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Figure 1.

Suppressor ability of iT-reg derived from CD4+CD45RO+ memory (CD4mem) and from CD4+CD45RA+ naïve (CD4naive) cells.

The ability of iT-reg obtained from CD4mem and CDnaive-derived Th17 cells was evaluated after 4-day co-culture by 3H-thymidine incorporation in 5 healthy subjects. Mean (+SEM) percentage suppression of CD4 effectors by CD4mem or CD4naive iT-reg before and after exposure to IL-6, IL-1β and rTGF-β. CD4mem but not CD4naive iT-reg maintain their suppressor ability after exposure to Th17 driving cytokines. *P≤0.05.

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Figure 1 Expand

Figure 2.

Phenotypic properties of supTh17.

Phenotype of CD4mem at baseline and of Th17, obtained from CD4mem after 3-day exposure to IL-6+IL-1β+rTGF-β; iT-reg, obtained following exposure of Th17 to high concentration IL-2 and T-cell expander; and supTh17, obtained upon iT-reg exposure to IL-6+IL-1β+rTGF-β. Cell phenotype was determined in 12 healthy subjects. (A) Representative flow cytometry plots of CD4 (X axis) and IL-17, CD25 and FOXP3 (Y axis) fluorescence. (B) Representative histogram depicting RORC fluorescence in CD4mem at baseline, Th17 and supTh17; representative flow cytometry plots of CD4 (X axis) and CCR6, IL-23R and IL-22 (Y axis) fluorescence. Compared to prototypic Th17, supTh17 display higher frequencies of IL-17+, FOXP3+ and IL-22+ lymphocytes, express similar levels of RORC and contain comparable numbers of CCR6+ cells.

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Figure 2 Expand

Figure 3.

supTh17 suppressive ability.

The ability of Th17, iT-reg and supTh17 cells to control CD4 target cell proliferation was evaluated after 4-day co-culture by 3H-thymidine incorporation in 10 healthy subjects. (A) Mean (+SEM) percentage inhibition of CD4 effector cell proliferation by Th17, iT-reg and supTh17 cells. (B) The ability of Th17, iT-reg and supTh17 cells to control CD4 target cell IL-17 and IFNγ production was evaluated after 4-day co-culture by intracellular cytokine staining in 10 healthy subjects. Mean (+SEM) percentage inhibition of CD4 effector cell IL-17 and IFNγ production by Th17, iT-reg and supTh17 cells. Compared to prototypic Th17, supTh17 exerted more effective control over CD4 cell proliferation and pro-inflammatory cytokine production. *P≤0.05; **P≤0.01.

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Figure 3 Expand

Figure 4.

Expression of CD39 and CD73 ectonucleotidases and associated ectoenzymatic activity.

(A) Mean (+SEM) frequency of (A) CD39+ cells, (B) CD39 mean fluorescence intensity (MFI) and of (C) CD39+CD73+ cells within CD4mem at baseline and within Th17, iT-reg and supTh17. Results from 12 healthy subjects are shown. *P≤0.05; **P≤0.01; ***P≤0.001. (D) CD39 ADPase enzymatic activity was assessed by TLC following incubation of Th17, iT-reg and supTh17 with [14C] radiolabeled ADP substrates. A representative of 3 independent experiments is shown. In accordance with high levels of CD39 and CD73, supTh17 generate AMP, adenosine and its derivative inosine.

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Figure 5.

Adenosinergic effects on cell immune phenotype and function.

(A) Mean (+SEM) frequency of CD39+ cells and of CD73+, FOXP3+ and IL-17+ lymphocytes within them in CD4mem at baseline, Th17, iT-reg and supTh17. Results from n = 12 healthy subjects. (B) Mean (+SEM) inhibition of CD4 T-cell proliferation by Th17, iT-reg and supTh17 in the absence or presence of adenosine. Adenosine boosts expression of CD39 and CD73 and enhances the suppressor properties of iT-reg, while not having any effect on supTh17. *P≤0.05.

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Figure 6.

Purinergic molecular signatures of supTh17 cells.

(A) Relative mRNA expression of A1, A2A, A2B, A3 receptors by Th17, iT-reg and supTh17 was determined by quantitative real-time PCR in 10 healthy subjects. Results are expressed as mean+SEM. (B) Expression of ADA was determined by immunoblot analysis. One representative of 3 independent experiments is shown. Mean (+SEM) ADA densities noted in Th17, iT-reg and supTh17 cells are also shown. (C) Mean (+SEM) CD26 MFI in Th17, iT-reg and supTh17 cells obtained from 5 healthy subjects was evaluated by flow cytometry. A representative histogram of CD26 fluorescence in CD4mem at baseline, Th17, iT-reg and supTh17 is shown. (D) Mean (+SEM) relative mRNA expression of PDE4A and PDE4B was determined by quantitative real-time PCR in 10 healthy subjects. supTh17 uniquely express low levels of A2A adenosine receptor, exhibit ADA activity associated with CD26 but do not substantially up-regulate levels of PDE. *P≤0.05; ***P≤0.001.

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Figure 7.

Demonstration of supTh17 cells in healthy subjects and associated decreases in Crohn’s disease.

The frequency of CD4+IL-17+ and of supTh17 was determined in PBMCs and LPMCs by flow cytometry. supTh17 were identified by initially gating CD4+CD45RO+ cells within PBMCs or LPMCs and then by determining the proportion of CD39+IL-17+ and FOXP3+ within them. Mean (+SEM) frequency of (A) CD4+IL-17+ and of (B) supTh17 cells in the circulation and in the lamina propria. Mean (+SEM) frequency of supTh17 positive for (C) Stat-3 and for (D) TNF-α and IL-2 in the circulation and in the lamina propria. Healthy subjects: n = 17; Crohn’s: n = 25; *P≤0.05; **P≤0.01; ***P≤0.001.

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Figure 8.

SupTh17, iT-reg and purinergic control of T-cell immune responses.

Both supTh17 and iT-reg cells have the capacity to suppress effector T-cells (Teff) by generating adenosine. In a manner distinct from iT-reg which are anergic, however, supTh17 express low levels of A2A receptor and exhibit nucleoside scavenging ecto-enzymatic activity. These properties confer on supTh17 an important intrinsic resistance to suppressive effects of adenosine, which may develop in parallel with prolonged cellular activation in accordance with memory T-cell status. These differences suggest that supTh17 might undergo conversion and be recruited as suppressor-type cells in the later evolution of immune responses where these cells may persist at sites of resolving injury.

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