Antileukemic T-cell responses can be predicted by the composition of specific regulatory T-cell subpopulations

J Immunother. 2013 May;36(4):223-37. doi: 10.1097/CJI.0b013e31829180e7.

Abstract

Regulatory T cells (Treg) are important regulators of immune responses. In acute myeloid leukemia (AML) patients before/after immunotherapy (stem cell transplantation or donor lymphocyte infusion), their suppressive role can contribute to suppress severe graft-versus-host reactions, but also to impair antileukemic reactions. As leukemia-derived dendritic cells (DCleu) are known to improve the antileukemic functionality of T cells, we evaluated the composition and development of distinct Treg subtypes in AML patients (n=12) compared with healthy probands (n=5) under unstimulated conditions and during stimulation with DCleu-containing DC (DC) or blast-containing mononuclear cells (MNC) in 0- to 7-day mixed lymphocyte cultures by flow cytometry. T-cell subgroups in AML patients were correlated with antileukemic functionality before and after DC or MNC stimulation by functional fluorolysis assays. (1) AML patients' T cells presented with significantly higher frequencies of Treg subgroups in unstimulated T cells compared with healthy probands. (2) After 7 days of DC or MNC stimulation, all Treg subtypes generally increased; significantly higher frequencies of Treg subtypes were still found in AML patients. (3) Antileukemic cytotoxicity was achieved in 36% of T cells after MNC compared with 64% after DC stimulation. Antileukemic activity after DC but not after MNC stimulation correlated with significantly lower frequencies of Treg subtypes (CD8Treg/Teff/em reg). Furthermore, cut-off values for Treg subpopulations could be defined, allowing a prediction of antileukemic response. We demonstrate a crucial role of special Treg subtypes in the mediation of antileukemic functionality. High CD8 Treg, Teff/em reg, and CD39 T cells correlated clearly with a reduced antileukemic activity of T cells. DC stimulation of T cells contributes to overcome impaired antileukemic T-cell reactivity. Refined analyses in the context of clinical responses to immunotherapies and graft versus host reactions are required.

MeSH terms

  • Adolescent
  • Adult
  • Aged
  • Antigens, CD
  • Cell Differentiation
  • Cells, Cultured
  • Child
  • Child, Preschool
  • Cytotoxicity, Immunologic
  • Dendritic Cells / cytology
  • Dendritic Cells / immunology
  • Dendritic Cells / metabolism
  • Female
  • Humans
  • Immunophenotyping
  • Leukemia, Myeloid, Acute / immunology*
  • Leukemia, Myeloid, Acute / pathology
  • Leukocytes, Mononuclear / immunology
  • Leukocytes, Mononuclear / metabolism
  • Lymphocyte Activation / immunology
  • Male
  • Middle Aged
  • Myelodysplastic Syndromes / immunology*
  • Myelodysplastic Syndromes / pathology
  • Neoplasm Staging
  • T-Lymphocyte Subsets / immunology*
  • T-Lymphocyte Subsets / metabolism
  • T-Lymphocytes, Regulatory / immunology*
  • T-Lymphocytes, Regulatory / metabolism
  • Young Adult

Substances

  • Antigens, CD