cell progenitors in human blood. J Exp Med 180: 83, 1994 19. Randolph GC, Beaulieu S, Lebecque S, Steinman RM, Mailer WA: Differentiation of monocytes into dendritic cells in a model of transendothelial trafficking. Science 282: 480, 1998 20. Rissoan MC, Soumelis V, Kadowaki N, Grouard G, Briere F, de Waal Malefyt R, Liu Y-J: Reciprocal control of T helper cell and dendritic cell differentiation. Science 283: 1183, 1999 21. Bender A, Sapp M, Schuler G, Steinman RM, Bhardwaj N: ' Improved methods for the generation of dendritic cells from non proliferating progenitors in human blood. J Immunol Methods 196:121, 1996 22. Romani N, Reider D, Heuer M, Ebner S, Kampgen E, Eibl B, Niederwieser D, Schuler G: Generation of mature dendritic cells from human blood: an improved method with special regard to clinical applicability. J Immunol Methods 196:137, 1996 23. Garrone P, Neidhardt E-M, Garcia E, Galibert L, van Kooten C, Banchereau J: Fas ligation induces apoptosis of CD40-activated human B lymphocytes. J Exp Med 182: 1265, 1995 24. Geluk A, van Meigaarden KE, Janson AAM, Drijfhout J-W, Meloen R, de Vries RRP, Ottenhoff T: Functional analysis of DR17 (DR3) -restricted mycobacterial T cell epitopes reveals DR17 binding motif and enables the design of allele-specific competitor peptides. J Immunol 149: 2864, 1992 25. Engering AJ, Cella M, Fluitsma D, Brockhaus M, Hoefsmit ECM, Lanzavecchia A, Pieters J: The mannose receptor functions as a high capacity and broad specificity antigen receptor in human dendritic cells. Eur J Immunol 27: 2412, 1997 26. Tan MCAA, Mommaas AA, Drijfhout J-W, Jordens R, underwater JJM, Verwoerd D, Mulder AA, van der Heiden AN, Scheidegger D, Oomens LCJM, Ottenhoff THM, Tulp A, Neefjes JJ, Koning F: Mannose receptor-mediated uptake of antigens strongly enhances HLA class II-restricted antigen presentation by cultured dendritic cells. Eur J Immunol 27: 2426, 1997 27. de Saint Vis B, Fugier-Vivier I, Massacrier C, GaiHard C, Vanbervliet B, Ait-Yahia S, Banchereau J, Liu Y-J, Lebecque S, Caux C: The cytokine profile expressed by human dendritic cells is dependent on cell subtype and mode of activation. J Immunol 160: 1666, 1998 28. Piemonti L, Monti P, Allavena P, Sironi M, Soldini L, Leone BE, Socci C, Di Carlo V: Glucocorticoids affect human dendritic cell differentiation and maturation. J Immunol 162: 6473, 1999 29. Blotta MH, Dekruyff RH, Umetsu DT : Corticosteroids inhibit IL-12 production in human monocytes and enhance their capacity to induce IL-4 synthesis in CD4+ lymphocytes. J Immunol 158: 5589, 1997 30. Visser J, van Boxel-Dezaire A, Methrost D, Brunt T, de Kloet ER, Nagelkerken L: Differential regulation of interleukin 10 (IL-10) and IL-12 by glucocorticoids in vitro. Blood. 91: 4255, 1998 31. van Kooten C, Banchereau J: Function of CD40 on B cells, dendritic cells and other cells. Curr Opin Immunol 9: 330, 1997 32. Scheinman RI , P.C. Cogswell PC, Lofquist AK, and Baldwin Jr AS: Role of transcriptional activation of I kappa B alpha in mediation of immunosuppression by glucocorticoids. Science 270: 283, 1995 33. Auphan N, Dinato JA, Rosette C, Helmberg A, Karin N: Immunosuppression by glucocorticoids: inhibition of NF-kappa B activity through induction of I kappa B synthesis. Science 270: 286, 1995 34. Murphy TL, Cleveland MG, Kulesza P, Magram J, Murphy KM: Regulation of interleukin 12 p40 expression through an NF- kappa B half site. Mol Cell Biol 15: 5258, 1995 35. Yoshimoto T, Nagase H, Ishida T, Inoue J, Nariuchi H: Induction of interleukin-12 p40 transcript by CD40 ligation via activation of nuclear factor-kappaB . Eur J Immunol 27: 3461, 1997 36. Ridge JP, Di Rosa F, Matzinger P: A conditioned dendritic cell can be a temporal bridge between a CD4+ T-helper and a T-killer cell. Nature 393: 474, 1998 37. Bennett SR, Carbone FR, Karamalis F, Flavell RA, Miller JF, Heath WR: Help for cytotoxic-T-cell responses is mediated by CD40 signalling. Nature 393: 478, 1998 38. Schoenberger SP, Toes REM, van der Voort El, Offringa R, Melief CJM: T-cell help for cytotoxic T lymphocytes is ' mediated by CD40-CD40L interactions. Nature 393: 480, 1998 39. Winzler C, Rovere P, Rescigno M, Granucci F, Penna G, Adorini L, Zimmermann VS, Davoust J, Ricciardi-Castagnoli P. Maturation stages of mouse dendritic cells in growth factor-dependent long-term cultures. J Exp Med 1997 Jan 20;185 (2) :317-28. 40. Schuurhuis DH, Laban S, Toes RE, Ricciardi-Castagnoli P, Kleijmeer MJ, van der Voort El, Rea D, Offringa R, Geuze HJ, Melief CJ, Ossendorp F. Immature dendritic cells acquire CD8 (+) cytotoxic T lymphocyte priming capacity upon activation by T helper cell -independent or -dependent stimuli. J Exp Med 2000 Jul 3 ; 192 (1) : 145-50

Claims: OJ OJ t t > l- 1 o σι O σι o SD 3 rt μ- Q Φ P . <! φ ti D ς. CD Q ti SD Ml ft Di μ- CO φ SD CD φ

Inventors: MELIEF CORNELIS JOHANNES MARIA, OFFRINGA RIENK, REA DELPHINE GABRIELLE JOSETTE, MELIEF, CORNELIS, JOHANNES, MARIA, OFFRINGA, RIENK, REA, DELPHINE, GABRIELLE, JOSETTE
Applicants: LEIDS UNI MEDISCH CT, MELIEF CORNELIS JOHANNES MARIA, OFFRINGA RIENK, REA DELPHINE GABRIELLE JOSETTE, LEIDS UNIVERSITAIR MEDISCH CENTRUM, MELIEF, CORNELIS, JOHANNES, MARIA, OFFRINGA, RIENK, REA, DELPHINE, GABRIELLE, JOSETTE
Application year: 2000
Main classification: A61K39
IPC codes: A61K35, A61P37, C12N5