Reference values for CD4+ and CD8+ T lymphocytes with naïve or memory phenotype and their association with mortality in the elderly.

BACKGROUND: Well-established reference values which take into account the influence of age on immune cell phenotype, and the impact of naïve or memory T cells on mortality have not been well defined in the elderly. OBJECTIVE: The aim of this study was to evaluate the reference values for the peripheral number of total and naïve or memory CD4 and CD8 T cells in a healthy population in Italy, and to analyze whether the immune phenotype was associated with an increased risk of death among older adults. METHODS: The number of total or naïve and memory CD4+ or CD8+ T cells was evaluated in the peripheral blood of 288 healthy people ranging in age from 20 to 107 years. Furthermore, to correlate peripheral immune phenotype with mortality rate after a 3-years follow-up, a retrospective analysis was performed on the results from those individuals aged >65 years at the time of the enrollment in the study. RESULTS: The absolute number of total and naïve T cells was progressively reduced with increasing age in both the CD4+ and CD8+ T cell populations. The decrease was particularly evident for cells with naïve phenotype, since CD4-naïve and CD8-naïve T cells respectively showed a 4- and a 2- to 3-fold reduction in 70- to >90-year-old subjects in comparison with young adults. The number of CD4 memory T cells significantly increased with age. No significant age-related change was observed in the number of CD8+ memory T cells. Of the 194 subjects included in the study of association of immune phenotype with mortality, 121 were alive and 73 deceased during the 3-year follow-up. The impact of immune parameters on survival demonstrated that only the absolute number of CD8 memory T cells, after adjustment for age, correlated with increased mortality (OR 1.007, 95% CI 1.002-1.012, p = 0.01). The correlation was significant in female but not in male subjects. CONCLUSION: We provide reference values for total and naïve or memory CD4 and CD8 T cell populations, and demonstrate that the absolute number of CD8 memory T cells, after adjustment for age, correlates with increased mortality.

Intrinsic and microenvironmental defects are involved in the age-related changes of Lin - c-kit+ hematopoietic progenitor cells.

The aim of this study was to evaluate through cross-transplantation models the effect of aging on the number of Lin(-)c-kit+ hematopoietic progenitor cells, on their ability to differentiate towards a lymphocyte phenotype, and on the role of the microenvironment in hematopoietic differentiation. The absolute number of purified Lin(-)c-kit+ cells from bone marrow was significantly lower in aged than in young mice. When transplanted in young recipients, Lin(-)c-kit+ hematopoietic progenitor cells from aged mice showed a reduced differentiation capacity in T cells and NK cells, compared to Lin(-)c-kit+ cells from young animals. The role of microenvironment in Lin(-)c-kit+ hematopoietic progenitor cells differentiation was evaluated by injecting young Lin(-)c-kit+ cells in young or aged recipients, the latter transplanted or not with a young thymus. In these conditions, the differentiation of Lin(-)c-kit+ cells from young mice in T and NK cells was less efficient in aged than in young recipients, independently of thymus grafting in aged recipients. In addition to quantitative defects qualitative alterations were also present in Lin(-)c-kit+ cells from aged mice, as evidenced by the fact that the injection of Lin(-)c-kit+ cells from aged donors in young recipients differentiated in CD4+ T cells that retained an interleukin-4 (IL-4) production in-between young and old control values. In conclusion, we have demonstrated that aging is associated with numerical and functional alterations of Lin(-)c-kit+ hematopoietic progenitor cells as well as with an altered microenvironment that is required for Lin(-)c-kit+ cells differentiation toward a lymphocyte phenotype.

Effect of the silybin-phosphatidylcholine complex (IdB 1016) on the development of mammary tumors in HER-2/neu transgenic mice.

Silybin, a main component of the milk thistle of Silybum marianum, has been reported to possess anticancer activity. We investigated the effects of IdB 1016, a complex of silybin with phosphatidylcholine, on the development of mammary tumors appearing spontaneously in HER-2/neu transgenic mice. The mechanisms involved in the antitumor effect of IdB 1016 were evaluated by studying the apoptosis, senescent-like growth arrest, intratumoral leukocyte infiltrate, and the expression of HER-2/neu and p53 in tumoral mammary glands from transgenic mice and in human breast SKBR3 tumor cells. The administration of IdB 1016 delayed the development of spontaneous mammary tumors, reduced the number and size of mammary tumor masses, and diminished lung metastasization in HER-2/neu transgenic mice. In tumoral mammary glands from IdB 1016-treated mice, a down-regulation of HER-2/neu gene expression was associated with an increased senescent-like growth arrest of tumor cells, and an increased infiltrate of neutrophils, CD4, and CD8 T cells. Both senescent-like growth arrest and apoptosis were significantly increased and were associated with a reduced p185(HER-2/neu) protein and an increased p53 mRNA in SKBR3 in vitro treated with IdB 1016 in comparison with control cells. The results show the antitumor effect of IdB 1016 in the development of spontaneous mammary tumors in HER-2/neu transgenic mice. The effect of IdB 1016 might be related to the down-regulation of HER-2/neu expression and the induction of senescent-like growth arrest and apoptosis through a p53-mediated pathway in tumor cells.

Zinc improves the development of human CD34+ cell progenitors towards Natural Killer cells and induces the expression of GATA-3 transcription factor.

The Natural Killer cell maturation from CD34(+) hematopoietic cell precursors is a complex process that requires the synergistic effect of different cytokines and growth factors. Although there have been a number of important advances in our understanding of the Natural Killer differentiation, the developmental step leading to mature Natural Killer cells is still poorly defined. We evaluated the effect of two zinc concentrations (10 and 20microM) on the kinetic of development of CD34(+) cell progenitors towards Natural Killer cells. CD34(+) cells were purified from peripheral blood and cultured in medium supplemented with interleukin-15, interleukin-7, Flt 3 ligand, and stem cell factor. CD34(+) cells underwent proliferation and progressively lost CD34 antigen and acquired a CD56(+) phenotype. These CD56(+) cells exerted cytotoxic activity and expressed the CD94 inhibitory receptor. The supplementation with zinc greatly increased both the number of cells in culture and the absolute number of CD56(+) cells. Zinc induced higher levels of cytotoxic activity and a higher number of perforin-producing and of CD94-bearing CD56(+) cells in comparison with zinc unsupplemented cultures in early stages of Natural Killer cell development. The zinc-induced changes in CD34-derived CD56(+) cells were associated with an increased expression of GATA-3, a zinc-finger transcription factor providing for maturation and activity of T and Natural Killer cells. The increase was related to a higher CD56(+) cell number (10microM zinc), or to an increased GATA-3 mRNA transcription in CD56(+) cells (20microM zinc). Our data demonstrate that zinc influences the proliferation and differentiation of CD34(+) progenitors.

Induction of alphadelta- and alphabeta-mediated T cell responses in healthy elderly subjects after influenza vaccination.

Influenza is an important cause of morbidity and mortality in the elderly and influenza vaccination has shown a decreased efficacy in aged people. Both gammadelta- and alphabeta-T cell responses, which are believed to play an important role in controlling influenza infection, are impaired during aging. The aim of this study was to evaluate the ability of influenza vaccine to induce cellular immune responses mediated by gammadelta- and alphabeta-T cells in healthy elderly subjects. After influenza vaccination, an increased proportion of Vgamma9Vdelta2 T cells having reduced proliferative capacity and increased perforin production, and then a differentiated effector/memory phenotype, was present. The peripheral number and the cytokine production of gammadelta T cells were not changed. A significant decrease of CD4 and CD8 naïve T cells and a corresponding increase of CD4 and CD8 memory T cells were found. The in vitro stimulation of PBMCs from elderly subjects with influenza antigens increased their proliferative capacity and the production of both IFNgamma and IL-4. The vaccine was clinically effective, since in the outbreak period, only one influenza case was noted. The results reported in this study demonstrate the activation of both gammadelta- and alphabeta-T cell responses in healthy elderly after influenza vaccination.

Age-related susceptibility of naive and memory CD4 T cells to apoptosis induced by IL-2 deprivation or PHA addition.

The increased age-associated incidence of infectious and cancer diseases has been related to the alteration of immune functioning found in the elderly (immunosenescence). The reduction of naive T cells, which determine an impaired ability to mount immune responses to new antigens, represents a hallmark of the aging process. The aim of this study was to evaluate the susceptibility to apoptosis of purified naive and memory CD4(+) T cells from peripheral blood of healthy people ranging in age from 20 to 98 years. Two mechanisms of T cell elimination by apoptosis have been evaluated: cytokine deprivation and activation-induced cell death. After Interleukin-2 deprivation, the percentage of naive and memory CD4(+) apoptotic cells significantly increased with donor age concomitantly with a reduction of Bcl-2 expression and an increase of intracellular content of reactive oxygen species. After phytohemagglutinin addition, the percentage of apoptotic cells, the expression of CD95, and the intracellular reactive oxygen species, were not significantly correlated with age both in naive and memory CD4(+) T cells. Our data demonstrate the existence of functional alterations of naive and memory T cell populations during ageing. These alterations are mainly related to the mechanism of the apoptotic event rather than to the type of cell population involved (naive or memory). The alterations of naive and memory T cells may have implications in the age-related susceptibility to diseases.

Effect of resveratrol on the development of spontaneous mammary tumors in HER-2/neu transgenic mice.

Resveratrol (Res) has been reported to possess cancer chemopreventive activity on the basis of its in vitro effects on tumor cells and in vivo experimental models of rodents transplanted with parental tumors or treated with carcinogens. We investigated the effects of Res on the development of mammary tumors appearing spontaneously in HER-2/neu transgenic mice at an early age. The mechanisms involved in the Res antitumor effect were evaluated by studying the immune effectiveness, tumor apoptosis and expression of mRNA and protein for HER-2/neu in tumoral mammary glands from Res-treated mice and in tumor cell lines. Res supplementation delayed the development of spontaneous mammary tumors (p < 0.001), reduced the mean number and size of mammary tumors (p < 0.0001) and diminished the number of lung metastases in HER-2/neu transgenic mice. The effects of Res were associated with downregulation of HER-2/neu gene expression and increased apoptosis both in tumoral mammary glands and in murine (N202) and human (SKBr3) tumor cell lines. Neither the basal, the IL-2-induced NK activity nor the lymphocyte number and proliferation was modified in Res-supplemented compared to control mice. Our results demonstrate that Res supplementation delays the development and reduces the metastasizing capacity of spontaneous mammary tumors in HER-2/neu transgenic mice. The antitumor effect of Res might be related to the downregulation of HER-2/neu expression and the induction of apoptosis in tumor cells.

Circulating gammadelta T cells in young/adult and old patients with cutaneous primary melanoma.

BACKGROUND: In a previous study we demonstrated the existence of numerical and functional alterations of gammadelta T cells in healthy elderly. Recently, we analysed the involvement of gammadelta T lymphocytes in malignant melanoma, describing a lower frequency of circulating gammadelta T cells, an altered pattern of cytokine production, and an impaired in vitro expansion of these cells in primary cutaneous melanoma patients. METHODS: In this study we investigated the existence of numerical and functional alterations of circulating gammadelta T cells in young/adult and old melanoma patients, comparing the data obtained with age-matched healthy subjects. RESULTS: We demonstrated that the number of circulating gammadelta+ T cells was significantly and similarly reduced in young/adult and old melanoma patients and in old healthy subjects in comparison with young healthy donors. The decrease was due to a reduction of Vdelta2 T cells whereas the number of Vdelta1 T cells was not affected. A higher percentage of gammadelta+ T cells producing TNF-alpha was found in old healthy donors, whereas a reduced number of TNF-alpha-producing gammadelta+ T cells was present in melanoma patients independently by age. No significant difference was observed in IFN-gamma production. After a 10-day in vitro culture, both the percentage and the expansion index of gammadelta T cells, and in particular of Vdelta2 subset, were significantly and similarly reduced both in young/adult and old melanoma patients, and in healthy aged people, in comparison with young/adult healthy subjects. CONCLUSIONS: Our study demonstrates that the numerical and functional impairment of gammadelta T cells found in melanoma patients is not correlated with age and that it has characteristics very similar to the alterations of gammadelta T cells found in old healthy subjects. We suggest that a similar impairment of gammadelta T cell population may be related to the increased susceptibility to tumors present in the elderly as well as in the pathogenesis of malignant melanoma.

Skewed representation of functionally distinct populations of Vgamma9Vdelta2 T lymphocytes in aging.

We recently demonstrated that numerical and functional alterations of gammadelta T cells are present in healthy elderly. Here we observed that the decreased absolute number of Vgamma9Vdelta2 T cells present in old subjects in comparison with young/adult and middle aged donors is due to the reduction of naive and central memory Vgamma9Vdelta2 T cells bearing CD27 and CCR7 antigens. The proportion of effector/memory Vgamma9Vdelta2 T cells lacking CD27 or CCR7 markers was significantly increased in the peripheral blood of old subjects in comparison with younger donors. Moreover, the percentage of CD69+ gammadelta T cells was significantly increased in old subjects in comparison with younger donors after overnight activation, confirming that more effector cells are available in aged people. A functional analysis in young/adult and middle aged donors revealed that effector/memory CD27- Vgamma9Vdelta2 T cells are increased after 10-days of in vitro colture in the presence of isopentenylpyrophosphate (IPP) and IL-2. In contrast, the IPP+IL-2 mediated differentiation and expansion of CD27- effector/memory cells was absent in old subjects, confirming a lack of naive and central memory cells responding to IL-2. Accordingly, the expansion index of effector/memory CD27- Vgamma9Vdelta2 T cells was negatively correlated with the donor age. Finally, terminally differentiated Vgamma9Vdelta2 T cells measured as perforin content after 10-day in vitro expansion showed no age-related difference. These data demonstrated a shift of the circulating gammadelta T cell population towards CD27- and CCR7- effector T cells in the elderly with the reduction of immature CD27+ and CCR7+ T cell precursors.

Low effectiveness of DNA vaccination against HER-2/neu in ageing.

We evaluated the effectiveness of vaccination with a HER-2/neu DNA plasmid to induce protective immunity against HER-2/neu overexpressing syngeneic TUBO tumour cells in old ages. Young and old Balb/c mice received three immunizations with a pCMVneuNT DNA plasmid and, successively, were challenged with TUBO cells. Young mice were completely protected whereas less than 60% protection was observed in old mice. Anti-p185(neu) antibodies were found in the sera from both young and old immunized mice, even if antibody production was significantly higher in young in comparison with old mice. Similarly, higher anti-p185(neu) lymphocyte proliferation was induced in young than in old mice. No anti-p185(neu) cytotoxicity was found in lymphocytes from old animals. We conclude that anticancer DNA vaccination has a lower effectiveness in old than in young ages.

Phenotype, antigen-presenting capacity, and migration of antigen-presenting cells in young and old age.

In the present paper, we investigated whether the phenotype, the antigen-presenting capacity, and the migration of antigen-presenting cells (APCs), are affected by the aging process. APCs were obtained incubating peritoneal monocyte-macrophage cells with granulocyte-macrophage colony-stimulating factor (GM-CSF) (immature APCs) or GM-CSF and IFNgamma (mature APCs). Phenotypically, after 8 days incubation, APCs cultures were composed of CD11c and Mac-3 cells, with a similar representation, both in young and old mice. The absolute number and the expression of MHC I and II, CD80, and CD86 both on immature and mature APCs were not significantly different in young and old mice. APCs from old mice induced similar lymphocyte proliferative responses but lower lymphocyte cytotoxicity and a reduced number of CD8(+) T cells producing IFNgamma in comparison with APCs from young animals. Lymphocyte responses were antigen-specific, since TS/A pulsed APCs induced lymphocyte cytotoxicity against TS/A but not against syngeneic TUBO tumor cells. The low expression of the mRNA for the migratory CCR7 chemokine receptor present in immature APCs from old mice was greatly increased in mature APCs up to the levels found in APCs from young animals. The in vivo migration of APCs was higher in old than in young mice. These results demonstrate that some alterations in APCs function are present in aging, suggesting that an increased migratory capacity of old APCs may be required to balance their reduced antigen presentation to cytotoxic lymphocytes.

Age-dependent effects of repeated immunization with a first generation adenovirus vector on the immune response and transgene expression in young and old rats.

We evaluated the kinetics of transgene expression and humoral and cellular immune responses against viral antigens and the product of the reporter gene LacZ in young (4 months) and old (20 months) Wistar rats. Animals received the intramuscular injection of a recombinant E1-deleted human type 5 adenovirus encoding beta-gal (Ad-LacZ) on days 0 and 30. The transgene expression evaluated on day 2 after infection revealed a significantly higher beta-gal activity in young than in old animals (1.9-fold increase, p<0.05). beta-gal expression decreased on day 6, and on day 15 transgene activity was undetectable in muscles from both groups. Ad-LacZ inoculation was repeated on day 30 in both animal groups. However, after the second adenovirus administration, no increase in beta-gal activity was observed. Humoral and cellular immune responses, evaluated after the first and second Ad-LacZ injection, developed with similar kinetics in young and old rats. In particular, the antigen specific antibodies were able to kill adenovirus-infected tumor cells in both complement-dependent cytotoxicity (CDC) and antibody-mediated cell-dependent cytotoxicity (ADCC) assays. Lymphocyte proliferation in response to the in vitro stimulation with specific antigens was significantly lower in old than in young animals whereas no difference was found in cytotoxic T lymphocyte activity against adenovirus-infected tumor cells. Our results demonstrate that repeated immunization with AdCMV.LacZ induces minor age-related differences in immune response which precludes gene expression both in young and old animals.

Numerical and functional alterations of circulating gammadelta T lymphocytes in aged people and centenarians.

The aim of this study was to evaluate the peripheral representation, in vitro expansion, cytokine production, and cytotoxicity of gammadelta T lymphocytes from 104 healthy subjects ranging in age from 19 to 103 years. We demonstrated that the absolute number of circulating gammadelta(+) T cells was reduced significantly in old people and centenarians in comparison with young subjects as a consequence of the age-related decreased lymphocyte number. The decrease was a result of an age-dependent reduction of Vdelta2 T cells, whereas the absolute number of Vdelta1 T cells was unaffected by age. As a consequence, the Vdelta2/Vdelta1 ratio was inverted in old subjects and centenarians. A higher percentage of gammadelta(+) T cells producing tumor necrosis factor alpha was found in old donors and centenarians, whereas no age-related difference was observed in interferon -gamma production. After a 10-day in vitro expansion, a twofold lower expansion index of gammadelta T cells, and particularly of a Vdelta2, but not of a Vdelta1 subset, was found in old people and centenarians in comparison with young subjects. The cytotoxicity of sorted gammadelta T cells was preserved in old people and centenarians. The alteration of gammadelta T cells could contribute to the age-related derangement of T cell-mediated, adoptive responses and may represent a new characteristic of immunosenescence.

Reactive oxygen species modulate Zn(2+)-induced apoptosis in cancer cells.

Some recent evidence has suggested a protective role of zinc against cancer. The mechanism by which zinc exerts this action has not been defined and, in particular, it has not been clarified whether zinc may directly act on cancer cells and the molecular mechanisms involved in this effect. In this study, we examined the in vitro effect of zinc on the apoptosis of mouse TS/A mammary adenocarcinoma cells, studying the zinc-dependent modulation of the intracellular levels of reactive oxygen species (ROS) and of p53 and Fas/Fas ligand pathways. We showed that zinc concentrations ranging from 33.7 to 75 muM Zn(2+) induced apoptosis in mammary cancer cells. The apoptosis was associated with an increased production of intracellular ROS, and of p53 and Fas/Fas ligand mRNA and protein. Zn(2+) induced a faint metallothionein response in TS/A cells in comparison with mouse lymphocytes. The treatment of tumor cells with the antioxidant N-acetylcysteine was able to prevent Zn(2+)-induced apoptosis, as well as the increase of p53 and Fas ligand protein induced by zinc. The data demonstrate that zinc exerts a direct action on mammary cancer cells inducing ROS-mediated apoptosis and that the effect may be mediated by the ROS-dependent induction of p53 and Fas/Fas ligand.