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Table 1.

Demographic and clinical characteristics of TB patients, latent infection individuals and healthy controls.

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Figure 1.

Representative flow cytometric plots showing gating strategy and expression of CD244/2B4.

(A) Viable lymphocytes in PBMCs were gated based on characteristic forward and side scatter profiles. (B) The gate depicting CD4/CD244 expression was defined by both control isotype staining and CD244 expression on CD3CD4 cells that showed clearly two cell subsets with positive and negative staining of CD244. (C and D) CD4+ T cells were defined as CD3+CD4+ cells (C) and CD244/2B4 expression on total CD4+ T cells was shown (D). (E and F) Antigen-responsive CD4+ T cells were identified by appearance of activation marker CD69 in the CD3+CD4+ cell population (E) and CD244/2B4 expression on M. tuberculosis antigen-responsive CD4+ T cells was shown (F). Isotype: isotype antibody control; LI: latent TB infection; TB: active TB patients.

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Figure 2.

The expression of CD244/2B4 on CD4+ T cells in active pulmonary TB patients, latent infection individuals and healthy controls.

(A) The frequencies of CD244/2B4-expressing total CD4+ T cells were similar among active TB patients, latent infection individuals and healthy controls. (B) Mean fluorescent intensity (MFI) of CD244/2B4 expression on total CD4+ T cells was significantly higher in active TB patients than in latent infection individuals and healthy controls. (C) The frequencies of CD244/2B4-expressing antigen-responsive CD4+ T cells increased significantly in retreatment active TB patients as compared with latent infection individuals and new active TB patients. (D) MFI of CD244/2B4 expression on antigen-responsive CD4+ T cells was significantly higher in retreatment active TB patients as compared with latent infection individuals and new active TB patients. New TB patients had significantly elevated expression of CD244/2B4 as compared with latent infection individuals. (E and F) When only M. tuberculosis culture-positive TB cases were selected for analysis, retreatment TB patients also had higher frequencies of CD244/2B4-expressing antigen-responsive CD4+ T cells (F) and elevated expression of CD244/2B4 as compared with latent infection individuals and new TB patients (G). (G and H) TB patients with more than 3 months of treatment, which contained all of the retreatment cases, had higher frequencies of CD244/2B4-expressing antigen-responsive CD4+ T cells (G) and elevated expression of CD244/2B4 as compared with those who were treated less than 1 month or between 1 to 3 months (H). HC: healthy controls; new: new TB patients; retreat: retreatment TB patients; ≤1 m: less than 1 month of treatment; 1–3 m: between 1 to 3 month of treatment; ≥3 m: more than 3 month of treatment. Mann-Whitney test was used for statistical analysis between groups. *: p<0.05; **: p<0.01; ***: p<0.001.

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Figure 3.

Influence of CD244/2B4 expression on IFN-γ production.

(A and B) Representative flow cytometric plots showing gating strategy of CD244/2B4-dull (AW) –middle (AU) and -bright (AV) CD4+ T cells, and Intracellular IFN-γ production in CD244/2B4-dull (AZ), -middle (AY) and -bright (AX) CD4+ T cells. (C) CD244/2B4-bright CD4+ T cells contained significantly lower ratio of IFN-γ-producing CD4+ cells, compared with CD244/2B4-dull CD4+ T cells. (D) CD244/2B4-bright CD4+ T cells had greatly reduced expression of IFN-γ, compared with CD244/2B4-dull and –middle CD4+ T cells. (E and F) T-SPOT.TB-negative TB patients had higher frequencies of CD244/2B4-expressing cells than T-SPOT.TB-positive TB patients. ELI+: ELISPOT-positive TB patients; ELI-: ELISPOT-negative TB patients. Mann-Whitney test was used for statistical analysis between groups. *: p<0.05; ***: p<0.001.

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Figure 4.

Activation of CD244/2B4 signaling resulted in significantly decreased IFN-γ production.

(A) Representative flow cytometric plots showing IFN-γ production in CD3+CD4+ T cells incubated with isotype control antibody (ISO) or with anti-CD244/2B4 antibody clone C1.7 (CK). (B to D) Activation of CD244/2B4 signaling by cross-linking led to significantly lower frequencies of IFN-γ-producing CD4+ T cells (B), decreased expression of IFN-γ as determined by flow cytometry (C), and reduced numbers of spot forming units in ELISPOT assay (D). Paired t-test was used for statistical analysis. *: p<0.05; **: p<0.01.

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Figure 5.

Rescue of IFN-γ production following CD244/2B4 receptor blocking.

(A) Representative flow cytometric plots showing IFN-γ production in stimulated CD3+CD4+ T cells when incubated with isotype control antibody (ISO) or blocking anti-CD244/2B4 antibody clone eBioPP35 (BL). (B to D) Blocking of CD244/2B4 signaling resulted in significantly higher frequencies of IFN-γ-producing CD4+ T cells (B), increased level of IFN-γ production in CD3+CD4+ T cells as determined by flow cytometry (C), and elevated numbers of spot forming units in ELISPOT assay (D), as compared with those incubated with isotype control antibody. Paired t-test was used for statistical analysis. **: p<0.01.

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