The involvement of regulatory T cells (Tregs) in immune homeostasis is now recognized as one of the fundamental mechanisms of immune tolerance. While several different types of Tregs cooperate to establish and maintain immune homeostasis, much current research is focused on defining the characteristics of the CD4⁺CD25⁺ Treg subset, as these cells can mediate dominant, long-lasting and transferable tolerance in many experimental models. The aim of this research was to characterize the biological role of a protein known as forkhead box P3 (FOXP3) that was initially identified as an essential transcription factor for the development of mouse CD4⁺CD25⁺ Tregs, in human CD4⁺ T cells. Following confirmation that, like mouse Tregs, human Tregs also expressed high levels of FOXP3, several approaches were used to investigate the role of this protein in human CD4⁺ T cells. 1) Characterization of endogenous FOXP3 expression in CD4⁺ T cell subsets revealed that this protein is not a Treg-specific marker as was previously thought. Instead, low-level and transient expression was found to be typical of highly activated non-regulatory effector T cells. 2) To generate large numbers of Tregs suitable for cellular therapy, the capacity of ectopic FOXP3 expression to drive Treg generation in vitro was explored. It was found that high and constitutive expression mediated by a lentiviral vector, but not fluctuating expression driven by a retroviral vector, was sufficient to generate suppressive cells. Over-expression strategies were also used to characterize a novel splice isoform unique to human cells, FOXP3Δ2 (FOXP3b). 3) To further probe the requirements of FOXP3 to induce suppressor function, a system for conditionally-active FOXP3 ectopic expression was developed. These studies established that FOXP3 acts a quantitative regulator rather than a “master switch” for Tregs, and that there is a temporal component to its capacity to direct Treg phenotype and function. In summary, this research has significantly expanded the understanding of the biological function of FOXP3 in human CD4⁺ T cells. Based on the potential of these cells to be manipulated for therapy, this work contributes to the field of immunology on both academic and clinical research fronts.

Chronic Kidney Disease (CKD) is a progressive condition that in the majority of cases leads to End Stage Renal Failure (ESRD) and the need for dialysis, with the only cure being renal transplant. CKD affects both adults and children; however the underlying causes of the disease are different. CKD in adults is most commonly secondary to diabetes and/or hypertension while CKD in children is usually caused by congenital structural abnormalities that result directly in renal dysfunction. There have been numerous reports of inflammatory and immunological disturbances in adult CKD that involve both the cellular and humoral immune systems. Consequences of these include an increased rate of cardiovascular disease (CVD), decreased response to vaccinations, as well as increased rates of infection, anaemia and malnutrition. Children with CKD display many of the clinical complications seen in adult kidney disease that are associated with inflammatory and immunological changes. In adults however, many of the primary conditions associated with CKD are inherently pro-inflammatory; therefore it is not clear whether the inflammatory changes observed in adults with CKD are due to pre-existing inflammatory conditions, renal disease per se or a combination of both. The majority of CKD in children is caused by conditions that are not inflammatory in nature. This presents a unique opportunity to study the inflammatory consequences of CKD alone, without the added complication of underlying inflammatory disorders. Despite this, there has been little investigation of the inflammatory and immunological status of children with CKD. Some very recent studies have shown that children with CKD have an increased systemic inflammatory state[1-3], however the nature of these immunological and inflammatory changes remains poorly defined. Identification of the specific inflammatory processes that occur in CKD may provide new treatment targets and the opportunity to develop urgently needed new therapies. The purpose of this thesis is to investigate the presence of immunological changes associated with inflammation in children with CKD. This is the first study to include children with very mild disease, and the significant changes that are present in the early stages of the disease are of particular note. I have shown that CKD in children is an intrinsically inflammatory condition, with increased accumulation of markers of oxidative stress and production of pro-inflammatory cytokines. The inflammatory markers identified in this study may be applied as a foundation for more sensitive diagnostic markers of disease progression as well as provide a basis for novel treatment strategies in this group of patients. Early identification of increased inflammation is a prerequisite for the application of preventive strategies. In addition, a better understanding of the level and mechanisms of systemic inflammation in children with CKD may enable a more accurate assessment of their risk of other inflammatory conditions such as CVD, anaemia, muscle wasting, and malnutrition. Future research that specifically focuses on the reasons and mechanisms for different rates of disease progression may emerge as a result of this study. Importantly, the findings of this study may have implications in the long term treatment of disease and may allow identification of new treatment strategies to achieve better patient outcomes. The outcomes of the study are: • Better definition of inflammatory profiles in paediatric CKD and correlation with disease severity and progression, which should contribute to improved management strategies. • Identification of new treatment targets to reduce the damage caused by chronic systemic inflammation. • Mechanistic understanding of the relationship of the inflammatory profile in regard to source leucocytes or other contributing cell types. / http://proxy.library.adelaide.edu.au/login?url= http://library.adelaide.edu.au/cgi-bin/Pwebrecon.cgi?BBID=1330366 / Thesis (Ph.D.) -- University of Adelaide, School of Paediatrics and Reproductive Health, 2008

The involvement of regulatory T cells (Tregs) in immune homeostasis is now recognized as one of the fundamental mechanisms of immune tolerance. While several different types of Tregs cooperate to establish and maintain immune homeostasis, much current research is focused on defining the characteristics of the CD4⁺CD25⁺ Treg subset, as these cells can mediate dominant, long-lasting and transferable tolerance in many experimental models. The aim of this research was to characterize the biological role of a protein known as forkhead box P3 (FOXP3) that was initially identified as an essential transcription factor for the development of mouse CD4⁺CD25⁺ Tregs, in human CD4⁺ T cells. Following confirmation that, like mouse Tregs, human Tregs also expressed high levels of FOXP3, several approaches were used to investigate the role of this protein in human CD4⁺ T cells. 1) Characterization of endogenous FOXP3 expression in CD4⁺ T cell subsets revealed that this protein is not a Treg-specific marker as was previously thought. Instead, low-level and transient expression was found to be typical of highly activated non-regulatory effector T cells. 2) To generate large numbers of Tregs suitable for cellular therapy, the capacity of ectopic FOXP3 expression to drive Treg generation in vitro was explored. It was found that high and constitutive expression mediated by a lentiviral vector, but not fluctuating expression driven by a retroviral vector, was sufficient to generate suppressive cells. Over-expression strategies were also used to characterize a novel splice isoform unique to human cells, FOXP3Δ2 (FOXP3b). 3) To further probe the requirements of FOXP3 to induce suppressor function, a system for conditionally-active FOXP3 ectopic expression was developed. These studies established that FOXP3 acts a quantitative regulator rather than a “master switch” for Tregs, and that there is a temporal component to its capacity to direct Treg phenotype and function. In summary, this research has significantly expanded the understanding of the biological function of FOXP3 in human CD4⁺ T cells. Based on the potential of these cells to be manipulated for therapy, this work contributes to the field of immunology on both academic and clinical research fronts. / Medicine, Faculty of / Medicine, Department of / Experimental Medicine, Division of / Graduate

5 Regulatory T cells (Tregs) are essential for the maintenance of peripheral self-tolerance and prevention of autoimmunity by suppressing the response of self-reactive CD8+ and CD4+ T cells. However, while interactions of Tregs with CD4+ T cells have been extensively studied, their effect on the self-tolerance of CD8+ T cells has not been explored in detail. The main aim of this diploma project was to provide evidence whether and how Tregs prevent autoimmunity induced by CD8+ T cells. We used an experimental mouse model of autoimmune diabetes allowing us to acutely deplete Tregs and titrate the number of self-reactive T cells, self- antigen affinity, and self-antigen doses. We found out that Tregs play an important role in the prevention of CD8+ T-cell mediated autoimmunity. Moreover, we revealed that Tregs suppress both high-affinity T cells that escape negative selection and relatively weakly self-reactive, but numerous, positively selected T cells. Tregs do so by increasing requirement for the number of self-reactive CD8+ T cells required for the autoimmunity induction. Intriguingly, presence of Tregs does not impact threshold for self-antigen. Moreover, for the first time, we showed that Tregs can suppress CD8+ T-cell-mediated autoimmunity in the absence of conventional CD4+ T cells. This means that...

This thesis addresses multiple approaches to investigating mechanisms of immune linked disease. There are four projects outlined below which describe the work of these investigations. First, educating students about techniques to study disease and therapies is an important area of research. Flow cytometry is a common technique in immunology and its versatility and high throughput abilities can be applied to many fields. While it is very useful, flow cytometry is a complex technique that requires training to operate and understand, and there are very few reports about administering effective training. This thesis outlines the first report of a full semester university course about flow cytometry. Students who completed the course reported increased confidence in their skill levels in conceptual, technical and analytical areas. Second, in the fight against cancer, immunotherapies may provide the necessary adaptability to successfully combat many cancer types. By strengthening and educating the immune system, clinicians can help patients fight cancer without resorting to harmful chemotherapeutics, or immunotherapies can be used in tandem with current treatments. Chimeric antigen receptor (CAR) T cells and checkpoint blockade are two of the most successful immunotherapies. CAR T cells combine the extraordinary binding ability of an antibody with T cell signaling molecules via genetic engineering, for a faster and more efficient cancer killing version of the patient's own T cells. These have been remarkably successful, but results depend on the specific signaling co-receptors that are included in the design. Increased understanding of co-receptor function could help in making CAR T cell design more specific, and enable CAR T cells to be effective against more types of cancers. Metabolic function is crucial in understanding T cell therapeutics because T cells need to use energy efficiently enough to compete with ravenous cancer cells. This thesis outlines an ongoing investigation into a co-receptor's effect on CAR T cell metabolism, suggesting that co-receptors can alter CAR T cell metabolism by increasing maximal respiration. Third, CD5 is a negative regulatory co-receptor on T cells that can modulate T cell activation. Related inhibitory co-receptors (PD-1 and CTLA-4) are currently being effectively blocked as checkpoint therapies to reactivate T cells towards cancerous cells. This thesis outlines ongoing work investigating CD5's impact on cellular metabolism. We have found that T cells without CD5 are hypermetabolic as compared to normal naïve T cells. CD5 deficient T cells also have higher maximal respiration, higher basal respiration and higher glycolytic capacity. These differences are also present transiently after non-specific activation. Thus, CD5 significantly regulates the ability of a T cell to use energy, suggesting that CD5 may be a good target for creating more efficient T cell immunotherapies. Fourth, in a separate project, this thesis examines environmental causes of disease. Asthma and allergies are common and growing problems in children and adults. Evaporative cooling can be a less expensive alternative to central cooling, but its effects on allergens and other bioaerosols in the home remains unclear. This project examines the relationship between evaporative cooling and bioaerosols (dust mites, bacterial endotoxin, and fungal β-(1→3)-D-glucans) in low income homes in Utah. We report significantly higher levels of these bioaerosols, particularly fungi in homes with evaporative cooling after adjusting for home-specific factors.

Type 1 Diabetes (T1D) is an autoimmune disease characterized by islet -specific T cells that infiltrate the pancreas and destroy the β-cells, crippling the necessary supply of insulin to control blood glucose levels. Although the disease can be managed by blood glucose monitoring, insulin injections and strict dietary regimens, there is currently no cure and complications continue to cause significant morbidity and mortality. Immunotherapies designed to inhibit islet-specific T cells are an attractive approach to treat T1D. Antibodies blocking the Interleukin-7/Interleukin-7 Receptor α (IL-7/IL-7Rα) pathway, which is critical for naïve and memory T cell survival, have shown promise in the non-obese diabetic (NOD) mouse model. Systemic administration of anti-IL-7Rα antibodies have prevented and reversed T1D in these models. However, hyperglycemia returned upon cessation of treatment, indicating no durable tolerance was established. Because of these results, I sought to better understand the mechanisms underlying the impact of IL-7Rα blockade on conventional islet-specific T cells and regulatory T cells (Tregs). I hypothesized that IL-7 signaling blockade (1) altered metabolism leading to impaired diabetogenic T cell effector functions and (2) impaired Tregs in peripheral tissues, potentially diminishing the therapeutic activity of anti-IL-7Rα antibodies. The data show that IL-7 signaling blockade impaired mitochondrial respiration independent of calcium signaling and downstream proteins. Impaired respiration shifted T cells to a more inefficient metabolic state. These inefficiencies were associated with diminished pro-inflammatory cytokine production. The cell-intrinsic role of IL-7 signaling in Tregs was assessed by crossing floxed IL-7Rα NOD mice with NOD mice that expressed Cre recombinase exclusively in Foxp3+ Tregs. At the onset of T1D IL-7Rα-deficient Tregs presented in lower frequencies than IL-7Rα-sufficient Tregs in pancreatic lymph nodes, and expressed higher levels of the co-inhibitory receptors PD-1 and TIGIT, indicating a more exhausted phenotype. Importantly, NOD mice with IL-7Rα-deficient Tregs developed T1D earlier. The data presented herein show that IL-7 signaling regulates T cell mitochondrial metabolism, T cell effector function, and identifies a role for IL-7 in the survival and function of Tregs in peripheral tissues during T1D development. This work simultaneously validates the IL-7 pathway as a potential immunotherapeutic target to modulate islet-specific T cells and cautions that unintended effects on protective Tregs must be taken into account for therapeutic strategies.

CD4 T cells differentiate into multiple effector subsets that mediate pathogen clearance. ThCTL are anti-viral effectors with MHC-II restricted cytotoxicity. The factors regulating ThCTL generation are unclear, in part due to a lack of a signature marker. I show here that in mice, NKG2C/E identifies ThCTL that develop in the lung during influenza A virus (IAV) infection. ThCTL phenotype indicates they are highly activated effectors with high levels of binding to P-selectin, T-bet, IFNγ production, and degranulation. ThCTL express increased levels of granzymes and perforin and lower levels of genes associated with memory and recirculation compared to non-ThCTL lung effectors. ThCTL are also restricted to the site of infection, the lung in IAV and systemically in LCMV. ThCTL require Blimp-1 for their differentiation, suggesting a unique effector CD4 population. As ThCTL are highly activated, they also require antigen signaling post priming during IAV infection. Late antigen was necessary and sufficient for the differentiation of ThCTL. In the context of late antigen encounter, ThCTL surprisingly do not require CD80 and CD86 costimulation for their differentiation. Additionally ThCTL do not require late IL-2 for their differentiation and instead require late IL-15 signals for their efficient generation. Thus these data suggest ThCTL are marked by the expression of NKG2C/E and represent a unique CD4 effector population specialized for cytotoxicity.

Interleukin-7 is an essential cytokine that plays a major role in the development and homeostatic maintenance of T-cells. The presence of soluble forms of various cytokine receptors have been proposed to be involved in the endogenous regulation of cytokine activity. Due to the natural ability of soluble CD127 (sCD127) to bind to IL-7, there is an interest in its potential application as an immunotherapeutic agent in diseases, where IL-7 has been found to be relevant, including HIV infection. In this study, I hypothesize that by administering sCD127 to healthy mice, IL-7 activity should be enhanced, thus enhancing T cell proliferation in vivo. The work presented here focuses on three main objectives: 1) evaluating the effect of IL-7 with or without sCD127 on T cell proliferation in healthy mice; 2) validating a mouse model of T cell depletion using anti-CD4 and CD8 antibodies; and 3) determining the effect of sCD127 treatment with or without IL-7 on T cell reconstitution and proliferation in the T cell depletion model. To assess the effect of administering exogenous sCD127, IL-7 or the combination on T cell proliferation, peripheral blood mononuclear cells and spleen were isolated, and stained to characterize T cell number, proliferation, and surface CD127 expression by flow cytometry. For the T cell depletion model, wild type C57BL/6 mice were injected intra-peritoneally with 150 μg single dose of anti-CD4 and anti-CD8 depleting antibodies. Consequently, mice were bled weekly to demonstrate the kinetics of T cell reconstitution following depletion (from d7 to d63). Our results demonstrated that in healthy mice daily treatment with murine IL-7 significantly stimulated T cell proliferation and consequently increased cell number. This observation was further boosted by pre-complexing IL-7 with sCD127. For T cell depletion experiments, the kinetics of T-cell reconstitution was different between the CD4+ and CD8+ T cells. CD4+ T cell reconstitution was almost complete 6 weeks following T cell depletion, while CD8+ T cells were only partially reconstituted at this time point. Treatment with IL-7 or combined therapy had a transient and significant effect on T cell proliferation and reconstitution, and this influence was abrogated after treatment discontinuation. Interestingly, CD8+ T cells exert greater responses to our treatments in that a more pronounced proliferation and significant increase in cell number was observed relative to the effect seen on CD4+ T cells in both healthy and depleted mice. In conclusion, antibody-mediated T cell depletion is a potentially valuable tool to investigate lymphopenia-induced proliferation and potential therapies thereof. This study suggests that combining sCD127 and IL-7 therapies enhances IL-7-mediated T cell proliferation, and provides important information for the potential therapeutic use of sCD127 and its impact on IL-7 function.

Indiana University-Purdue University Indianapolis (IUPUI) / Tolerance mechanisms, which collectively work to prevent autoimmunity, play a key role in suppressing the adaptive immune response to tumor antigens. This phenomenon is attributed to the extensive overlap of tumor associated antigens with self peptides. We studied immune tolerance to tumor antigen TRP-1, a melanoma associated glycoprotein. Vaccination of Wild type (WT) and TRP-1 deficient (Bw) mice with TRP-1 antigen highlighted the substantial effect of tolerance on the T cell response: in the Bw population a log-fold differential was observed with greater clonal numbers and higher intensity of cytokine release from the antigen specific CD4+ T cell population. Additionally, TRP-1-reactive T cells derived from Bw mice demonstrated significantly more efficacious tumor treatment ability than WT donor cells when adoptively transferred into recipients challenged with B16 melanoma. Furthermore, donor Bw T cells were so potent as to overcome suppression by endogenous Tregs in mediating their effect. Probing for a tolerance mechanism, we isolated medullary thymic epithelial cells (mTECs) from WT mice and found that they promiscuously express TRP-1. Unexpectedly, TRP-1 expression in mTECs was found to occur independently of the prominent Autoimmune Regulator (Aire) transcription factor as well as the melanocyte specific transcription factor, mMitf. Our most recent data suggests that thymic dendritic cells may also express copies of the TRP-1 transcript. Future transplant studies will test whether mTECs or thymic dendritic cells directly tolerize TRP-1 specific T cells. Overall, these findings highlight the relevance of central tolerance to cancer immunology and compel further investigation of its mechanistic impact on the development of tumor-reactive T cells.bb

Indiana University-Purdue University Indianapolis (IUPUI) / Inflammatory immune responses are regulated by T cell subsets that secrete specific panels of cytokines. While CD8+ T cells that secrete IFN- and cytotoxic molecules (Tc1 cells) are known to mediate antiviral immunity, IL-17-secreting CD8+ T (Tc17) cells have only recently been described and the development and function of these cells has not been clearly examined. Using in vitro T cell cultures and mice deficient in transcription factors regulating lineage development, we defined Tc17 development and function. Similar to IL-17 secretion from CD4 T cells, IL-17 secretion from Tc17 cells is dependent on the transcription factor Stat3 and inhibited by Stat1. Expression of transcription factors important for Tc1 function, T-bet and Eomesodermin (Eomes), is reduced in Tc17 cells and consistent with this, Tc17 cells are non-cytotoxic in vitro. However, Tc17 cells are unstable and switch to cytotoxic IFN- producing cells when exposed to a Tc1 inducing cytokine, IL-12. Overexpression of the lineage promoting transcription factors T-bet and Eomes is unable to induce a Tc1 phenotype in Tc17 cells and Stat3 is also unable to switch Tc1 cells into Tc17 cells, suggesting additional signals are involved in CD8 T cell lineage commitment. In vivo, Tc17 cells are induced by vaccinia virus, dependant on Stat3, and are capable of mediating antiviral immunity. Tc17 cells acquire an IFN--secreting phenotype after encounter with virus in vivo, however, viral clearance by Tc17 cells is independent of IFN-. Instead, viral clearance is correlated with a gain in T-bet expression and cytotoxic function in Tc17 cells which have encountered virus. The development of anti-viral activity independent of IFN-, suggests that Tc17 cells may mediate anti-viral immunity through novel mechanisms that depend on the ability of Tc17 cells to acquire other phenotypes.