Antagonistic peptides specifically inhibit proliferation, cytokine production, CD40L expression, and help for IgE synthesis by Der p 1-specific human T-cell clones.

BACKGROUND: Allergic disorders are characterized by IgE antibody responses to a multitude of allergens as a result of the ability of these antibodies to specifically bind to high-affinity IgE receptors on mast cells and basophils. This interaction results in receptor activation and release of soluble mediators such as histamine and leukotrienes, which cause allergic reactions in various target organs. Because the synthesis of IgE is tightly regulated by cytokines and CD40 ligand (L) interactions, CD4+ helper T cells are obvious targets, with the aim to modulate allergen-induced IgE responses. OBJECTIVES: Because of the central role of allergen-specific T-helper type 2 (TH2) cells in the pathway leading to IgE synthesis in vitro and in vivo, we have evaluated the possibility of inhibiting allergen-induced activation of these cells by using allergen-derived peptides that have been modified by single amino acid substitutions. METHODS: Three cloned human TH2-like CD4+ T-cell lines, specific for Der p 1, the major allergen in house dust, were used in this study. Upon activation with Der p 1 or specific Der p 1-derived wild-type peptides, these T-cell clones produce high levels of IL-4 and IL-5 and low levels of interferon-gamma and IL-2, respectively, and furthermore give help to B cells for the production of IgE in vitro. Modified synthetic peptides were generated by the introduction of single amino acid substitutions into two different T-cell activation-inducing epitopes on Der p 1. The effects of these modified peptides were studied in Der p 1-induced proliferation, cytokine production, and in vitro IgE production assays. RESULTS: Several substituted Der p 1-derived peptides failed to induce T-cell proliferation, in contrast to the native peptides. In addition, some of these peptides acted as antagonists by strongly inhibiting wild-type peptide-induced proliferation as well as the production of interferon-gamma, IL-2, IL-4, and IL-5, although the production of the latter two cytokines was less affected than that of interferon-gamma, even at a 100-fold molar excess of the antagonistic peptides. In addition, the presence of an excess of each of the antagonistic peptides during the activation of Der p I-specific T-cell clones prevented induction of CD40L expression, resulting in a failure of these cells to give help to B cells for the production of IgE in vitro, even in the presence of exogenous IL-4. CONCLUSIONS: Substitution of certain amino acid residues in immunogenic Der p 1-derived peptides results in the generation of peptides that fail to induce proliferation of Der p 1-specific T-cell clones. In addition, these modified peptides have strong antagonistic activities on Der p 1-induced proliferation, cytokine production, and CD40L expression by allergen-specific T-cell clones as well as on T cell-mediated IgE production by B cells. These findings suggest that modified peptides interfere with allergen-induced activation of T cells, including the production of cytokines and the expression of surface molecules important for successful T cell-B cell interactions, and may therefore have therapeutic potential by inhibiting the expansion and function of allergen-specific TH2 cells.

Peptide-induced anergy in allergen-specific human Th2 cells results in lack of cytokine production and B cell help for IgE synthesis. Reversal by IL-2, not by IL-4 or IL-13.

The induction of anergy in T cells is believed to be the result of triggering of the TCR in the absence of adequate costimulation mediated through the interaction of CD28 and its ligands, CD80 and CD86. Here, we demonstrate that stimulation of human group I allergen in Dermatophagoides pteronyssinus extract (Der p 1)-specific CD4+ Th2-like T cell clones with Der p 1-derived peptides in the absence of professional APC results in a state of nonresponsiveness. The induction of anergy occurred despite the expression of high levels of CD28, CD80, and CD86 on the surface of the T cell clones and was not prevented by the addition of anti-CD28 mAb. The anergic, Der p 1-specific, Th2 cells failed to mobilize calcium from intracellular stores, to proliferate, and to produce IL-2, IL-4, IL-13, GM-CSF, and TNF-alpha following optimal stimulation with Der p 1-derived peptide and autologous APC. However, they mobilized intracellular calcium following stimulation with Ca(2+)-ionophore and produced all of the above cytokines, including IFN-gamma, when stimulated with phorbol ester and Ca2+ ionophore. These results indicate that the anergic T cell clones are capable of responding to signals circumventing the TCR/CD3 complex activation pathway. In contrast to T cell clones optimally activated with peptide and APC, anergic T cells failed to induce IgG4 and IgE synthesis when cocultured with B cells, even in the presence of exogenous IL-4 or IL-13. Anergic T cells expressed normal levels of CD40L, suggesting that their inability to help in Ig production by B cells is due to conditions other than a lack of expression of this molecule. Finally, exogenous IL-2 restored the helper function of anergic Th2 T cells for IgE production by B cells, which was greatly enhanced by the addition of IL-4 or IL-13. These data suggest that induction of anergy in allergen-specific Th2 T cells by allergen-derived peptides may play an important role in the successful desensitization of allergic patients.

Induction of non-responsiveness in human allergen-specific type 2 T helper cells.

Activation of allergen-reactive human T helper (Th)2 cells in the absence of professional antigen-presenting cells, induces non-responsiveness or anergy in these cells in vitro. This induction of anergy is accompanied by phenotypic modulation and altered cytokine production. Furthermore, peptide-treated Th2 cells fail to provide B-cell help for IgE synthesis. Recent studies indicate that impaired signal transduction via the T-cell receptor may account for the lack of responsiveness to antigenic stimulation. Here, we review present knowledge on the cell biology of non-responsive or anergic Th2 cells.

IL-12 transiently induces IFN-gamma transcription and protein synthesis in human CD4+ allergen-specific Th2 T cell clones.

IL-12 is a cytokine produced by monocytes and Epstein-Barr virus-transformed B cells which initiates Th1 responses by inducing the development of CD4+, IFN-gamma producing Th1 T cells in mouse and human. We have previously reported that allergen-specific CD4+ Th2 T cell clones produce IFN-gamma, following activation by phorbol ester (TPA) and calcium ionophore, indicating that these cells still have the ability to produce IFN-gamma. This observation, together with the capacity of IL-12 to induce IFN-gamma, prompted us to examine the effects of rIL-12 on the cytokine production profiles of a panel of cloned allergen-specific Th2 cell lines, and compare these to the effects of rIL-12 on the cytokine production by Th0 and Th1 T cell clones. Activation with antigen or TPA/anti-CD3 mAb of Th2 T cell clones that had been preincubated with rIL-12 and rIL-2 for 5 days induced or enhanced the expression of IFN-gamma transcripts, as well as the production of IFN-gamma by these cells. Furthermore, in a different set of experiments, it was found that the presence of rIL-12 during a 12 h stimulation of Th2 T cell clones induced or enhanced the expression of IFN-gamma transcripts, as well as the production of IFN-gamma by these cells. rIL-12 also enhanced IFN-gamma production by Th0 and Th1 T cells, but, in contrast, rIL-12 had no effect on the production of IL-4, nor on the frequency of IL-4 producing cells, as judged by analysis of intracellularly produced cytokines.(ABSTRACT TRUNCATED AT 250 WORDS)

Preferential formation of C3b-IgG complexes in vitro and in vivo from nascent C3b and naturally occurring anti-band 3 antibodies.

Naturally occurring anti-band 3 antibodies appear to have tissue homeostatic functions in the clearance of senescent red cells and in eliciting selective phagocytosis of oxidatively stressed red cells by mediating C3b deposition under conditions that favor the alternative complement pathway (Lutz, H. U., Bussolino, F., Flepp, R., Fasler, S., Stammler, P., Kazatchkine, M. D., and Arese, P. (1987) Proc. Natl. Acad. Sci. U.S.A. 84, 7368-7372). They overcome the notoriously low affinities of naturally occurring antibodies by having affinity for C3 which renders these antibodies preferred targets of nascent C3b. Anti-band 3 antibodies preferentially formed covalently linked C3b-IgG complexes, when C3 was activated randomly by trypsin. IgG depleted of anti-band 3 antibodies had almost lost the ability to form C3b-IgG complexes. Likewise, anti-band 3 antibodies, but not anti-spectrin antibodies, preferentially formed C3b-IgG complexes on oxidatively stressed red cells in the presence of a 10(3)-fold excess of other serum IgG, when complement deposition was initiated by antibody binding in diluted serum. Moreover, anti-band 3 antibodies preferentially formed C3b-IgG complexes at a 10(5)-fold excess of other IgG on in vivo aging red cells, since C3b-IgG complexes from senescent red cells contained exclusively anti-band 3 antibodies with an affinity for C3. Thus, the low titer, low affinity naturally occurring antibody became functionally relevant by preferred generation of C3b-IgG complexes that can nucleate alternative complement pathway C3 convertases and represent the most effective opsonins (Fries, L. F., Siwik, S. A., Malbran, A., and Frank, M. M. (1987) Immunology 62, 45-51).

Density separation of human red blood cells on self forming Percoll gradients: correlation with cell age.

Human red blood cells were density separated on self-forming Percoll gradients. Redistribution of density fractionated red blood cells was studied by recentrifugation on self-forming Percoll gradients. A protocol that avoids centrifugation of red cells prior to removal of white cells and introduces EDTA before red cell pelleting completely avoided redistribution. Dense red cells separated according to this method were senescent on the basis of a biochemical and a physical criterion: the increase in the band 4.1a:4.1b ratio (Mueller, T., Jackson, C.W., Dockter, M.E. and Morrison, M. (1987) J. Clin. Invest. 79, 492-499) and the loss of maximum deformability. Characterization also included the relative content of two surface proteins (complement receptor 1, CR1 (Ripoche, J. and Sim, R.B. (1986) Biochem. J. 235, 815-821); decay accelerating factor, DAF) on density fractionated red cells. Unlike cytoplasmic proteins, these proteins face similar conditions, whether located on circulating reticulocytes or aging red cells. Both components were lost linearly within experimental errors with cell density and were lower by 60 and 40% in dense than light cells, respectively.

How naturally occurring anti-band 3 antibodies stimulate C3b deposition to senescent and oxidatively stressed red blood cells.

Several naturally occurring antibodies stimulate alternative complement pathway C3b deposition. One type of these antibodies, human anti-band 3 antibody, is involved in opsonizing senescent and oxidatively stressed red cells with C3b (Proc. Natl. Acad. Sci. USA 84[1987]7368). The mechanism was investigated, by which it stimulates alternative complement pathway. Anti-band 3 antibodies are preferred targets for nascent C3b which forms ester bonds with IgG and generates C3b-IgG complexes. Since C3b-IgG and free C3b can equally well nucleate alternative convertases and since C3b in C3b-IgG is protected from degradation (J. Exp. Med. 160[1984]1640), generation of C3b-IgG complexes means stimulation of alternative complement pathway. Anti-band 3 antibodies are preferred targets for the shortlived, nascent C3b since they bind to native C3 by a site distant from the antigen binding site. In vitro generation of C3b-IgG complexes confirmed a preferential formation of C3b-anti-band 3 complexes. Thus, an affinity for C3 may be all what is required to make an antibody a stimulator of the alternative complement pathway and thereby a potent opsonin.

An affinity for complement C3 as a possible reason for the potency of naturally occurring antibodies in mediating tissue homeostasis.

Certain naturally occurring antibodies stimulate alternative complement pathway C3b deposition. We propose that only those IgG antibodies stimulate alternative complement pathway which have an affinity for C3. Their weak binding to C3 in plasma increases the probability that covalently linked C3b-IgG complexes are formed during C3 activation. Such complexes are known to be much more efficient than C3b in mediating positive feedback of C3 activation, since they are more stable against inactivation by factor I and H. The hypothesis is supported by functional properties of naturally occurring antibodies to erythrocyte band 3 protein. Their ability to stimulate alternative complement pathway C3b deposition increases the potency of these low titer antibodies as opsonins.

Electrophoretic properties of human IgG and its subclasses on sodium dodecyl-sulfate-polyacrylamide gel electrophoresis and immunoblots.

Unreduced human immunoglobulin G (IgG) which was not aggregated showed anomalous apparent molecular masses on sodium dodecyl sulfate-polyacrylamide gel electrophoresis (SDS-PAGE). It migrated mainly as three distinct bands with apparent molecular masses from 190 to 240 kDa on gels containing 8% polyacrylamide, when denatured at 37 degrees C. Generation of this banding pattern has two reasons: (a) the pattern is a superposition of bands originating from the four IgG subclasses that differ in molecular masses and structures; and (b) the complexity of the band pattern is further increased, because IgG myeloma proteins of the IgG1 and IgG2 subclass migrated as doublets, while IgG3 and IgG4 formed primarily one band with slightly different apparent molecular masses. These properties were independent of the type of light chain in all myeloma proteins studied. Generation of doublets suggests heterogeneities of monoclonal proteins. The two separable protein populations from IgG1 differ in their susceptibility to reduction. Reduction at 37 degrees C cleaved the larger into heavy and light chain, while it generated heavy chain dimer and light chain from the smaller species. Hence, it is possible that monoclonal IgG1 are comprised of at least two subpopulations of molecules with different S-S bonds. Doublet formation of IgG2 remains unexplained, since both species were equally sensitive to reduction. Knowledge on the anomalous properties of IgG on SDS-PAGE is a prerequisite to run immunoblots from unreduced cellular antigens without confounding cell-associated IgG with cellular antigens.

Naturally occurring anti-band 3 antibodies and complement in phagocytosis of oxidatively-stressed and in clearance of senescent red cells.

Treatment of human red blood cells with diamide and opsonization with whole serum enhanced their phagocytosis by mononuclear phagocytes. Opsonization of diamide-treated red cells with whole serum containing 20-100 times the physiologic concentration of naturally occurring anti-band 3 antibodies further increased the extent of phagocytosis. Enhanced phagocytosis was due to an anti-band 3 mediated binding of C3b to red cells via the alternative pathway. Red cell-bound anti-band 3 was slightly elevated on diamide-treated cells and elicited a C3 binding that exceeded the amount of bound antibody by two orders of magnitude. Pretreatment of red cells with a monoclonal anti-CR1 did not significantly inhibit opsonization and phagocytosis if cells were opsonized at elevated anti-band 3 concentrations. On the other hand, phagocytosis of mildly oxidized (20 microM diamide) red cells was completely inhibited by blocking CR1 if cells were opsonized with serum containing physiologic concentrations of anti-band 3. The results suggest that two types of opsonization mediate in vitro phagocytosis: one operating at physiologic anti-band 3 concentrations with mildly oxidized red cells (IC-like mechanism) and one that operates with either heavily oxidized (greater than 200 microM diamide) red cells at physiologic anti-band 3 concentrations, or with mildly oxidized cells opsonized at elevated concentration of anti-band 3. The latter mechanism is relevant in vivo. It is most likely that it starts by Fab-dependent binding of anti-band 3 to diamide-induced band 3 protein oligomers. Complement activation may occur by assembly of an alternative convertase on C3b covalently bound to red cell-associated anti-band 3. This mechanism is also likely to mediate clearance of senescent red cells, as it was primarily from senescent red cells that we could isolate complexes containing IgG covalently bound to C3b.

[Alternative complement pathway activation by anti-band 3 antibodies]. / "Anti-Bande-3"-Antikörper aktivieren Komplement über den alternativen Weg.

Naturally occurring antibodies against the anion exchange protein of red cells (band 3 protein) can elicit in whole serum a strong C3b deposition to red cells under conditions which favor alternative complement pathway activation. Such a mode of opsonization calls for generation of an alternative C3 convertase nucleated by C3b covalently bound to anti-band 3. Senescent, but not young, red cells should also carry "C3b-anti-band 3" complexes, if clearance of in vivo aged red cells occurred by the same mechanism. We succeeded in isolating covalently linked complexes of C3b and IgG primarily from membranes of senescent red cells.

Naturally occurring anti-band-3 antibodies and complement together mediate phagocytosis of oxidatively stressed human erythrocytes.

Treatment of erythrocytes with the thiol-specific oxidant azodicarboxylic acid bis(dimethylamide) (diamide) enhances their phagocytosis by adherent monocytes. Phagocytosis of diamide-treated erythrocytes required that the cells were opsonized with whole serum, since complement inactivation abolished phagocytosis. Opsonization with whole serum containing 20-100 times the physiological concentration of naturally occurring anti-band-3 antibodies enhanced phagocytosis of diamide-treated erythrocytes. High inputs of anti-band-3 also restored phagocytosis of erythrocytes that had been incubated with complement-inactivated serum. Elevated concentrations of anti-spectrin antibodies were ineffective in whole and complement-inactivated serum. Specific recognition of diamide-treated erythrocytes by anti-band-3 antibodies may be due to generation of anti-band-3 reactive protein oligomers on intact diamide-treated erythrocytes. Generation of such oligomers was dose-dependent with respect to diamide. Bound anti-band-3 alone was not sufficient to mediate phagocytosis. It resulted in deposition of complement component C3b on the cells through activation of the alternative complement pathway in amounts exceeding that of bound antibodies by two orders of magnitude. Thus, anti-band-3 and complement together mediate phagocytosis of oxidatively stressed erythrocytes, which stimulate senescent erythrocytes with respect to bound antibody and complement.

Diamide enhances phagocytosis of human red cells in a complement- and anti band 3 antibody-dependent process.

Human red cells treated with 20-200 microM diamide were opsonized by serum and phagocytized by adherent monocytes. Phagocytosis was dependent on complement. It was enhanced by supplementing whole serum and was restored by supplementing complement-inactivated serum with naturally occurring antibodies which bind to the major integral protein of the human red cell, band 3 protein. Diamide induced oligomers of anti band 3 reactive oligomers, and enhanced anti band 3 binding to red cells. Complement C3 binding paralleled that of anti band 3 and exceeded it by two orders of magnitude. Thus, naturally occurring antibodies have functional properties which were not abolished by other serum Ig and may be involved together with complement in the clearance of red cells subjected to oxidant stress.

[Medical statistics in compulsory accident insurance]. / Die Medizinalstatistik in der obligatorischen Unfallversicherung.

The medical statistics in the compulsory accident insurance are conceived as a secondary statistic. It includes both injuries and medical services. Since the Swiss National Accident Insurance Fund started in 1918, there were regular reports about medical statistics. The current statistics of the agency are organized as a sampling statistic. Only disability benefits are covered in toto. The statistical organization permits the identification of single cases in terms of specific characteristics and to analyze them further. The new accident insurance law makes accident insurance obligatory for all persons who are not self-employed. The regulation, included in this law, to record statistics uniformly will hopefully help toward the improvement of medical statistics within the compulsory accident insurance scheme.

[Sports accidents: 1963-1973 statistics]. / Sportunfälle: Statistik 1963-1973

Every year, the Swiss Accident Insurance Administration is paying a considerable amount of money for sports accidents. From 1963 to 1973 the number of these accidents has increased more markedly than other types of accidents. Different tendencies can be observed in the different types of sports: skiing accidents have, after a long period of retrogression until 1973, shown a noticeable augmentation again. Football accidents and accidents in other types of sports have on the other hand increased year by year. Mountaineering and aquatic sports often result in fatal accidents. The numerous preventive measures in skiing accidents have obviously been successful. Not only the fractures have decreased, but also the average number of days where sickness benefit was paid. Next to the traffic accidents, the skiing accidents are the most expensive ones. The nature of the healing cost in sports accidents has changed during the period from 1967 to 1972, depending on the different types of sports. In particular, hospital costs have changed considerably. The number of medical consultations per accident has decreased. Payment of sickness benefit has followed the development of the salaries on the one hand and the modifications of the number of lost days on the other. Finally, the costs of the annuities show more or less the same tendency as the ones for sickness benefit. A very gross estimation on the economical losses through sports accidents in Switzerland makes us believe that the direct and indirect costs actually amount to more than one thousand millions of Swiss Francs per year.