Inflamed areas are characterized by infiltration of immune cells, local hypoxia and alterations of cellular redox states. We investigated the impact of hypoxia on survival, proliferation, cytokine secretion, intracellular energy and redox state of human CD4+ T cells.We found that pathophysiological hypoxia (<2% O 2 ) significantly decreased CD4 + T-cell survival after mitogenic stimulation. This effect was not due to an increased caspase-3/7-mediated apoptosis or adenosine-5 -triphosphate (ATP) consumption/depletion. However, the ability of stimulated T cells to proliferate was reduced under hypoxic conditions, despite increased expression of CD25. Pathophysiological hypoxia was also found to modify intracellular ROS (iROS) levels in stimulated T cells over time as compared with levels found in normoxia. Physiological hypoxia (5% O 2 ) did not decrease CD4 + T-cell survival and proliferation or modify iROS levels as compared with normoxia. We conclude that pathophysiological hypoxia affects T-cell proliferation and viability via disturbed IL-2R signalling downstream of STAT5a phosphorylation, but not as a result of impaired cellular energy homeostasis. We suggest iROS links early events in T-cell stimulation to the inhibition of the lymphoproliferative response under pathophysiological hypoxic conditions. The level of iROS may therefore act as a mediator of immune functions leading to down-regulation of long-term T-cell activity in inflamed tissues.Keywords: Bioenergetics r CD4 + T cells r Hypoxia r ROS
IntroductionLocal pathophysiological hypoxia is associated with the pathogenesis of arthritis [1], sepsis [2], ischemic areas after embolic ischemic stroke [3], fracture haematoma [4,5] and in fast growingCorrespondence: Dr. Timo Gaber e-mail: gaber@drfz.de tumour tissue [6]. In these areas of compromised oxygen supply, immune cells are able to be functionally active [7]. Pathophysiological hypoxia (<2% O 2 ) is known to enhance the proinflammatory potential of myeloid cells such as neutrophils and macrophages [8], but lack of oxygen also acts in a tissue * These authors contributed equally to this work.C 2013 WILEY-VCH Verlag GmbH & Co. KGaA, Weinheim www.eji-journal.eu Eur. J. Immunol. 2013. 43: 1588-1597 Immunomodulation 1589 protective manner and suppresses typical T-cell effector functions, such as production of cytokines and T-cell proliferation [9,10]. Early observations reported that hypoxia stimulates Con A-induced PBMC proliferation and increases IL-2 expression [11]. These data were partially confirmed by Naldini et al. [12,13] using PHA-stimulated PBMCs, although these authors reported a delay of cell cycle progression. Moreover, and observed an increase in PHA/IL-2-driven or TCR/IL-2-driven T-cell proliferation under hypoxia, an inhibition of apoptosis and an increased expression of CD25 per cells. These data on T-cell proliferation were confirmed by Bohnenkamp et al. [17]. However, Loeffler et al. [18] were the first to report that T cells exposed to hypoxia proliferate only weakly or not at all....