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Lymphocyte Selection and Tolerance
Chander Raman2004
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Lecture Focus:
• Lymphocyte Selection: Central Tolerance• T-cell selection• B-cell selection
• Peripheral Tolerance • Peripheral control of autoreactivity.
• Breakdown of tolerance• Autoimmune diseases
• Restoration of tolerance• Treatment of autoimmune diseases
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Tolerance: Inability to respond to antigen stimulation OR Immunological unresponsiveness.
Why do we need tolerance?
-Initial T-cell receptor rearrangement or B-cell receptor rearrangement leads to generation of repertoire that has the potential to recognize all antigens –
DOES NOT DISCRIMINATE BETWEEN SELF-REACTIVITY AND REACTIVITY TO FOREIGN ANTIGENS
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Tolerance:
• Central tolerance• Negative selection of immature lymphocytes by clonal deletion of self reactive clones during development.
• T cells – thymus• B cells – bone marrow
Clonal deletion occurs by induction of programmed cell death or apoptosis
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Death by Neglect
Negative Selection
T-Cell Selection - Overview
Double Negative
Double PositiveCD4+CD8+
Single PositiveCD4+ orCD8+(Positive selection based on MHC reactivity)
(Negative Selection)
(Positive selection for ability to recognize antigen)
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Menu FB
Death by Neglect
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Evidence for Requirement for Central Tolerance
AIRE (autoimmune regulator) Transcription Factor –”Master” Regulator of Ectopic Expression of Peripheral Tissue- Restricted Antigens in stromal cells of the thymic Medulla.
•Originally identified as a human autosomal recessive disorder known as APECED (autoimmune polyendocrinopathy-candidiasis-ectodermal dystrophy.
• AIRE-/- mice exhibit wide spread organ-specific autoimmunity, such as ovary, retina testis, stomach. (Anderson et al, Science)
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AIRE-Deficient Mice
Normal Mice
Loss of Thymic Selection lead to Autoimmunity
Autoantibodies to different organs shown in GREEN in AIRE-deficient mice
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AIRE allows for the expression of antigens to which T-cells are negatively selected.
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B-Cell Development
Sensitive to Negative Selection – Central Tolerance
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Binding to self molecules in the bone marrow can lead to the deletion or inactivation of immature B cells.
B-Cell Selection in the Bone Marrow
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Factors That Regulate Central Tolerance
• Most Important – Strength of Signals initiated by antigen receptor– Intracellular signal strength is dependent on:
• Avidity of interaction of between antigen and antigen receptor
• Affinity of interaction between antigen and antigen receptor
• Co-stimulatory signals that enhance signal strength (CD28)
• Signals that attenuate signals strength – Inhibitory receptors (CD5)
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Signal Strength
Survival
Death
Negative selectionPositive selectionDeath by Neglect
Co-stimulation
Inhibition (attenuation)
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Peripheral Tolerance• Not all self-reactive T or B cells are deleted
during development. Reasons include:– Need for a peripheral repertoire that will protect
from pathogens– Peripheral tissue specific antigens not expressed
in the thymus.– Expression of neo-antigens occurring as a result
of tissue damage.– Expression of specific endopeptidases that modify
peptides in thymus.– Positive selection of specificities that exhibit weak
self-reactivity but with the propensity for pathogenic autoreactivity.
Control of autoreactive T cells in the periphery is termed Peripheral Tolerance
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Peripheral Tolerance
Peripheral control of autoreactivity
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• Peripheral Tolerance:– Clonal deletion, clonal anergy or clonal
ignorance of mature self-reactive T and mature or transitional B cells.
– Regulated by:• Co-stimulatory molecules (signal 2)• Cytokines (signal 3)• Inhibitory molecules• T-regulatory cells (Tr), T-suppressor cells (Ts)• Dendritic cells.
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Anergyand/or
Apoptosis
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Maloy and Powrie, Nature Immunol. 2:816
T Regulatory Cells (Tr)
CD4+
CD25+
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T suppressor cells and Inhibitory Molecules
Feinberg & Silvestri, Nature Immunol, 3:215
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Tolerance Induction by Dendritic Cells
Lutz and Schuler, Trends Immunol: 23:9
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Immunity vs Tolerance in Peripheral B Cells
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Breakdown of tolerance Autoimmune
diseases
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Venn Diagram: Requirements for the Development of Autoimmune Disease
Focus on AutoimmunityNature Immunology, Sept 2001 (Vol 2)www.nature.com/ni
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Development of Autoimmunity
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Autoimmune Diseases
• Organ specific autoimmune diseases:– Immune response directed to a specific organ
leading to cellular damage and organ destruction
• Diabetes – Cell mediated immune response to pancreatic islet beta cells.
• Goodpasture’s syndrome – Antibody to basement membrane of kidney glomeruli.
• Graves disease – Stimulating antibody to thyroid stimulating hormone receptor (TSHr)
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Autoimmune Diseases
• Systemic autoimmune diseases:– Immune response to wide variety of antigens involving
several organs and tissues. Often involves both cell-mediated and humoral.
• Systemic lupus erythematosus (SLE) – Primary antibody response to DNA and nucleoproteins and progressive development of antibodies to other tissues.
• Rheumatoid arthritis (RA) – IgM antibodies to Fc portion of IgG.
• Multiple sclerosis (MS) – T cell response to myelin basic protein
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Organ Specific and Systemic Autoimmune Diseases in Human
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Hypothesis for the Development of Type 1 Diabetes
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Systemic Lupus Erythematosus
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- Genetic Predisposition- MHC genes – eg. HLA DR4 in Diabetes- Other susceptibility genes
- Sex Differences
Susceptibility to Autoimmune Diseases
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Contribution of Susceptibility Gene Alleles to Development of Autoimmunity
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Therapeutic Intervention
- Conventional therapeutic approaches- Anti-inflammatories, immunosuppressive drugs, Cytotoxic drugs
- New therapies- TNFr (EMBREL – etanerecept)- anti-CD20 (depletes B-cells – treatment of SLE)
- Experimental/New approaches- TNF receptor family agonists/antagonists
- Blys/BlysR(s) (Inhibition of activation and differentiation)- TRAIL/TRAILR(s) (Apoptosis inducing)
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Ware, Nature. 404:949
Decoy Receptors in Regulation of Lymphocyte Activation and Autoimmunity
Soluble Receptor
Agonist or antagonist antibody
Pharmacological Inhibitors
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Decoy Receptors In Treatment of Autoimmune Diseases