Regulatory T (T reg ) cells can suppress a wide variety of immune responses, including antitumor and alloimmune responses.The mechanisms by which T reg cells mediate their suppressive effects depend on the context of their activation. We previously reported that granzyme B is important for T reg cell-mediated suppression of antitumor immune responses. We therefore hypothesized that granzyme B may likewise be important for suppression of graft-versus-host disease (GVHD). We found that allogeneic mismatch induces the expression of granzyme B in mixed lymphocyte reactions and in a model of graft-versus-host disease (GVHD). However, wild-type and granzyme B-deficient T reg cells were equally able to suppress effector T (T eff ) cell proliferation driven by multiple stimuli, including allogeneic antigen-presenting cells. Surprisingly, adoptive transfer of granzyme B-deficient T reg cells prevented GVHD lethality, suppressed serum cytokine production in vivo, and prevented target organ damage. These data contrast strikingly with our previous study, which demonstrated that granzyme B plays a nonredundant role in T reg cell-mediated suppression of antitumor responses. Taken together, these findings suggest that targeting specific T reg cell-suppressive mechanisms, such as granzyme B, may be therapeutically beneficial for segregating GVHD and graft-versus-tumor immune responses. (Blood. 2010;115: 1669-1677)
IntroductionCD4 ϩ Foxp3 ϩ regulatory T (T reg ) cells play an indispensable role in maintaining peripheral tolerance to self-antigens by suppressing effector immune responses. Mice or humans with a deficiency of T reg cells, induced by antibody-mediated 1,2 or toxin-mediated 3,4 depletion or by mutations 5 and deletions 6,7 of the lineage specification factor Foxp3, manifest severe autoimmune disease. In addition to preventing autoimmunity, T reg cells can also suppress immune responses generated against tumor cells, 8,9 alloantigens, 10 allergens, [11][12][13] and microbial antigens. 14,15 Several mechanisms have been proposed to explain how T reg cellmediated suppression of effector immune responses occurs. In certain model systems, T reg -cell secretion of anti-inflammatory cytokines, such as transforming growth factor- and interleukin-10 (IL-10), has been shown to be required for suppressive function. [16][17][18] In other experimental settings, contact-dependent mechanisms, such as interactions between CTLA-4 on T reg cells and CD80/CD86 on antigen-presenting cells (APCs), have also been reported. [19][20][21] Because of the variety of animal models, in vitro activation methods, and readouts for suppression, rigorously defining nonredundant T reg -suppressive mechanisms has been challenging and controversial. It is probable that T reg cells use multiple mechanisms depending on the context in which they are activated in vivo. 22 Our group previously demonstrated that human regulatory T cells can use the perforin/granzyme pathway to suppress effector T (T eff )-cell proliferation and kill autologous immune cells. ...