Unraveling the identity of FoxP3+ regulatory T cells in Granulomatosis with Polyangiitis patients

Sci Rep. 2019 Jun 4;9(1):8273. doi: 10.1038/s41598-019-44636-y.

Abstract

Human CD4+FoxP3+T-cells are heterogeneous in function and include not only suppressive cells (Tregs), but also effector cells that transiently express FoxP3 upon activation. Previous studies in Granulomatosis with Polyangiitis (GPA-)patients have demonstrated an increase in FoxP3+T-cells with impaired suppressive capacity and an increase in Th17 cells. We hypothesized that the increase in FoxP3+T-cells results from an increase in non-suppressive effector-like cells. The frequency of circulating CD4+FoxP3+T-cell subsets were determined by flow cytometry in 46 GPA-patients in remission and 22 matched healthy controls (HCs). Expression levels of FoxP3 and CD45RO were used to distinguish between CD45RO- FoxP3low resting Tregs (rTreg), CD45RO+FoxP3high activated Tregs (aTreg) and CD45RO+FoxP3low proinflammatory non-suppressive T-cells (nonTreg). Intracellular expression of IFNγ, IL-17, and IL-21 was compared within these subsets. We found a significant increase in the frequency of nonTreg cells in GPA-patients as compared with HCs. Importantly, within the nonTreg subset, antineutrophil cytoplasmic autoantibody (ANCA-)positive patients demonstrated a significantly higher percentage of IL-17+ and IL-21+ cells when compared with ANCA-negative patients and HCs. Moreover, expanded nonTregs from ANCA-positive patients induced excessive proliferation of responder cells in vitro and exhibited higher IL-21 production. Production of IL-17 and IL-21 in non-suppressive FoxP3+T-cells may point toward a pathogenic role in ANCA formation.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Aged
  • Antibodies, Antineutrophil Cytoplasmic
  • CD4-Positive T-Lymphocytes / immunology
  • Female
  • Flow Cytometry
  • Forkhead Transcription Factors / genetics*
  • Granulomatosis with Polyangiitis / genetics*
  • Granulomatosis with Polyangiitis / immunology
  • Granulomatosis with Polyangiitis / pathology
  • Humans
  • Immunologic Memory / genetics*
  • Immunologic Memory / immunology
  • Interferon-gamma / genetics
  • Interleukin-17 / genetics
  • Interleukin-21
  • Interleukins / genetics
  • Leukocyte Common Antigens / genetics
  • Male
  • Middle Aged
  • T-Lymphocytes, Regulatory / immunology*
  • Th17 Cells / immunology

Substances

  • Antibodies, Antineutrophil Cytoplasmic
  • FOXP3 protein, human
  • Forkhead Transcription Factors
  • IFNG protein, human
  • IL17A protein, human
  • Interleukin-17
  • Interleukins
  • Interferon-gamma
  • Leukocyte Common Antigens
  • Interleukin-21