Natural killer T (NKT) lymphocytes express an invariant T cell antigen receptor (TCR) encoded by the Valpha14 and Jalpha281 gene segments. A glycosylceramide-containing alpha-anomeric sugar with a longer fatty acyl chain (C26) and sphingosine base (C18) was identified as a ligand for this TCR. Glycosylceramide-mediated proliferative responses of Valpha14 NKT cells were abrogated by treatment with chloroquine-concanamycin A or by monoclonal antibodies against CD1d/Vbeta8, CD40/CD40L, or B7/CTLA-4/CD28, but not by interference with the function of a transporter-associated protein. Thus, this lymphocyte shares distinct recognition systems with either T or NK cells.

A lymphocyte subpopulation, the Valpha14 natural killer T (NKT) cells, expresses both NK1.1 and a single invariant T cell receptor encoded by the Valpha14 and Jalpha281 gene segments. Mice with a deletion of the Jalpha281 gene segment were found to exclusively lack this subpopulation. The Valpha14 NKT cell-deficient mice could no longer mediate the interleukin-12 (IL-12)-induced rejection of tumors. Although the antitumor effect of IL-12 was thought to be mediated through natural killer cells and T cells, Valpha14 NKT cells were found to be an essential target of IL-12, and they mediated their cytotoxicity by an NK-like effector mechanism after activation with IL-12.

We have recently identified ␣-galactosylceramide (␣-GalCer) as a specific ligand for an invariant V␣14͞ V␤8.2 T cell receptor exclusively expressed on the majority of V␣14 NKT cells, a novel subset of lymphocytes. Here, we report that ␣-GalCer selectively activates V␣14 NKT cells resulting in prevention of tumor metastasis. The effector mechanisms of the ligand-activated V␣14 NKT cells seem to be mediated by natural killer (NK)-like nonspecific cytotoxicity. Indeed, the cytotoxic index obtained by ␣-GalCeractivated V␣14 NKT cells was reduced by the addition of cold target tumor cells or by treatment with concanamycin A, which inhibits activation and secretion of perforin, but not by mAbs against molecules involved in the NKT cell recognition and conventional cytotoxicity, such as CD1d, V␤8, NK1.1, Ly49C, Fas, or Fas ligand. These results suggest that the ligand-activated V␣14 NKT cells kill tumor cells directly through a CD1d͞V␣14 T cell receptor-independent, NK-like mechanism.A novel lymphoid lineage, V␣14 natural killer (NK) T cells, distinct from other lymphoid cells including T cells, B cells, and NK cells, is characterized by the early development at day 9.5 of gestation before thymus formation (1) and also by coexpression of the NK receptor and a single, invariant T cell receptor (TCR) encoded by V␣14 and J␣281 gene segments (2-4) in association with a highly skewed set of V␤s, mainly V␤8.2 (5-13). Moreover, the generation of V␣14 NKT cells is exclusively dependent on the expression of the invariant V␣14 TCR as evidenced by the fact that V␣14 NKT cells do not develop in the invariant V␣14 TCR-deficient mice (14) and that the forced expression of the invariant V␣14 TCR leads exclusively to V␣14 NKT cell generation and blocks conventional T cell development (15, 16).Although physiological functions of V␣14 NKT cells remain to be elucidated, the extensive analysis has shown that V␣14 NKT cells are able to mediate allograft bone marrow rejection (17), control autoimmune disease development (18,19), and produce large amounts of both interleukin 4 (IL-4) and interferon ␥ (16,20,21). These findings suggest that V␣14-NKT cells play complicated roles in regulating immune responses more than simply as IL-4 or interferon ␥ providers for Th2 or Th1 cell development, respectively, so far reported (22,23). In addition, we have demonstrated recently that V␣14 NKT cells are a primary target of IL-12 and exert a major effector function in IL-12-mediated tumor rejection (14).A ligand for the invariant V␣14͞V␤8.2 TCR exclusively expressed on V␣14 NKT cells has been identified recently to be ␣-galactosylceramide (␣-GalCer) (16). In addition, ␣-GalCer is presented by a monomorphic non-majorhistocompatibility gene complex (non-MHC) class Ib molecule, CD1d, expressed on dendritic cells (DC), and the ligand͞CD1 complex selectively stimulates to proliferate V␣14 NKT cells but not other lymphocytes only if costimulatory signals generated by CD40͞CD40 ligand and B7͞ CD28 interactions are provided (16). The results suggest th...

The immunological mechanisms that regulate abortion are largely unknown. Here, we found that a distinct subset of lymphocytes, V␣14 NKT cells expressing an invariant antigen receptor encoded by V␣14͞J␣281 and V␤7 segments, accumulated in the decidua during pregnancy and provoked abortion upon stimulation with ␣-galactosylceramide (␣-GalCer), a specific ligand for V␣14 NKT cells. The ␣-GalCer-mediated abortion was not observed in V␣14 NKT-, IFN-␥-, tumor necrosis factor ␣-, or perforin-knock-out mice and appeared to be due to the degeneration of embryonic trophoblasts mediated by the activated V␣14 NKT cells whose perforin-dependent killing and production of IFN-␥ and tumor necrosis factor ␣ were essential. The possible role of the decidual V␣14 NKT cells in the pathogenesis of abortion is discussed.

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The importance of macrolide-resistant (MR) Mycoplasma pneumoniae has become much more apparent in the past decade. We investigated differences in the therapeutic efficacies of macrolides, minocycline, and tosufloxacin against MR M. pneumoniae. A total of 188 children with M. pneumoniae pneumonia confirmed by culture and PCR were analyzed. Of these, 150 patients had a strain with an MR gene and 134 had one with an A-to-G mutation at position 2063 of M. pneumoniae 23S rRNA domain V. Azithromycin (n ‫؍‬ 27), clarithromycin (n ‫؍‬ 23), tosufloxacin (n ‫؍‬ 62), or minocycline (n ‫؍‬ 38) was used for definitive treatment of patients with MR M. pneumoniae. Defervescence within 48 h after the initiation of antibiotic therapy was observed in 41% of the patients in the azithromycin group, 48% of those in the clarithromycin group, 69% of those in the tosufloxacin group, and 87% of those in the minocycline group. The average number of days of fever after the administration of antibiotic treatment was lower in the minocycline and tosufloxacin groups than in the macrolide groups. The decrease in the M. pneumoniae burden, as estimated by the number of DNA copies, after 48 to 96 h of treatment was more rapid in patients receiving minocycline (P ‫؍‬ 0.016) than in those receiving tosufloxacin (P ‫؍‬ 0.049), azithromycin (P ‫؍‬ 0.273), or clarithromycin (P ‫؍‬ 0.107). We found that the clinical and bacteriological efficacies of macrolides against MR M. pneumoniae pneumonia was low. Our results indicated that minocycline rather than tosufloxacin can be considered the first-choice drug for the treatment of M. pneumoniae pneumonia in children aged >8 years.

We conducted nationwide surveillance to investigate regional differences in macrolide-resistant (MR) Mycoplasma pneumoniae strains in Japan. The prevalence of MR M. pneumoniae in pediatric patients gradually increased between 2008 and 2012. Although regional differences were observed, high levels of MR genes were detected in all seven surveillance areas throughout Japan and ranged in prevalence from 50% to 93%. These regional differences were closely related to the previous administration of macrolides.

NK1.1+ T [natural killer (NK) T] cells ex-press an invariant T cell antigen receptor a chain (TCRa) encoded by VCYl4 and Ja281 segments in association with a limited number of V,Bs, predominantly Vj88.