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Am. J. Respir. Cell Mol. Biol., Volume 18, Number 3, March 1998 370-383

T-Cell Repertoire in the Blood and Lungs of Atopic Asthmatics before and after Ragweed Challenge

Vladimir V. Yurovsky, Els J. M. Weersink, Susan S. Meltzer, Wendy C. Moore, Dirkje S. Postma, Eugene R. Bleecker, and Barbara White

Department of Medicine, University of Maryland, Baltimore, Maryland; Department of Pulmonology, University Hospital, Groningen, The Netherlands; and Medicine and Research Services, Veterans Affairs Medical Center, Baltimore, Maryland


    Abstract
Top
Abstract
Introduction
Materials & Methods
Results
Discussion
References

T cells play a pivotal role in initiating and orchestrating allergic responses in asthma. The goal of this work was to learn whether ragweed challenge in the lungs alters the T-cell repertoire expressed in the blood and lungs of atopic asthmatics. Analyses of cell numbers, differentials, and T-cell subsets in bronchoalveolar lavage (BAL) fluids showed that ragweed challenge was associated with preferential recruitment of CD4+ T cells into the lungs. A reverse transcriptase-polymerase chain reaction (RT-PCR) was used to amplify T-cell receptor (TCR) gene transcripts from unfractionated, CD4+, and CD8+ T cells in blood and BAL fluids. As judged by RT-PCR, the usage of TCR Valpha and Vbeta gene families in BAL fluids was similar to that in blood. Ragweed challenge did not change the levels of expression of these V gene families. The clonality of T cells was estimated by analyzing the diversity of TCR V-(D)-J junctional region nucleotide lengths associated with each Valpha and Vbeta gene family, using sequencing gel electrophoresis. Most V gene families in blood and BAL fluids were associated with multiple junctional region lengths before and after ragweed challenge, indicating polyclonal expression. Some V gene families were expressed in an oligoclonal manner in unfractionated, CD4+, and CD8+ T cells in BAL fluids before ragweed challenge, as indicated by a few predominant junctional region lengths. The majority of these V gene families became polyclonal after challenge, compatible with polyclonal T-cell influx during inflammation immediately after ragweed challenge. However, some V gene families became oligoclonal or developed a new oligoclonal pattern of junctional region lengths in BAL T cells after ragweed challenge. Surprisingly, this occurred in both CD4+ and CD8+ T cells. In one of these instances, DNA sequencing of Vbeta 21 junctional regions in CD8+ T cells confirmed a change from polyclonal to oligoclonal expression after ragweed challenge. These findings show that ragweed challenge is associated with polyclonal influx and oligoclonal activation of both CD4+ and CD8+ T cells in the lungs.


    Introduction
Top
Abstract
Introduction
Materials & Methods
Results
Discussion
References

Activated T cells contribute to the pathophysiology of atopic asthma through the production of cytokines that cause inflammation and promote IgE production (1, 2). Allergen-specific activation of T cells occurs when T-cell antigen receptors (TCR) bind peptide fragments of the allergen bound to major histocompatibility complex molecules and the T cell receives a co-stimulatory signal. Most TCRs consist of an alpha  chain encoded by rearranged variable (V), joining (J), and constant (C) region genes and a beta  chain encoded by V, diversity (D), J, and C genes (3, 4). The V-(D)-J junctional region sequence determines antigen specificity of the TCR (5, 6). T-cell responses to allergens and other conventional protein antigens may be oligoclonal, as characterized by use of a limited set of Valpha or Vbeta gene families with conservation of junctional region sequences (7).

Most previous studies of the T cells in the lungs of asthmatic patients have tested numbers of lymphocytes, percentages of CD4+ and CD8+ T cells, and markers of T-cell activation. T cells, especially CD4+ T cells, are increased in bronchial mucosal biopsies from asthmatics and express more CD25 (interleukin-2 receptor) and HLA-DR (11- 13). Numbers of T cells are similar in bronchoalveolar lavage (BAL) fluids from stable asthmatics and control subjects in many (14), but not all (17, 18), reports. After allergen challenge, numbers of T cells in BAL fluids may remain unchanged (19) or increase (22). In studies in which T-cell numbers increased, both CD4+ and CD8+ T cells have been reported to increase in BAL fluids after allergen challenge (22).

In contrast to many studies that test effects of allergen exposure on numbers and types of lymphocytes in the lungs, there are limited data that address the effect of allergen exposure on the T-cell repertoire expressed in the lungs. One previous report used heteroduplex analysis of TCR to test the effects of house dust mite, parietaria, and cat allergens on the TCR diversity in the lungs (25). Clonally expanded T cells were found in the lower respiratory tract of asthmatic patients after allergen inhalation. In this study, we test the effect of ragweed challenge on levels of Valpha or Vbeta gene expression and TCR clonality of blood and BAL T cells in atopic asthmatics, including fractionated CD4+ and CD8+ populations.

    Materials and Methods
Top
Abstract
Introduction
Materials & Methods
Results
Discussion
References

Subjects

Six nonsmoking atopic asthmatics entered the study. Each met American Thoracic Society criteria for the clinical diagnosis of asthma (26). None had an asthma exacerbation for 2 mo before the study or status asthmaticus within the past 2 yr. All subjects had a 3+ or 4+ positive skin test to ragweed, as judged by area of intradermal induration 15 min after scratch test with short ragweed antigen in a glycerine base (Greer Laboratories Inc., Lenoir, NC). All subjects had a fall of 20% or more in forced expiratory volume in 1 s (FEV1) in response to a provocative methacholine dose less than 25 mg, confirming airway hyperresponsiveness (27). Short-acting beta 2 agonists were withheld for 8 h and theophylline preparations for 48 h before the methacholine challenge. FEV1 was measured with a wet spirometer (Sensomatics Corp., Anaheim, CA) and was required to be greater than 50% of predicted value before methacholine challenge. One normal nonatopic volunteer entered the study as a control. Subject characteristics are given in Table 1.

                              
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TABLE 1
Subject characteristics

All subjects gave their written informed consent. The protocol of the study was approved by the Institutional Review Board of the University of Maryland School of Medicine.

Ragweed Challenge

Asthma therapy was withheld from all patients before the study. Inhaled corticosteroids were withheld for 4 wk, cromolyn sodium for 2 wk, and beta 2 agonists for 24 h. The protocol consisted of two BAL procedures. The FEV1 before the first BAL was always greater than 70% of predicted value. Fentanyl (Janssen Pharmaceutica, Titusville, NJ) and midazolam-HCl (Hoffmann-LaRoche Inc., Nutley, NJ) were administered intravenously for light sedation and amnesia. Topical anesthesia was given by inhalation of 5 ml of 4% lidocaine with a DeVilbiss nebulizer #646 (DeVilbiss, Somerset, PA). Additional local anesthesia was provided directly into the airways as needed with 2% lidocaine through the bronchoscope (Model BF10; Olympus, Lake Success, NY). The right middle lobe and lingula of each asthmatic patient were each lavaged with 120 to 140 ml (six or seven 20-ml aliquots) of sterile saline prewarmed to 37°C. The lavage fluids were recovered by gentle suction. Purified ragweed antigen (Greer Laboratories Inc.), 480 protein nitrogen units in 5 ml saline, was then instilled in the right upper lobe. The subject was observed after bronchoscopy until sedation resolved and pulmonary function was stable. Subjects withheld beta 2 agonists unless a greater than 20% decrease in peak flow measurements occurred. Twenty-four hours later, a second BAL was done of the ragweed-challenged right upper lobe of each asthmatic patient, with 120 to 140 ml (six or seven 20-ml aliquots) of sterile saline prewarmed to 37°C. The subject was again observed after bronchoscopy until stable.

Eighteen months after the initial study, Patients 2 and 4 were challenged with saline in an identical manner to serve as placebo control subjects.

The normal donor was challenged with ragweed in a similar manner, except the right middle lobe, right upper lobe, and lingula were each lavaged with six 20-ml aliquots of prewarmed sterile saline before the challenge. Purified ragweed antigen, 480 protein nitrogen units in 5 ml saline per lobe, was then instilled into the right middle lobe and the lingula. Twenty-four hours later, the two ragweed-challenged lobes were each lavaged with six 20-ml aliquots of prewarmed sterile saline. It was necessary to lavage three lobes at baseline and two lobes after ragweed challenge to obtain enough cells for analyses. It was shown previously that pooling cells from different lobes does not bias the comparison of the TCR repertoires in the lung (28).

Thirty milliliters of blood was drawn before each bronchoscopy. Blood and BAL fluids were kept on ice until processed.

BAL Fluid Cell Count and Differential

The volume of BAL fluid was measured. BAL fluid was filtered through loose sterile gauze to remove mucus and then centrifuged at 450 × g, 4°C, for 10 min. The cell pellet was washed twice and resuspended in 10 ml of phosphate-buffered saline (PBS). A cell count was done with a hemocytometer. Cells per milliliter and total cells were determined. Cytocentrifuge slides were made from 5 × 105 BAL cells. Slides were stained with a modified Giemsa stain (Baxter Scientific Products, Glendale, CA). Cell differential was done on 400 cells.

Peripheral Blood Mononuclear Cells

Peripheral blood mononuclear cells (PBMC) were isolated by density gradient centrifugation using Histopaque-1077 (Sigma Chemical Co., St. Louis, MO) and washed with PBS.

CD4+ and CD8+ Cell Separation

Positive selection of CD8+ and CD4+ cells from PBMC and BAL cells was done with sequential use of Dynabeads M-450 CD8 and CD4 (Dynal Inc., Great Neck, NY), according to the manufacturer's directions. Our previous flow cytometric analyses of cells isolated in an identical manner revealed that > 95% of T cells expressed the selected marker.

Flow Cytometric Analyses of Cell Surface Markers

The PBMC and BAL cells were resuspended in Hanks' balanced salt solution containing 5% horse serum and 0.1% sodium azide. For two-color immunofluorescence analyses, 3 × 105 to 5 × 105 cells were stained with the desired pair of monoclonal antibodies (mAbs), using standard techniques. Antibodies were directly coupled to fluorescein isothiocyanate (FITC) or phycoerythrin (PE). To determine percentages of CD3 cells that coexpressed CD4, CD8, or gamma /delta TCR, cells were stained with anti-CD3 mAb (anti-Leu-4-PE) and anti-CD4 (anti-Leu-3a+3b-FITC), anti-CD8 (anti-Leu-2a-FITC), or anti-gamma /delta TCR (TCRdelta 1-FITC) mAb. Percentages of CD3+, CD4+, and CD8+ T cells that expressed CD25, HLA-DR, and the memory marker CD29 were also determined. Cells were stained with anti-Leu-4-FITC, anti-Leu-3a+3b-FITC, or anti-Leu-2a-FITC mAb and anti-CD25-PE, anti-HLA-DR-PE, or anti-CD29-PE mAb. The mAb TCRdelta 1 was from T Cell Sciences (Boston, MA). All other mAbs were from Becton-Dickson (Mountain View, CA). Cellular fluorescence was measured with a FACScan flow cytometer (Becton-Dickson), with data gathered in the list mode. Viable lymphocytes were selected for analysis based upon forward and 90° side light scatter characteristics.

RT-PCR Amplification of TCR Junctional Region Transcripts

Reverse transcriptase-polymerase chain reaction (RT-PCR) of Valpha and Vbeta TCR junctional region RNA was performed as previously described (29). Total cellular RNA was isolated from unfractionated, CD4+, and CD8+ T cells from PBMC and BAL by acid guanidinium thiocyanate-phenol-chloroform extraction, using RNA STAT-60TM (Tel-test "B," Inc., Friendswood, TX). First strand cDNA was synthesized in a 60-µl reaction mixture containing 2 µg of total RNA, 50 mM Tris-HCl (pH 8.3), 75 mM KCl, 3 mM MgCl2, 0.5 mM of each dNTP, 0.4 µM of Calpha 3' primer (5'-ATCATAAATTCGGGTAGGATCC-3') and Cbeta 3' primer (5'-CATTCACCCACCAGCTCAGCT-3'), and 400 U of Moloney murine leukemia virus reverse transcriptase (Bethesda Research Laboratories, Gaithersburg, MD). The reaction mixture was incubated at 42°C for 60 min, heated at 95°C for 5 min, and then diluted with water to a final volume of 250 µl. Five microliters of cDNA were amplified using one of a panel of 5' oligonucleotide primers specific for TCR 22 Valpha or 25 Vbeta gene families and a 3' oligonucleotide primer specific for Calpha or Cbeta , respectively (Clonetech Laboratories, Palo Alto, CA). The C region primers were end-labeled with 32P. The PCR was done in the manufacturer's recommended buffer, using a Cetus/Perkin Elmer thermal cycler for 35 cycles under the following conditions: denaturation at 95°C for 1 min, primer annealing at 55°C for 1 min, and primer extension at 72°C for 1 min. The Valpha and Vbeta primers were designed to anneal to areas of maximum V region sequence diversity, which were different for each V gene. The size range of the different Valpha -Calpha amplification products was 290 to 430 bp. The size range of Vbeta -Cbeta amplification products was 180 to 370 bp.

To quantitate V gene expression, PCR amplification of the C region of the alternate TCR strand was done in the same reaction tube used to amplify the V region. A pair of Calpha -Calpha control primers was used with Vbeta -Cbeta primer pairs, and, conversely, a pair of Cbeta -Cbeta control primers was used with Valpha -Calpha primer pairs. One primer in each pair was end-labeled with 32P. The concentration of V region primers was 0.5 µM and that of the control primers was 0.1 µM. Sizes of the internal standards were 604 bp and 146 bp for Calpha -Calpha and Cbeta -Cbeta internal standards, respectively. The RT-PCR products were separated by electrophoresis on a 1.8% agarose gel. 32P incorporation into Valpha -Calpha , Vbeta -Cbeta , Calpha -Calpha , and Cbeta -Cbeta cDNA was measured using PhosphorImager (Molecular Dynamics, Sunnyvale, CA). The integrated intensity of each V-C band was normalized to the opposite C-C band amplified in the same tube. The relative amount of each V gene family was expressed as a percentage of the total intensities of 22 Valpha -Calpha or 25 Vbeta -Cbeta bands, after normalizing for Cbeta -Cbeta or Calpha -Calpha bands, respectively.

Analysis of TCR Junctional Region Lengths

Analysis of the distribution of nucleotide lengths of amplified TCR cDNAs was done as previously described (29). The RT-PCR products were subjected to electrophoresis in a 6% Long RangerTM (AT Biochem, Malvern, PA) sequencing gel. M13mp18 bacteriophage sequence was used as the size marker. M13mp18 single-stranded DNA (United States Biochemical, Cleveland, OH) was sequenced by the standard dideoxy-mediated chain termination method, using a 32P-labeled M13 (-20) primer (5'-GTAAAACGACGGCCAGT-3') and SequenaseTM (United States Biochemical). The RT-PCR products and M13mp18 nucleotide sequence were detected by autoradiography using XAR-5 film (Eastman Kodak, Rochester, NY).

DNA Sequencing

RT-PCR-amplified Vbeta 21-Cbeta cDNA was ligated into pCRTMII vector (Invitrogen Corp., San Diego, CA) and then used to transform INValpha F' competent cells, according to the manufacturer's instructions. Plasmids containing the cDNA inserts were isolated by conventional techniques and sequenced by the dideoxy-mediated chain termination method, using the same Cbeta primer as for PCR amplification (Clontech Laboratories). DNA sequences were analyzed by electrophoresis in a 7% Long RangerTM gel.

Statistical Analyses

Statistical analyses of the effects of ragweed challenge on cell numbers and percentages, T-cell subsets, and V gene expression were done using a two-tailed paired t test, to compare data from the same donor before and after challenge. Because multiple comparisons of V gene expression were made, differences were not considered significant unless P < 0.01. A chi-square analysis was used to compare the frequencies of skewing of different patterns of TCR junctional length distribution in asthmatic patients after ragweed or saline challenge and in control donor.

    Results
Top
Abstract
Introduction
Materials & Methods
Results
Discussion
References

Cells in BAL Fluids

Cell counts and differentials were done on BAL fluids from asthmatics before and after ragweed challenge (Table 2). Because different numbers of lobes were lavaged before and after ragweed, the number of cells recovered was corrected per 120 ml PBS infused. This was the volume of PBS usually used to lavage one lobe. Ragweed challenge caused a 3-fold increase in total cells recovered. Total numbers of macrophages doubled after ragweed challenge, but the percentage of macrophages decreased. Total numbers of lymphocytes increased in concert with the increase in total cells after ragweed challenge, leaving percentage of lymphocytes unchanged. Ragweed challenge was associated with an increase in both numbers and percentages of neutrophils and eosinophils. However, the increase in number of eosinophils was not statistically significant, because of wide individual variation. Compared with the asthmatics, 10-fold fewer cells per 120 ml PBS infused were recovered from the control donor before and after ragweed challenge (695,000 cells before and 2,350,000 cells after). Ragweed challenge did not cause a change in percent macrophages (92% right-arrow 94%), lymphocytes (6% right-arrow 6%), neutrophils (0.5% right-arrow 0.5%), or eosinophils (0% right-arrow 0%) in BAL fluid from the control donor.

                              
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TABLE 2
Cell counts and differential of BAL fluids

Flow cytometric analyses were done to measure T-cell subsets in blood and BAL fluids in asthmatic patients before and after ragweed challenge (Figure 1). First, comparisons were done to test whether T-cell subsets in BAL fluids were different from those in paired blood samples. More CD3+, CD4+, and CD8+ T cells in BAL fluids expressed HLA-DR, CD25, and CD29. This was true before and after ragweed challenge.


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Figure 1.   Two-color flow cytometric analyses of T-cell subsets before and 24 h after segmental ragweed challenge. Data are presented as percentage of T cells expressing the first marker that also express the second marker. The mean ± SEM of results are presented. *P =< 0.05 or dagger P =< 0.005 by paired two-tailed t test, blood before versus BAL before or blood after versus BAL after; Dagger P =< 0.05 by paired two-tailed t test, BAL before versus BAL after.

Next, comparisons were done to test whether ragweed challenge changed T-cell subsets in blood or BAL fluids. Ragweed challenge in the lungs caused no change in T-cell subsets in the blood. However, ragweed challenge was associated with a change in T-cell subsets in BAL fluids. The percentage of T cells expressing CD4 increased, with a reciprocal decrease in the percentage of T cells expressing CD8 (Figure 1A). Thus, the increase in total lymphocytes in BAL fluids after ragweed challenge (Table ) was associated with preferential homing of CD4+ T cells. Expression of HLA-DR, CD25, and CD29 was not increased on BAL T cells 24 h after ragweed challenge (Figures 1B through 1D). If anything, expression of HLA-DR and CD25 tended to decrease on BAL T cells after challenge, which may reflect influx of T cells from the periphery.

TCR Valpha and Vbeta Gene Usage in Unfractionated PBMC and BAL Cells

The levels of expression of 22 Valpha and 25 Vbeta gene families were measured in unfractionated PBMC and BAL cells before and after ragweed challenge (Figure 2). Being aware of limitations of quantitative PCR, we involved the coamplification of a reference template in the same reaction tube. The number of PCR cycles was carefully monitored to ensure that amplified product was proportional to the amount of starting template (29). The quantity of the amplified reference template was similar in all samples in a given experiment, so relative quantity of TCR V gene transcripts could be inferred.


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Figure 2.   Relative amounts of Valpha and Vbeta gene families in unfractionated PBMC and BAL fluids from atopic asthmatic patients before and after ragweed challenge. 32P-labeled RT-PCR-amplified products were separated on a 1.8% agarose gel and quantitated using a PhosphorImager. The value of each V gene family in a given individual was normalized to the corresponding internal standard and presented as a percentage of the total 22 Valpha or 25 Vbeta values, respectively. The mean ± SEM of results are presented. Valpha expression is given in A (PBMC) and B (BAL fluids). Vbeta expression is given in C (PBMC) and D (BAL fluids).

All Valpha gene families were expressed in BAL fluids (Figure 2B) at levels similar to those in blood drawn at the same time (Figure 2A). Ragweed challenge had no significant effect on the level of expression of any Valpha gene family in blood or BAL fluids (Figures 2A and 2B). The same findings were true for Vbeta gene families (Figures 2C and 2D). The expression of each Vbeta gene family was similar in blood and BAL fluids at baseline and did not change significantly after ragweed challenge.

Increased Diversity of TCR Junctional Region Lengths in Unfractionated BAL T Cells from Asthmatics after Ragweed Challenge

The diversity of T-cell repertoire was analyzed by testing the distribution of nucleotide lengths of TCR junctional regions associated with the different Valpha and Vbeta gene families. Polyclonal expression of T cells bearing any particular V gene will be associated with multiple TCR junctional region lengths. Clonal T-cell populations have identical TCR junctional region lengths.

Most Valpha and Vbeta gene families in each asthmatic patient were expressed in a polyclonal manner with multiple junctional region lengths in both blood and BAL fluids, with no difference before and after ragweed challenge. For example, Figure 3 shows multiple junctional region lengths of TCR expressing Valpha 16, Valpha 21, Vbeta 12, and Vbeta 22 gene families in blood and BAL fluid from Patient 1, before and after ragweed challenge. The multiple lengths were frequently normally distributed.


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Figure 3.   Analysis of TCR junctional region lengths of Valpha and Vbeta gene families in peripheral blood and BAL fluids before and after ragweed challenge. 32P-labeled PCR-amplified products were separated on sequencing gel and visualized by autoradiography. Representative V gene families and source of cells are indicated. Lane a is before and lane b is after ragweed challenge.

In contrast to this common polyclonal pattern, some V gene families were expressed with a skewed pattern of TCR junctional region lengths or a few predominant lengths in unfractionated T cells in baseline BAL fluids (Figure 3, compare BAL lane a to blood lane a). When one or two bands predominated and comprised > 50% of PCR amplification products by densitometry, this pattern was designated oligoclonal for purposes of description. A number of Valpha and Vbeta gene families were skewed or oligoclonal in baseline BAL but became more polyclonal after ragweed challenge, with a less restricted pattern of TCR junctional region lengths. Examples of such changes include the Vbeta 9 and Vbeta 20 gene families in Patient 4, the Vbeta 17 and Vbeta 20 gene families in Patient 5, and the Vbeta 20 gene family in Patient 6 (Figure 3, compare BAL lanes a and b). This change from a skewed or oligoclonal pattern to a more polyclonal pattern of TCR junctional region lengths is compatible with polyclonal T-cell influx during the inflammatory response.

In the control, the Vbeta 8, Vbeta 9, and Vbeta 12 gene families were expressed with skewed TCR junctional region lengths in baseline BAL cells. In contrast to the findings with the asthmatics, these patterns changed little after ragweed challenge (Figure 3, compare BAL lanes a and b in the control). This difference from asthmatics is compatible with a milder inflammatory response to ragweed challenge in the control donor. As an additional control, no changes in TCR junctional region length distribution were seen when Patient 4 was challenged with saline rather than ragweed (Figure 4, compare BAL lanes a and b).


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Figure 4.   Lack of changes in TCR junctional region length distribution in peripheral blood or BAL fluids from Patient 4 after saline challenge. Representative V gene families and source of cells are indicated. Lane a is before and lane b is after saline challenge.

Oligoclonal T-Cell Responses to Ragweed Challenge in Unfractionated BAL Cells from Asthmatics

Ragweed challenge was associated with a second change in the T-cell repertoire in the BAL fluids of the asthmatic patients. The TCR junctional region lengths associated with some V gene families displayed a new skewed or oligoclonal pattern after ragweed challenge. The development of a new pattern of restricted junctional region lengths occurred in BAL T cells in Patient 2 in the Valpha 21, Vbeta 9, Vbeta 10, and Vbeta 17 gene families, in Patient 4 in the Vbeta 21 gene family, in Patient 5 in the Vbeta 21 gene family, and in Patient 6 in the Vbeta 8 gene family (Figure 5, compare BAL lanes a and b). The most striking example was the Vbeta 10 family, in which one predominant junctional region length was seen 24 h after ragweed exposure (Figure 5). These findings are compatible with ragweed-associated recruitment of T cells bearing these V genes. In the control donor challenged with ragweed and in two asthmatic patients challenged with saline, no Valpha or Vbeta gene family in blood or BAL T cells developed a more restricted pattern of TCR junctional region lengths after challenge. These results show that the induction of restricted diversity of the TCR was specific for the asthmatic phenotype and for allergen challenge.


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Figure 5.   New patterns of skewed or oligoclonal TCR junctional region lengths develop in BAL fluids after ragweed challenge. Lane a is before and lane b is after ragweed challenge.

Changes in the CD4+ and CD8+ T-Cell Repertoire in BAL Fluids in Asthmatics after Ragweed Challenge

In Subjects 2, 5, and 6 and in the control donor, CD4+ and CD8+ T-cell subpopulations were isolated from blood and BAL cells. The TCR junctional region lengths expressed by these subpopulations were determined. Findings with the CD4+ and CD8+ cells confirmed the previous results with unfractionated cells. The most common finding was a polyclonal pattern of TCR junctional region lengths in both blood and BAL cells, both before and after ragweed challenge (data not shown). Similarly, as seen with unfractionated cells, some V gene families were expressed with a skewed or oligoclonal pattern of junctional region lengths in baseline BAL cells. These patterns became less restricted after ragweed challenge, compatible with the polyclonal influx of both CD4+ and CD8+ T cells. In CD4+ T cells, this was seen in Patient 2 in the Vbeta 5.1 and Vbeta 21 gene families, in Patient 5 in the Vbeta 21 and Vbeta 22 gene families, and in Patient 6 in the Vbeta 22 gene family (Figure 6, panel A, compare lanes a and b). This was also seen in CD8+ T cells, in Patient 2 in the Vbeta 21 gene family, in Patient 5 in the Vbeta 17 and Vbeta 22 gene families, and in Patient 6 in the Vbeta 17 gene family (Figure 6, panel B, compare lanes a and b). In contrast to the findings with the asthmatics, ragweed challenge of the nonatopic control donor did not cause any change in patterns of TCR junctional region lengths in CD4+ and CD8+ T cells from blood or BAL fluid (data not shown). Similarly, no changes in patterns of TCR junctional region lengths in CD4+ or CD8+ BAL T cells were seen when Patient 2 was challenged with saline as a placebo control 18 mo after the ragweed study (Figure 6, compare lanes c and d). Of note, the changes in baseline expression of the Vbeta 21 gene family in CD8+ BAL T cells over time (Figure 6, panel B, Vbeta 21, compare lanes a and c) may reflect the T-cell exposure to different environmental antigens.


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Figure 6.   Skewed or oligoclonal patterns of TCR junctional region lengths in CD4+ and CD8+ T cells from BAL fluids become polyclonal after ragweed challenge. A shows CD4+ cells and B shows CD8+ cells from BAL fluids. Patient 2 underwent a placebo saline challenge 18 mo after the initial study. Lane a is before ragweed challenge, lane b is after ragweed challenge, lane c is before saline challenge, and lane d is after saline challenge.

A few V gene families were expressed with a more restricted or different pattern of TCR junctional region lengths following ragweed challenge. This was demonstrated in the Vbeta 15 gene family in CD4+ T cells from Patient 2 (Figure 7, panel A, compare lanes a and b). Surprisingly, this was also seen in CD8+ T cells, in Patient 2 in the Vbeta 17 and Vbeta 20 gene families, in Patient 5 in the Vbeta 20 and Vbeta 21 gene families, and in Patient 6 in the Vbeta 8, Vbeta 9, and Vbeta 20 gene families (Figure 7, panel B, compare lanes a and b). Thus, the Vbeta 20 gene family became expressed with a more restricted or different pattern of TCR junctional region lengths in CD8+ T cells from these three donors. Such changes in patterns of TCR junctional region lengths in CD4+ or CD8+ BAL T cells were not seen when Patient 2 was challenged with saline (Figure 7, compare lanes c and d) or when normal donor was challenged with ragweed (data not shown).


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Figure 7.   New patterns of skewed or oligoclonal TCR junctional region lengths develop in CD4+ and CD8+ T cells from BAL fluids after ragweed challenge. A shows CD4+ cells and B shows CD8+ cells from BAL fluids. Lane a is before ragweed challenge, lane b is after ragweed challenge, lane c is before saline challenge, and lane d is after saline challenge.

Sequence Analysis of Vbeta 21-Cbeta Junctional Regions in CD8+ BAL T Cells

To confirm that the presence of TCR rearrangement of predominant length is consistent with the oligoclonal expansion of T cells expressing the given V segment, Vbeta 21-Cbeta PCR amplification products from CD8+ BAL T cells from Patient 5 before and after ragweed challenge (see Figure 7, Vbeta 21, lanes a and b) were subcloned into a bacterial vector and sequenced across the junctional region. Nine distinct clones were isolated before the challenge, each of them just once (Figure 8). The nucleotide lengths of their CDR3 sequences varied from 33 to 45 bp, which corresponded to the multiple bands of PCR amplification products seen in Figure 7 (Vbeta 21, lane a). Twenty-five independent clones were isolated after the challenge, 22 of them identical, with their CDR3 length corresponding to the major band seen in Figure 7 (Vbeta 21, lane b). Thus, the diversity of TCR Vbeta 21-Cbeta junctional sequences confirmed the oligoclonal character of expansion of CD8+ BAL T cells after the ragweed challenge. Of note, 27 of total 34 junctional sequences used Jbeta 2.1 segment.


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Figure 8.   Nucleotide sequences of Vbeta 21-Dbeta -Jbeta rearrangements amplified from CD8+ BAL T cells from Patient 5 before and after ragweed challenge. RT-PCR products were subcloned into a bacterial vector and the plasmid inserts were sequenced using the same Cbeta primer as for PCR. Assignment of Jbeta segments was made according to nomenclature (30). CDR3 length was calculated as the number of nucleotides from, but not including, the J region-encoded GXG triplet (where G is glycine and X is any amino acid) to the nearest preceding V region-encoded cysteine (31).

    Discussion
Top
Abstract
Introduction
Materials & Methods
Results
Discussion
References

This study tested whether segmental allergen exposure in the lung altered the T-cell repertoire expressed in the blood or lung during a late-phase allergic response. BAL fluids were used as the source of T cells for several reasons. The lavage can be obtained easily and repeatedly, with low risk to the patient. Millions of T cells with excellent viability can be recovered from BAL fluid, which facilitates isolation of subpopulations. T cells in the airways are likely to represent those in adjacent mucosal tissue. The phenotype of BAL T cells correlates well with those obtained from tissue in both normal and diseased lungs (32). Compared to testing BAL T cells, analysis of the T-cell repertoire in a transbronchial, thoracoscopic, or open lung biopsy is associated with a greater risk to the patient from obtaining the sample. Moreover, bias in results may be introduced by biopsy site and size, with analyses of fewer T cells.

All TCR Valpha and Vbeta gene families were expressed in blood and BAL fluids of atopic asthmatics. Levels of V gene expression in BAL fluids were similar to those of the same V gene in blood. Expression of Vbeta 1 through Vbeta 9 gene families was generally higher than other Vbeta families. This finding is not unexpected. Increased usage of Vbeta 1 through Vbeta 9 has been reported previously in blood (33) and BAL fluids (28) of normal donors and in BAL fluids from patients with sarcoidosis (34, 35) and systemic sclerosis (36). At baseline and following ragweed challenge, most V gene families were expressed in a polyclonal manner, as assessed by multiple TCR junctional region lengths associated with each V gene. These findings indicate that the TCR repertoire is diverse in blood and BAL fluids of atopic asthmatics, before and after ragweed challenge.

Despite this diversity, some Valpha and Vbeta gene families were expressed in baseline BAL fluids with restricted TCR junctional region lengths. The set of V gene families that were expressed with restricted junctional region lengths was different in each subject, although the Vbeta 20 gene family showed restricted junctional region lengths in baseline BAL cells from three donors. This baseline skewing of TCR junctional region lengths was not due to small numbers of T cells tested nor to limitations of RT-PCR technique. V gene families that were oligoclonal in some donors were expressed in other donors at the same level, in a polyclonal manner. The reproducibility of patterns of TCR junctional region lengths in different lobes and over time has been shown previously in normal donors (28).

Oligoclonal V gene familes were found among unfractionated, CD4+, and CD8+ T cells in baseline BAL fluids from asthmatic patients. Oligoclonal CD4+ and CD8+ T cells have been previously found in lungs of normal humans (28). Therefore, the presence of oligoclonal CD4+ and CD8+ T cells in baseline BAL fluids may or may not be related to atopic asthma in these subjects. Following ragweed challenge, several changes occurred in the T-cell repertoire in BAL fluids. Some V gene families that were expressed with restricted junctional region lengths in baseline BAL fluids developed more diverse junctional region lengths after ragweed exposure. This was seen in unfractionated, CD4+, and CD8+ T cells from BAL fluids. This finding is compatible with an influx of polyclonal T cells. This interpretation is supported by the increase in total CD4+ and CD8+ lymphocytes within BAL fluids after ragweed exposure, although there is preferential migration of CD4+ cells. Our finding of polyclonal changes in the T-cell repertoire in BAL fluids 24 h after ragweed challenge may reflect mechanisms governing lymphocyte recruitment and retention, the timing of the lavage, or the dose of antigen used. It takes lymphocytes 12 to 15 h to travel through the lungs (37). Given timing of the lavage 24 h after ragweed exposure, it is likely that many of the sampled T cells have entered the lung because of its inflamed state but may not be retained. Of note, in an animal model of secondary immune response in the lung, numbers of antigen-specific B cells peak on Day 4 and are back to baseline by Day 10 (38). Not all T cells are retained equally well in the lungs (39, 40). The presence of relevant antigen may (41) or may not (40) be an important determinant of retention. Future studies are needed to test later times after ragweed challenge to determine whether, once the polyclonal influx has resolved, an oligoclonal subset of T cells is retained within the lungs. Serial studies in individual patients are more difficult than analyses at a single time point as they require allergen challenge of several lobes at the same time and multiple subsequent lavages of the same patient. This design may provoke a more significant decline in pulmonary function than allergen challenge of a single lobe.

The observation that the T-cell repertoire becomes more polyclonal after segmental ragweed challenge may also be related to the high local concentration of antigen that occurs with segmental allergen challenge. This induces a pronounced inflammatory response that appears to cause nonspecific recruitment of lymphocytes. Exposure to smaller doses of antigen may allow for preferential activation and proliferation of ragweed-specific T cells within the lungs, without inducing the nonspecific inflammatory infiltrate. In dogs primed in the lungs with sheep red blood cells, rechallenge with small antigen doses leads to no inflammation or increase in vascular permeability but is associated with proliferation of antigen-specific B lymphocytes (42).

In addition to a polyclonal influx of T cells, ragweed challenge was associated with a second change in the T-cell repertoire. This change was the emergence of a new skewed or oligoclonal pattern of TCR junctional region lengths for some V gene families. This pattern was observed in unfractionated, CD4+, and CD8+ T cells. The finding that CD8+ T cells became oligoclonal after ragweed challenge was unexpected, especially since this included the Vbeta 20 gene family in three donors. Given the typical processing pathway for soluble exogenous antigens (43), it is expected that ragweed peptides would be recognized by CD4+, not CD8+, T cells. The specificity and function of oligoclonal CD8+ T cells that arise in response to allergen challenge is unknown at this time. We speculate that they may provide a beneficial downregulatory effect on the inflammatory response induced by CD4+ allergen-specific T cells. Indeed, some reports suggest a beneficial effect of developing a CD8+ T-cell response as part of atopy. CD8+ T cells are increased in BAL fluids from patients who are protected from developing a late-phase asthmatic response to allergen challenge (23). Successful immunotherapy is associated with the development of suppressive CD8+ T cells (44).

In summary, we have observed changes in the unfractionated, CD4+, and CD8+ T-cell repertoire in BAL fluids from atopic asthmatics 24 h after segmental allergen challenge. These changes suggest both a polyclonal influx of T cells and ragweed-associated activation of T cells within the lungs. Future studies are needed to correlate changes in the T-cell repertoire in BAL fluids with those in mucosal biopsies.

    Footnotes

Address correspondence to: Dr. Vladimir V. Yurovsky, Department of Medicine, University of Maryland, MSTF Room 8-23, 10 S. Pine St., Baltimore, MD 21201. E-mail: vyurovsk{at}umabnet.ab.umd.edu.

(Received in original form February 20, 1997 and in revised form July 16, 1997).

Acknowledgments: This work was supported by a Veterans Administration Career Investigator Award (to B.W.).

Abbreviations BAL, bronchoalveolar lavage; C, constant; CDR, complementarity-determining region; D, diversity; FEV1, forced expiratory volume in 1 s; FITC, fluorescein isothiocyanate; J, joining; mAb, monoclonal antibody; PBMC, peripheral blood mononuclear cells; PBS, phosphate-buffered saline; PE, phycoerythrin; RT-PCR, reverse transcriptase-polymerase chain reaction; TCR, T-cell antigen receptor(s); V, variable.

    References
Top
Abstract
Introduction
Materials & Methods
Results
Discussion
References

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