Peripheral Blood Lymphocyte Subsets (CD4+, CD8+ T Cells,NK Cells) in Patients with Cardiovascular and Neurological Complications after Carotid Endarterectomy

Background: The aim of the study was to evaluate the differences in the circulating immune cells’ subgroups after the atherosclerotic plaque removal in patients presenting with postoperative complications as compared to the patients without complications after carotid endarterectomy (CEA). Methods: Patients with significant carotid atherosclerosis (n = 124, age range: 44 to 87 years) who underwent CEA were enrolled in a prospective study. The immunology study using flow cytometry was performed to determine the percentages of peripheral blood T cells (CD4⁺, CD8⁺, Treg—CD4⁺/CD25⁺) and NK (natural killer) cells before and after the procedure. The data were expressed as the percentage of total lymphocytes ± the standard error of mean. Results: The mean percentage of lymphocytes (61.54% ± 17.50% vs. 71.82% ± 9.68%, p = 0.030) and CD4 T lymphocytes (T helper, 38.13% ± 13.78% vs. 48.39% ± 10.24%, p = 0.027) was significantly lower six hours after CEA in patients with postoperative 30-day cardiovascular and neurological complications as compared to the group without complications. On the other hand the mean NK level in the group with complications was significantly higher (21.61% ± 9.00% vs. 15.80% ± 9.31%, p = 0.048). Conclusions: The results of this study suggest that after carotid endarterectomy the percentages of circulating immune cells subsets differ in patients with and without postoperative complications.     

1型糖尿病反义肽噬菌体疫苗诱导CD8~+T细胞对病理性CD4~+T细胞的抑制作用

目的观察1型糖尿病反义肽噬菌体疫苗诱导CD8+T细胞对病理性CD4+T细胞的抑制作用。方法用1型糖尿病反义肽噬菌体疫苗免疫非肥胖型糖尿病(NOD)小鼠,并同时设立噬菌体空载体免疫组和未免疫空白对照组。于初次免疫后第20周,检测各组小鼠血糖;磁珠法分离免疫小鼠CD8+T细胞,并用合成反义肽及IL-2诱导刺激作为效应细胞;分离噬菌体空载体免疫组和空白对照组小鼠CD4+T细胞,用合成正义肽及IL-2诱导刺激作为靶细胞。将效应细胞与靶细胞按不同比例混合,以乳酸脱氢酶(LDH)释放法检测CTL的杀伤活性。结果初次免疫后第20周,1型糖尿病反义肽噬菌体疫苗免疫组小鼠血糖水平保持正常,而另外2组小鼠血糖均高于正常水平。1型糖尿病反义肽噬菌体疫苗免疫组诱导的CD8+T细胞作效应细胞,当效靶比为100∶1时,对噬菌体空载体免疫组CD4+T细胞的杀伤效率最高,达47.95%±11.30%,而噬菌体空载体免疫组诱导的小鼠CD8+T细胞对空白对照组的CD4+T细胞无杀伤作用。结论1型糖尿病反义肽噬菌体疫苗能够诱导CD8+T细胞抑制病理性CD4+T细胞。     

猪瘟疫苗免疫反应低下猪CD3~+CD4~+和CD4~+CD25~+淋巴细胞亚群分析

目的分析猪瘟疫苗免疫反应低下猪CD3+CD4+和CD4+CD25+淋巴细胞亚群的分布。方法将接种过猪瘟疫苗的种母猪经ELISA和血清中和试验检测筛选出猪瘟病毒(CSFV)抗体阴性猪。从中挑选出15头作为研究对象,以15头抗体阳性猪作为对照。采集猪的抗凝血,分离外周血淋巴细胞(PBL),流式细胞术检测30头猪PBL中CD3+CD4+和CD4+CD25+淋巴细胞亚群的分布。结果CSFV抗体阴性猪PBL中CD3+CD4+细胞的比例(24.09%±1.29%)明显低于CSFV抗体阳性猪(37.49%±1.60%);CSFV抗体阴性猪PBL中CD4+CD25+细胞的比例(2.34%±0.20%)明显高于CSFV抗体阳性猪(1.64%±0.13%)。结论PBL中CD3+CD4+淋巴细胞亚群的减少及CD4+CD25+淋巴细胞亚群的增加,可能是导致猪瘟疫苗免疫反应低下的重要原因。     

Treg-Resistant Cytotoxic CD4+ T Cells Dictate T Helper Cells in Their Vicinity: TH17 Skewing and Modulation of Proliferation

Cytotoxic CD4⁺ T cells (CD4 CTL) are terminally differentiated T helper cells that contribute to autoimmune diseases, such as multiple sclerosis. We developed a novel triple co-culture transwell assay to study mutual interactions between CD4 CTL, conventional TH cells, and regulatory T cells (Tregs) simultaneously. We show that, while CD4 CTL are resistant to suppression by Tregs in vitro, the conditioned medium of CD4 CTL accentuates the suppressive phenotype of Tregs by upregulating IL-10, Granzyme B, CTLA-4, and PD-1. We demonstrate that CD4 CTL conditioned medium skews memory TH cells to a TH17 phenotype, suggesting that the CD4 CTL induce bystander polarization. In our triple co-culture assay, the CD4 CTL secretome promotes the proliferation of TH cells, even in the presence of Tregs. However, when cell−cell contact is established between CD4 CTL and TH cells, the proliferation of TH cells is no longer increased and Treg-mediated suppression is restored. Taken together, our results suggest that when TH cells acquire cytotoxic properties, these Treg-resistant CD4 CTL affect the proliferation and phenotype of conventional TH cells in their vicinity. By creating such a pro-inflammatory microenvironment, CD4 CTL may favor their own persistence and expansion, and that of other potentially pathogenic TH cells, thereby contributing to pathogenic responses in autoimmune disorders.     

复合通用CD4~+T辅助细胞表位基因克隆载体的构建及测序

目的构建复合通用CD4+T辅助细胞表位基因克隆载体,并进行测序。方法由DNA work2.0软件设计并人工合成20条55个碱基的寡核苷酸序列,利用套叠PCR技术人工合成全基因序列,并克隆至pUC19载体,转化大肠杆菌DH5α,提取质粒,酶切鉴定并进行测序。结果经PCR扩增出645bp的目的DNA片段。酶切鉴定筛选出8个阳性克隆,经测序获得一个序列完全正确的克隆。结论已成功构建了复合通用CD4+T辅助细胞表位基因克隆载体,为研究表位疫苗和细菌多糖结合疫苗提供了新的载体表位。     

附红细胞体感染小鼠CD4~+ T淋巴细胞相关因子的检测

目的动态检测小鼠感染附红细胞体后CD4+T淋巴细胞相关细胞因子的变化情况,探讨CD4+T淋巴细胞发挥的免疫学效应。方法将小鼠随机分为实验组(纯化的附红细胞体)和对照组(生理盐水),均经腹腔免疫接种,0.5 ml/只。分别于感染后第3、5、7、9 d,经小鼠尾尖采血,镜下观察附红细胞体形态并进行PCR鉴定。建模成功后,分别于感染后第3、5、7、9 d无菌取小鼠脾脏,采用RT-PCR法检测小鼠脾脏中IL-4、IL-17、IFNγ基因的转录水平。结果各时间点感染小鼠的红细胞均出现不同程度的变形,边缘被附红体附着,PCR扩增产物可见602 bp的特异条带。实验组小鼠脾脏IL-4、IL-17、IFNγ均有不同程度的表达,IL-17在感染在第3天上调,5 d达到高峰,7 d开始下降;IFNγ在感染第3天表达上调,5 d明显下降,7 d表达上升,9 d达到高峰;IL-4始终处于低表达状态。实验组小鼠脾脏IL-4、IL-17、IFNγ的转录水平均高于对照组(P<0.01),IL-17和IFNγ的表达呈相互抑制状态,IL-4呈被抑制状态。结论附红细胞体感染后,IL-17在早期发挥了促进炎症发生和抵抗感染的免疫学作用;IFNγ在感染后期发挥保护炎性反应,避免炎性反应过度发生的免疫学效应;IL-4在此感染过程中作用不明显。     

Near-Complete Remission of Glioblastoma in a Patient Treated with an Allogenic Dendritic Cell-Based Vaccine: The Role of Tumor-Specific CD4+T-Cell Cytokine Secretion Pattern in Predicting Response and Recurrence

Immunotherapy has brought hope to the fight against glioblastoma, but its efficacy remains unclear. We present the case of CST, a 25-year-old female patient with a large right-hemisphere glioblastoma treated with a dendritic–tumor cell fusion vaccine. CST showed a near-complete tumor response, with a marked improvement in her functional status and simultaneous increases in tumor-specific CD8+ and CD4+ T cells. Two months before recurrence, the frequency of tumor-specific T cells decreased, while that of IL-17 and CD4+ T cells increased. CST passed away 15 months after enrollment. In this illustrative case, the tumor-specific CD4+ T-cell numbers and phenotype behaved as treatment efficacy biomarkers, highlighting the key role of the latter in glioblastoma immunotherapy.     

The Proteomic Landscape of Resting and Activated CD4+ T Cells Reveal Insights into Cell Differentiation and Function

CD4+ T cells (T helper cells) are cytokine-producing adaptive immune cells that activate or regulate the responses of various immune cells. The activation and functional status of CD4+ T cells is important for adequate responses to pathogen infections but has also been associated with auto-immune disorders and survival in several cancers. In the current study, we carried out a label-free high-resolution FTMS-based proteomic profiling of resting and T cell receptor-activated (72 h) primary human CD4+ T cells from peripheral blood of healthy donors as well as SUP-T1 cells. We identified 5237 proteins, of which significant alterations in the levels of 1119 proteins were observed between resting and activated CD4+ T cells. In addition to identifying several known T-cell activation-related processes altered expression of several stimulatory/inhibitory immune checkpoint markers between resting and activated CD4+ T cells were observed. Network analysis further revealed several known and novel regulatory hubs of CD4+ T cell activation, including IFNG, IRF1, FOXP3, AURKA, and RIOK2. Comparison of primary CD4+ T cell proteomic profiles with human lymphoblastic cell lines revealed a substantial overlap, while comparison with mouse CD+ T cell data suggested interspecies proteomic differences. The current dataset will serve as a valuable resource to the scientific community to compare and analyze the CD4+ proteome.     

CD4+ T-Cell Plasticity in Non-Infectious Retinal Inflammatory Disease

Non-infectious uveitis (NIU) is a potentially sight-threatening disease. Effector CD4⁺ T cells, especially interferon-γ-(IFNγ) producing Th1 cells and interleukin-17-(IL-17) producing Th17 cells, are the major immunopathogenic cells, as demonstrated by adoptive transfer of disease in a model of experimental autoimmune uveitis (EAU). CD4⁺FoxP3⁺CD25⁺ regulatory T cells (Tregs) were known to suppress function of effector CD4⁺ T cells and contribute to resolution of disease. It has been recently reported that some CD4⁺ T-cell subsets demonstrate shared phenotypes with another CD4⁺ T-cell subset, offering the potential for dual function. For example, Th17/Th1 (co-expressing IFNγ and IL-17) cells and Th17/Treg (co-expressing IL-17 and FoxP3) cells have been identified in NIU and EAU. In this review, we have investigated the evidence as to whether these ‘plastic CD4⁺ T cells’ are functionally active in uveitis. We conclude that Th17/Th1 cells are generated locally, are resistant to the immunosuppressive effects of steroids, and contribute to early development of EAU. Th17/Treg cells produce IL-17, not IL-10, and act similar to Th17 cells. These cells were considered pathogenic in uveitis. Future studies are needed to better clarify their function, and in the future, these cell subsets may in need to be taken into consideration for designing treatment strategies for disease.     

CD8+ T Cell-Induced Expression of Tissue Inhibitor of Metalloproteinses-1 Exacerbated Osteoarthritis

Despites the fact that T cells are involved in the pathogenesis of osteoarthritis (OA) little is known about the roles of CD8⁺ T cells in this disease. We investigated the effects of CD8⁺ T cells and the expression of tissue inhibitor of metalloproteinases 1 (TIMP-1) on joint pathology. Using anterior cruciate ligament-transection (ACLT), OA was induced in mice. The knee joints were histologically assessed for manifestations of OA. The CD8⁺ T cells from splenocytes and synovium were flow-cytometrically and immunochemically evaluated, respectively. Local expression of TIMP-1, matrix metalloproteinase (MMP)-13, and VEGF were examined. Cartilage degeneration was slower in CD8⁺ T cell knockout mice than in control mice. CD8⁺ T cells were activated once OA was initiated and expanded during OA progression. More CD8⁺ T cells from splenocytes expressed TIMP-1 in ACLT-group mice than in Sham-group mice. The number of TIMP-1-expressing CD8⁺ T cells in OA mice correlated with the disease severity. TIMP-1 expression in cartilage was co-localized with that of MMP-13 and VEGF. TIMP-1 protein was detected in synovium in which angiogenesis occurred. During the pathogenesis of OA, the expression of TIMP-1, VEGF and MMP-13 accompanying with CD8⁺ T cells activation were increased. Furthermore, inhibiting the expression of TIMP-1 in joints could retard the progression of OA.     

抗人T淋巴细胞CD4人-鼠嵌合抗体的真核表达

目的在小鼠骨髓瘤细胞SP2/0中表达抗人T淋巴细胞CD4人-鼠嵌合抗体。方法真核表达质粒PAG4622+CD4VL和PAH4604+CD4VH经酶切和序列测定后,采用电穿孔转染技术将二者共转染SP2/0细胞,经组胺醇和霉酚酸联合筛选阳性克隆,通过ELISA、流式细胞术、RT-PCR和DNA测序的方法进行初步鉴定。结果真核表达质粒经酶切和测序鉴定证明构建正确。获得2株分泌抗人T淋巴细胞CD4人-鼠嵌合抗体的阳性SP2/0细胞克隆0925CASP2/0和1107CASP2/0,嵌合抗体表达量为0.5～2ng/ml。结论已成功地在SP2/0细胞中表达了抗人T淋巴细胞CD4人-鼠嵌合抗体,为该抗体在其他真核细胞中的高效表达及临床应用奠定了基础。     

Role of CD4+ T Cells in the Control of Viral Infections: Recent Advances and Open Questions

CD4+ T cells orchestrate adaptive immune responses through their capacity to recruit and provide help to multiple immune effectors, in addition to exerting direct effector functions. CD4+ T cells are increasingly recognized as playing an essential role in the control of chronic viral infections. In this review, we present recent advances in understanding the nature of CD4+ T cell help provided to antiviral effectors. Drawing from our studies of natural human immunodeficiency virus (HIV) control, we then focus on the role of high-affinity T cell receptor (TCR) clonotypes in mediating antiviral CD4+ T cell responses. Last, we discuss the role of TCR affinity in determining CD4+ T cell differentiation, reviewing the at times divergent studies associating TCR signal strength to the choice of a T helper 1 (Th1) or a T follicular helper (Tfh) cell fate.     

A Role for Human Renal Tubular Epithelial Cells in Direct Allo-Recognition by CD4+ T-Cells and the Effect of Ischemia-Reperfusion

Direct allorecognition is the earliest and most potent immune response against a kidney allograft. Currently, it is thought that passenger donor professional antigen-presenting cells (APCs) are responsible. Further, many studies support that graft ischemia-reperfusion injury increases the probability of acute rejection. We evaluated the possible role of primary human proximal renal tubular epithelial cells (RPTECs) in direct allorecognition by CD4+ T-cells and the effect of anoxia-reoxygenation. In cell culture, we detected that RPTECs express all the required molecules for CD4+ T-cell activation (HLA-DR, CD80, and ICAM-1). Anoxia-reoxygenation decreased HLA-DR and CD80 but increased ICAM-1. Following this, RPTECs were co-cultured with alloreactive CD4+ T-cells. In T-cells, zeta chain phosphorylation and c-Myc increased, indicating activation of T-cell receptor and co-stimulation signal transduction pathways, respectively. T-cell proliferation assessed with bromodeoxyuridine assay and with the marker Ki-67 increased. Previous culture of RPTECs under anoxia raised all the above parameters in T-cells. FOXP3 remained unaffected in all cases, signifying that proliferating T-cells were not differentiated towards a regulatory phenotype. Our results support that direct allorecognition may be mediated by RPTECs even in the absence of donor-derived professional APCs. Also, ischemia-reperfusion injury of the graft may enhance the above capacity of RPTECs, increasing the possibility of acute rejection.     

复合通用CD4~+Th细胞表位基因的原核表达及免疫学特性

目的构建复合通用CD4+Th细胞表位基因的原核表达载体,检测表达蛋白的免疫学特性,并探讨其作为载体蛋白的可能性。方法以限制性核酸内切酶BamHⅠ和HindⅢ双酶切重组质粒pUC19-Pep10,回收长度为650bp左右的目的片段,插入原核表达载体pQE30中,获得重组质粒pQE30-Pep10,转化大肠杆菌M15后进行诱导表达。表达产物经SDS-PAGE和Westernblot分析后,进行亲和层析纯化及透析复性,获得重组蛋白Pep10,将Pep10和TT分别免疫雌性BALB/c小鼠,以间接ELISA法和流式细胞术分别检测其免疫原性和淋巴细胞增殖效应。结果SDS-PAGE显示重组蛋白Pep10相对分子质量约为23000,表达量达41%,主要以包涵体形式表达,Westernblot检测可见特异性染色条带,纯化后纯度达94%,共获得42mg重组蛋白。其体外淋巴细胞增殖效应与TT相当,增殖指数分别为4.216和4.736,而免疫原性远低于TT,特异性IgG几何平均滴度(GMT)分别为1∶15758.65和1∶67558.81。结论已成功构建重组原核表达载体pQE30-Pep10,并在大肠杆菌中高效表达,且表达的重组蛋白Pep10具有良好的淋巴细胞增殖效应和较低的免疫原性,有可能作为一种新型载体蛋白,用于多糖结合疫苗的研制。     

Opposing Roles of DCs and iNKT Cells in the Induction of Foxp3 Expression by MLN CD25+CD4+ T Cells during IFNγ-Driven Colitis

We have previously shown that a deficiency of CD1d-restricted invariant natural killer T (iNKT) cells exacerbates dextran sulfate sodium (DSS)-induced colitis in Yeti mice that exhibit IFNγ-mediated hyper-inflammation. Although iNKT cell-deficiency resulted in reduced Foxp3 expression by mesenteric lymph node (MLN) CD4⁺ T cells in DSS-treated Yeti mice, the cellular mechanisms that regulate Foxp3 expression by CD25⁺CD4⁺ T cells during intestinal inflammation remain unclear. We found that Foxp3⁻CD25⁺CD4⁺ T cells expressing Th1 and Th17 phenotypic hallmarks preferentially expanded in the MLNs of DSS-treated Yeti/CD1d knockout (KO) mice. Moreover, adoptive transfer of Yeti iNKT cells into iNKT cell-deficient Jα18 KO mice effectively suppressed the expansion of MLN Foxp3⁻CD25⁺CD4⁺ T cells during DSS-induced colitis. Interestingly, MLN dendritic cells (DCs) purified from DSS-treated Yeti/CD1d KO mice promoted the differentiation of naive CD4⁺ T cells into Foxp3⁻CD25⁺CD4⁺ T cells rather than regulatory T (Treg) cells, indicating that MLN DCs might mediate Foxp3⁺CD25⁺CD4⁺ T cell expansion in iNKT cell-sufficient Yeti mice. Furthermore, we showed that Foxp3⁻CD25⁺CD4⁺ T cells were pathogenic in DSS-treated Yeti/CD1d KO mice. Our result suggests that pro-inflammatory DCs and CD1d-restricted iNKT cells play opposing roles in Foxp3 expression by MLN CD25⁺CD4⁺ T cells during IFNγ-mediated intestinal inflammation, with potential therapeutic implications.     

T Cells in Multisystem Inflammatory Syndrome in Children (MIS-C) Have a Predominant CD4+ T Helper Response to SARS-CoV-2 Peptides and Numerous Virus-Specific CD4− CD8− Double-Negative T Cells

We studied SARS-CoV-2-specific T cell responses in 22 subacute MIS-C children enrolled in 2021 and 2022 using peptide pools derived from SARS-CoV-2 spike or nonspike proteins. CD4+ and CD8+ SARS-CoV-2-specific T cells were detected in 5 subjects, CD4+ T helper (Th) responses alone were detected in 12 subjects, and CD8+ cytotoxic T cell (CTL) responses alone were documented in 1 subject. Notably, a sizeable subpopulation of CD4− CD8− double-negative (DN) T cells out of total CD3+ T cells was observed in MIS-C (median: 14.5%; IQR 8.65–25.3) and recognized SARS-CoV-2 peptides. T cells bearing the Vβ21.3 T cell receptor (TcRs), previously reported as pathogenic in the context of MIS-C, were detected in high frequencies, namely, in 2.8% and 3.9% of the CD4+ and CD8+ T cells, respectively. However, Vβ21.3 CD8+ T cells that responded to SARS-CoV-2 peptides were detected in only a single subject, suggesting recognition of nonviral antigens in the majority of subjects. Subjects studied 6–14 months after MIS-C showed T cell epitope spreading, meaning the activation of T cells that recognize more SARS-CoV-2 peptides following the initial expansion of T cells that see immunodominant epitopes. For example, subjects that did not recognize nonspike proteins in the subacute phase of MIS-C showed good Th response to nonspike peptides, and/or CD8+ T cell responses not appreciable before arose over time and could be detected in the 6–14 months’ follow-up. The magnitude of the Th and CTL responses also increased over time. In summary, patients with MIS-C associated with acute lymphopenia, a classical feature of MIS-C, showed a physiological response to the virus with a prominent role for virus-specific DN T cells.     

Human CD4+CD45RA+ T Cells Behavior after In Vitro Activation: Modulatory Role of Vasoactive Intestinal Peptide

Naїve CD4⁺ T cells, which suffer different polarizing signals during T cell receptor activation, are responsible for an adequate immune response. In this study, we aimed to evaluate the behavior of human CD4⁺CD45RA⁺ T cells after in vitro activation by anti-CD3/CD28 bead stimulation for 14 days. We also wanted to check the role of the VIP system during this process. The metabolic biomarker Glut1 was increased, pointing to an increase in glucose requirement whereas Hif-1α expression was higher in resting than in activated cells. Expression of Th1 markers increased at the beginning of activation, whereas Th17-associated biomarkers augmented after that, showing a pathogenic Th17 profile with a possible plasticity to Th17/1. Foxp3 mRNA expression augmented from day 4, but no parallel increases were observed in IL-10, IL-2, or TGFβ mRNA expression, meaning that these potential differentiated Treg could not be functional. Both VIP receptors were located on the plasma membrane, and expression of VPAC₂ receptor increased significantly with respect to the VPAC₁ receptor from day 4 of CD4⁺CD45RA⁺ T activation, pointing to a shift in VPAC receptors. VIP decreased IFNγ and IL-23R expression during the activation, suggesting a feasible modulation of Th17/1 plasticity and Th17 stabilization through both VPAC receptors. These novel results show that, without polarizing conditions, CD4⁺CD45RA⁺ T cells differentiate mainly to a pathogenic Th17 subset and an unpaired Treg subset after several days of activation. Moreover, they confirm the important immunomodulatory role of VIP, also on naїve Th cells, stressing the importance of this neuropeptide on lymphocyte responses in different pathological or non-pathological situations.     

Deregulated Expression of Immune Checkpoints on Circulating CD4 T Cells May Complicate Clinical Outcome and Response to Treatment with Checkpoint Inhibitors in Multiple Myeloma Patients

Unlike solid-tumor patients, a disappointingly small subset of multiple myeloma (MM) patients treated with checkpoint inhibitors derive clinical benefits, suggesting differential participation of inhibitory receptors involved in the development of T-cell-mediated immunosuppression. In fact, T cells in MM patients have recently been shown to display features of immunosenescence and exhaustion involved in immune response inhibition. Therefore, we aimed to identify the dominant inhibitory pathway in MM patients to achieve its effective control by therapeutic interventions. By flow cytometry, we examined peripheral blood (PB) CD4 T cell characteristics assigned to senescence or exhaustion, considering PD-1, CTLA-4, and BTLA checkpoint expression, as well as secretory effector function, i.e., capacity for IFN-γ and IL-17 secretion. Analyses were performed in a total of 40 active myeloma patients (newly diagnosed and treated) and 20 healthy controls. At the single-cell level, we found a loss of studied checkpoints’ expression on MM CD4 T cells (both effector (Teff) and regulatory (Treg) cells) primarily at diagnosis; the checkpoint deficit in MM relapse was not significant. Nonetheless, PD-1 was the only checkpoint distributed on an increased proportion of T cells in all MM patients irrespective of disease phase, and its expression on CD4 Teff cells correlated with adverse clinical courses. Among patients, the relative defect in secretory effector function of CD4 T cells was more pronounced at myeloma relapse (as seen in declined Th1/Treg and Th17/Treg cell rates). Although the contribution of PD-1 to MM clinical outcomes is suggestive, our study clearly indicated that the inappropriate expression of immune checkpoints (associated with dysfunctionality of CD4 T cells and disease clinical phase) might be responsible for the sub-optimal clinical response to therapeutic checkpoint inhibitors in MM.     

Indoleamine 2,3-Dioxygenase (IDO) Downregulates the Cell Surface Expression of the CD4 Molecule

Indoleamine 2,3-dioxygenase (IDO) has been implicated in preventing the fetus from undergoing maternal T cell-mediated immune responses, yet the mechanism underlying these kinds of IDO-mediated immune responses has not been fully elucidated. Since the CD4 molecule plays a central role in the onset and regulation of antigen-specific immune responses, and T cell is sensitive in the absence of tryptophan, we hypothesize that IDO may reduce cell surface CD4 expression. To test this hypothesis, an adenoviral vector-based construct IDO-EGFP was generated and the effect of IDO-EGFP on CD4 expression was determined on recombinant adenoviral infected C8166 and MT-2 cells, by flow cytometry and/or Western blot analysis. The results revealed a significant downregulation of cell membrane CD4 in pAd-IDOEGFP infected cells when compared to that of mock-infected cells or infection with empty vector pAd-EGFP. Further experiments disclosed that either an addition of tryptophan or IDO inhibitor could partly restore CD4 expression in pAd-IDOEGFP infected C8166 cells. Our findings suggest that downregulation of CD4 by IDO might be one of the mechanisms through which IDO regulates T cell-mediated immune responses.