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. 2015 Oct 7;7(308):308ra160.
doi: 10.1126/scitranslmed.aab0166.

ST2 blockade reduces sST2-producing T cells while maintaining protective mST2-expressing T cells during graft-versus-host disease

Affiliations

ST2 blockade reduces sST2-producing T cells while maintaining protective mST2-expressing T cells during graft-versus-host disease

Jilu Zhang et al. Sci Transl Med. .

Abstract

Graft-versus-host disease (GVHD) remains a devastating complication after allogeneic hematopoietic cell transplantation (HCT). We previously identified high plasma soluble suppression of tumorigenicity 2 (sST2) as a biomarker of the development of GVHD and death. sST2 sequesters interleukin-33 (IL-33), limiting its availability to T cells expressing membrane-bound ST2 (mST2) [T helper 2 (TH2) cells and ST2(+)FoxP3(+) regulatory T cells]. We report that blockade of sST2 in the peritransplant period with a neutralizing monoclonal antibody (anti-ST2 mAb) reduced GVHD severity and mortality. We identified intestinal stromal cells and T cells as major sources of sST2 during GVHD. ST2 blockade decreased systemic interferon-γ, IL-17, and IL-23 but increased IL-10 and IL-33 plasma levels. ST2 blockade also reduced sST2 production by IL-17-producing T cells while maintaining protective mST2-expressing T cells, increasing the frequency of intestinal myeloid-derived suppressor cells, and decreasing the frequency of intestinal CD103 dendritic cells. Finally, ST2 blockade preserved graft-versus-leukemia activity in a model of green fluorescent protein (GFP)-positive MLL-AF9 acute myeloid leukemia. Our findings suggest that ST2 is a therapeutic target for severe GVHD and that the ST2/IL-33 pathway could be investigated in other T cell-mediated immune disorders with loss of tolerance.

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Conflict of interest statement

Conflict of Interest:

Dr. Paczesny has a patent on “Methods of detection of graft-versus-host disease” licensed to Viracor-IBT Laboratories. Otherwise, the authors have no other relevant conflicts of interest to declare.

Figures

Fig. 1
Fig. 1. ST2 blockade and GVHD
(A) Irradiated C3H.SW mice (1100 cGy) were transplanted with syngeneic ( formula image) or allogeneic B6 ( formula image) BM cells (5 × 106) and splenic purified T cells (2 × 106). Soluble ST2 concentrations in plasma collected at indicated times post-HCT from C3H.SW recipients (unit: ng/mL) (p=0.0001; n=10–12; t-test). The data are from 4 independent experiments. (B) Clinical scores of GVHD and survival curves for C3H.SW mice receiving syngeneic ( formula image) or allogeneic B6 cells and treated with anti-mouse ST2 antibody ( formula image) or IgG control antibody ( formula image) at day -1 and day +1 post-HCT. The data are from 3 independent experiments (p values for GVHD scores are in Table S1, p=0.0256 for survival analysis; n=15–23 per group; t-test for GVHD score and Log-rank test for survival analysis). (C) Irradiated NSG mice (350 cGy) received 2.5 × 106 T cells purified from PBMCs of healthy donors ( formula image). The control group was irradiated without receiving human T cells ( formula image). Human soluble ST2 concentrations in plasma collected at indicated times post-HCT from NSG recipient mice with or without engrafted human T cells (unit: pg/mL). The data are from 3 independent experiments (p=0.0028; n=7–9 per group; t-test). (D) Clinical scores of GVHD and survival curves for NSG mice receiving human T cells and treated with anti-human and anti-mouse ST2 antibodies ( formula image) or IgG control antibody ( formula image) every other day from day -1 to day +5 (4 doses) (p values for GVHD scores are in Table S1, p= 0.0329 for survival analysis; n=10 per group; t-test for GVHD score and Log-rank test for survival analysis). (E) IFN-γ, IL-17, IL-23, IL-10, and IL-33 concentrations in plasma collected every 5 days post-HCT from the B6→C3H.SW model (unit: pg/mL). The data are from 3 independent experiments. Syngeneic group ( formula image); allogeneic groups treated with anti-ST2 ( formula image) or IgG control ( formula image) (p values are in Table S1; n=3–9 per group, t-test).
Fig. 2
Fig. 2. Soluble ST2 (sST2) and membrane ST2 (mST2) expression during GVHD
(A) In the B6→C3H.SW model, mRNA expression of sST2 and mST2 in different organs (spleen, small intestine, large intestine, skin, bone marrow, lung, heart, liver, and peripheral blood) of C3H.SW recipients mice at day 10 post-allogeneic HCT. The data are from 4 independent experiments (p values are in Table S2; n=4; one-way ANOVA). (B) sST2/actin mRNA expression in intestine or intestinal cell subsets (epithelial cells, stromal cells, endothelial cells, or non-T hematopoietic cells) from C3H.SW recipients mice at day 10 post-allogeneic HCT (n=5). The data are from 2 independent experiments with 2–3 pooled mice. (C) Western blot analysis of sorted intestinal stromal cells from IgG control or anti-ST2 antibody treated C3H.SW recipients mice at day 10 post-allogeneic HCT [M=marker (kDa)] (left). The red box indicates the lack of sST2 protein present after anti-ST2 treatment. The bar graph shows the sST2/actin ratio in IgG control or anti-ST2 treated mice (n=6). The data are from 2 independent experiments with 3 pooled mice. (D) sST2/actin expression on sorted intestinal stromal cells and T cells from C3H.SW mice at day 10 and day 28 post-allogeneic HCT. The data are from 2 independent experiments with 2–3 pooled mice (p=0.0120; n=5; t-test). (E) Western blot analysis of sorted intestinal T cells from IgG control or anti-ST2 antibody–treated C3H.SW recipients 10 days post-allogeneic HCT [M=marker (kDa)]. The red box indicates the lack of sST2 protein present after anti-ST2 treatment. The unmodified blots are in Fig. S9. The bar graph shows the sST2/actin ratio in CD4 T cells from IgG control or anti-ST2 treated mice. The data are from 2 independent experiments with 3 pooled mice (p=0.0032; n=6; t-test). (F) sST2 secretion by both murine and human in vitro differentiated T cell subsets. The data are from 3–4 independent experiments (p values are in Table S2; n=3–4; t-test). The unmodified blots are in Fig. S9.
Fig. 3
Fig. 3. ST2 deficiency and T cell populations during GVHD
(A) Transcriptome analysis of T cell related genes in mesenteric lymph node (MLN) T cells from anti-ST2–treated vs. IgG–treated C3H.SW recipient mice at day 10 post-allogeneic HCT. MLN T cells from 4 mice in each group were pooled for analysis. (B and C) Flow cytometric analysis of transcription factor and cytokine production by donor-derived CD4+ splenic T cells from IgG-treated or anti-ST2-treated C3H.SW recipients mice at day 10 after allogeneic HCT. The bar graphs show the percentages of cells expressing IFN-γ or Tbet (p=0.0150 for IFN-γ, p=0.0055 for T-bet; n=5; t-test) (B) and IL-17/IFN-γ or RORγt (p= 0.0003 for IL-17/IFN-γ and p=0.0075 for RORγt; n=4–5; t-test) (C). The data are from 2 independent experiments. Gating strategy for (B) and (C) found in Fig. S10. (D) Survival curves for C3H.SW recipient mice receiving either only 5 × 106 wild type (WT) B6 BM cells ( formula image) or 2 × 106 WT ( formula image) or ST2−/− B6 T cells ( formula image) (p=0.0289; n=6–10; Log-rank test). The data are from 2 independent experiments. (EG) Flow cytometric analysis at day 10 after allogeneic HCT shows percentages of intestinal CD4+ T cells expressing IFN-γ and Tbet (p=0.0173 for IFN-γ and p=0.0320 for Tbet; n=4; t-test) (E) and IL-17/IFN-γ, and RORγt (p=0.0273 for IL-17/IFN-γ and p=0.0273 for RORγt; n=4–5; t-test) (F) as well as Ki67 proliferation staining of cells expressing both IL-17 and IFN-γ (p=0.0088; n=4; t-test) (G). The data are from 2 independent experiments. (H) The bar graphs show the percentages of T cells expressing IL-4 or GATA3 from IgG-treated or anti-ST2-treated C3H.SW recipients mice at day 10 after allogeneic HCT, and the flow cytometry plots show mST2 expression on GATA3 T cells after IgG or anti-ST2 treatment. The data are from 2 independent experiments (p=0.0049 for IL-4 and p=0.0252 for GATA3; n=6; t-test). (I) IL-4 and GATA3-expressing T cells from C3H.SW recipient mice receiving WT or ST2−/− B6 T cells at day 10 after allogeneic HCT (p=0.0032 for IL-4 and p=0.0253 for GATA3; n=4; t-test). The data are from 2 independent experiments. (J) The bar graphs show the percentages of intestinal T cells expressing FoxP3 from IgG-treated or anti-ST2-treated C3H.SW recipients mice at day 10 after allogeneic HCT, and the flow cytometry plots show mST2 expression on FoxP3 T cells after IgG or anti-ST2 treatment (p=0.0087; n=5; t-test). The data are from 2 independent experiments. (K) FoxP3 and IL-10 expressing T cells from C3H.SW recipient mice receiving WT or ST2−/− B6 T cells at day 10 after allogeneic HCT. The data are from 2 independent experiments (p=0.0459 for FoxP3 and p=0.0471 for IL-10; n=4–5; t-test). (L) Survival curves for C3H.SW recipients mice transplanted with 5 × 106 B6 TCD BM cells plus either 2 × 105 WT ( formula image) or ST2−/− B6 ( formula image) regulatory T cells (Tregs) with 2 × 106 WT B6 conventional T cells. ( formula imageTCD BM only). The data are from 2 independent experiments (p=0.043; n=5–10 per group; Log-rank test). Flow cytometric gating strategies are in Fig. S10.
Fig. 4
Fig. 4. ST2 deficiency and antigen-presenting cells during GVHD
Flow cytometric analysis of intestinal myeloid-derived suppressor cells (MDSCs = MAC-1+Gr-1+ cells), CD103+ dendritic cells, and CD11c+ total dendritic cells in the B6 (CD45.1+)→C3H.SW (CD45.2+) model at 10 days post-allogeneic HCT. (A) Donor CD45.1+ MDSCs in IgG control or anti-ST2-treated C3H.SW recipients (p=0.0247; n=4; t-test). The data are from 2 independent experiments. (B) Donor CD45.1+ MDSCs in C3H.SW recipients receiving WT or ST2−/− B6 T cells (p=0.0277; n=3; t-test). (C) Donor CD45.1+CD103+ dendritic cells in IgG control or anti-ST2-treated C3H.SW recipients (p=0.0012; n=8; t-test). The data are from 4 independent experiments. (D) Donor CD45.1+CD103+ dendritic cells in C3H.SW recipients receiving WT or ST2−/− B6 T cells (p=0.0244; n=3; t-test). (E) Expression of MHC-II and co-stimulation molecules on CD11c+ total dendritic cells from IgG control and anti-ST2-treated mice, representative flow cytometry histograms (top panels) and bar graphs (bottom panels) of mean fluorescence intensity (MFI) (p=0.0391 for MHC II, p=0.0469 for CD40, p=0.0154 for CD80, and p=0.0263 for CD86; n=3; t-test). Flow cytometric gating strategies are in Fig. S11.
Fig. 5
Fig. 5. ST2 deficiency and GVL activity
(A) Transcriptome analysis of anti-tumor related genes in MLN T cells from anti-ST2-treated vs. IgG-treated C3H.SW recipient mice at day 10 post-allogeneic HCT. MLN T cells from 4 mice in each group were pooled for analysis. (B) In vitro cytotoxic T lymphocyte assay with A20 and MLL-AF9 retrovirally induced acute myeloid leukemia in the presence of IgG control and anti-ST2 mAb (5 μg/mL) (n=3). The data are from 3 independent experiments. (C) Survival curves of C3H.SW mice receiving 104 GFP+ MLL-AF9 leukemic cells with syngeneic HCT C3H.SW→C3H.SW ( formula image) or allogeneic HCT (B6→C3H.SW) treated with IgG control ( formula image) or anti-ST2 mAb ( formula image) (p=0.010; n=5–10 per group; Log-rank test). (D) Survival curves of C3H.SW mice receiving 104 GFP+ MLL-AF9 leukemic cells with syngeneic HCT C3H.SW→C3H.SW ( formula image) or allogeneic HCT (B6→C3H.SW) treated with 6 doses (100 μg/dose, every other day from day -1 to day +9) of IgG control ( formula image) or anti-ST2 mAb ( formula image) (p=0.0357; n=4–5 per group; Log-rank test). (E) Survival curves of C3H.SW mice receiving 104 GFP+ MLL-AF9 leukemic cells with WT ( formula image) or ST2−/− ( formula image) B6 T cells (p=0.0203; n=6–10 per group; Log-rank test).

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