Regulatory T cells represent a specialized subpopulation of T lymphocytes that may modulate spontaneous HIV-1 disease progression by suppressing immune activation or inhibiting antiviral T cell immune responses. While effects of classical \(CD25^{hi}FoxP3^+CD4^+\) regulatory T cells during HIV-1 infection have been analyzed in a series of recent investigations, very little is known about the role of non-classical regulatory T cells that do not express intracellular FoxP3. Here I evaluated two groups of non-classical Treg cells. One is phenotypically identified by the surface expression of HLA-G, an HLA class Ib molecule. The other Treg cell population is characterized by the surface expression of latency-associated peptide (LAP), a membrane-bound form of \(TGF-\beta\). Both HLA-G and LAP-expressing T cells are present in small proportions in peripheral blood of healthy individuals. I performed a systematic study on the phenotypic and functional profile of HLAG- and LAP- expressing regulatory T (Treg) cells in patients with different stages of HIV-1 infection. I found that HLA-G-expressing Treg cells were highly susceptible to HIV-1 infection, and were significantly reduced in individuals with progressive HIV-1 disease courses. Moreover, the proportion of \(HLA-G^+\) CD4 and CD8 T cells was positively correlated with CD4 T cell count and inversely correlated with markers of HIV-1 associated immune activation. Mechanistically, this correlation corresponded to a substantially increased ability of \(HLA-G^+\) Treg cells to inhibit bystander immune activation, while only minimally affecting functional properties of HIV-1-specific T cells. In contrast, no significant change in \(LAP^+\) Treg cell frequencies was found in progressive HIV-1 infection, and these frequencies were not correlated with immune activation. This observation was consistent with functional analysis, which indicated that \(LAP^+\) Treg cells did not suppress bystander activation. These investigations indicate an important role of \(HLA-G^+\) Treg cells for balancing bystander immune activation and anti-viral immune activity in HIV-1 infection, and suggest that the loss of these cells during advanced HIV-1 infection may contribute to immune dysregulation and HIV-1 disease progression. In the meantime, \(LAP^+\) Treg cells do not appear to play an important role in determining HIV-1 disease outcome.

<p>Several labs have previously demonstrated that humoral immune responses at one mucosal tissue can disseminate to other mucosal sites, giving rise to the theory of the common mucosal immune system (CMIS). Evidence that demonstrates a similar link between systemic immune responses and mucosal protection is lacking despite indications that both mucosal and systemic memory B cells share common circulatory pathways. The focus of this study is to determine the contribution of blood-borne B cells to mucosal immunity in humans, and how B cells trafficking through blood can be induced to traffic to mucosal tissues.</p> <p>To address these aims, I have performed several analyses of active and inactive peripheral blood memory B cell (MBC) populations in normal, healthy humans. Analysis of recently activated blood B cells confirmed the revealed that the majority of pre-plasma cells (PPC) in blood of healthy, normal humans secrete IgA, and that the majority of IgA- positive PPC secrete primarily polymeric IgA. A large fraction of blood PPC also express CCR10, and this population contains the highest fraction of IgA-expressing and pIgA-secreting PPC in blood. In contrast, most CCR10- PPC secrete IgG, although a small fraction secretes and stains positive for IgA, and analysis of α4β7expression by blood MBC revealed that CCR10 is more inclusive of IgA-switched and pIgA-secreting PPC in blood. The data presented in this study demonstrate that IgA+/CCR10+ PPC represent the mucosal subset of PPC in the blood of healthy humans, and can be investigated as representative of recent or ongoing mucosal immune responses.</p> <p><em>In vitro </em>polyclonal stimulation of blood MBC through CD40 was able to induce CCR10 expression by blood MBC treated with IL-21, IL-2, IL-10 with additions of other germinal center (GC) cytokines such as IL-5 and TGF-β enhancing CCR10 induction. Surprisingly, CCR10 expression by IgG MBC stimulated under these conditions was similar to that of IgA MBC, demonstrating that CCR10 expression is not limited to IgA- switched B cell clones. The results of this study demonstrate that CCR10 expression is inducible by many GC factors, and importantly, is not limited to IgA-switched B cells.</p> <p>Systemic immunization of healthy volunteers with tetanus toxoid/diphtheria vaccine induced a robust systemic IgG response, but also resulted in a post-immunization mobilization of IgA PPC in blood. These PPC were not specific for tetanus or diphtheria, and in several volunteers showed specificity for mucosal pathogens such as poliovirus (PV) and herpes simplex virus (HSV) glycoproteins. In addition, stimulation of anti-HSV IgG memory was also observed. Thus we have demonstrated that a systemic immune response is capable of inducing antibody relevant to mucosal immunity, possibly exposing a mechanism through which systemic and mucosal humoral immune responses are linked.</p> <p>The studies presented here demonstrate the presence of mucosal B cell memory in blood and thus provide new insight into ways to assess and manipulate mucosal immunity.</p> / Doctor of Philosophy (Medical Science)

Epidemiologische Daten belegen eine Assoziation von Infektionen mit der Exazerbation von Autoimmunerkrankungen, wobei man aber die Wege, die dahin führen noch nicht voll versteht. Die gängigste Hypothese sieht die Ursache für die Entstehung von Autoimmunerkrankungen in der Kreuzreaktivität zwischen mikrobiellen und Selbst-Antigenen, die von der selben T-Zelle erkannt werden. Dieser Antigen-spezifische Mechanismus konnte allerdings bisher nicht durch die Forschung belegt werden. In dieser Arbeit wird gezeigt, dass im Modell der experimentellen autoimmunen Enzephalitis durch die Aktivierung mit Lipopolysacchariden gramnegativer Bakterien (LPS) Schübe in normalen Mäusen ausgelöst werden können. Diese Art der Behandlung führt in-vitro zur Proliferation und zur Zytokinproduktion bei einem Teil der T-Helfer (Th)-Effektor/Gedächtniszellen. Dabei ist zwar der physische Kontakt zwischen Th-Zellen und CD4--LPS-responsiven Zellen essentiell, jedoch geschieht die Aktivierung nicht über den T-Zellrezeptor. Als entscheidend hat sich die Bindung von kostimulatorischen Rezeptoren auf Th-Zellen durch kostimulatorische Moleküle auf CD4--Zellen erwiesen. Diese Form der Bystander-Aktivierung bietet eine Antigen-unabhängige Erklärung für die Zusammenhänge von Infektion und Autoimmunität, die mit den klinischen und epidemiologischen Daten besser vereinbar ist als die Antigen-spezifischen Modelle. / Infections sometimes associate with exacerbations of autoimmune diseases through pathways that are poorly understood. Antigen-specific mechanisms such as cross-reactivity between a microbial antigen and a self-antigen have received no direct support. Here it is shown that activation by lipopolysaccharide (LPS) induces relapses of experimental autoimmune encephalitis (EAE) in normal mice. This form of treatment induces proliferation and cytokine production in a fraction of effector/memory T helper (Th) lyphocytes in vitro via physical contact of Th cells with CD4--LPS-responsive cells. TCR mediated signals are not necessary; rather what is required is ligation of costimulatory receptors on Th cells by costimulatory molecules on the CD4- cells. This form of bystander activation provides an antigen-independent link between infection and autoimmunity that might fit the clinical and epidemiological data on the connection between infection and autoimmunity better than the antigen-specific models.

In der Arbeit wurde die Rolle von Bakterien für das Entstehen von Autoimmunität untersucht. Insbesondere wurde untersucht, inwieweit Bakterien entweder spezifisch (über "Kreuzreaktivität") oder antigenunabhängig (über "Bystander-Aktivierung") eine Aktivierung von autoreaktiven CD4+- T-Zellen induzieren können. Es konnte gezeigt werden, dass es bei dem untersuchten, MBP-spezifischen T-Zellrezeptor multiple, natürlich vorkommende, kreuzreaktive Peptide mikrobiellen Ursprungs gibt, die eine Aktivierung der T-Zellen hervorrufen und in vivo experimentelle autoimmune Enzephalomyelitis (EAE) induzieren können. Weiterhin wurde untersucht, inwieweit Lipopolysaccharid (LPS) als unspezifischer Aktivator des Immunsystems eine Aktivierung der autoreaktiven T-Zellen in vitro hervorrufen kann und inwieweit in vivo EAE durch LPS hervorgerufen werden kann. Es wurde gezeigt, dass LPS in vitro einen kleinen Anteil der CD4+ - T-Zellen aktiviert. Wurden den transgenen T+alpha- -Mäusen LPS appliziert, erkrankten diese an EAE. Somit gibt es sowohl in vitro als auch in vivo in den T+alpha- -Mäusen Hinweise für eine Relevanz von "Bystander-Aktivierung". Abschließend wurde diskutiert, inwieweit entweder "Kreuzreaktivität" oder "Bystander-Aktivierung" als Auslöser für Autoimmunität unter physiologischen Bedingungen in Frage kommt. Aufgrund der in dieser Arbeit gezeigten Ergebnisse wurde postuliert, dass keine der beiden Mechanismen alleiniger Auslöser sei, da es aufgrund der Häufigkeit von Infektionen, kreuzreaktiven Peptiden und des Vorkommens von autoreaktiven T-Zellen auch in gesunden Individuen ansonsten sehr viel häufiger zu Autoimmunität kommen müsste. Unter bestimmten Bedingungen könnte die Aktivierung von T-Zellen über Kreuzreaktivität oder über "Bystander-Aktivierung" Autoimmunität auslösen oder verstärken, wenn bereits andere Mechanismen des Immubnsystems, die Autoimmunität verhindern, versagt haben. / In this thesis the role of bacteria for the induction of autoimmunity was investigated. In detail, it was examined whether bacteria are able to activate autoreactive CD4+-T-cells antigen-specific ("cross-reactivity") or antigen-unspecific ("bystander-activation"). It was shown that the examined transgenic MBP-peptide specific T-cell-receptor recognized many natural occurring cross-reactive peptides of microbial origin, which induced an activation of the T-cells in vitro and which could induce autoimmune encephalomyelitis (EAE) in the T-cell-receptor transgenic mice in vivo. Furthermore, it was examined, whether lipopolysaccharide (LPS) as activator of the innate immune system could induce an unspecific activation of the autoreactive T-cells in vitro and whether administration of LPS in the transgenic mice could induce EAE in vivo. It was shown that LPS activates a small percentage of CD4+ - T-cells. Application of LPS to the transgenic T+alpha- mice induced EAE. Therefore, the role of bystander-activation was indicated in vitro and in vivo. Finally, it was discussed, whether either cross-reactivity or bystander-activation could be sufficient for inducing autoimmunity under physiologic conditions. Due to the results presented in this work, it is postulated that none of the both mechanisms could be inductor of autoimmunity alone. If one of these mechanisms was sufficient, autoimmunity in humans should be a frequent event, because infections and autoreactive T cells are both findings which occur in healthy humans very often. However, under certain conditions either cross-reactivity or bystander-activation could trigger or exacerbate autoimmunity, when other mechanisms which inhibit autoimmunity have failed.